Public Health Situation Research Articles

Sentimentos e Percepções de usuários SUS dependentes curados da COVID-19

Due to the whole context of pandemic and its social impacts, a fragile situation in public health is faced, and may not only cause physical illness, but especially mental suffering, which has a high chance of occurring in the general population and persisting with post-pandemic psychological symptoms. The study aimed to understand feelings and perceptions experienced by dependent UHS users affected by Coronavirus, as well as the sequelae resulting from the process of illness and cure of the virus. This is descriptive, exploratory study type with a qualitative approach. The collection was carried out in the municipality of Guarabira, PB, with 20 dependent UHS users, who were affected by COVID-19, and who had been cured for at least 1 month. Users were invited to participate in the research through social networks. The interviews were guided by the data collection instrument and conducted remotely, using digital audio and video platforms. The age range of the interviewees ranged from 20 to 63 years, and 17 (85%) were females and 3 (15%) were males. Most females had completed higher education and were single. Feelings such as fear, anxiety, anguish, and loneliness, and the presence of sequelae after the cure of COVID-19 were identified. These feelings were clearly exposed in the interviewees' statements and the most prevalent feeling was fear. The study allowed for the identification of feelings harmful to the mental health of the participants. Through the reports, the presence of important sequelae after the cure of COVID-19 was also identified.

«Мягкое право» на защите от COVID-19 : сравнительные подходы в национальном правовом регулировании пандемии государствами – членами Европейского союза

COVID-19 has resulted in the unprecedented closure of borders and the blocking of cities and regions, it has taken millions of lives, created an emergency situation in public health and administrative management. In order to respond to the coronavirus pandemic in a timely manner and apply unified approaches to its «taming», the EU institutions and public authorities of national member states, in addition to the current legislative acts, have widely used such legal regulators of public life and administrative management as soft law. With the use of circulars, instructions, guidelines and other acts of soft law, the rules of behavior of the population and its individual groups in a pandemic began to be urgently introduced, the procedure for vaccination and remote work and education were explained. Acts of soft law, which, according to the theory of law, are not binding, on the one hand, have become an internal guide to the actions of authorities to organize the management of subordinate infrastructure, save the economy, on the other hand, external rules aimed at voluntary compliance with them by residents of cities and settlements (recommendations, appeals, explanations, etc.). Main strategies of the EU member states in the application of soft law measures are aimed at saving human life, supporting the economy, education and healthcare. Flexible, prompt and unified use of hard and soft law on the territory of the EU member states at the beginning of the pandemic – spring-summer 2020, a period of confusion and emergency, allowed to stabilize the situation, invent a vaccine against COVID-19, open borders and transport links, strengthen the capabilities of medicine and education. This article examines the peculiarities of the application of soft law in some EU member states – Italy, Germany, Hungary, Greece, Sweden – at the first most difficult stages of the pandemic. These countries followed different approaches to combating the pandemic, ranging from complete isolation and the introduction of a «state of siege» in Italy and ending with soft recommendations in Sweden. These differences are not only due to the legal and political traditions of these countries, but also to the specific approaches of those states, reflecting the special conditions they faced at the local level.

Feelings and perceptions of Unified Health System-dependent users cured of COVID-19

Due to the whole context of pandemic and its social impacts, a fragile situation in public health is faced, and may not only cause physical illness, but especially mental suffering, which has a high chance of occurring in the general population and persisting with post-pandemic psychological symptoms. The study aimed to understand feelings and perceptions experienced by dependent UHS users affected by Coronavirus, as well as the sequelae resulting from the process of illness and cure of the virus. This is descriptive, exploratory study type with a qualitative approach. The collection was carried out in the municipality of Guarabira, PB, with 20 dependent UHS users, who were affected by COVID-19, and who had been cured for at least 1 month. Users were invited to participate in the research through social networks. The interviews were guided by the data collection instrument and conducted remotely, using digital audio and video platforms. The age range of the interviewees ranged from 20 to 63 years, and 17 (85%) were females and 3 (15%) were males. Most females had completed higher education and were single. Feelings such as fear, anxiety, anguish, and loneliness, and the presence of sequelae after the cure of COVID-19 were identified. These feelings were clearly exposed in the interviewees' statements and the most prevalent feeling was fear. The study allowed for the identification of feelings harmful to the mental health of the participants. Through the reports, the presence of important sequelae after the cure of COVID-19 was also identified.

Hydrocarbon-Based Contaminants in Drinking Water Sources and Shellfish in the Soku Oil and Gas Fields of South-South Nigeria

Environmentally unfriendly Oil exploration activities have been ongoing in the Soku area of the Niger Delta of Nigeria since 1956. This study evaluated the concentration of hydrocarbons and heavy metals in Shellfish and drinking water sources in the study area. It revealed the absence (<0.001 mg/l) of most heavy metals (Ni, Ch, Cd, Pb mg/l) in the water column; a high concentration of the major ion composition of seawater (sulphates 5 - 1018; calcium 0.502 - 53.502; sodium 1.247 - 63.337; potassium 0.508 - 102.745; magnesium 0.354 - 42.574 mg/l); and high PAHs (<0.001 - 0.032 mg/l) levels occurring above WHO limits (0.007 mg/l) with some risk of exposure to cancer. Results from the analysis of shellfish showed that concentrations of chromium and zinc were below permissible limits while cadmium concentrations were slightly above permissible limits of the European Community. Nickel and lead were above permissible limits in the fish samples in all standards while PAHs occurred at the cancer risk levels of 10?6. A review of the public health situation in the Soku area with a view to understanding current trends, sources of perturbations and preferable solutions to the potential public health challenges raised in this study is hereby recommended. Also, this study recommends that relevant agencies and developmental partners should launch a national drive to create awareness among people/environmental/public health professionals’/health workers/administrators on this regional concern.

Improving Immunization Rates During the 2019 Measles Outbreak.

In 2019, there were multiple outbreaks of measles in the United States. In the context of the public awareness of these outbreaks, we performed an intervention with the intent to improve the rate of measles immunization in our pediatric population. Pediatric patients that were lacking adequate measles immunization were identified by electronic medical record (EMR) survey. Charts were reviewed and updated if records were found to be incomplete. Parents of the remaining children were sent a letter, personally signed by the child’s primary care provider, encouraging measles immunization. A measles fact sheet, produced by the United States Center for Disease Control, was also included with the letter. There were 44 patients in the study group whose parents received a letter and measles fact sheet. As a result, 5 of these children were brought in for a measles, mumps, and rubella (MMR) immunization. The 44 patients whose parents received a letter included 20 patients whose parents had previously expressed intent to not vaccinate their children as documented in the EMR. None of these children received an MMR immunization. Although small in scope, this project provides a glimpse into the importance of personal provider guidance to parents who are inclined to immunize their children. Unfortunately, it also demonstrated that provider advice did not change the opinions of parents who had already taken a stance against vaccination, even in the context of an urgent public health situation that had garnered widespread coverage in the lay press and social media.

Prevalence and predictive risk factors of hypertension in patients hospitalized in Kamenge Military hospital and Kamenge University teaching hospital in 2019: A fixed effect modelling study in Burundi.

Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi. Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software. Overall, 16.7% of the patients were found to be hypertensive. This study didn't showed any significant difference of hypertension's prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40-59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors. The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.

Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting.

The leadership of the Semmelweis University as a leading institution of higher education in Hungary and the Central Eastern European region within the area of medicine and health sciences has decided to reflect on the unfavorable public health situation in the country as well as the deteriorating health behavior and health status indicators in the Hungarian population by the development of an occupational setting-based personalized public health model program targeting its about 8500 employees. Based on its infrastructure and human resources the core element of the program is the establishment of the Center of Preventive Services (CPS) with units providing health risk assessment for each employee, and whenever necessary consultation with medical specialist in preventive medicine and public health, as well as counseling with dietician, physiotherapist and/or health psychologist. The service providers are the staff members of the relevant faculties in collaboration with partner primary and occupational care physicians. The units of the CPS can also serve as practical training sites for students at various levels of medical and health sciences training, and strongly contribute to the development and improvement of their skills to be able for working as a team in service provision. The employees are not only beneficiaries of health risk assessment and screening repeated on a regular basis and adequate interventions at the right time, but they also serve as a sample for a longitudinal cohort study and further ad hoc surveys for defining and implementing interventions to support health protection, disease prevention and healthy aging among them.

Key factors influencing multidrug-resistant tuberculosis in patients under anti-tuberculosis treatment in two centres in Burundi: a mixed effect modelling study

BackgroundDespite the World Health Organization efforts to expand access to the tuberculosis treatment, multidrug resistant tuberculosis (MDR-TB) remains a major threat. MDR-TB represents a challenge for clinicians and staff operating in national tuberculosis (TB) programmes/centres. In sub-Saharan African countries including Burundi, MDR-TB coexists with high burden of other communicable and non-communicable diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence which well defines the at-risk population. In this study, using data from two referral anti-tuberculosis in Burundi, we model the key factors associated with MDR-TB in Burundi.MethodsA case-control study was conducted from 1stAugust 2019 to 15th January 2020 in Kibumbu Sanatorium and Bujumbura anti-tuberculosis centres for cases and controls respectively. In all, 180 TB patients were selected, comprising of 60 cases and 120 controls using incidence density selection method. The associated factors were carried out by mixed effect logistic regression. Model performance was assessed by the Area under Curve (AUC). Model was internally validated via bootstrapping with 2000 replications. All analysis were done using R Statistical 3.5.0.ResultsMDR-TB was more identified among patients who lived in rural areas (51.3%), in patients’ residence (69.2%) and among those with a household size of six or more family members (59.5%).Most of the MDR-TB cases had already been under TB treatment (86.4%), had previous contact with an MDR-TR case (85.0%), consumed tobacco (55.5%) and were diabetic (66.6 %). HIV prevalence was 32.3 % in controls and 67.7 % among cases. After modelling using mixed effects, Residence of patients (aOR= 1.31, 95%C: 1.12-1.80), living in houses with more than 6 family members (aOR= 4.15, 95% C: 3.06-5.39), previous close contact with MDR-TB (aOR= 6.03, 95% C: 4.01-8.12), history of TB treatment (aOR= 2.16, 95% C: 1.06-3.42), tobacco consumption (aOR = 3.17 ,95% C: 2.06-5.45) and underlying diabetes’ ( aOR= 4.09,95% CI = 2.01-16.79) were significantly associated with MDR-TB. With 2000 stratified bootstrap replicates, the model had an excellent predictive performance, accurately predicting 88.15% (95% C: 82.06%-92.8%) of all observations. The coexistence of risk factors to the same patients increases the risk of MDR-TB occurrence. TB patients with no any risk factors had 17.6% of risk to become MDR-TB. That probability was respectively three times and five times higher among diabetic and close contact MDR-TB patients.ConclusionThe relatively high TB’s prevalence and MDR-TB occurrence in Burundi raises a cause for concern especially in this context where there exist an equally high burden of chronic diseases including malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.

Multiple and High-Risk Clones of Extended-Spectrum Cephalosporin-Resistant and blaNDM-5-Harbouring Uropathogenic Escherichia coli from Cats and Dogs in Thailand.

Resistance to extended-spectrum cephalosporins (ESC) and carbapenems in Escherichia coli (E. coli), increasingly identified in small animals, indicates a crisis of an antimicrobial resistance situation in veterinary medicine and public health. This study aimed to characterise the genetic features of ESC-resistant E. coli isolated from cats and dogs with urinary tract infections in Thailand. Of 72 ESC-resistant E. coli isolated from diagnostic samples (2016–2018), blaCTX-M including group 1 (CTX-M-55, -15 and -173) and group 9 (CTX-M-14, -27, -65 and -90) variants were detected in 47 isolates (65.28%) using PCR and DNA sequencing. Additional antimicrobial resistance genes, including plasmid-mediated AmpC (CIT and DHA), blaNDM-5, mcr-3, mph(A) and aac(6′)-Ib-cr, were detected in these isolates. Using a broth microdilution assay, all the strains exhibited multidrug-resistant phenotypes. The phylogroups were F (36.11%), A (20.83%), B1 (19.44%), B2 (19.44%) and D (4.17%), with several virulence genes, plasmid replicons and an integrase gene. The DNA fingerprinting using a repetitive extragenic palindromic sequence-PCR presented clonal relationships within phylogroups. Multiple human-associated, high-risk ExPEC clones associated with multidrug resistance, including sequence type (ST) 38, ST131, ST224, ST167, ST354, ST410, ST617 and ST648, were identified, suggesting clonal dissemination. Dogs and cats are a potential reservoir of ESC-resistant E. coli and significant antimicrobial resistance genes.

Impacts of the COVID-19 Pandemic to the Asian and Asian American Communities: Persistent History, Collective Resistance, and Intersectional Solidarity

Th e impact of the COVID- 19 global pandemic to American communities extends beyond physical health problems to include political, economic, education, business, mental health, and social relation impacts. This essay, based on a summer and fall 2020 place-based research project collaboration between Purdue Honors College students and the Purdue Asian American and Asian Resource and Cultural Center, examines impacts of the COVID-19 pandemic to the Asian and Asian American communities. Th e research asks what the impacts of COVID-19 are to Asian/American communities, how COVID-19 anti-Asian racism is unique or not unique, how the Asian American communities have collectively responded to the racism connected to the pandemic, and how Asian American communities displayed solidarity with other communities during this difficult time in public health and racial justice. Th e essay connects extensive media and archival research to detail COVID-19 impacts in the areas of health and wellness, job security, and social/racial justice. The essay then documents the persistent history of stereotyping and racism to Asian/American communities particularly in the midst of larger changes in political, national security, or public health situations. The next part of the essay provides an analysis of the rising number of reporting centers utilizing different platforms to counter the experience of racism. Finally, with the tragic deaths of Breonna Taylor, Ahmaud Arbery, and George Floyd that sparked forms of solidarity with the Black Lives Matter movement, the essay examines specific online and offline eff orts in regard to Asian and Asian American solidarity.

Community Reintegration of Long-Stay Hospitalised Mental Health Consumers During COVID-19 Pandemic

ABSTRACT Mandatory restrictions on social activities and access to services during the COVID-19 pandemic prevented discharge into the community of consumers from an extended-stay, hospital-based rehabilitation program. This article describes a revised discharge process that overcame the pandemic-related restrictions by replacing the graded and slow discharge process with a one-stage, full-time transition that facilitated the discharge of 16 adult consumers. No adverse mental health outcomes occurred during the process. The change of practice with its positive results reflected therapeutic risk-taking. The COVID-19 pandemic provided scope for creativity and innovation in mental health care and psychiatric rehabilitation. IMPLICATIONS Innovation and collaboration by service providers can promote consumers’ positive risk-taking to return to a life in mainstream society after a prolonged stay in an inpatient rehabilitation unit. Community reintegration of consumers with enduring severe mental illness can occur under adverse public health and social situations like the COVID-19 pandemic with innovative hospital discharge planning.

Acute Watery Diarrhea Surveillance During the Rohingya Crisis 2017-2019 in Cox's Bazar, Bangladesh.

BackgroundForcibly Displaced Myanmar Nationals (FDMNs) fled into Cox’s Bazar, Bangladesh due to internal conflict. Considering the public health situation, a surveillance network was established to identify the enteric pathogens and early detection of cholera epidemics. The purpose of this manuscript is to report the clinical, epidemiological determinants of cholera and other enteric pathogens among hospitalized diarrheal patients from FDMNs and host community.MethodsA total of 11 sentinel surveillance sites were established around the camps in Ukhia and Teknaf Upazila, Cox’s Bazar. Rapid diagnostic testing was conducted for immediate detection of cholera cases. Stool samples were transferred to the Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b) laboratory for culture.ResultsA total of 8134 participants with diarrhea were enrolled from 2017 to 2019: 4881 were FDMNs and 3253 were from the Bangladeshi host community. Among the FDMNs, the proportion of Vibrio cholerae was 0.7%, the proportion of enterotoxigenic Escherichia coli (ETEC) was 4.9%, and the proportion of Shigella was 1.5%. The distributions from host community were 1.2% V cholerae, 1.8% ETEC, and 1.1% Shigella. Similar risk factors have been identified for the diarrheal pathogens for both communities.ConclusionsThis surveillance helped to monitor the situation of diarrheal diseases including cholera in refugee camps as well as in the neighboring host community. These findings lead policymakers to take immediate preventive measures.

Territorial Conflict, Domestic Crisis, and the Covid-19 Pandemic in the South Caucasus. Explaining Variegated EU Responses.

Territorial Conflict, Domestic Crisis, and the Covid-19 Pandemic in the South Caucasus. Explaining Variegated EU Responses.

Impact Of COVID-19 Stay At Home Public Health Restrictions On Physical Activity

The public health response to the COVID-19 pandemic may have changed recreational physical activity behavior. Due to ‘Stay at Home’ restrictions, gyms and indoor exercise facilities were closed by public health orders in many states. PURPOSE: To understand how recreational physical activity behaviors changed based on state-wide COVID-19 Stay at Home restrictions. METHODS: Data on recreational physical activity behavior from three time periods were collected via a retrospective internet survey (n = 144) based on a modified International Physical Activity Questionnaire. Respondents reported days per week and duration of walking, vigorous, and moderate physical activity before, during, and after Stay at Home restrictions in a Western state (March 26 - May 1, 2020.) Days per week data were analyzed across time periods with a one-way repeated measures ANOVA. Friedman’s test was used to analyze minutes per week data across time periods. RESULTS: The one-way ANOVA examining days of vigorous physical activity showed a significant effect (F(2,286) = 4.48, p = .012). Post hoc analysis using the Holm correction revealed a statistically significant decrease in days of vigorous physical activity from before to after restrictions (mean difference = .39 days, p = .014). The analysis of weekly minutes of activity showed a significant difference between time periods for walking (Χ2(2) = 22.44, p < .001). Conover’s post hoc comparisons with Bonferroni correction indicated minutes of walking were greater during the restrictions (Mdnd = 150) compared to before (Mdnb = 110, p < .001) and after (Mdna = 120, p = .002). Vigorous physical activity was also different across time periods (Χ2(2) = 6.73, p = .035), with median vigorous physical activity being lower after restrictions (Mdna = 90) than before (Mdnb = 120) with p = .039. CONCLUSIONS: COVID-19 restrictions had an impact on recreational physical activity. Walking minutes per week increased during restrictions and returned to pre-restriction levels afterwards, with no significant change in number of days of walking per week. Vigorous activity decreased across the time periods in days and duration and did not return to initial levels. It may be important to consider and promote alternative physical activity options in public health situations that require restrictions.

The effect of COVID-19 lockdowns on sleep time perception: Comparing actigraphy and sleep diary measures

COVID-19 has become a long-term problem, and global pandemic conditions may persist for years. Researchers are providing mounting evidence of relationships between COVID-19 lockdowns and sleep problems. However, few studies have investigated the impact of home isolation on sleep time perception, especially in comparable social isolation situations with similar pressures. Subjective sleep time perception parameters were derived from sleep diaries. Objective parameters were derived from actigraphy. Subjective and objective data were obtained between February 17 and February 27, 2020 from 70 adult participants subject to COVID-19 related lockdown provisions in China. We divided participants into a home stayers (HS) group (subject to full stay-at home orders) and an area-restricted workers (ARW) group (permitted to work at their nearby workplaces). The HS group demonstrated significantly delayed actigraphy-defined sleep onset time compared to self-reported sleep onset time; this effect was absent in the ARW group. Between-group differences in actigraphy-defined sleep onset time and significant between-group differences for actigraphy-defined and self-reported wake-up time were observed. HS group participants also presented significantly delayed actigraphy-defined wake-up time compared with self-reported wake-up time. No significant effect was found on total sleep time perception. Moreover, sleep/wake time misperception were found to be associated with daylight exposure and physical activity levels respectively. To the extent they are generalizable, these results suggest that lockdown restrictions can affect sleep onset and wake-up time perception but not total sleep time perception. Public health policy should consider such effects in the present pandemic situation and in future emergent public health situations.

Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

BackgroundRelatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program.Model and recommendationsSuccess in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program.SummaryThese principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

Application of the WHO (2007) Growth Reference in Assessing the Anthropometric Status of Nigerian Adolescents; a Systematic Review and Meta Analysis

ObjectivesThe study was designed to assess the application of WHO 2007 growth reference by local studies published from 2008 to 2020 in data generation of Nigerian adolescents’ anthropometric status. MethodsMeta-analysis of literatures on anthropometric status of adolescents in Nigeria by articles published from 2009–2020 was conducted. A bibliographic survey was carried out in several databases –Google Scholar, PubMed and African Journal Online. Review of abstracts and full texts followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodology for anthropometric assessment of these eligible studies were compared to WHO 2007 growth reference. Data was analysed using IBM SPSS version 25. ResultsA total of 24 articles which captured 12,482 adolescents met the inclusion criteria. More than one fifth (20.8%) of the studies adopted the WHO 2007 growth references in their data generation. A weak positive correlation was observed between year of publication and application of WHO 2007 reference in data generation (r = .0.28; p = 0.04). ConclusionsThe low application of an age long guideline by local researchers is of concern. Hence, the need to ensure quick adoption of standard indicators/guidelines in local studies will not only promote the generation of pooled evidence to reveal cross-cutting gaps but also ensure that the public health situation is not under/over estimated. Funding SourcesThis research work received no funding.

The impact on human behaviour in shared building spaces as a result of COVID-19 restrictions

ABSTRACT The emerging trend dynamic work approaches is resulting in more open space designs at workplaces – a trend that is now being accelerated by the pandemic. This requires an objective understanding of how shared spaces are actually used, both in normal times and in response to a public health situation such as the COVID-19 pandemic. The purpose of this research was therefore to collect and analyse real- time occupancy patterns in open learning spaces before and after building policy restrictions were implemented due to the COVID pandemic. Based on three distinct spaces in a university building in Cincinnati, USA, time-simultaneous occupant counts were supplemented with position data from computer-vision cameras used to analyse occupancy patterns, physical distances between occupants, group formations, and occupancy duration. We found significant changes in occupant counts and spatial distribution between the two time periods. We analysed how architectural design elements influenced social behaviour, i.e. in this context the physical distances, group formations, and occupancy duration assigned to individual occupants within different physical contexts of the building. While the primary purpose was to study the impact of the pandemic on social behaviour within buildings, we noted essential design challenges for promoting human well-being within higher education facilities.

Mathematical model of COVID-19 with comorbidity and controlling using non-pharmaceutical interventions and vaccination.

Pandemic is an unprecedented public health situation, especially for human beings with comorbidity. Vaccination and non-pharmaceutical interventions only remain extensive measures carrying a significant socioeconomic impact to defeating pandemic. Here, we formulate a mathematical model with comorbidity to study the transmission dynamics as well as an optimal control-based framework to diminish COVID-19. This encompasses modeling the dynamics of invaded population, parameter estimation of the model, study of qualitative dynamics, and optimal control problem for non-pharmaceutical interventions (NPIs) and vaccination events such that the cost of the combined measure is minimized. The investigation reveals that disease persists with the increase in exposed individuals having comorbidity in society. The extensive computational efforts show that mean fluctuations in the force of infection increase with corresponding entropy. This is a piece of evidence that the outbreak has reached a significant portion of the population. However, optimal control strategies with combined measures provide an assurance of effectively protecting our population from COVID-19 by minimizing social and economic costs.

COVID-19 Cover Pages May Cause Nocebo Effects on Public Health: First Observations on the Connection between Media and Health Data across Cultures

Based on the observation that language use can harm health, the paper looks at the public health situation in late 2020 as compared to the situation in spring 2020-the health situation is mainly defined via A) The weekly deaths 2020; B) The weekly deaths 2020 compared to the 2016-2019 average; C), The death rates measured as weekly z-scores at the national level, and as additional indicators; D) The death rates attributed to COVID-19; E) The intensive care unit days attributed to COVID-19; and F) The hospitalized COVID-19 patients.