Implementation Of Public Health Measures Research Articles

Students’ psychological state and its associated factors during an outbreak of COVID-19 in Pakistan: a web-based survey

PurposeCoronavirus disease 2019 (COVID-19) pandemic has led to unprecedented mental health repercussions in the lives of every individual including university students. Therefore, study on students’ psychological state and its associated factors during the pandemic are of importance. This study aims to discuss the aforementioned issue.Design/methodology/approachAn online survey was done on a total of 207 university students of Pakistan to collect information on socio-demographic characteristics, concerns or fears amidst COVID-19 and mental distress. Validated tools; Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9)-Depression were used to assess stress, anxiety and depression, respectively.FindingsAround 14% of the university students were experiencing severe stress and anxiety, while 8.2% had severe depression. The authors found that stress among university students was related to psychiatric illness or symptoms (OR = 5.1: 1.1, 22.9) and unpredictability due to the pandemic (OR = 3.7: 1.2, 11.2). The significant determinants of anxiety were psychiatric illness/symptoms (OR = 6.6: 3.4, 12.9), implementation of public health measures (OR = 3.7: 1.1, 11.6), employed mothers (OR = 2.4: 1.1, 5.0) and lack of support from university administration (OR = 2.2: 1.0, 5.0). While the factors associated with depression included psychiatric illness or symptoms (OR = 8.4: 3.3, 21.5), unpredictability due to pandemic (OR = 6.8: 2.2, 20.7), impaired social support system (OR = 3.7: 1.3, 10.4) and studying without a scholarship (OR = 2.1: 1.0, 4.4).Research limitations/implicationsThese findings call for an urgent need to develop appropriate interventions and educational programs that could address the psychological needs of students.Practical implicationsThe study directs the role of university and faculty in dealing the mental health needs of the student in COVID-19 pandemic time.Social implicationsEducational programs are important that could address the psychological needs of students in COVID-19 pandemic.Originality/valueUniversity students reported mental distress during COVID-19 pandemic which shows that younger people are at risk of COVID-19 repercussions. Moreover, several stressors (i.e. impaired social support system and lack of support from universities) were revealed that could be mitigated by implementing appropriate strategies.

Classifying Australian citizens' responses to COVID‐19 preventative behaviour directives: A latent class approach

AbstractThe primary defence against COVID‐19 has been the implementation of public health measures that rely on voluntary compliance with behavioural directives. Compliance is often conceptualised as a single dimension, but there may be distinct patterns of compliance with COVID‐19 preventative behaviours. This study examined behavioural profiles in response to preventative behaviour directives during the early stages of the COVID‐19 pandemic in Australia. A representative sample of Australian residents (n = 978) responded to a survey measuring self‐reported compliance with a range of preventative measures, trust in various institutions and a range of psychological and demographic variables. The latent class analysis identified five distinct behavioural profiles characterised by different degrees of compliance with different health behaviours. In addition to those who complied with most measures and those who complied with none, there were profiles that complied with most measures except specific ones, including limiting interactions with others and visitations. These profiles were associated with a number of demographic and psychological characteristics, including trust. Implications for public health interventions are discussed.

A Small Surge in Incidence of SARS-CoV-2 Omicron Variant in the "Dynamic Zero" Period.

To describe the epidemiological characteristics and transmission dynamics of SARS-CoV-2 Omicron variant during "Dynamic Zero" period, we analyzed data on the 108 laboratory-confirmed SARS-CoV-2 cases during 14 to 30 May 2022 in Beichen district, Tianjin, China. We collected information on demographic characteristics, exposure history, and illness timelines of the 108 cases. We described characteristics of the patients and estimated the key epidemiological parameters, including serial interval and the time-dependent reproduction number of the Omicron variant, Rt. Among the 108 laboratory-confirmed patients, the median age was 38 years old, and 50.9% were females. Obvious symptoms were observed among 67.6% (73/108) of all cases, and major clinical manifestations included fever, sore throat, and cough, which occurred in 31.5%, 26.9%, and 19.4% of the 108 cases, respectively. The mean and standard deviation of the SI were estimated as 2.89 and 0.95 days, the Rt varied from 1.24 to 0.27 for a 7-day timelapse. The low reproduction number and the Omicron outbreak being suppressed within a short time marked the effectiveness of the implemented public health measures, such as nucleic acid screening, social distancing, masking, vaccination, medical treatment of patients, and isolation of close contacts. These measures play an important role in fulfilling the goal of controlling the spread of the disease.

SG-APSIC1098: Impact of the COVID-19 pandemic on influenza vaccination uptake among healthcare workers

Objectives: Influenza vaccination is encouraged for all healthcare workers (HCWs) to reduce the risk of acquiring the infection and onward transmission to colleagues and patients during the influenza season. Thus, vaccination was introduced at Singapore General Hospital (SGH) in 2007 and has been offered to all HCWs at no cost. The HCW influenza vaccination program is conducted annually in October and biannually during years with vaccine mismatch. However, influenza vaccine uptake remained low among HCWs. We sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on influenza vaccine uptake among HCWs. Methods: At SGH, 2 methods of vaccine delivery are offered: centralized (1-month drop-in system during office hours) and decentralized (administered by vaccination teams in offices or ward staff in inpatient locations). In the 4-year study period between 2018 and 2021, 6 influenza vaccination exercise campaigns were conducted during 8 influenza seasons. During each exercise, ~9,000 HCWs were eligible for vaccination. Results: Prior to the COVID-19 pandemic, vaccine uptake in the Southern Hemisphere was 77.6% (6,964 of 8,977) in 2018 and 84.2% (7,296 of 8,670) in 2019. During the COVID-19 pandemic in 2020, vaccine uptake in the Southern Hemisphere increased by 10% to 94.1% (8,361 of 8,889). In the Northern Hemisphere, vaccine uptake was 79.2% (7,114 of 8,977) in 2018, and this increased by 17.9% to 97.1% (8,926 of 9,194) during the COVID-19 pandemic in 2020. During the 2021 Southern Hemisphere influenza season, no vaccination program was conducted because the risk of influenza was considered low due to the closure of international borders and the implementation of public health measures. In addition, priority was given to COVID-19 vaccination efforts. Conclusions: Increased uptake of the influenza vaccination was observed during the COVID-19 pandemic. Anxiety created by the respiratory disease pandemic and debate surrounding vaccines likely contributed to increased awareness and uptake in influenza vaccine among HCWs.

Understanding the management of hypertension in Asia: results of a literature search

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Servier, France Background Hypertension poses a significant healthcare burden in Asia. Detection, treatment and control of hypertension are suboptimal, despite the existence of clear international guidelines and the availability of safe and effective treatments. Purpose To understand hypertension management in Asia, based on the analysis of national guidelines, treatment patterns and patient characteristics. Methods A PubMed search was performed using four search strings relating to 1) hypertension; 2) treatment/management/drug therapy; 3) guideline, consensus, real world evidence; and 4) Asian countries. The search was restricted to English language articles published since January 2008 to July 2022. Articles were filtered by relevance to the research question, study size, scope, methodology, and country/region to identify a target of 100 final references. Results The search yielded 2,436 articles, of which 92 were selected as being most relevant. Compared with Europeans, Asians appeared to have higher systolic blood pressure (BP), diastolic BP, and mean arterial pressure, with stronger association between BP and stroke. Rates of severe hypertension were also higher. Trends identified in the literature suggested that calcium channel blockers are the most common monotherapy used in Asian countries, with a high variability across the region. In the available publications focused on the studies with RAAS inhibitors, the majority of them compared the use of angiotensin receptor blockers as mono/combination therapy versus combination therapy with ACE inhibitors, calcium channel blockers or diuretics. Among treated patients, the observed control rates were only ~35–40% (~10% or less in the general population). There is a lack of focus on selecting the most appropriate treatment for each individual patient. Areas for improvement in delivering guideline-directed therapy for improved BP control also included facilitating access to health care and compliance with medication (including support mechanisms like community programmes, telemedicine, mobile phone apps and home BP monitoring), improving diet (reducing salt intake) and encouraging exercise. Conclusions Asian patients and European patients have different clinical profiles, with more severe hypertension in Asians. Rates of BP control across Asia are low. The management of hypertension requires a focused multimodal and supportive approach with implementation of public health measures, more effective screening initiatives and evidence-based goal-driven recommendations for appropriate pharmacotherapy augmented by lifestyle changes.

Clinical Simulation in Undergraduate Nursing Programs as a Response to the Covid-19 Pandemic: Protocol for an Integrative Review

The COVID-19 pandemic brought the world to a standstill, forcing businesses to close or adjust operations to online platforms. Nursing Educational Institutions (NEIs) were similarly affected by the implementation of public health measures to reduce the transmission of COVID-19, leading to abrupt lockdowns and campus closures, reduced or no face-to-face time in labs, and a sudden loss of clinical placement sites for students. To combat this problem, NEIs had to adjust their conventional practices and find alternative, novel approaches to fulfill the required hands-on lab teaching and clinical practice hours for their students. Many NEIs turned to simulation to close this gap for nursing students. Therefore, this integrative review seeks to explore what innovative simulation strategies were used during the pandemic era and the lessons that can be learned from these innovations. Key Terms: COVID-19, simulation, innovative strategies, undergraduate nursing

Welfare States and Covid-19 Responses: Eastern versus Western Democracies

AbstractThis study uses a welfare state lens to examine disparities in Covid-19 infections and mortality rates between countries in Eastern Europe compared to West European democracies. Expanding on Esping-Andersen’s typology of welfare regimes, the authors compare six country groups to conduct a multivariate statistical analysis that, when controlling for economic and health differences, shows the number of cases and deaths per 100,000 to be significantly higher for Eastern Europe. In comparing First, Second, and Third Wave data, the difference in Covid-19 infections and mortality rates can be explained through stricter lockdown measures implemented in the East at the start of the First Wave. Overall higher numbers in the East reflect comparatively looser state measures in response to the Second and Third Waves as well as the lack of trust in government and the weak implementation of public health measures.

Impact of national COVID-19 restrictions on incidence of notifiable communicable diseases in England: an interrupted time series analysis

BackgroundNon-pharmaceutical interventions (NPIs), such as travel restrictions, social distancing and isolation policies, aimed at controlling the spread of COVID-19 may have reduced transmission of other endemic communicable diseases, such as measles, mumps and meningitis in England.MethodsAn interrupted time series analysis was conducted to examine whether NPIs was associated with trends in endemic communicable diseases, using weekly reported cases of seven notifiable communicable diseases (food poisoning, measles, meningitis, mumps, scarlet fever and pertussis) between 02/01/2017 to 02/01/2021 for England.ResultsFollowing the introduction of COVID-19 restrictions, there was an 81.1% (95% CI; 77.2–84.4) adjusted percentage reduction in the total number of notifiable diseases recorded per week in England. The greatest decrease was observed for measles, with a 90.5% percentage reduction (95% CI; 86.8–93.1) from 42 to 5 cases per week. The smallest decrease was observed for food poisoning, with a 56.4% (95%CI; 42.5–54.2) decrease from 191 to 83 cases per week.ConclusionsA total reduction in the incidence of endemic notifiable diseases was observed in England following the implementation of public health measures aimed at reducing transmission of SARS-COV-2 on March 23, 2020. The greatest reductions were observed in diseases most frequently observed during childhood that are transmitted via close human-to-human contact, such as measles and pertussis. A less substantive reduction was observed in reported cases of food poisoning, likely due to dining services (i.e., home deliveries and takeaways) remaining open and providing a potential route of transmission. This study provides further evidence of the effectiveness of non-pharmaceutical public health interventions in reducing the transmission of both respiratory and food-borne communicable diseases.

Spatial-temporal clustering of an outbreak of SARS-CoV-2 Delta VOC in Guangzhou, China in 2021.

In May 2021, the SARS-CoV-2 Delta variant led to the first local outbreak in China in Guangzhou City. We explored the epidemiological characteristics and spatial-temporal clustering of this outbreak. Based on the 153 cases in the SARS-CoV-2 Delta variant outbreak, the Knox test was used to analyze the spatial-temporal clustering of the outbreak. We further explored the spatial-temporal clustering by gender and age groups, as well as compared the changes of clustering strength (S) value between the two outbreaks in Guangzhou. The result of the Knox analysis showed that the areas at short distances and brief periods presented a relatively high risk. The strength of clustering of male-male pairs was higher. Age groups showed that clustering was concentrated in cases aged ≤ 18 years matched to 18-59 years and cases aged 60+ years. The strength of clustering of the outbreak declined after the implementation of public health measures. The change of strength of clustering at time intervals of 1-5 days decreased greater in 2021 (S = 129.19, change rate 38.87%) than that in 2020 (S = 83.81, change rate 30.02%). The outbreak of SARS-CoV-2 Delta VOC in Guangzhou has obvious spatial-temporal clustering. The timely intervention measures are essential role to contain this outbreak of high transmission.

Five consecutive epidemiological waves of COVID-19: a population-based cross-sectional study on characteristics, policies, and health outcome

BackgroundThis study was conducted with the intension of providing a more detailed view about the dynamics of COVID-19 pandemic. To this aim, characteristics, implemented public health measures, and health outcome of COVID-19 patients during five consecutive waves of the disease were assessed.MethodsThis study was a population-based cross-sectional analysis of data on adult patients who were diagnosed with COVID-19 during five waves of the disease in Iran. Chi-squared test, One-way ANOVA, and Logistic Regression analysis were applied. A detailed literature review on implemented public health policies was performed by studying published documents and official websites responsible for conveying information about COVID-19.ResultsData on 328,410 adult patients was analyzed. Main findings indicated that the probability of dying with COVID-19 has increased as the pandemic wore on, showing its highest odd during the third wave (odds ratio: 1.34, CI: 1.283–1.395) and has gradually decreased during the next two waves. The same pattern was observed in the proportion of patients requiring ICU admission (P < 0.001). First wave presented mainly with respiratory symptoms, gastrointestinal complaints were added during the second wave, neurological manifestations with peripheral involvement replaced the gastrointestinal complaints during the third wave, and central nervous system manifestations were added during the fourth and fifth waves. A significant difference in mean age of patients was revealed between the five waves (P < 0.001). Moreover, results showed a significant difference between men and women infected with COVID-19, with men having higher rates of the disease at the beginning. However, as the pandemic progressed the proportion of women gradually increased, and ultimately more women were diagnosed with COVID-19 during the fifth wave. Our observations pointed to the probability that complete lockdowns were the key measures that helped to mitigate the virus spread during the first twenty months of the pandemic in the country.ConclusionA changing pattern in demographic characteristics, clinical manifestations, and severity of the disease has been revealed as the pandemic unfolded. Reviewing COVID-19-related public health interventions highlighted the importance of immunization and early implementation of restrictive measures as effective strategies for reducing the acute burden of the disease.

7.K. Workshop: The implementation of ”Good or Best Practices”: what can we learn from each other?

Abstract Introduction The value of evidence-informed development and implementation of public health measures and practices - often called “good” or “best practices” - has been widely acknowledged in order to effectively address public health challenges. Yet information on such measures and practices remains insufficiently accessible to practitioners, policy and decision-makers. On a national level, several European countries have developed “Best Practice Portals” in order to support the uptake, implementation and dissemination of acknowledged public health best practices or policies. Objective Six countries in Europe with a national “portal” have recently compared the rationale, structure, and processes used by their respective national portals, gaining first insights into how development and implementation of best practices can be further supported from a national level. The workshop will present these first insights, as well as further promising approaches to facilitate access to best practices, such as innovative digital tools which local public health actors, policy and decision-makers may use to inform selection of best practices for their contexts. Methods The workshop starts with three presentations to introduce and to illustrate the topic. In the second half of the workshop we ask for an active contribution of the participants. For interaction, the open space method will be used. Programme 1. Three presentations of 10 minutes with 1-3 questions: • The presentation of the results of a survey in Poland assessing the decision-makers’ needs with regard to the implementation of best practices/evidence-informed policymaking • A descriptive case comparison of six European program registries and the European Best Practice Portal, illustrating different approaches to support implementation of evidence-informed public health measures and practices • Presentation of a digital tool to support evidence-informed planning and implementation of healthy and active environments by local public health actors 2. Discussion with the open space method (20 min) In each of the four corners of one room, there is a flipchart with a moderator and a discussion question. Every participant is free to choose one of the flipcharts to discuss the topic with other participants who have chosen the same topic. The participant is free to go to another corner if he/she wants to join also other discussions. Discussion topics are: • What are the advantages and limitations of national best practice portals in supporting the implementation of evidence-informed practices? • What are other strategies to improve implementation and what makes them successful? • How digital planning tool can be useful in evidence-informed planning and implementation?? • How can national portals collaborate with the EU Best practice portal? 3. Conclusion (10 min): every flip chart moderator reflects on their discussion, presenting 3 of the most important findings. Key messages • National best/good practice portals have an important role to play in supporting the implementation of good/best practices. • Different strategies should be employed to facilitate implementation of evidence-informed practices.

1.Q. Workshop: Summarising research evidence related to COVID-19 impact

Abstract After the first SARS-CoV-2 infections surge in late 2019, and its spreading worldwide, COVID-19 rapidly became a pandemic by March 2020. Facing a new public health crisis, the scientific community deployed research efforts to study this new disease, generating a large amount of scientific evidence in a very fast way. This research was developed in several directions, for instance, describing how COVID-19 impacts the population's health and well-being. Specifically, the research aimed at describing and evaluating the risk factors either for being infected or evolving toward adverse outcomes, such as hospitalisation or death. Moreover, the effectiveness of implemented public health measures was assessed since countries’ governments rapidly implemented them to mitigate the pandemic.Therefore, several literature reviews have been performed within the European Project ‘Population Health Information Research Infrastructure (PHIRI)’ to summarise and share the published COVID-19 evidence through a health information portal, where researchers and other stakeholders can exchange best practices and expertise. This workshop aims at sharing the collaborative work and experience of a large group of European researchers within the PHIRI consortium, consisting in preliminary results and lessons learnt with the scientific community. The workshop format consists of five presentations by PHIRI members, each one presenting their literature review work, followed by a discussion among the presenters and with the audience. The first workshop presentation will describe the methodological aspects of research conducted to assess the COVID-19 impact on the population's health and well-being, including research methods and statistical methods. The subject for the second talk will show a representative sample of health indicators used to evaluate the direct impact of COVID-19 in the scientific literature. The third presentation will elaborate on a short and long-term impact of COVID-19 crisis on population with frailty, multimorbidity or with different socioeconomic status; evidence derived from systematic literature reviews of population-based studies. The fourth presentation will describe the effectiveness and impact of tracking COVID-19 patients using digital contact tracing tools. The last presentation describes the methodological aspects of a systematic literature review conducted to gain an overview of the foresight studies that have been done throughout the World about COVID-19. Key messages • During the pandemic, a literature reviews provide an important tool to summarise the large amount of scientific evidence that was generated. • This workshop aims at sharing the collaborative work and experience of a large group of European researchers participating at PHIRI, the results and lessons learned with the scientific community.

Perception of undergraduate medical students regarding the use of Information and Communication Technologies

INTRODUCTION: Information and communication technologies enhance collaboration between students and health personnel worldwide to generate globalized health research and to improve the implementation of public health measures. OBJECTIVE: To evaluate the perception of information and communication technologies of medical students from a private university in the city of Medellín-Colombia. METHODOLOGY: Descriptive observational study that included pre-med and first-semester medical students who gave their consent. Variables such as sociodemographic, academic, information, and communication technologies skills and perception were included in the study. The information was collected through a survey made in Microsoft Forms®; absolute and relative frequencies were used for the analysis. RESULTS: 69 students participated in the study, of which 69.5% (48) were women; the average age was 17 years. Regarding access to electronic devices, it was found that 98.5% (68) had a cell phone, while 94.2% (65) had their own computer, and 100% (69) had internet access at home. CONCLUSION: Students perceive that due to the pandemic, the use of the Internet for academic activities increased, which impacted the time that was dedicated to digital entertainment activities; furthermore, they perceive that the trend in the use of information and communication technologies leads to a dehumanization of society.

Sports Participation and Anti-Epidemic: Empirical Evidence on the Influence of Regular Physical Activity on the COVID-19 Pandemic in Mainland China.

This study aims to investigate the effects and influencing mechanisms of regular physical activity (RPA) on the COVID-19 pandemic. Daily data from 279 prefecture-level cities in mainland China were collected from 1 January to 17 March 2020. A two-way fixed-effects model was used to identify the causal relationship between physical activity and COVID-19, while also considering factors such as patterns of human behavior and socioeconomic conditions. The instrumental variable (IV) approach was applied to address potential endogeneity issues for a more accurate causal identification, and the mediating effect model was applied to examine the mechanisms of the influence of physical activity on the epidemic. We found that regular physical activity significantly improves individual immunity, which, in turn, leads to a reduction in the probability of being infected with COVID-19. Furthermore, we investigated the heterogeneity of the influence, finding that the negative impact of physical activity on the pandemic is more pronounced in the absence of adequate medical resources, strong awareness of prevention among residents, and fully implemented public health measures. Our results provide empirical evidence for the mechanisms of influence of physical activity on the pandemic. We would suggest that not only should physical activity be actively practiced during the pandemic, but also long-term regular exercise habits should be consciously cultivated to improve the ability of the individual immune system to better cope with sudden outbreaks of emerging infectious diseases.

Higher US COVID-19 hospitalizations are associated with compromised endometrial cancer care; 20% fewer patients were treated surgically during the first year of the pandemic (437)

Objectives: To estimate the magnitude of postponed or canceled hysterectomies (hyst) for endometrial cancer (EC) associated with the COVID-19 pandemic.Methods: Hospitals submitting data to the Vizient database for the period from February 1, 2018, through June 30, 2021, provided the study population. We queried Vizient to identify all patients undergoing hyst for EC by month. The CDC declared a national emergency in February 2020; therefore, we defined a two-year pre-pandemic period as of February 1, 2018, through January 31, 2020; February 1, 2020, began the pandemic period. The mean number of monthly EC hyst for the 2-year pre-pandemic period established a baseline, and this was compared to the number of EC hyst per month during the pandemic. We calculated the “deficit” as the difference between the annual baseline and the number of hyst done during the first year of the pandemic. Monthly variance from baseline in EC hyst during the pandemic was graphed against the US COVID-19 hospitalization rates.Results: Total 314 hospitals reported data on 22,067 patients. The mean baseline (pre-pandemic) number of EC hyst/month was 582 (range: 539 to 644). In the first year of the pandemic period, the mean number of hyst/month was 466 (range: 350 to 537), a statistically significant decrease (p<0.0002). The monthly variance ranged from 42% in May 2020 to 4% in December 2020. The total deficit for the first 12 months of the pandemic was 1,440, a 20% decrease from the annual baseline. We were unable to determine how many EC patients did not have hyst due to personal COVID-19 infection. However, less than 4% of hospitalized patients in Vizient had both a diagnosis of active or history of COVID-19 and EC. Figure 1 shows that monthly deficits closely mirror the number of US COVID-19 hospitalizations. Conclusions: Hyst is the treatment of choice for the majority of women with EC; therefore, we conclude that the care of approximately one in five EC patients in the US who were surgical candidates was compromised during the first 12 months of the COVID-19 pandemic. Although this retrospective study did not demonstrate cause and effect, it is logical to consider that delivery of optimal EC care has been profoundly, adversely, affected by higher COVID-19 hospitalization rates, not primarily due to EC patients actually having COVID-19 infections. We propose that broader implementation of public health measures to decrease COVID-19 hospitalization might facilitate optimal care for a substantial number of EC patients.[NB at the time of abstract submission, for most major hospitals, data was complete through June 2021, too early to evaluate associations with the Delta variant. By the time of the SGO meeting, we anticipate data to be complete through the end of December 2021, providing insights related to the recent surge].

Implementation of Multi-level Interventions to Mitigate Risk of SARS-CoV-2 Delta Variant at a PUBLIC UNIVERSITY in Southern United States.

During the coronavirus disease 2019 (COVID-19) pandemic, navigating the implementation of public health measures in a politically charged environment for a large state entity was challenging. However, Louisiana State University (LSU) leadership developed and deployed an effective, multi-layered mitigation plan and successfully opened in-person learning while managing cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the fourth surge. We describe the plan to provide a framework for other institutions during this and future responses. The goals were 3-fold: maintain a quality learning environment, mitigate risk to the campus community, and ensure that LSU operations did not contribute to health-care stress. As of September 2022, LSU has achieved high compliance with interventions and relatively low virus activity on campus compared with peer institutions. This university model can serve as a template for similar implementation plans in the context of complex socio-political and economic considerations.

Influenza incidence overlapped with COVID-19 or under COVID-19 control measures.

IntroductionCOVID‐19 pandemic caused infection when influenza was still prevalent. This study was conducted to examine influenza incidence overlapped with COVID‐19 and the effect of the COVID‐19 measures on influenza incidence as a proxy.MethodsThe routine sentinel surveillance data on COVID‐19 and influenza was obtained from the national integrated care electronic health record system. Data were collected in 28 points from 11 months before the outbreak (from March 2019 to January 2020) and 17 months after the outbreak (February 2020 to June 2021).ResultsIn Iran, the incidence rate of influenza was 51.1 cases per 100,000 populations in November 2019, while it was only 0.1 in November 2020. The average number of influenza cases specifically for the Kurdistan province during the seasonal flu peak in 2019–2020 was 2.5 cases per 100,000 populations, while the average of influenza cases in the preceding 4 years was 0.4 cases per 100,000 populations. In other words, the seasonal peak of influenza in Iran was significantly higher than that of previous and after years.ConclusionIt seems that some of the nonpharmaceutical interventions (NPIs) used to control COVID‐19 are effective against influenza epidemics and the results indicated a marked decline in the number of influenza cases may cause after the implementation of public health measures for COVID‐19. The results showed the seasonal peak of influenza in Iran was significantly higher than that of previous years, so it seems that the influenza winter peak season (November 2019) overlapped with SARS‐CoV‐2 causing observed undetected infection during influenza winter peak.

153-LB: Type 1 Diabetes (T1D) Onset and COVID-19—Effect of the Second Wave on Diabetes Ketoacidosis and ICU Admission Rates in Newly Diagnosed Children with T1D in Kuwait

Introduction: The COVID-19 pandemic had affected access to healthcare services around the globe. On February 24th, 2020, the first wave of the pandemic was announced. The government of Kuwait had implemented public health measures including curfews, nationwide lockdowns, and limited access to healthcare services. The second wave was declared on March 7, 2021; virtual visits, availability of diabetes clinics, and easier access to healthcare facilities may change the frequency of diabetes ketoacidosis (DKA) and the requirement for ICU admission for children with type 1 diabetes (T1D) onset in the second wave. Aims: To evaluate DKA at presentation and ICU admission among children with T1D onset during the first and second waves using data from Childhood Onset Diabetes electronic Registry (CODeR) . Methods: Data were extracted from CODeR. Included patients were aged less than 14 years at the time of T1D diagnosis in the period (February 24th - December 31st, 2021) , and in the same period in 2020. Results: Between February and December 2021, 253 children were identified to have T1D onset, compared with 282 during the same period in 2020. There were no significant differences between HbA1c levels (11.41% vs. 11.56%;p value=0.21) and frequency of DKA in both groups (56.4% vs. 54%, p value=0.51) . Mild/moderate DKA rates didn't differ in both periods (66.1% vs. 60.7%, p value=0.42) , and Severe DKA as well (33.9% vs. 39.3%, p value=0.42) . No significant difference in ICU admission rates was observed in both periods (25.5% vs. 23.9%,p value=0.74) . Conclusion: The second wave of the COVID-19 pandemic didn't change DKA frequency or the requirement of ICU admission compared to the first wave. Further studies investigating the frequency of DKA, ICU admission, and other factors are needed over longer periods to evaluate how the COVID-19 pandemic affects DKA changes as the pandemic continues. Disclosure F. Othman: None. D. Al-abdulrazzaq: None. H. Alkandari: None. Funding Dasman Diabetes Institute (RA MoH 2021-017)

Proceedings of the Brazilian Academy of Dentistry Sponsored Symposium on New Perspectives on Dental Education—9/24/2021

To create a forum to facilitate further discussion, the Brazilian Academy of Dentistry organized an international symposium to discuss the experience of having to deal with dental education during the implementation of public health measures to mitigate the spread of SARS-CoV-2 in schools in Brazil, India, Portugal, Sweden, and the United States. An additional goal of the symposium was to discuss the need of continued faculty development. Therefore, the aim of this paper is to summarize these discussions.

Tracking SARS-CoV-2 Variants Using a Rapid Typification Strategy: A Key Tool for Early Detection and Spread Investigation of Omicron in Argentina.

SARS-CoV-2 variants of concern (VOC) and interest (VOI) present mutations in reference to the original virus, being more transmissible. We implemented a rapid strategy for the screening of SARS-CoV-2 VOC/VOIs using real time RT-PCR and performed monitoring and surveillance of the variants in our region. Consecutive real-time RT-PCRs for detection of the relevant mutations/deletions present in the Spike protein in VOC/VOIs (TaqMan™ SARS-CoV-2 Mutation Panel, Applied Biosystems) were implemented. A total of 6,640 SARS-CoV-2 RNA samples (Cts < 30) from infected individuals in Central Argentina during 2021 were analyzed using different algorithms that were gradually adapted to the changing scenarios of local variant circulation. The strategy developed allowed the early detection and the identification of VOC/VOIs that circulated through the year, with a 100% of concordance with the WGS. The analyses of the samples showed introductions of VOCs Alpha and Gamma in February and March 2021, respectively. Gamma showed an exponential increase, with a peak of detection in July (72%), being responsible of the second wave of COVID19 in Argentina. Since VOC Delta entered into the region, it increased gradually, together with VOI Lambda, replacing VOC Gamma, until being the main variant (84.9%) on November. By December, these variants were replaced by the emergent VOC Omicron in a term of 2 weeks, producing the third wave. We report a useful tool for VOC/VOI detection, capable to quickly and cost-effectively monitor currently recognized variants in resource-limited settings, which allowed to track the recent expansion of Omicron in our region, and contributed to the implementation of public health measures to control the disease spread.