High Rates Of COVID-19 Infection Research Articles

'Is It Safe? Is it not?' A Youth-Led Photovoice Study of Youth Perspectives of COVID-19 Vaccine Confidence.

Youth have been uniquely affected by the COVID-19 pandemic. Despite high rates of COVID-19 infection, youth had one of the lowest vaccine uptake rates. Certain characteristics can affect vaccine uptake, such as mental health and substance use, but it is important to understand uptake for an effective response to pandemics. This study examined the perspectives of youth with mental health or substance use concerns on COVID-19 vaccine confidence, hesitancy and overall COVID-19 vaccine perspectives. Using photovoice, a community-based participatory research method, a sample of 27 youth aged 14-24 years participated in a series of photography workshops and focus groups. Participants submitted final photographs for discussion. Focus groups were recorded, transcribed and thematically analysed. Four themes were generated: (1) Youth deciphered the vaccine discourse in a changing information landscape; (2) mixed perspectives of families, friends and loved ones influenced the vaccine journey; (3) complex societal influences affected views and decisions around the COVID-19 vaccine; and (4) youth navigated their vaccine journeys through first- and second-hand experiences. The four themes and subthemes highlight the evolution of youth's journeys with the COVID-19 vaccine over the course of the pandemic and into the late-pandemic period. Youth with mental health or substance use challenges navigated a complex environment during the COVID-19 pandemic. The wide variety of factors influencing vaccine perspectives should be taken into account in public health messaging and future research on youth vaccine uptake. Youth-led and youth-engaged research can help solicit rich and meaningful perspectives of young people on important public health issues. This was a youth-led study. A youth research analyst conducted the study activities together with the support of a youth advisory group, an adult photographer with lived experience, and a scientific team.

Impact of COVID-19 on essential service provision for reproductive, maternal, neonatal, and child health in the Southeast Asia region: a systematic review

There is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services globally. The Southeast Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, with potential adverse impacts on provision of reproductive, maternal, neonatal, and child health (RMNCH) services. We conducted a systematic literature review of quantitative evidence to characterise the impact of COVID-19 on the provision of essential RMNCH services across the SEAR. Studies published between December 2019 and May 2022 were included in the study. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist. We reviewed 1924 studies and analysed data from 20 peer-reviewed studies and three reports documenting quantitative pre-post estimates of RMNCH service disruption because of the COVID-19 pandemic. Eleven studies were of low methodological quality, in addition to seven and five studies of moderate and high methodological qualities respectively. Six countries in the region were represented in the included studies: India (11 studies), Bangladesh (4), Nepal (3), Sri Lanka (1), Bhutan (1) and Myanmar (1). These countries demonstrated a wide reduction in antenatal care services (-1.6% to-69.6%), facility-based deliveries (-2.3% to-52.4%), child immunisation provision (-13.5% to-87.7%), emergency obstetric care (+4.0% to-76.6%), and family planning services (-4.2% to-100%). There have been large COVID-19 pandemic related disruptions for a wide range of RMNCH essential health service indicators in several SEAR countries. Notably, we found a higher level of service disruption than the WHO PULSE survey estimates. If left unaddressed, such disruptions may set back hard-fought gains in RMNCH outcomes across the region. The absence of studies in five SEAR countries is a priority evidence gap that needs addressing to better inform policies for service protection. WHO Sri Lanka Country Office.

Recommendations Related to Visitor and Movement Restrictions in Long-Term Care and Retirement Homes in Ontario during the COVID-19 Pandemic: Perspectives of Residents, Families, and Staff.

In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents' health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.

The Influence of Organizational Aspects of the U.S. Agricultural Industry and Socioeconomic and Political Conditions on Farmworkers’ COVID-19 Workplace Safety

Farmworkers in the U.S. experienced high rates of COVID-19 infection and mortality during the COVID-19 pandemic. Their workplace may have been a significant place of exposure to the novel coronavirus. Using political economy of health theory, this study sought to understand how organizational aspects of the agricultural industry and broader socioeconomic and political conditions shaped farmworkers’ COVID-19 workplace safety during the pandemic. Between July 2020 and April 2021, we conducted and analyzed fourteen in-depth, semi-structured phone interviews with Latinx farmworkers in California. Findings show that regulatory oversight reinforced COVID-19 workplace safety. In the absence of regulatory oversight, the organization of the agricultural industry produced COVID-19 workplace risks for farmworkers; it normalized unsafe working conditions and the worker—rather than employer—responsibility for workplace safety. Under these conditions, farmworkers enacted personal COVID-19 preventative practices but were limited by financial hardships that were exacerbated by the precarious nature of agricultural employment and legal status exclusions from pandemic-related aid. Unsafe workplace conditions negatively impacted workplace camaraderie. Study findings have implications for farmworkers’ individual and collective agency to achieve safe working conditions. Occupational safety interventions must address the organizational aspects that produce workplace health and safety inequities and disempower farmworkers in the workplace.

Impact of COVID-19 on the treatment of depressive patients in Germany-a gap in care for the mentally ill?

The COVID-19 pandemic led to a higher incidence of depression and a worsening of psychiatric conditions, while pre-existing constraints of the healthcare system and safety regulations limited psychiatric care. We investigated the impact of the pandemic on the clinical care of patients with a single episode (SE-MDD) or major depressive disorder (MDD) in Germany. Nationwide inpatient data were extracted from the German Institute for Hospital Remuneration System for 2020 and 2021 (depression data) and the Robert Koch Institute (COVID-19 incidence). Changes in inpatients were tested with linear regression models. Local cases of depression in our department compared to 2019 were explored with one-way ANOVA and Dunnett's test. Across Germany, the inpatient numbers with both SE-MDD and MDD declined by more than 50% during three out of four COVID-19 waves. Higher COVID-19 incidence correlated with decreased inpatient numbers. In our department, fewer MDD inpatients were treated in 2020 (adj. p < 0.001) and 2021 (adj. p < 0.001) compared to 2019, while the number of SE-MDD inpatients remained stable. During this period fewer elective and more emergency inpatients were admitted. In parallel, MDD outpatient admissions increased in 2021 compared to 2019 (adj. p = 0.002) and 2020 (adj. p = 0.003). During high COVID-19 infection rates, MDD patients received less inpatient care, which might cause poor outcomes in the near future. These data highlight the necessity for improved infrastructure in the in- and outpatient domains to facilitate accessibility to adequate care.

Preventive practice and associated factors among health care workers towards COVID-19 in Addis Ababa covid care center

Background: COVID-19 has made exceptional challenges to public health globally. Healthcare experts who are at the frontline of the outbreak reaction are at increased risk of getting infected. The high infection rate of COVID-19 has been reported amongst frontline health care workers which might be linked to low prevention practice. However, in the context of Ethiopia, studies ascribed to the prevention practice against COVID-19 among healthcare workers are limited. Therefore, this study aimed to assess the Preventive practice against COVID-19 and associated factors among health care workers. Methods and materials: Institution-based cross-sectional study design was conducted on 240 healthcare workers at millennium covid care center and a pretested structured questionnaire was used for the data collection. The data was entered into epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and binary logistic regression were used. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were quantified to measure effect sizes of independent variables and to declare statistical significance respectively. Result: This study showed that 55% of health care workers have good preventive practice and In line with this, lack of personal protective equipment(AOR=2.978, 95%CI(1.426-6.220)), designed isolation area (AOR=2.251, 95%CI(1.056-4.799)), availability of chemical disinfectant (AOR=5.055, 95%CI (2.283-11.191)), training on covid case management(AOR=6.04, 95%CI(2.569-14.204)), infection prevention guideline availability (AOR=2.59, 95%CI(1.192-5.627), and discomfort while using PPE (AOR=4.125 95%CI (1.779-9.561)) showed significant association with the preventive practice of frontline health care workers towards covid 19. Conclusion: The overall finding of this study revealed that healthcare workers had poor preventive practice (45%) towards covid 19. Addressing these identified factors will enable to reduce the infection rate among health care providers. Keywords: covid 19, prevention practice, factors, frontline, Ethiopia

Trends in Delirium and New Antipsychotic and Benzodiazepine Use Among Hospitalized Older Adults Before and After the Onset of the COVID-19 Pandemic

The COVID-19 pandemic caused large disruptions to health care for hospitalized older adults. The incidence and management of delirium may have been affected by high rates of COVID-19 infection, staffing shortages, overwhelmed hospital capacity, and changes to visitor policies. To measure changes in rates of delirium and related medication prescribing during the COVID-19 pandemic among hospitalized older adults. This population-based, repeated cross-sectional study used linked databases to measure rates of delirium and related medication prescriptions among adults aged 66 years or older hospitalized before and during the COVID-19 pandemic (January 1, 2017, to March 31, 2022) in Ontario, Canada. The first 2 years of the COVID-19 pandemic (March 1, 2020, to March 31, 2022). The main outcomes were weekly rates of delirium per 1000 admitted population and monthly rates of new antipsychotic and benzodiazepine prescriptions per 1000 discharged population. Observed rates were compared with projected rates based on modeling from 3 years before pandemic onset. Among 2 128 411 hospitalizations of older adults over the 5-year study period (50.7% female; mean [SD] age, 78.9 [8.3] years), absolute rates of delirium increased from 35.9 per 1000 admitted population during the prepandemic period to 41.5 per 1000 admitted population throughout the pandemic. The adjusted rate ratio (ARR) of delirium during the pandemic compared with the projected rate was 1.15 (95% CI, 1.11-1.19). Monthly rates of new antipsychotic prescriptions increased from 6.9 to 8.8 per 1000 discharged population and new benzodiazepine prescriptions from 4.4 to 6.0 per 1000 discharged population and were significantly higher during the pandemic compared with projected rates (antipsychotics: ARR, 1.28; 95% CI, 1.19-1.38; benzodiazepines: ARR, 1.37; 95% CI, 1.20-1.57). Rates were highest during pandemic waves 1 (March to June 2020), 3 (March to June 2021), and 5 (December 2021 to February 2022) and remained elevated above projected levels throughout the first 2 years of the pandemic. In this repeated cross-sectional study of hospitalized older adults, there was a temporal association between COVID-19 pandemic onset and significant increases in rates of delirium in the hospital and new antipsychotic and benzodiazepine prescriptions after hospital discharge. Rates remained elevated over 2 years. Pandemic-related changes such as visitor restrictions, staff shortages, isolation practices, and reduced staff time at the bedside may have contributed to these trends.

Knowledge, attitudes, and practices about COVID-19 pandemic: a bibliometric analysis.

In order to avoid high rates of COVID-19 infection, one of the main tasks that must be performed is to improve the knowledge, attitudes, and practices (KAP) about the virus. In this sense, Health Education is an essential tool for dealing with the virus. The aim of health education is to educate individuals through educational, motivational, skill development, and awareness techniques, and an understanding of the main needs of KAP is essential for this. Many KAP studies were published during the COVID-19 pandemic, and the aim of the present study was to analyze these publications through a bibliometric study. A bibliometric analysis of the publications on KAP and COVID-19 was conducted in the Web of Science Core Collection database. The RStudio Bibliometrix and VOSviewer packages were utilized to analyze the scientific production, authors, citations, countries, publishers, journals, research areas, and keywords. Of the 1,129 articles published, 777 were included in the study. The year with the most publications and citations was 2021. Three authors were underlined (all from Ethiopia), due to the number of articles published, the number of citations, and the collaboration networks established. As for the countries, most of the publications came from Saudi Arabia, while China obtained the most citations. PLOS One and Frontiers in Public Health published the most articles on the subject. The most frequent keywords were knowledge, attitudes, practices, and COVID-19. At the same time, others were identified based on the population group analyzed. This is the first bibliometric study on KAP and COVID-19. The significant number of publications identified on KAP and its relationship to the COVID-19 pandemic, in the span of only 3 years, indicates the increased interest in this area. The study provides relevant information to researchers who are approaching this subject for the first time. It is a useful tool that can stimulate new studies and collaborations between researchers from different countries, areas and approaches. At the methodological level, a step-by-step guide is provided for future authors who wish to perform a bibliometric analysis.

Motivators and Barriers to COVID-19 Vaccination in Young Adults Living in the USA.

High rates of COVID-19 infection and lower vaccination rates among young adults aged 18 to 26 in the United States prompted this study to examine motivating factors and barriers to COVID-19 vaccination and identify preferences in COVID-19 vaccine education. Three focus group discussions were completed. Transcribed data were analyzed using thematic analysis. Three key themes were identified including (1) motivating factors to vaccination, (2) barriers to vaccination, and (3) COVID-19 vaccination educational intervention design recommendations. Motivating factors included five relevant subthemes: civic duty, fear related to the disease process; fear related to emerging variants and breakthroughs; fear regarding the suffering of others; and freedom. Barriers included four subthemes: lack of trust, misinformation, politics, and pressure. Attempts to further educate young adults about the COVID-19 vaccine should consider strategies that target motivating factors and barriers while also making accurate information accessible through social media.

Patients with Monoclonal Gammopathy Have a High Rate of Second Symptomatic COVID-19 Infection Even after a Prior COVID-19 Infection and Vaccination

Background: Patients with hematologic malignancies, including multiple myeloma (MM), light chain (AL) amyloidosis, smoldering MM (SMM) and monoclonal gammopathy of undetermined significance (MGUS), have disproportionately high rates of COVID-19 infection and associated mortality. While inferior immune response to COVID-19 vaccination have been described in patients with monoclonal gammopathy, information on the rate and severity of COVID-19 infections in patients who do demonstrate immunogenicity after a prior infection or vaccination is limited. Additionally, the prevalence and clinical course of second symptomatic COVID-19 infections in patients with monoclonal gammopathy is not known. Methods: Patients with MGUS, SMM, MM or AL amyloidosis evaluated at Mayo Clinic Rochester, Arizona, and Florida between 12/01/2019 and 8/31/2021 were screened. Patients with a positive polymerase chain reaction test for SARS-CoV-2 and either a spike Ab (Ab) or a nucleocapsid Ab tested were included. Spike Ab was reported quantitatively (positive result >0.8 IU/mL per laboratory standard) and nucleocapsid Ab testing was reported as either positive or negative. For this study, we defined "fully vaccinated” as 2 doses of Pfizer or Moderna mRNA vaccine or 1 dose of the Janssen vaccine based on the prevalent CDC recommendation during the study period. Patients with a 2nd symptomatic COVID-19 infection had an interim negative COVID-19 test result with complete clinical recovery. Results: Out of 19,943 patients with an underlying monoclonal gammopathy, 483 patients (2.4%) had a documented positive COVID-19 PCR test and 101 patients had COVID-19 antibody testing performed [spike Ab=54, nucleocapsid Ab=47]. The baseline characteristics of these 101 patients are depicted in Table 1. Out of the 101 patients, 13 (13%) developed a 2nd symptomatic COVID-19 infection. Details of the timeline for second infections in relation to vaccination, antibody testing and ongoing treatment are depicted in Figure 1. The majority of 2nd COVID-19 were mild (11/13, 85%) and the 2 patients (15%) with a severe 2nd infection were both unvaccinated. The median time to 2nd infection was 6.3 months (range 1-19 months) from the 1st COVID-19 infection. Of the 42 patients with MM/AL, 25 patients were in remission and 1 out of these 25 (4%) patients developed a 2nd COVID-19 infection. Compared to patients in remission, 5 (29%) of the 17 patients with MM/AL not in remission developed a 2nd infection (p=0.03). Rate of 2nd infection was 21% (6/28) in unvaccinated patients compared to 10% (7/73) in patients after completion of initial vaccination series (p=0.11). Six out of the 7 vaccinated patients had received a third dose of vaccination prior to the 2nd infection. Among the 382 patients in whom an antibody test was not performed, 22 (6%) patients developed a second infection out of which 3 (14%) were severe. Out of 101 patients, 85 patients were unvaccinated at the time of first infection and 63 (74%) developed a positive COVID-19 Ab after the 1st symptomatic infection (spike Ab n=38, nucleocapsid Ab n=25). Out of these 63 patients with seropositivity, 7 (11%) developed a second symptomatic COVID-19 infection at a median time of 9.9 months (range 2.9-19.6) from first COVID-19 infection and 6 (range 2-18.7) months from the time of antibody testing. To assess seropositivity after vaccination, spike Ab was used as nucleocapsid Ab can be negative after mRNA vaccination. Among the vaccinated patients at the time of first infection (n=16), 6 had a spike Ab tested before 1st COVID-19 infection at a median of 65 (range 16-109) days from vaccination. Of these, 5 (83%) demonstrated a positive spike Ab response to the vaccination. Despite seropositivity, all 5 developed COVID-19 and 2 patients with positive spike Ab developed a severe 1st COVID-19 infection (without mortality) at 84 days and 99 days from vaccination, respectively [spike Ab level was 145 IU/mL and > 250 IU/mL, respectively]. None of the vaccinated and seropositive patients (n=10) developed a 2nd symptomatic COVID-19 infection. Conclusion: Patients with an underlying MM, AL or MGUS demonstrate a substantial risk for second symptomatic COVID-19 infections suggesting a rapidly waning immunity. Most of the 2nd COVID-19 infections were mild, with severe infections restricted to the unvaccinated population. Patients in whom underlying MM or AL was in remission was protective against a 2nd infection. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Bilingual care navigation and enhanced case management during COVID-19.

COVID-19 disparities exposed health inequity across socioeconomic status, with community members of color experiencing higher rates of COVID-19 infections, hospitalizations, and death. Racial/ethnic differences were especially disparate in Benton and Washington counties in northwest Arkansas, a region in the United States that experienced high COVID-19 infection rates. To address these disparities and support families with COVID-19, the University of Arkansas for Medical Sciences and Community Clinic (a federally qualified health center) worked with the Arkansas Department of Health and community partners to develop systematic Care Navigation and Enhanced Case Management. During an initial screening process, contact tracers offered Care Navigation and Enhanced Case Management services to individuals who tested positive for COVID-19 within Washington and Benton counties. Bilingual community health navigators, social workers, and nurses began providing enhanced case management to households that accepted services. Between September 9, 2020 and June 19, 2021, 3,502 households representing ∼13,000 individuals were offered services, and 1,511 (43.1%) households requested/accepted services. Based on our experience, we provide four recommendations for practice: (a) provide contact tracing in community members' preferred language, (b) incorporate assessments into the contact tracing process to ensure community members have necessary resources for quarantine, (c) implement comprehensive care navigation and case management services for those who need additional support, and (d) integrate bilingual health navigators who are part of the target community into the process. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prevalence of SARS-COV-2 Antibodies in Dental Healthcare Providers

Background: Occupational hazards and risks are a common public health issue, especially when healthcare workers safety is concerned; they are on high risk of catching infections such like COVID-19. The possibility of cross-infection between dental practitioners and patients is significantly higher due to the close exposure of dental staff to patient oral environment. Aim: To assess the prevalence of SARS-COV-2 antibodies in dental workers working in the Peshawar Dental College and Hospital, Peshawar. Study Design: Cross sectional study Place and Duration of Study: Department of Orthodontics, Peshawar Dental College &amp; Hospital, Peshawar from 1st January 2020 to 31st December 2020. Methodology: One hundred and thirty three dental workers were enrolled. The investigation was run to detect immunoglobulin G and M antibodies against the SARS-CoV-2-2. The aspirated aerosol and air was evacuated and dissipated into the atmosphere. Results: Mean age was 29.4±1.4 years and males were dominant 74 (55.6%) and male workers found greater with positive antibodies. The prevalence of SARS-CoV-2 antibodies was 33.0%. Proportionately dental assistants (20.5% vs 16.9%) and ancillary staff (20.5% vs 10.1%) had higher prevalence. Sore throat and body aches were more common in positive antibodies cases while travel history was found significantly associated with it (40.9% vs 25.0%, p-value, 0.05). Conclusion: High frequency of SARS-COV-2 antibodies was found in dental workers showing a high infection rate of COVID-19 in healthcare workers in local settings. Keywords: Dental workers, COVID-19 infection, Antibodies, SARS-COV-2

Risk factors for COVID-19 virus infection among health workers: A case-control study in the Bono East Region of Ghana

BackgroundDisproportionately high rates of COVID-19 infection among health workers prompts the need to identify the risk factors to help guide the design and implementation of interventions. The aim of this study was to characterize the risk factors for COVID-19 infection among health workers.MethodsA case-control study was designed to recruit 154 health workers who tested positive for the COVID-19 virus and 308 who tested negative from 8 hospitals and 11 health directorates in the Bono East Region of Ghana. Crude and adjusted logistic regression analysis was used to determine risk factors.ResultsHand hygiene compliance for the recommended moments ranged from 55.3% to 77.4%. Personal protective equipments (PPE) use was 59.5% when patients’ COVID-19 status was unknown and at least 90.7% when patient was positive. We identified years of practice experience (adjusted odds ratio (AOR) = 1.81; 95% CI: 1.07, 3.07; p=0.028), adherence to infection prevention and control (IPC) when in contact with patients whose COVID-19 status is unspecified (AOR=1.71; 95% CI: 1.09, 2.70; p=0.020) and type of facility (AOR=1.69, 95% CI: 1.09, 2.62; p=0.019) as risk factors.ConclusionThe findings underscore the need for health workers to improve in COVID-19 risk perception.

A scoping review of COVID-19 online mis/disinformation in Black communities.

BackgroundMis/disinformation has reached an epidemic level with the COVID-19 virus and can be largely attributed to the growing digitalization of information and its rapid transmission via social media. Approximately 96% of Canadians and 80% of Americans report encountering COVID-19 dis/misinformation on at least one social media site/app. COVID-19 dis/misinformation promotes scepticism and a lack of confidence in COVID-19 interventions. Black people have been disproportionately affected by the COVID-19 pandemic in terms of negative impacts on their livelihoods and are also more likely to be hesitant to receive the COVID-19 vaccine. Dis/misinformation contributes to high rates of COVID-19 infection and low uptake of COVID-19 vaccination. Hence, the purpose of this scoping review was to map out the nature and extent of current research on COVID-19 disinformation among Blacks in Africa and the African diaspora.MethodsWe searched and reviewed articles from major databases such as MEDLINE, EMBASE, and CINAHL. Our search strategy involved the following concepts: 1) COVID-19, including variants; 2) misinformation, conspiracy theories, and fake news, and modes of misinformation transmission such as social media; and 3) Blacks or people of African descent, or the African diaspora. We retrieved 600 articles that were independently screened by two researchers. We included studies focusing on 1) Black people living inside or outside Africa; and 2) COVID-19 online dis/misinformation among this population. A total of 19 studies fit our inclusion criteria. We used a thematic analysis to analyse qualitative data.ResultsOur findings indicate Black people are accessing and often sharing online disinformation and misinformation primarily through social media platforms such as WhatsApp, Facebook, Twitter, YouTube, and Instagram. Dis/misinformation concerns the origin of COVID-19, transmission, prevention, and treatment of COVID-19, assertions of race immunity to the virus, distrust in government and health organizations, and intervention research and programming.ConclusionsThere is a global paucity of literature addressing COVID-19 online dis/misinformation among Black people. Dis/misinformation can fuel vaccine hesitancy and threaten the goal of herd immunity. Knowledge of the impact and implications of COVID-19 online dis/misinformation is necessary to inform public health interventions in Black communities.

Financial Burden and Catastrophic Health Expenditure Associated with COVID-19 Hospitalizations in Kerala, South India.

IntroductionCatastrophic health expenditure during COVID-19 hospitalization has altered the economic picture of households, especially in low resource settings with high rates of COVID-19 infection. This study aimed to estimate the out of pocket (OOP) expenditure and the proportion of households that incurred catastrophic health expenditure due to COVID-19 hospitalization in Kerala, South India.Materials and MethodsA cross-sectional study was conducted among a representative sample of 155 COVID-19 hospitalized patients in Kottayam district over four months, using a pretested interview schedule. The direct medical and non-medical costs incurred by the study participants during hospitalization and the total monthly household expenditure were obtained from the respective COVID-19 affected households. Catastrophic health expenditure was defined as direct medical expenditure exceeding 40% of the household’s capacity to pay.ResultsFrom the study, median and mean OOP expenditure was obtained as USD 93.57 and USD 502.60 respectively. The study revealed that 49.7% of households had catastrophic health expenditure, with 32.9% having incurred distress financing. Multivariate analysis revealed being below poverty line, hospitalization in private healthcare facility, and presence of co-morbid conditions as significant determinants of catastrophic health expenditure.ConclusionHigh levels of catastrophic health expenditure and distress financing revealed by the study have unveiled major unaddressed challenges in the road to universal health coverage.

The impact of COVID-19 on essential health service provision for endemic infectious diseases in the South-East Asia region: A systematic review.

SummaryBackgroundThere is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services. The South East Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, and continues to bear a significant proportion of communicable disease burden worldwide.MethodsWe conducted a systematic literature review of quantitative evidence to estimate the impact of COVID-19 on the provision of essential prevention, detection, treatment, and management services for five high-burden infectious diseases across the SEAR.FindingsA total of 2338 studies were reviewed, and 12 studies were included in our analysis, covering six countries across the SEAR (Bhutan, Sri Lanka, Nepal, Myanmar, Thailand, and India) for three conditions of interest (HIV, TB, dengue fever). We identified significant disruption to TB testing (range=25% to 77.9%) and diagnoses (range=50% to 58%) in India, Nepal, and Indonesia; and similar disruptions were observed for screening, new diagnoses and commencing HIV treatment in India and Thailand. There was also drastically reduced case detection for dengue fever (range=75% to 90% disrupted) in Bhutan and Sri Lanka. No studies were identified for malaria nor hepatitis in any country, and nor for any service in the remaining six SEAR countries.InterpretationWe identified evidence of significant disruption to the prevention, diagnoses, treatment, and management of TB, HIV, and dengue fever due to the COVID-19 pandemic across multiple SEAR country settings. This has the potential to set back hard-fought gains in infectious disease control across the region. The lack of evidence for the impact of the pandemic on malaria and hepatitis services, and in the remaining six SEAR countries, is an important evidence gap that should be addressed in order to inform future policy for service protection and pandemic preparedness.FundingThis work was supported by the WHO Sri Lanka Country office.

The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review.

The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. We used the Joanna Briggs Institute's Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. 239324.

Knowledge and practices related to COVID-19 among mothers of under-2 children and adult males: a cross-sectional study in Bangladesh.

ObjectivesTo assess the knowledge and practices related to COVID-19 among Bangladeshi mothers with children aged 2 years or less and adult males.DesignWe conducted a cross-sectional study to assess the knowledge and practices using a multistage cluster sampling technique.SettingsSix districts with high COVID-19 infection rates in Bangladesh.Participants2185 mothers of under-2 children and 657 adult males were surveyed in December 2020.Main outcome measuresWe constructed weighted composite knowledge and practice scores and examined associations between composite scores and background characteristics using linear regression models.ResultsKnowledge on possible routes of transmission of the novel coronavirus and the critical handwashing and mask-wearing etiquettes was poor. On a scale of 100, the mean composite knowledge scores of mothers and adult males were respectively 33.5 (SD=15; 95% CI 32.9 to 34.1) and 38.2 (SD=14.8; 95% CI 37.1 to 39.4). In contrast to knowledge, adult males obtained lower practice scores than mothers, primarily due to poor physical distancing practices. The mean practice scores of mothers and adult males were 63.0 (SD=18.1; 95% CI 62.3 to 63.8) and 53.4 (SD=17.5; 95% CI 52.0 to 54.7). Moreover, education, household income and access to television and the internet are significantly associated with knowledge. People residing proximal to a city revealed higher knowledge than the relatively distant ones. This was also the case for practice scores; however, the other factors associated with knowledge did not have a significant association with practices.ConclusionsIn general, both mothers and adult males presented with poor knowledge and practices related to COVID-19. While local, national and international institutions should design and implement educational interventions to help improve knowledge, our research shows that mere knowledge may not be enough to ensure practice. Hence, authorities could reinforce positive social norms by setting benchmarks and introducing rewards or sanctions to improve practices.

The Impact of COVID-19 Pandemic on Halting Sustainable Development in the Colca y Volcanes de Andagua UNESCO Global Geopark in Peru—Prospects and Future

Events, such as the COVID-19 pandemic, that rapidly impact global communication and travel have significant consequences for the tourism industry, which is one of the pillars of global development. We assess the impacts of the COVID-19 crisis on the Colca y Volcanes de Andagua UNESCO Global Geopark in Peru. The Colca y Volcanes de Andagua Geopark was established immediately prior to the pandemic in October 2019. The instability of the government in Peru during the pandemic and the difficult living conditions in the high Andes, such as the lack of drinking water, cleaning agents, medical care, and the high levels of poverty, particularly in the geopark region, has contributed to the significantly high COVID-19 infection rates. In addition, detrimental impacts faced by the local community are a direct result of a reduction in travellers to the area due to legislative restrictions, which have had negative consequences on the local tourism industry. There is an urgent need for the recovery of the local tourism industry to prevent the permanent closure of tourism facilities and to minimise poverty rates.

Rethinking COVID-19 and Beyond: Prevention, Remedies, and Recovery.

In a relatively short timeframe, millions of deaths and illnesses associated with COVID-19 have been reported, accompanied by substantial economic losses, and overall, negatively impacting society. This experience should serve as a wakeup call to those in public health and healthcare, along with politicians and citizens: COVID-19 is considered a predictable and preventable disaster. While various reactive responses to address the pandemic were implemented, some with adverse effects, proactive measures in the years before COVID-19 were neglected. Predominately this involved the development of a preventable overfat pandemic, which played a key role in both rising rates of chronic disease, the comorbidities that increase the risk for COVID-19, along with associated inflammation and malnutrition. This increased the risk of infection in billions of people worldwide, which, in essence, primed society for high rates of COVID-19 infection. Excess body fat evolves primarily from poor nutrition, particularly the overconsumption of sugar and other refined carbohydrates, which replace the vital nutrients needed for optimal immune function. Sugar and refined carbohydrates must be considered the new tobacco, as these foods are also devoid of nutrients, and underly inflammatory chronic diseases. A balanced diet of nutrient-dense wholefood must be emphasized to combat infectious and inflammatory diseases. Implementing proactive preventive lifestyle changes must begin now, starting with simple, safe, and inexpensive dietary modifications that can quickly lead to a healthier population.