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Topical Collection "COVID-19 Research"

Editor

Prof. Dr. Paul B. Tchounwou
E-Mail Website
Collection Editor
Department of Biology, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch Street, Box 18750, Jackson, MS 39217, USA
Interests: environmental health and diseases; gene-environment interactions; environmental toxicology, mutagenesis and carcinogenesis; environmental epidemiology and disease control; health risk assessment and management; ecological risk assessment and management; environmental chemistry and computational toxicology; environmental genomics and proteomics; environmental medicine; and natural resources damage assessment and management
Special Issues and Collections in MDPI journals

Topical Collection Information

Dear Colleagues,

As Editor-in-Chief of the International Journal of Environmental Research and Public Health, I am delighted to invite you to contribute articles for this Topical Collection of the journal dedicated to COVID-19 Research: Challenges and Opportunities.

COVID-19 is a highly infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first discovered in December 2019 in Wuhan, China. Since that time, SARS-CoV-2 infection has become a pandemic. It is now considered to be the most challenging health issue of our times. It has rapidly spread over the world, and as of 7 February 2021, there have been about 27 million confirmed cases and 462,000 COVID-related deaths in the United States. Globally, more than 105 million confirmed cases and 2.3 million deaths have been reported.

Initially transmitted through animals to humans, SARS-CoV-2 has a high degree of pathogenicity, and has since been transmitted extensively from humans to humans by both symptomatic patients and asymptomatic individuals. The clinical manifestations COVID-19 may appear 2–14 days after exposure to the virus, with symptoms ranging from mild to severe symptoms including fever or chills, cough, shortness of breath or difficulty breathing, fatigue, body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea, trouble breathing, persistent pain or pressure in the chest, confusion, inability to wake or stay awake, and bluish lips or face.

This COVID-19 pandemic has created and continues to cause devastating medical, psychological, socio-economic, and environmental impacts on all aspects of human endeavors. These deleterious impacts disproportionally affect marginalized population groups, such as racial/ethnic minorities, individuals of low socioeconomic status, and people with disabilities. In order to reduce the incidence/prevalence and mortality rates associated with COVID-19, several public health measures, including wearing masks/face covers, social distancing, and hygiene have been recommended. Great efforts have also been made to develop effective vaccines against SARS-CoV-2. A few of these vaccines have already received emergency use authorizations from government agencies, and are currently being distributed for vaccinations.

This Topical Collection of IJERPH is designed to enable the rapid publication and dissemination of innovative research aimed at advancing the scientific knowledge and highlighting future perspectives on the SARS-CoV-2 and COVID-19 pandemic. We are interested in all aspects of COVID-19 research, including the biomedical, socio-behavioral, economic, environmental, and clinical aspects. Detailed areas of emphasis are listed below under the Keywords section.

Prof. Dr. Paul B. Tchounwou
Collection Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • SARS-CoV-2 biology, biochemistry, and physiopathology 
  • COVID-19 pandemic 
  • Biomarkers of exposure, sensitivity, and effect 
  • COVID-19 epidemiology, diagnostics, and therapeutic strategies 
  • Vaccine development and vaccinations 
  • Socio-economic, psychological, and environmental impacts 
  • Health education and COVID-19 prevention 
  • COVID-19 health disparities

Published Papers (34 papers)

2021

Article
The Relationships between Character Strengths and Subjective Wellbeing: Evidence from Greece under Lockdown during COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(20), 10868; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010868 (registering DOI) - 15 Oct 2021
Abstract
COVID-19 was first identified in December 2019. As long as this type of coronavirus was new, the main way for governments to avoid the spread of the infection was enforced quarantine. Besides public health protection, quarantine can have a psychological impact on the [...] Read more.
COVID-19 was first identified in December 2019. As long as this type of coronavirus was new, the main way for governments to avoid the spread of the infection was enforced quarantine. Besides public health protection, quarantine can have a psychological impact on the residents, with main symptoms being angst, anxiety, depressive, and PTSD symptoms. As it has been found that character strengths can promote subjective wellbeing, the purpose of the study was to examine this relationship under the new situation of quarantine in the Greek population in adults who were in quarantine for at least two weeks. The total sample consisted of 354 participants who were aged 18–72-years-old. A total of 263 participants were women (74.3%), 91 were men (25.7%), and 94.6% of them were highly educated. The sample was a convenience sample. The tools used were PANAS, PERMA and finally VIA-114GR. The data analysis was completed using SPSS software version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY, USA: IBM Corp) and EQS 6.1 (Multivariate Software Inc.: Encino, CA, USA, 2006). The results showed that love, curiosity, persistence, hope, and zest are strongly associated with subjective wellbeing, even in conditions such as quarantine, and can support specific aspects of it. Full article
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Article
Wearing a Surgical Face Mask Has Minimal Effect on Performance and Physiological Measures during High-Intensity Exercise in Youth Ice-Hockey Players: A Randomized Cross-Over Trial
Int. J. Environ. Res. Public Health 2021, 18(20), 10766; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010766 - 14 Oct 2021
Viewed by 240
Abstract
COVID-19 transmission is prevalent during ice-hockey; however, it is unknown whether wearing face masks as a mitigation strategy affects hockey players’ performance. We used a randomized cross-over study to compare wearing a surgical mask to a sham mask (control) in youth hockey players [...] Read more.
COVID-19 transmission is prevalent during ice-hockey; however, it is unknown whether wearing face masks as a mitigation strategy affects hockey players’ performance. We used a randomized cross-over study to compare wearing a surgical mask to a sham mask (control) in youth hockey players (21 males, 5 females, 11.7 ± 1.6 y) during a simulated hockey period (cycle ergometry; six shifts of 20 s of “easy” pedaling (40% peak power), 10 s of “hard” pedaling (95% peak power), 20 s of “easy” pedaling, with shifts separated by 5 min rests). A seventh shift involved two 20 s Wingate tests separated by 40 s rest. Heart rate, arterial oxygen saturation and vastus lateralis tissue oxygenation index (hemoglobin saturation/desaturation) was assessed each shift. On-ice testing was conducted with the maximal Yo-Yo intermittent recovery test. No differences between mask and control conditions for performance were found (Wingate average power: 245 ± 93 vs. 237 ± 93 W, Peak power: 314 ± 116 vs. 304 ± 115 W, on-ice distance: 274 ± 116 vs. 274 ± 110 m) and for heart rate or arterial oxygen saturation during simulated hockey shifts. Tissue oxygenation index was lower from shifts one to six for males (p < 0.05) and shift seven for females (p < 0.01) while wearing a mask. Wearing a face mask had no effect on performance in hockey players with only minor effects on muscle oxygenation. ClinicalTrials.gov (NCT04874766) (accessed on 6 May 2021). Full article
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Article
COVID-19 Pandemic and Personality: Agreeable People Are More Stressed by the Feeling of Missing
Int. J. Environ. Res. Public Health 2021, 18(20), 10759; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010759 - 13 Oct 2021
Viewed by 192
Abstract
The COVID-19 pandemic and the measures taken to contain it have substantial consequences for many people, resulting in negative effects on individual well-being and mental health. In the current study, we examined whether individual changes in perceived stress relative to pre-pandemic levels depended [...] Read more.
The COVID-19 pandemic and the measures taken to contain it have substantial consequences for many people, resulting in negative effects on individual well-being and mental health. In the current study, we examined whether individual changes in perceived stress relative to pre-pandemic levels depended on differences in behavior, appraisal, and experience of pandemic-related constraints. In addition, we tested whether this potential relationship was moderated by personality traits. We conducted an online survey during the end of the first lockdown in Germany in spring 2020, and assessed pandemic-related individual consequences as well as perceived stress. These data were related to the big five personality traits and to ratings of perceived stress obtained from the same participants in a study conducted before the outbreak of the pandemic, using the same standardized stress questionnaires. There was no overall increase, but a large interindividual variety in perceived stress relative to pre-pandemic levels. Increased stress was associated especially with strong feelings of missing. This relationship was moderated by agreeableness, with more agreeable people showing a higher association of the feeling of missing and the increase of perceived stress. In addition, openness and conscientiousness were positively correlated with an increase in stress. The results highlight the importance of considering personality and individual appraisals when examining the consequences of the COVID-19 pandemic on perceived stress and well-being. Full article
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Article
Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being: A Pandemic Case Study
Int. J. Environ. Res. Public Health 2021, 18(20), 10680; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010680 - 12 Oct 2021
Viewed by 266
Abstract
Societal crises and personal challenges are often followed by substantial changes in physical activity. Is there a link between such changes and psychological well-being? Seeking to answer this question, we conducted a correlational study on a representative sample in Sweden during the first [...] Read more.
Societal crises and personal challenges are often followed by substantial changes in physical activity. Is there a link between such changes and psychological well-being? Seeking to answer this question, we conducted a correlational study on a representative sample in Sweden during the first year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased their physical activity compared to their self-reported activity level prior to the pandemic, whereas 32% had increased it. The results showed a positive and robust association between changes in daily activity level and corresponding changes in psychological well-being. Specifically, individuals who had reduced their physical activity over the last year reported lower life satisfaction than before, and individuals who had increased their physical activity reported higher life satisfaction than before. The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data, meaning that individuals who reported increasing inactivity per day also reported a greater decline in life satisfaction. Additional analyses showed that the association between daily activity level and life satisfaction was somewhat stronger for men than for women, but there was no difference when comparing individual versus organized activities. The current study was based on a cross-sectional design, measuring self-reported change over time. Recent work from other research teams have used longitudinal data and experience-sampling in different settings, finding similar results. We conclude that there is good reason to recommend physical exercise as a coping strategy in difficult times. Full article
Article
Political Ideologies, Government Trust, and COVID-19 Vaccine Hesitancy in South Korea: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2021, 18(20), 10655; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010655 - 12 Oct 2021
Viewed by 297
Abstract
This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. [...] Read more.
This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. We used multivariate logistic regression models to identify the factors associated with vaccine hesitancy. Respondents who self-identified as liberal or held “no political opinion” had higher rates of vaccine hesitancy than conservative respondents. People’s trust in the government’s countermeasures was associated with vaccination. Respondents who had risk perceptions (affective and cognitive) of COVID-19 had lower rates of vaccine hesitancy. Perceptions that the vaccine was not safe and being aged 18–29, 30–39, or 40–49 were associated with a higher probability of vaccine hesitancy. This study found that even if vaccine safety and risk perceptions toward COVID-19 were adjusted, self-rated political ideologies and government trust was associated with COVID-19 vaccine hesitancy. More effort to communicate with those who are liberal or no political opinion, younger, and have lower level of trust in the government are required to dissolve vaccine hesitancy. Further studies should analyze the mechanism of COVID-19 vaccine uptake for effective herd immunity. Full article
Article
Burnout and the Psychological Impact among Physiatrists in Saudi Arabia during COVID-19
Int. J. Environ. Res. Public Health 2021, 18(18), 9621; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189621 - 13 Sep 2021
Viewed by 622
Abstract
Background: Burnout is an emerging critical issue facing specialists and trainees in all disciplines and not particularly studied among physiatry specialists and trainees in Saudi Arabia during the COVID-19 pandemic. Objective: To assess physiatrist burnout, depression, anxiety, and stress during the current COVID-19 [...] Read more.
Background: Burnout is an emerging critical issue facing specialists and trainees in all disciplines and not particularly studied among physiatry specialists and trainees in Saudi Arabia during the COVID-19 pandemic. Objective: To assess physiatrist burnout, depression, anxiety, and stress during the current COVID-19 pandemic crisis in Saudi Arabia. Design: Cross-sectional study. Setting: By distributing an electronic survey, the researcher assessed burnout using the Maslach Burnout Inventory (MBI) Human Services Survey (HSS) in the midst of the curfew that Saudi authorities imposed. Participants: One hundred one participating trainees, specialists, and consultants. Results: Of the 101 study participants, the majority (73.3%) were between the ages of 24 and 34 years old, with the rest distributed within the age group ranging from 35 to 65 years old. Junior residents represented 34.7%, senior residents 22.8%, physiatrist specialists 26.7%, and consultants 15.8%. The sample included 55.4% males and 44.6% females; 64.4% of the participants were married, 29.7% were still single, and 5.9% were divorced. Among the total group participating, 25.7% were handling COVID-19 patients. In the total participant sample, 80.2% reported experiencing burnout, 10.9% experienced stress, and 22.8% and 6.9% experienced anxiety and depression, respectively. Conclusion: Burnout in Saudi Arabia exists among more than two-thirds of practicing physiatrists in Physical Medicine & Rehabilitation (PM&R), and that did not appear to have a statistically significant influence on stress, anxiety, or depression (p > 0.05). The current COVID-19 global pandemic might escalate burnout and influence mental health outcomes. The healthcare authority and administration should take the lead in identifying the challenges, overcoming the obstacles, and optimizing clinician well-being, delivering up-to-date solutions, and promptly checking their effectiveness. Full article
Article
Provision of Psychodynamic Psychotherapy in Austria during the COVID-19 Pandemic: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(17), 9046; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179046 - 27 Aug 2021
Viewed by 414
Abstract
The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the [...] Read more.
The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the attitudes toward and practice of remote psychotherapy among Austrian therapists with a psychodynamic orientation at the onset of the pandemic as well as changes in the therapeutic process that were experienced by the therapists due to switching to a remote setting. A total of 161 therapists with psychodynamic orientation took part in an online survey. The results show that attitudes toward remote psychotherapy changed positively in psychodynamically orientated therapists and most are willing to switch to remote settings, if necessary. However, many therapists reported negative effects of remote psychotherapy and prefer seeing their patients in-person. The strongest changes were experienced with regard to transference/countertransference, the therapeutic process and the intensity of session. The analysis further revealed an overall decrease in the number of patients treated, indicating an undersupply of psychotherapy, at least during the first wave of COVID-19 infection in Austria. In summary, the experience during the first COVID-19 lockdown has led to an increase in remote psychotherapy and more openness toward these treatment modalities among psychodynamically oriented therapists. However, in-person therapy will remain the first choice for most therapists. Full article
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Article
Mental Health of Apprentices during the COVID-19 Pandemic in Austria and the Effect of Gender, Migration Background, and Work Situation
Int. J. Environ. Res. Public Health 2021, 18(17), 8933; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18178933 - 25 Aug 2021
Viewed by 740
Abstract
This study assessed the mental health of apprentices during the COVID-19 pandemic in Austria and the effect of gender, migration background, work situation, and work sector. An online survey via REDCap was performed with a sample of 1442 apprentices (female: 53.5%, male: 45.4%, [...] Read more.
This study assessed the mental health of apprentices during the COVID-19 pandemic in Austria and the effect of gender, migration background, work situation, and work sector. An online survey via REDCap was performed with a sample of 1442 apprentices (female: 53.5%, male: 45.4%, diverse: 1.1%, migration background: 28.4%) from 29 March to 18 May 2021. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), well-being (WHO-5), disordered eating (EAT-8), and insomnia (ISI-7). There was a high prevalence of clinically relevant depression (cut-offs ≥11 for adolescents, ≥10 for adults: 48.3%), anxiety (cut-offs ≥11 for adolescents, ≥10 for adults: 35.4%), insomnia (cut-off ≥15: 27%), and disordered eating (cut-offs ≥2 for men, ≥3 for women: 50.6%). Linear models revealed that apprentices with female and diverse gender, migration background, and unemployed status showed the poorest scores on all mental health measures (all p-values < 0.05) except disordered eating. These findings emphasize the need for intersectional strategies to reduce and prevent adverse mental health consequences of the COVID-19 pandemic for apprentices. Full article
Article
Changes in Adolescents’ Psychosocial Functioning and Well-Being as a Consequence of Long-Term COVID-19 Restrictions
Int. J. Environ. Res. Public Health 2021, 18(16), 8755; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168755 - 19 Aug 2021
Cited by 1 | Viewed by 1205
Abstract
This work studied self-reports from adolescents on how the COVID-19 pandemic has changed their behaviors, relationships, mood, and victimization. Data collection was conducted between September 2020 and February 2021 in five countries (Sweden, the USA, Serbia, Morocco, and Vietnam). In total, 5114 high [...] Read more.
This work studied self-reports from adolescents on how the COVID-19 pandemic has changed their behaviors, relationships, mood, and victimization. Data collection was conducted between September 2020 and February 2021 in five countries (Sweden, the USA, Serbia, Morocco, and Vietnam). In total, 5114 high school students (aged 15 to 19 years, 61.8% females) responded to our electronic survey. A substantial proportion of students reported decreased time being outside (41.7%), meeting friends in real life (59.4%), and school performance (30.7%), while reporting increased time to do things they did not have time for before (49.3%) and using social media to stay connected (44.9%). One third of the adolescents increased exercise and felt that they have more control over their life. Only a small proportion of adolescents reported substance use, norm-breaking behaviors, or victimization. The overall COVID-19 impact on adolescent life was gender-specific: we found a stronger negative impact on female students. The results indicated that the majority of adolescents could adapt to the dramatic changes in their environment. However, healthcare institutions, municipalities, schools, and social services could benefit from the findings of this study in their work to meet the needs of those young people who signaled worsened psychosocial functioning, increased stress, and victimization. Full article
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Article
Empirical Evaluation of Alternative Time-Series Models for COVID-19 Forecasting in Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(16), 8660; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168660 - 16 Aug 2021
Viewed by 591
Abstract
COVID-19 is a disease-causing coronavirus strain that emerged in December 2019 that led to an ongoing global pandemic. The ability to anticipate the pandemic’s path is critical. This is important in order to determine how to combat and track its spread. COVID-19 data [...] Read more.
COVID-19 is a disease-causing coronavirus strain that emerged in December 2019 that led to an ongoing global pandemic. The ability to anticipate the pandemic’s path is critical. This is important in order to determine how to combat and track its spread. COVID-19 data is an example of time-series data where several methods can be applied for forecasting. Although various time-series forecasting models are available, it is difficult to draw broad theoretical conclusions regarding their relative merits. This paper presents an empirical evaluation of several time-series models for forecasting COVID-19 cases, recoveries, and deaths in Saudi Arabia. In particular, seven forecasting models were trained using autoregressive integrated moving average, TBATS, exponential smoothing, cubic spline, simple exponential smoothing Holt, and HoltWinters. The models were built using publicly available daily data of COVID-19 during the period of 24 March 2020 to 5 April 2021 reported in Saudi Arabia. The experimental results indicate that the ARIMA model had a smaller prediction error in forecasting confirmed cases, which is consistent with results reported in the literature, while cubic spline showed better predictions for recoveries and deaths. As more data become available, a fluctuation in the forecasting-accuracy metrics was observed, possibly due to abrupt changes in the data. Full article
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Review
The Early Stage of the COVID-19 Outbreak in Tunisia, France, and Germany: A Systematic Mapping Review of the Different National Strategies
Int. J. Environ. Res. Public Health 2021, 18(16), 8622; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168622 - 15 Aug 2021
Viewed by 650
Abstract
The multitude of national strategies used against the COVID-19 pandemic makes it necessary to review and synthesize them in order to identify potential gaps and shortcomings, and to help prioritize future control efforts. This systematic mapping review is aimed at identifying the coronavirus [...] Read more.
The multitude of national strategies used against the COVID-19 pandemic makes it necessary to review and synthesize them in order to identify potential gaps and shortcomings, and to help prioritize future control efforts. This systematic mapping review is aimed at identifying the coronavirus pandemic management strategies adopted by France, Tunisia, and Germany during the early stage of the COVID-19 outbreak. A set of government websites in addition to the PubMed and Google Scholar databases were searched to identify scientific articles and institutional documents related to the national strategies of the three countries up until July 2020. The references included were mapped and narratively synthesized based on the pillars of the Monitoring and Evaluation Framework of the Strategic Preparedness and Response Plan defined by the World Health Organization. Of the 2765 records screened, 65 documents were included in the study. The analysis of these documents showed that Germany was the first country to implement mass screening of cases and that France was the first country to implement measures to impose general containment at the national level. It also showed that Tunisia was the only country to have imposed the confinement of passengers on repatriation flights in dedicated containment centers and at the expense of the state. Full article
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Article
Assessing the Knowledge and Attitude toward COVID-19 Vaccination in Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(15), 8185; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158185 - 02 Aug 2021
Viewed by 755
Abstract
COVID-19 was declared a pandemic by the WHO in March 2020. The most promising strategy to control the pandemic was to develop a vaccine. However, vaccination hesitancy is a major threat to world public health. Understanding the reasons behind this hesitancy might help [...] Read more.
COVID-19 was declared a pandemic by the WHO in March 2020. The most promising strategy to control the pandemic was to develop a vaccine. However, vaccination hesitancy is a major threat to world public health. Understanding the reasons behind this hesitancy might help in developing encouragement strategies. This cross-sectional study aimed to assess the knowledge and attitude toward the COVID-19 vaccine in Saudi Arabia. A total of 1599 responses were received; the overall vaccine acceptancy was 79.2%. Age, sex, and nationality of participants significantly predicted the vaccination status. A significantly higher proportion of participants, who reported being vaccinated, or intended to receive the vaccine, stated that the COVID-19 infection is dangerous, or varies from person to person; the vaccine is safe, and think there is a definite need for the vaccine (p < 0.001). The major encouragement factors to receive the vaccine were either confidence in the government decisions (54.8%), or the feeling of responsibility to stop the pandemic (48.7%), whereas the main discouraging factors were concerns about the insufficient clinical trials (11.4%), or the undiscovered side effects (11%). The results of this study indicate good acceptance toward the COVID-19 vaccine among residents of Saudi Arabia. Full article
Article
Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong: A Syndemic Perspective
Int. J. Environ. Res. Public Health 2021, 18(15), 8168; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158168 - 02 Aug 2021
Cited by 1 | Viewed by 1011
Abstract
The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity [...] Read more.
The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72–3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32–2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system. Full article
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Study Protocol
COVID-19 Vaccines Safety Tracking (CoVaST): Protocol of a Multi-Center Prospective Cohort Study for Active Surveillance of COVID-19 Vaccines’ Side Effects
Int. J. Environ. Res. Public Health 2021, 18(15), 7859; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157859 (registering DOI) - 25 Jul 2021
Cited by 2 | Viewed by 2612
Abstract
Background: Coronavirus disease (COVID-19) vaccine-related side effects have a determinant role in the public decision regarding vaccination. Therefore, this study has been designed to actively monitor the safety and effectiveness of COVID-19 vaccines globally. Methods: A multi-country, three-phase study including a cross-sectional survey [...] Read more.
Background: Coronavirus disease (COVID-19) vaccine-related side effects have a determinant role in the public decision regarding vaccination. Therefore, this study has been designed to actively monitor the safety and effectiveness of COVID-19 vaccines globally. Methods: A multi-country, three-phase study including a cross-sectional survey to test for the short-term side effects of COVID-19 vaccines among target population groups. In the second phase, we will monitor the booster doses’ side effects, while in the third phase, the long-term safety and effectiveness will be investigated. A validated, self-administered questionnaire will be used to collect data from the target population; Results: The study protocol has been registered at ClinicalTrials.gov, with the identifier NCT04834869. Conclusions: CoVaST is the first independent study aiming to monitor the side effects of COVID-19 vaccines following booster doses, and the long-term safety and effectiveness of said vaccines. Full article
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Article
The Impact of the COVID-19 Pandemic on Independent Creative Activities in Two Large Cities in Romania
Int. J. Environ. Res. Public Health 2021, 18(14), 7674; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147674 - 19 Jul 2021
Viewed by 882
Abstract
The COVID-19 pandemic has had both financial and activity-related effects on a number of areas of activity, among which those involving the creative industries have proved to be weak in their capacity to survive the halting of all events held in physical spaces. [...] Read more.
The COVID-19 pandemic has had both financial and activity-related effects on a number of areas of activity, among which those involving the creative industries have proved to be weak in their capacity to survive the halting of all events held in physical spaces. The long-term effects of the current health crisis are bringing about changes in cultural demand and offer and highlighting the need to adapt and to think of new ways of functioning. Taking its cue from this situation, the research underlying our article set out to investigate the ways in which Romania’s independent creative sector is adapting. We achieved this by means of conducting 25 semi-structured interviews and undertaking case studies of two cities that are among the most effervescent from the point of view of cultural and creative industries, Timișoara and Cluj-Napoca. With the strengthening of this sector as the aim in view, the forms of early social resilience we identified are capable in the short term of taking action to ensure the survival of some of the spaces; in the medium term, through activating mechanisms that encourage entrepreneurial spirit, they will be able to adapt to any external shock. Full article
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Article
Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult Population: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(13), 7073; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137073 - 02 Jul 2021
Cited by 1 | Viewed by 991
Abstract
Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the [...] Read more.
Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the Croatian adult general population before vaccination began. The specific objectives were to test differences regarding socio-demographic characteristics and to examine perceptions and attitudes about vaccination against COVID-19 considering the level of VL against COVID-19. A cross-sectional study with a translated and psychometrically tested questionnaire was conducted in 1227 participants before the start of vaccination, from 15 to 31 January 2021. The results show a medium level of vaccine literacy (M = 2.37, SD = 0.54) and a significant difference between functional and interactive-critical vaccine literacy (p < 0.001). The level of vaccine literacy grew with the level of education (p = 0.031) and reduced with age (p < 0.001). Participants who were employed, had chronic diseases, took medicine, or consumed alcohol daily had a lower level of vaccine literacy. There is room for progress in the COVID-19 VL level for the adult population in Croatia, especially at the interactive-critical VL, which could have an important role in people accepting the vaccine against the COVID-19 disease. A satisfactory level of vaccine literacy in the population is necessary because it can contribute to the fight against the pandemic. Full article
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Article
Assessing the Level of Awareness of COVID-19 and Prevalence of General Anxiety Disorder among the Hail Community, Kingdom of Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(13), 7035; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137035 - 30 Jun 2021
Viewed by 974
Abstract
Background: The COVID-19 pandemic has caused a major public health problem around the world. Therefore, the aim of the study was to assess the awareness and prevalence of General Anxiety Disorder (GAD) with regard to COVID-19 among the Hail community, in the Kingdom [...] Read more.
Background: The COVID-19 pandemic has caused a major public health problem around the world. Therefore, the aim of the study was to assess the awareness and prevalence of General Anxiety Disorder (GAD) with regard to COVID-19 among the Hail community, in the Kingdom of Saudi Arabia, in order to help health authorities to effectively control the pandemic. Methods: A cross-sectional online survey was completed by 412 participants living in Hail, Saudi Arabia. The questionnaire assessed demographic characteristics, knowledge, attitudes, and practices for the prevention of COVID-19, as well as psychological feelings in terms of GAD as an impact of the COVID-19 pandemic. Results: The study found that most of the respondents demonstrated good knowledge, attitudes, and practice for COVID-19 prevention. The elderly and employed demonstrated significant positive attitudes and practices (p < 0.05). Participants with a positive attitude were almost two and a half times (OR = 2.4; 95% CI: 1.54–3.99) more likely to have good practices. Additionally, the rural respondents were less likely (OR = 0.45; 95% CI: 0.21–0.96) to have a positive attitude. Married participants were more than one and a half (OR = 1.60; 95% CI: 1.04–2.44) times more likely to have a positive attitude. The prevalence of GAD was 21.8% and was significantly increased among participants with inadequate knowledge (OR = 2.01; 95% CI: 1.25–3.22), females (OR = 1.92; 95% CI: 1.19–3.09), individuals with chronic diseases (OR = 1.71; 95% CI: 1.02–2.86), and non-Saudi participants (OR = 2.44; 95% CI: 1.02–5.85). Conclusions: Ensuring a sufficient combination of relatively good levels of knowledge, positive attitudes, and desired practices serves as a good approach to preventing the spread of COVID-19. However, the increased prevalence of GAD requires the attention of policymakers. Therefore, a great emphasis should be placed on health awareness campaigns, with a focus on misconceptions and the provision of counseling. Full article
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Article
Self-Isolation and Quarantine during the UK’s First Wave of COVID-19. A Mixed-Methods Study of Non-Adherence
Int. J. Environ. Res. Public Health 2021, 18(13), 7015; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137015 - 30 Jun 2021
Viewed by 850
Abstract
Self-isolation and quarantine measures were introduced by the UK Government on 12 March 2020 as part of the ‘delay’ phase to control the spread of SARS-CoV-2. Non-adherence to self-isolation for 7 days after the development of symptoms is considered suboptimal and little is [...] Read more.
Self-isolation and quarantine measures were introduced by the UK Government on 12 March 2020 as part of the ‘delay’ phase to control the spread of SARS-CoV-2. Non-adherence to self-isolation for 7 days after the development of symptoms is considered suboptimal and little is known about adherence to quarantine for 14 days if a co-habitant developed symptoms. This study aims to analyse non-adherence behaviours to self-isolation and quarantine measures by identifying their potential psycho-social and demographic predictors and by exploring people’s accounts of their experiences with these measures. A mixed-methods convergent design was used, comprising an online survey (n = 681) completed by residents in six North London boroughs and qualitative interviews with a subsample of participants (n = 16). Findings identified not accessing community support, lack of control over leaving the house, and lack of perceived benefit and need to follow the rules as behaviours associated with non-adherence to quarantine (42.7%). Non-adherence to self-isolating measures (24.4%) was associated with individuals’ perceived lack of control over responsibilities, lack of control over leaving the house, uncertainty about symptoms experienced, lack of access to tests, and distrust in the Government. Adherence to self-isolation and quarantine could be improved through strengthening perceived benefit to self-isolate with messages emphasising its effectiveness, by implementing a two-way information system to support symptoms identification, and with Government-funded, locally supported packages at different levels (financial, food, and practical needs). Full article
Article
Knowledge, Attitudes, and Practices Regarding COVID-19 among Healthcare Workers in Uganda: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2021, 18(13), 7004; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137004 - 30 Jun 2021
Cited by 2 | Viewed by 987
Abstract
Healthcare workers (HCWs) are at high risk of COVID-19. However, data on HCWs’ knowledge, attitudes, and practices (KAP) toward COVID-19 are limited. Between September and November 2020, we conducted a questionnaire-based COVID-19 KAP survey among HCWs at three hospitals in Uganda. We used [...] Read more.
Healthcare workers (HCWs) are at high risk of COVID-19. However, data on HCWs’ knowledge, attitudes, and practices (KAP) toward COVID-19 are limited. Between September and November 2020, we conducted a questionnaire-based COVID-19 KAP survey among HCWs at three hospitals in Uganda. We used Bloom’s cut-off of ≥80% to determine sufficient knowledge, good attitude, and good practice, and multivariate Poisson regression with robust variance for statistical analysis. Of 717 HCWs invited to participate, 657 (91.6%) agreed and were enrolled. The mean age (standard deviation) of enrollees was 33.2 (10.2) years; most were clinical HCWs (64.7%) and had advanced secondary school/other higher-level education (57.8%). Overall, 83.9% had sufficient knowledge, 78.4% had a positive attitude, and 37.0% had good practices toward COVID-19. Factors associated with KAP were: Knowledge: being a clinical HCW (aRR: 1.12; 95% CI: 1.02–1.23) and previous participation in health research (aRR: 1.10; 95% CI: 1.04–1.17); Attitude: age > 35 years (aRR: 0.88; 95% CI: 0.79–0.98); Practice: being a clinical HCW (aRR: 1.91; 95% CI: 1.41–2.59). HCWs in Uganda have good knowledge and positive attitude but poor practices towards COVID-19. Differences in COVID-19 KAP between clinical and non-clinical HCWs could affect uptake of COVID-19 interventions including vaccination. Full article
Article
Is There a Temporal Relationship between COVID-19 Infections among Prison Staff, Incarcerated Persons and the Larger Community in the United States?
Int. J. Environ. Res. Public Health 2021, 18(13), 6873; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136873 - 26 Jun 2021
Cited by 1 | Viewed by 1322
Abstract
Background: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. Methods: We employed population-standardized regressions with fixed [...] Read more.
Background: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. Methods: We employed population-standardized regressions with fixed effects for prisons to predict the number of active cases of COVID-19 among incarcerated persons using data from the Federal Bureau of Prisons (BOP) for the months of March to December in 2020 for 63 prisons. Results: There is a significant relationship between the COVID-19 prevalence among staff, and through them, the larger community, and COVID-19 prevalence among incarcerated persons in the US federal prison system. When staff rates are low or at zero, COVID-19 incidence in the larger community continues to have an association with COVID-19 prevalence among incarcerated persons, suggesting possible pre-symptomatic and asymptomatic transmission by staff. Masking policies slightly reduced COVID-19 prevalence among incarcerated persons, though the association between infections among staff, the community, and incarcerated persons remained significant and strong. Conclusion: The relationship between COVID-19 infections among staff and incarcerated persons shows that staff is vital to infection control, and correctional administrators should also focus infection containment efforts on staff, in addition to incarcerated persons. Full article
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Article
Impact of the COVID-19 Pandemic on Patients Affected by Non-Communicable Diseases in Europe and in the USA
Int. J. Environ. Res. Public Health 2021, 18(13), 6697; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136697 - 22 Jun 2021
Cited by 1 | Viewed by 784
Abstract
An international online patient community, Carenity, conducted a patient study in two independent waves among adults affected by non-communicable diseases (NCDs) in Europe and in the United States of America (USA). The study aimed to assess the real time impact of the coronavirus [...] Read more.
An international online patient community, Carenity, conducted a patient study in two independent waves among adults affected by non-communicable diseases (NCDs) in Europe and in the United States of America (USA). The study aimed to assess the real time impact of the coronavirus disease 2019 (COVID-19) on the medical conditions of patients with NCDs, their access to health care, and their adaptation to daily life as well as to describe their sources of information on COVID-19 and their needs for specific information and support. During the pandemic, 50% of the patients reported a worsening of their medical condition, and 17% developed a new disease. Additionally, 26% of the respondents reported an impact of the pandemic on regular/long-term treatment intake. 54% of the patients felt very or completely socially isolated and reported a strong impact of the COVID-19 pandemic on their stress level and state of mind, with higher levels observed in the USA compared to Europe. 59% of the respondents wished to have received additional information regarding the risks associated to their medical condition during the pandemic. Television was the most used source of information, whereas physicians were the most trusted one. This study describes the substantial impact of the COVID-19 pandemic on NCD patients. Full article
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Article
Modeling Provincial Covid-19 Epidemic Data Using an Adjusted Time-Dependent SIRD Model
Int. J. Environ. Res. Public Health 2021, 18(12), 6563; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126563 - 18 Jun 2021
Cited by 2 | Viewed by 763
Abstract
In this paper, we develop a forecasting model for the spread of COVID-19 infection at a provincial (i.e., EU NUTS-3) level in Italy by using official data from the Italian Ministry of Health integrated with data extracted from daily official press conferences of [...] Read more.
In this paper, we develop a forecasting model for the spread of COVID-19 infection at a provincial (i.e., EU NUTS-3) level in Italy by using official data from the Italian Ministry of Health integrated with data extracted from daily official press conferences of regional authorities and local newspaper websites. This data integration is needed as COVID-19 death data are not available at the NUTS-3 level from official open data channels. An adjusted time-dependent SIRD model is used to predict the behavior of the epidemic; specifically, the number of susceptible, infected, deceased, recovered people and epidemiological parameters. Predictive model performance is evaluated using comparison with real data. Full article
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Article
Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study
Int. J. Environ. Res. Public Health 2021, 18(12), 6351; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126351 - 11 Jun 2021
Viewed by 968
Abstract
In 2020, Taiwan’s healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent [...] Read more.
In 2020, Taiwan’s healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent ED users remains unknown. This cohort study determined the impact of the COVID-19 pandemic on healthcare-seeking behaviors among frequent ED users at Taipei City Hospital, Taiwan. We included ED users aged ≥ 18 years admitted to Taipei City Hospital during February 2019–January 2020 (before the pandemic) and February 2020–January 2021 (during the pandemic). Frequent ED users were patients with four or more ED visits per year. Stepwise logistic regression was performed to identify predictors of frequent ED use during the COVID-19 pandemic. Frequent ED users had shorter hospital stays in the ED during the pandemic. After adjusting for sociodemographic factors and other covariates, patients with a triage status of level 4–5, pneumonia diagnosis, giddiness, or dyspnea were more likely frequent ED visitors during the COVID-19 pandemic. To reduce the risk of acquiring COVID-19, it is important to utilize territorial healthcare or telehealth to avoid inappropriate ED visits for patients with a low level of risk or chronic disease. Full article
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Article
Pregnancy and COVID-19 Pandemic Perception in Malaysia: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(11), 5762; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115762 - 27 May 2021
Viewed by 1118
Abstract
Pregnant women are susceptible to COVID-19 complications due to gestation-related physiological changes. We aimed to evaluate the level of maternal knowledge, perception, and practice during the pandemic. A cross-sectional study was conducted during the Malaysian Movement Control Order (MCO) between April and June [...] Read more.
Pregnant women are susceptible to COVID-19 complications due to gestation-related physiological changes. We aimed to evaluate the level of maternal knowledge, perception, and practice during the pandemic. A cross-sectional study was conducted during the Malaysian Movement Control Order (MCO) between April and June 2020. A self-administered electronic questionnaire that included the knowledge and practice domains was distributed. A newly designed set of questions was used to evaluate (1) women’s perception of MCO and (2) maternal experience, which was subdivided into clinical care provision and maternal anxiety. The survey response rate was 93% with the final number for analysis of 415. The majority of women (95%) demonstrated an adequate level of knowledge on COVID-19, whilst 99% had a good practice. We found that tertiary education (p < 0.001), employment status (p = 0.03), higher household income (p < 0.001), and multiple sources of information (p < 0.001) were independent predictors of adequate maternal knowledge on COVID-19. Women with adequate knowledge also reported a more positive perception of MCO (p < 0.001) and better obstetric care experience (p = 0.037), as did those of Malay ethnicity. Younger (p < 0.001) and nulliparous (p = 0.01) women demonstrated greater anxiety levels. The majority of our women reported good practice and adequate knowledge, which contributed to a positive perception of MCO and better maternal obstetric experience. First-time mothers may benefit from extra support and reassurance during the pandemic to alleviate maternal anxiety. Full article
Article
Pregnancy Outcome, Antibodies, and Placental Pathology in SARS-CoV-2 Infection during Early Pregnancy
Int. J. Environ. Res. Public Health 2021, 18(11), 5709; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115709 - 26 May 2021
Cited by 1 | Viewed by 798
Abstract
There are reports that pregnant women infected with SARS-CoV-2 not only have increased morbidity but also increased complications and evidence of maternal and fetal vascular malperfusion on placental pathology. This was a retrospective study of pregnant women diagnosed with SARS-CoV-2 infection after March [...] Read more.
There are reports that pregnant women infected with SARS-CoV-2 not only have increased morbidity but also increased complications and evidence of maternal and fetal vascular malperfusion on placental pathology. This was a retrospective study of pregnant women diagnosed with SARS-CoV-2 infection after March 2020. The results of reverse transcription polymerase chain reaction testing and IgM and IgG antibody testing of the amniotic fluid, cord blood, placenta, and maternal blood were confirmed at delivery. Placentas were evaluated histopathologically. The study included seven pregnant women diagnosed with SARS-CoV-2 infection during pregnancy at a mean gestational age of 14.5 weeks. Out of the seven women, five were infected during the first trimester. The mean gestational age at delivery was 38.4 weeks. The reverse transcription polymerase chain reaction results for maternal plasma, cord blood, placenta, and amniotic fluid were negative and IgG antibodies were detected in maternal plasma and cord blood. On placental pathology, maternal vascular malperfusion was found in only one case, fetal vascular malperfusion in four cases, and inflammatory changes were found in two cases. Pregnancy outcomes for women diagnosed with SARS-CoV-2 infection during early pregnancy are positive and it is likely that maternal antibodies are passed to the fetus, which results in a period of immunity. Full article
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Article
Disposal Behavior of Used Masks during the COVID-19 Pandemic in the Moroccan Community: Potential Environmental Impact
Int. J. Environ. Res. Public Health 2021, 18(8), 4382; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084382 - 20 Apr 2021
Cited by 3 | Viewed by 2154
Abstract
The spread of coronavirus disease-2019 (COVID-19) levied on the Moroccan authorities to increase their mask production capacity, which reached up to 12 million facemask units produced per day. This increase in personal protective equipment (PPE) production and consumption is an efficient tool to [...] Read more.
The spread of coronavirus disease-2019 (COVID-19) levied on the Moroccan authorities to increase their mask production capacity, which reached up to 12 million facemask units produced per day. This increase in personal protective equipment (PPE) production and consumption is an efficient tool to address the spread of COVID-19. However, this results in more plastic and microplastic debris being added into the land and marine environments, which will harm the ecosystem, wildlife, and public health. Such a situation needs deep individual behavior observation and tracking, as well as an assessment of the potential environmental impact of this new type of waste. For this reason, we assessed the Moroccan population’s behavior regarding the use and disposal of facemasks and gloves. An exploratory survey was prepared and shared via social media and email with the population of Rabat-Salé-Kénitra and Casablanca-Settat regions. Additionally, we calculated the estimated number and weight of daily and weekly PPE used and generated by the studied regions. The survey showed that 70% of the respondents threw their discarded masks and gloves in house trash or trash bins after their first use, whereas nearly 30% of respondents admitted that they did not wear masks because they did not leave their homes during the lockdown, while from the 70% of facemask users, more than five million (equivalent to 40,000 kg) of facemasks would be generated and disposed of daily by the community of these regions, which presents 35% of the total engendered facemask waste in Morocco. Accordingly, the environment impact of facemasks showed that the greenhouse gas footprint is about 640 kT CO2 eq./year for the whole of Morocco, while the energy footprint is around 60,000 GWh/year. Furthermore, an urgent multidisciplinary environmental assessment of the potential impact of PPE must be conducted among the 12 Moroccan regions. This study demonstrated the real impact of the COVID-19 PPE on human behavior and the environment and suggests a need for providing new didactic management of facemasks and gloves. Full article
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Article
Does International Travel Frequency Affect COVID-19 Biosecurity Behavior in the United States?
Int. J. Environ. Res. Public Health 2021, 18(8), 4111; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084111 - 13 Apr 2021
Cited by 3 | Viewed by 1181
Abstract
High-quality biosecurity practices are critical to restarting international tourism. Effective market segmentation improves the communication and efficacy of health advice. Travel frequency is an important basis for health-related consumer segmentation, as it is closely related to risk of greater exposure to infectious diseases. [...] Read more.
High-quality biosecurity practices are critical to restarting international tourism. Effective market segmentation improves the communication and efficacy of health advice. Travel frequency is an important basis for health-related consumer segmentation, as it is closely related to risk of greater exposure to infectious diseases. Theoretically grounded studies of tourist biosecurity behavior and travel frequency have largely been neglected, although insights into practices and attitudes are especially relevant for coronavirus disease of 2019 (COVID-19 (coronavirus disease of 2019) health responses. Therefore, this research constructed and tested a conceptual model applying Value–Attitude–Behavior theory to US travelers to see whether the frequency of international travel affected tourist COVID-19 related biosecurity behavior. US respondents were drawn from a panel using a quota sampling technique according to the age and gender of American outbound tourists. An online survey was administered in September 2020. The responses (n = 395) of those who traveled internationally within five years were analyzed utilizing partial least squares-structural equation modeling (PLS-SEM) with multi-group analysis. Travel frequency significantly affects biosecurity behavior. High travel frequency (≥8 trips) has the strongest effect of value on biosecurity attitudes, personal norms, social norms, and biosecurity social norms, leading to biosecurity behaviors. Biosecurity behaviors pertaining to medium travel frequency (4–7 trips) are significantly influenced by personal norms. At low travel frequency (1–3 trips) levels, biosecurity behaviors are stimulated by biosecurity attitudes and social norms, showing the highest predictive power among the three groups. This work provides insights into international travel consumer biosecurity practices and behavior. From a market segmentation perspective, the levels of international travel frequency have various influences on biosecurity values, attitudes, personal norms, social norms, and behaviors. The biosecurity behaviors of low-frequency travelers are found to be the most significant of the three groups, suggesting that individuals who travel less frequently are more likely to practice responsible COVID-19 biosecurity behavior. Full article
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Article
Knowledge, Attitudes, and Practices Related to COVID-19 Among Malawi Adults: A Community-Based Survey
Int. J. Environ. Res. Public Health 2021, 18(8), 4090; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084090 - 13 Apr 2021
Cited by 3 | Viewed by 903
Abstract
Introduction: It is well-recognized that containing COVID-19 successfully is determined by people’s prevention measures which are related to their knowledge, attitudes, and practices (KAP). This perception has attracted attention in low- and middle-income countries (LMIC) due to their fragile health systems and economies. [...] Read more.
Introduction: It is well-recognized that containing COVID-19 successfully is determined by people’s prevention measures which are related to their knowledge, attitudes, and practices (KAP). This perception has attracted attention in low- and middle-income countries (LMIC) due to their fragile health systems and economies. The objective of this study was to understand how residents in Malawi perceived COVID-19, to determine the factors related to KAP. Methods: A semi-structured questionnaire was used for the data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistic, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. Results: A total of 580 questionnaires were involved. The mean knowledge, attitude, and practice (KAP) scores were 10 (SD = ±3, range: 3–19), 16 (SD = ±4, range: 5–25), and 2 (SD = ±1, range: 0–5), respectively. Lack of money and resources (39%) was the biggest challenge for people who practice prevention measures. Among the participants, the radio (70%) and friends/family (56%) were the main sources of information. A higher economic status was associated with better KAP. Conclusions: A low level of KAP was detected among the population. The people faced challenges regarding a lack of necessary preventive resources and formal information channels. The situation was worse considering vulnerable population who had low economic status. Further all-round health education is urgently needed along with providing adequate health supplies and ensuring proper information management. Full article
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Article
Public KAP towards COVID-19 and Antibiotics Resistance: A Malaysian Survey of Knowledge and Awareness
Int. J. Environ. Res. Public Health 2021, 18(8), 3964; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083964 - 09 Apr 2021
Cited by 3 | Viewed by 1439
Abstract
This study aimed to assess the knowledge of the Malaysian public on the coronavirus disease 2019 (COVID-19) and antibiotics, the practice of preventive measures and attitude towards the new norms. The web-based questionnaire was disseminated online from 1 to 31 October 2020. Out [...] Read more.
This study aimed to assess the knowledge of the Malaysian public on the coronavirus disease 2019 (COVID-19) and antibiotics, the practice of preventive measures and attitude towards the new norms. The web-based questionnaire was disseminated online from 1 to 31 October 2020. Out of 2117 respondents, 1405 (66.4%) knew that transmission of COVID-19 virus could happen in asymptomatic people. In term of antibiotics knowledge, 779 (36.8%) respondents were aware that taking antibiotics could not speed up the recovery process of all infections. Less than half of the respondents (49.0%) knew that antibiotics are effective against bacterial infection only. Majority (92.3%) practiced good preventive measures. Majority of the respondents strongly agreed that quarantine should be made mandatory for all arrival from overseas (97.2%) and wearing face masks should be made mandatory in all public areas (94.0%). Respondents of Chinese ethnicity (p = 0.008), middle-aged (p = 0.002), with tertiary education (p = 0.015) and healthcare related education (p < 0.001), from the higher income groups (p = 0.001) were more likely to have better knowledge on COVID-19. The Malaysian public demonstrated good knowledge towards COVID-19, adequate practice of preventive measures and high acceptance towards the new norm. Knowledge on antibiotics use and resistance was poor, which warrants attention from the health authorities. Full article
Article
Fluctuations in National Resilience during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(8), 3876; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083876 - 07 Apr 2021
Cited by 1 | Viewed by 652
Abstract
The current study measured national resilience (NR) in three different time frames during the coronavirus disease 2019 (COVID-19) pandemic in Israel (N = 804). We investigated two main issues: first, the direction and extent of NR changes during the crisis, and second, [...] Read more.
The current study measured national resilience (NR) in three different time frames during the coronavirus disease 2019 (COVID-19) pandemic in Israel (N = 804). We investigated two main issues: first, the direction and extent of NR changes during the crisis, and second, the predictors of NR. The results show the following: (a) the average NR score declined significantly across the three repeated measures, with a medium-size effect. (b) Three of the four identified NR factors declined significantly across the three measurements: belief in the government and the prime minister (large effect size); belief in civil society; and patriotism (medium effect size); while trust in Israeli national institutions was the lowest and did not weaken significantly. (c) Analyzing the prediction of NR factors indicated that the levels of the three NR factors mainly reflected one’s political attitudes, sense of political and economic threats, rather than health threats. One conclusion concerns the importance of trust in leadership as the most sensitive component in the decline of national resilience following a crisis. Full article
Article
Knowledge and Perception of COVID-19 Pandemic during the First Wave (Feb–May 2020): A Cross-Sectional Study among Italian Healthcare Workers
Int. J. Environ. Res. Public Health 2021, 18(7), 3767; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073767 - 04 Apr 2021
Cited by 1 | Viewed by 920
Abstract
Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers’ (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey® and distributed [...] Read more.
Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers’ (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey® and distributed the link through Facebook and Whatsapp closed groups. The research instrument was a 31 items questionnaire distributed using Facebook and Whatsapp. It was conducted in Italy from February to May 2020. The study participants were general practitioners, pediatricians and other health professionals. A total of 958 participants were included: 320 (33.4%) general practitioners, 248 (25.9%) pediatricians and 390 (40.7%) other health professionals. The highest response rate was from Northern Italy (48.1%), followed by Central Italy (29.9%) and Southern Italy (22.0%). Less than a half (46%) of respondents felt they had a good level of information of COVID-19 case definition and of national prevention guidelines. Respondents reported to have changed their clinical practice; particularly, they increased the use of masks (87.1%, p < 0.001), disinfection and sanitization of doctors’ offices (75.8%, p < 0.001), the use of protective glasses (71.2%, p < 0.001), alcoholic hand solution (71.2%, p < 0.001), and hand washing (31.8%, p = 0.028). HCWs are at high risk of infection; less than a half of them felt adequately prepared to face COVID-19 pandemic, so they need extensive information and awareness of the disease to take adequate precautionary measures, and they are crucial to disseminate good practices. Full article
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Article
COVID-19 Pandemic Is Associated with an Adverse Impact on Burnout and Mood Disorder in Healthcare Professionals
Int. J. Environ. Res. Public Health 2021, 18(7), 3654; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073654 - 01 Apr 2021
Viewed by 1210
Abstract
The coronavirus disease 2019 (COVID-19) pandemic results in a profound physical and mental burden on healthcare professionals. This study aims to evaluate burnout status and mood disorder of healthcare workers during this period. An online questionnaire was voluntarily answered by eligible adult employees [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic results in a profound physical and mental burden on healthcare professionals. This study aims to evaluate burnout status and mood disorder of healthcare workers during this period. An online questionnaire was voluntarily answered by eligible adult employees in a COVID-19 specialized medical center. The major analysis included the burnout status and mood disorder. Factors related to more severe mood disorder were also identified. A total of 2029 participants completed the questionnaire. There were 901 (44.4%) and 923 (45.5%) participants with moderate to severe personal and work-related burnout status, respectively. Nurses working in the emergency room (ER), intensive care unit (ICU)/isolation wards, and general wards, as well as those with patient contact, had significantly higher scores for personal burnout, work-related burnout, and mood disorder. This investigation identified 271 participants (13.35%) with moderate to severe mood disorder linked to higher personal/work-related burnout scores and a more advanced burnout status. Univariate analysis revealed that nurses working in the ER and ICU/isolation wards were associated with moderate to severe mood disorder risk factors. Multivariate analysis demonstrated that working in the ER (OR, 2.81; 95% CI, 1.14–6.90) was the only independent risk factor. More rest, perquisites, and an adequate supply of personal protection equipment were the most desired assistance from the hospital. Compared with the non-pandemic period (2019), employees working during the COVID-19 pandemic (2020) have higher burnout scores and percentages of severe burnout. In conclusion, this study suggests that the COVID-19 pandemic has had an adverse impact on healthcare professionals. Adequate measures should be adopted as early as possible to support the healthcare system. Full article
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Article
Is It Possible to Be Happy during the COVID-19 Lockdown? A Longitudinal Study of the Role of Emotional Regulation Strategies and Pleasant Activities in Happiness
Int. J. Environ. Res. Public Health 2021, 18(6), 3211; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063211 - 19 Mar 2021
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Abstract
This study aimed to longitudinally analyze the role played by two emotional regulation strategies (cognitive reappraisal and expressive suppression), through the mediating effect of engagement in pleasant activities during lockdown, in changes in affective and cognitive happiness in comparison with pre-pandemic levels. Eighty-eight [...] Read more.
This study aimed to longitudinally analyze the role played by two emotional regulation strategies (cognitive reappraisal and expressive suppression), through the mediating effect of engagement in pleasant activities during lockdown, in changes in affective and cognitive happiness in comparison with pre-pandemic levels. Eighty-eight participants from a community sample were evaluated at two timepoints. At timepoint 1 (before the COVID-19 pandemic), participants were evaluated on emotional regulation and cognitive and affective happiness. At timepoint 2 (during the COVID-19 lockdown), participants were evaluated on cognitive and affective happiness and the frequency with which they engaged in pleasant activities. We found an optimal fit of the proposed model in which cognitive reappraisal was significantly related to engagement in more pleasant activities during the lockdown. In turn, these pleasant activities were related to more affective happiness during the lockdown (compared with pre-pandemic levels), and this affective happiness was associated with greater cognitive happiness. In conclusion, cognitive reappraisal was a protective factor for affective and cognitive happiness through the mediating role of engagement in pleasant activities during lockdown. Limitations and future lines of investigation are discussed. Full article
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Article
Experimental Investigation of Aerosol and CO2 Dispersion for Evaluation of COVID-19 Infection Risk in a Concert Hall
Int. J. Environ. Res. Public Health 2021, 18(6), 3037; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063037 - 16 Mar 2021
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Abstract
The dispersion of small aerosols in a concert hall is experimentally studied for estimating the risk of infection with SARS-CoV-2 during a concert. A mannequin was modified to emit an air stream containing aerosols and CO2. The aerosols have a size [...] Read more.
The dispersion of small aerosols in a concert hall is experimentally studied for estimating the risk of infection with SARS-CoV-2 during a concert. A mannequin was modified to emit an air stream containing aerosols and CO2. The aerosols have a size distribution with a peak diameter (δ) close to 0.3 µm and a horizontal initial particle velocity (vp,x) of 2.4 m/s. The CO2-concentration (c) emitted simultaneously is 7500 ppm. It is investigated, if the spatial dissipation of aerosols and CO2 can be correlated. This would allow the use of technically easier CO2 measurements to monitor compliance with aerosol concentration limits. Both aerosol and CO2 concentrations are mapped by different sensors placed around the mannequin. As a result, no significant enrichment of aerosols and CO2 was obtained outside a radius of 1.5 m when the fresh air ventilation in the concert hall has a steady vertical flow with a velocity of vg,z=0.05 m/s and the installed ventilation system was operating at an air change rate per hour (ACH) of 3, corresponding to an air exchange rate of 51,000 m3/h. A Pearson correlation coefficient of 0.77 was obtained for CO2 and aerosol concentrations measured simultaneously at different positions within the concert hall. Full article
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