Project description:BACKGROUND:We tested whether the tendency to worry could affect psychological responses to quarantine by capitalizing on the opportunity of having collected data before the COVID-19 outbreak on measures of worry, anxiety, and trait mindfulness in a group of university students. METHODS:Twenty-five participants completed self-report measures assessing worry (Penn State Worry Questionnaire, PSWQ), anxiety (Anxiety Sensitivity Index, ASI-3), and trait mindfulness (Mindful Attention Awareness Scale, MAAS) at T0 (pre-lockdown, 4 November 2019-17 February 2020) and T1 (at the end of lockdown, 26 April-30 April 2020). We compared assessments at the two time points in the whole sample and in high and low worriers (defined at T0 by scores on PSWQ respectively above and below 1.5 SD from mean of the Italian normative sample). OUTCOMES:High worriers showed at T1 a significant increase of anxiety sensitivity and fear of mental health in comparison to low worriers. Moreover, in the whole sample, at T1 trait mindfulness was inversely related to worry and fear of mental health. INTERPRETATION:A valuable approach to support individuals experiencing anxiety related to the COVID-19 outbreak could be represented by mindfulness-based interventions improving the ability to focus attention and awareness on the present moment.
Project description:ObjectiveTo identify chatbot use cases deployed for public health response activities during the Covid-19 pandemic.Material and methodsWe searched PubMed/MEDLINE, Web of Knowledge, and Google Scholar in October 2020 and performed a follow-up search in July 2021. We screened articles based on their abstracts and keywords in their text, reviewed potentially relevant articles, and screened their references to (a) assess whether the article met inclusion criteria and (b) identify additional articles. Chatbots, their use cases, and chatbot design characteristics were extracted from the articles and information from other sources and by accessing those chatbots that were publicly accessible.ResultsOur search returned 3334 articles, 61 articles met our inclusion criteria, and 61 chatbots deployed in 30 countries were identified. We categorized chatbots based on their public health response use case(s) and design. Six categories of public health response use cases emerged comprising 15 distinct use cases: risk assessment, information dissemination, surveillance, post-Covid eligibility screening, distributed coordination, and vaccine scheduler. Design-wise, chatbots were relatively simple, implemented using decision-tree structures and predetermined response options, and focused on a narrow set of simple tasks, presumably due to need for quick deployment.ConclusionChatbots' scalability, wide accessibility, ease of use, and fast information dissemination provide complementary functionality that augments public health workers in public health response activities, addressing capacity constraints, social distancing requirements, and misinformation. Additional use cases, more sophisticated chatbot designs, and opportunities for synergies in chatbot development should be explored.
Project description:Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first reported in late 2019 from Wuhan, China. Considering COVID-19's alarming levels of spread and severity, the World Health Organization (WHO) declared a global pandemic on March 11, 2020. The first case of COVID-19 in Nepal was reported on January 23, 2020. The Government of Nepal implemented different public health measures to contain COVID-19, including border closures and a countrywide lockdown. We collected the daily data provided by the Ministry of Health and Population (MoHP) of the Government of Nepal and illustrated the early epidemiological characteristics of COVID-19 in Nepal. By May 31, 2020, 1,572 cases and eight deaths were reported in Nepal associated with COVID-19. The estimate of prevalence for COVID-19 among tested populations was 2.25% (95% CI: 2.15-2.37%) and case-fatality rate was 0.5%. The majority of the cases were young males (n = 1,454, 92%), with overall average age being 30.5 years (ranging from 2 months to 81 years) and were mostly asymptomatic. There were only five cases from three districts until the end of March, but cases surged from April and spread to 57 out of 77 districts of Nepal by the end of May 2020 despite the continuous lockdown. Most of these cases are from the southern plains of Nepal, bordering India. As the effect of COVID-19 is expected to persist longer, the Government of Nepal should make appropriate strategies for loosening lockdowns in a phase-wise manner while maintaining social distancing and personal hygiene and increasing its testing, tracking, and medical capacity.
Project description:With the rapidly changing landscape of the Covid-19 outbreak, how to best address the needs and continue to protect the health and well-being of people with disabilities (PwDs) is a global public health priority. In this commentary we identify three public health areas of ongoing need and offer possible strategies to address each. These areas include: the types of data that would help clarify risks for PwDs and help assure their safety long term; the prevention, treatment and mitigation measures for PwDs that are needed through the duration of the outbreak; and the issues of equity in access to and quality of medical care for PwDs. Because of the rapid nature of the public health response, it is critical to reassess and readjust our approach to best address the needs of PwDs in the months and years to come and to incorporate these new practices into future emergency preparedness responses.
Project description:BackgroundPublic health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021.Methods/designThe goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health across the country with respect to interventions in their response to COVID-19. The Framework Method of thematic analysis will be applied to assess the qualitative answers to the open-ended questions that speak to public health policy features.DiscussionThe strengths of the study protocol include the engagement of Medical Health Officers/Medical Officers of Health as research partners and a robust integrated knowledge translation approach to further public health services and systems research in Canada.
Project description:BackgroundA variety of public health measures have been implemented during the COVID-19 pandemic in Canada to reduce contact between individuals. The objective of this study was to provide empirical contact pattern data to evaluate the impact of public health measures, the degree to which social contacts rebounded to normal levels, as well as direct public health efforts toward age- and location-specific settings.MethodsFour population-based cross-sectional surveys were administered to members of a paid panel representative of Canadian adults by age, gender, official language, and region of residence during May (Survey 1), July (Survey 2), September (Survey 3), and December (Survey 4) 2020. A total of 4981 (Survey 1), 2493 (Survey 2), 2495 (Survey 3), and 2491 (Survey 4) respondents provided information about the age and setting for each direct contact made in a 24-h period. Contact matrices were constructed and contacts for those under the age of 18 years imputed. The next generation matrix approach was used to estimate the reproduction number (Rt) for each survey. Respondents with children under 18 years estimated the number of contacts their children made in school and extracurricular settings.ResultsEstimated Rt values were 0.49 (95% CI: 0.29-0.69) for May, 0.48 (95% CI: 0.29-0.68) for July, 1.06 (95% CI: 0.63-1.52) for September, and 0.81 (0.47-1.17) for December. The highest proportion of reported contacts occurred within the home (51.3% in May), in 'other' locations (49.2% in July) and at work (66.3 and 65.4% in September and December). Respondents with children reported an average of 22.7 (95% CI: 21.1-24.3) (September) and 19.0 (95% CI 17.7-20.4) (December) contacts at school per day per child in attendance.ConclusionThe skewed distribution of reported contacts toward workplace settings in September and December combined with the number of reported school-related contacts suggest that these settings represent important opportunities for transmission emphasizing the need to support and ensure infection control procedures in both workplaces and schools.
Project description:ObjectiveThis study focuses on the epidemiology of COVID-19 in Europe and investigates public health response in severely hit countries.MethodsEuropean Centre for Disease Prevention and Control, Oxford COVID-19 Government Response Tracker and Health System Response Monitor were referred. The relationship between stringency index and COVID-19 cases, and between speed of stringency implementation and growth of cases was examined using linear regression.ResultsThe case-fatality ratio (CFR) of Europe (2.35%) was higher than the global CFR (2.2%). United Kingdom, Russia, France, Italy, Spain, and Germany together, accounted for 61.15% of cases and 65.62% of deaths in Europe. Significant relationship was observed between growth of COVID-19 cases and late substantive stringency imposed by countries. Population aged 65 and above (r = 0.9037, p < 0.01) and male population (r = 0.8701, p < 0.01) were significantly and positively correlated with COVID-19 deaths. The public health system of even big European countries encountered roadblocks, such as shortages of healthcare resources and deferral of non-COVID-19 treatments while dealing with the unprecedented pandemic.ConclusionEven big and richest European countries delayed the implementation of non-pharmaceutical interventions which led to rapid virus transmission. The pandemic has posed a reminder to make the public health system more resilient, as epidemics and pandemics of this nature will continue to threaten in future as well.
Project description:Since 2013, the US Centers for Disease Control and Prevention has offered the Public Health Emergency Management Fellowship to health professionals from around the world. The goal of this program is to build an international workforce to establish public health emergency management programs and operations centers in participating countries. In March 2021, all 141 graduates of the fellowship program were invited to complete a web survey designed to examine their job roles and functions, assess their contributions to their country's COVID-19 response, and identify needs for technical assistance to strengthen national preparedness and response systems. Of 141 fellows, 89 successfully completed the survey. Findings showed that fellowship graduates served key roles in COVID-19 response in many countries, used skills they gained from the fellowship, and desired continuing engagement between the Centers for Disease Control and Prevention and fellowship alumni to strengthen the community of practice for international public health emergency management.
Project description:BACKGROUND:In an effort to prevent infants being infected with SARS-CoV-2, some governments, professional organisations, and health facilities are instituting policies that isolate newborns from their mothers and otherwise prevent or impede breastfeeding. WEIGHING OF RISKS IS NECESSARY IN POLICY DEVELOPMENT:Such policies are risky as was shown in the early response to the HIV pandemic where efforts to prevent mother to child transmission by replacing breastfeeding with infant formula feeding ultimately resulted in more infant deaths. In the COVID-19 pandemic, the risk of maternal SARS-CoV-2 transmission needs to be weighed against the protection skin-to-skin contact, maternal proximity, and breastfeeding affords infants. CONCLUSION:Policy makers and practitioners need to learn from the mistakes of the HIV pandemic and not undermine breastfeeding in the COVID-19 pandemic. It is clear that in order to maximise infant health and wellbeing, COVID-19 policies should support skin-to-skin contact, maternal proximity, and breastfeeding.