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Topical Collection "Outbreak of a Novel Coronavirus: A Global Health Threat"

Editor

Dr. Jianyong Wu
E-Mail Website
Guest Editor
Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599, USA
Interests: data science; global environmental health; infectious diseases; spatial epidemiology
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

The outbreak of the novel coronavirus (COVID-19) emerged in Wuhan in December 2019 and has become an ongoing epidemic in China. The outbreak is spreading rapidly. So far, over 60,000 cases have been confirmed and the death toll has surpassed 1500. Human infections by the virus were also reported in more than 20 countries outside China, such as Japan, Singapore, and Thailand. The World Health Organization (WHO) declared the outbreak of the novel coronavirus a global health emergency

Currently, the priority is to contain the spreading of the virus and help patients to recover. Meanwhile, it is urgent to understand how the virus is transmitted between people, what factors lead to the outbreak, what are patterns and future trends of outbreak, and what are efficient ways to curb the outbreak and treat patients? To answer these questions, it needs researchers, doctors, and health care professionals from cross-disciplinary fields to work together to share data, experience, and insights.

This Topical Collection solicits papers that help to understand the outbreak of a novel coronavirus from global health perspectives. Papers closely related to the topics below are particularly welcome:

  • Epidemiological characteristics of the outbreak of a novel coronavirus
  • Environmental fate and transmission pathway of a novel coronavirus;
  • Pattern recognition and prediction of the outbreak using data analytics
  • Experience and insight in preventing and curbing the outbreak  
  • Global health influence of the outbreak of a novel coronavirus

High quality research and review papers will be considered.

Dr. Jianyong Wu
Guest 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

  • Global health
  • Transmission pathway
  • Epidemiology
  • Pattern recognition
  • Predictive modeling
  • Prevention and control

Published Papers (48 papers)

2021

Jump to: 2020

Article
To Wear or Not to Wear: Analysis of Individuals’ Tendency to Wear Masks during the COVID-19 Pandemic in China
by , and
Int. J. Environ. Res. Public Health 2021, 18(21), 11298; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111298 (registering DOI) - 27 Oct 2021
Abstract
During the COVID-19 pandemic, the percentage of Chinese people wearing masks was very high, as was the acceptance and initiative toward mask wearing. This national action merits our exploration of the psychological reasons as well as the general social and environmental factors behind [...] Read more.
During the COVID-19 pandemic, the percentage of Chinese people wearing masks was very high, as was the acceptance and initiative toward mask wearing. This national action merits our exploration of the psychological reasons as well as the general social and environmental factors behind this behavior. In this article, we integrated the Unified Theory of Acceptance and Use of Technology 2 (UTAUT 2) as well as Health Belief Model and set up a mask acceptance model. We used a questionnaire survey and received 337 valid questionnaires. The results indicate that social influence, perceived susceptibility to COVID-19, perceived hedonic benefit (appearance enhancement), and a perceived barrier (hindrance to communication) exert significant influences on the willingness to wear masks. Meanwhile, social influence plays an intermediary role between interdependent self-construal and intention to wear a mask. We hope to reveal the micro psychological reasons for the national action and reflect on the cultural characteristics of Chinese people in the special context of the COVID-19 pandemic. Full article
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Article
School Teachers’ Self-Reported Fear and Risk Perception during the COVID-19 Pandemic—A Nationwide Survey in Germany
Int. J. Environ. Res. Public Health 2021, 18(17), 9218; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179218 - 01 Sep 2021
Viewed by 573
Abstract
With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited [...] Read more.
With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited to take part in a cross-sectional COVID-19-specific online survey. Descriptive statistical analysis was performed. Factors associated with teachers’ fears of contracting the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were evaluated with an adjusted multivariable regression analysis. The median age of the 6753 participating teachers was 43 years, and 77% were female. Most teachers worked in high schools (29%) and elementary schools (26%). The majority of participants (73%) feared contracting SARS-CoV-2 at school, while 77% intended to receive their COVID-19 vaccination. Ninety-eight percent considered students to pose the greatest risk. Female and younger teachers were significantly more anxious to get infected and teachers who opposed the re-opening of schools had significantly higher odds of being more anxious (p < 0.001). To the authors’ knowledge, this is the first study to describe teachers’ risk perception of COVID-19 and their attitudes towards vaccinations in a nationwide survey. The anxiety correlates with the COVID-19 protection measures demanded and appears to be a driving factor rather than rational logic. Full article
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Article
Family E-Chat Group Use Was Associated with Family Wellbeing and Personal Happiness in Hong Kong Adults amidst the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(17), 9139; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179139 - 30 Aug 2021
Viewed by 533
Abstract
Instant messaging (IM) is increasingly used for family communication amidst the COVID-19 pandemic. However, evidence remains scarce on how family e-chat groups were used and their associations with family and individual wellbeing amidst the pandemic. The numbers of family e-chat groups, functions used, [...] Read more.
Instant messaging (IM) is increasingly used for family communication amidst the COVID-19 pandemic. However, evidence remains scarce on how family e-chat groups were used and their associations with family and individual wellbeing amidst the pandemic. The numbers of family e-chat groups, functions used, and messages sent and received daily in groups were reported by 4890 adults in May 2020, and their associations with family wellbeing and personal happiness and the mediation effect of family communication quality were examined. Results showed that sending/receiving text messages was most commonly used, followed by receiving/sending photos/pictures, making voice calls, receiving/sending short videos and voice messages, and making video calls. Women and older people used more non-text functions. Higher levels of family wellbeing and personal happiness were associated with having more groups, receiving/sending photos/pictures, video calls, more IM functions used, and more IM messages received/sent daily. Forty-six point two to seventy-five point five percent of their associations with more groups and more functions used were mediated by family communication quality. People having more family e-chat groups and using more IM functions may be more resilient amidst the pandemic, while those without or with low use of family e-chat groups amidst the pandemic would need more attention and assistance in the presence of social distancing. Full article
Review
The Pandemic beyond the Pandemic: A Scoping Review on the Social Relationships between COVID-19 and Antimicrobial Resistance
Int. J. Environ. Res. Public Health 2021, 18(16), 8766; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168766 - 19 Aug 2021
Cited by 1 | Viewed by 849
Abstract
The social sciences are essential to include in the fight against both public health challenges of antimicrobial resistance (AMR) and COVID-19. In this scoping review, we document what social science knowledge has been published about the social relationship between COVID-19 and AMR and [...] Read more.
The social sciences are essential to include in the fight against both public health challenges of antimicrobial resistance (AMR) and COVID-19. In this scoping review, we document what social science knowledge has been published about the social relationship between COVID-19 and AMR and which social science interventions are suggested to address this social relationship. We analysed 23 peer-reviewed articles published between 2019 and 2021. Results emphasize that changes in antibiotic prescription behaviour, misinformation, over-burdened health systems, financial hardship, environmental impact and gaps in governance might increase the improper access and use of antibiotics during the COVID-19 pandemic, increasing AMR. The identified social sciences transformation strategies include social engagement and sensitisation, misinformation control, health systems strengthening, improved infection prevention and control measures, environmental protection, and better antimicrobial stewardship and infectious diseases governance. The review emphasizes the importance of interdisciplinary research in addressing both AMR and COVID-19. Full article
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Review
What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus?
Int. J. Environ. Res. Public Health 2021, 18(16), 8638; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168638 - 16 Aug 2021
Cited by 2 | Viewed by 1180
Abstract
The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not [...] Read more.
The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases. Full article
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Article
Inactivation of Replication-Competent Vesicular Stomatitis Virus as SARS-CoV-2 Surrogate on Common Surfaces by Disinfectants
Int. J. Environ. Res. Public Health 2021, 18(14), 7714; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147714 - 20 Jul 2021
Viewed by 710
Abstract
Surface disinfection is part of a larger mitigation strategy to prevent the spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus causing coronavirus disease-2019 (COVID-19). Research evaluating the time, nature, and extent of surface disinfection of replication-competent viruses is needed. We evaluated [...] Read more.
Surface disinfection is part of a larger mitigation strategy to prevent the spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus causing coronavirus disease-2019 (COVID-19). Research evaluating the time, nature, and extent of surface disinfection of replication-competent viruses is needed. We evaluated the efficacy of two disinfectants against a replication-competent SARS-CoV-2 surrogate on three common public surfaces. Vesicular stomatitis virus expressing green fluorescent protein (VSV-GFP) was our replication-competent SARS-CoV-2 surrogate. Disinfection occurred using Super Sani-Cloth Germicidal Disposable Wipes and Oxivir Tb spray per manufacturer instructions to test the efficacy at reducing the presence, viability, and later replication of VSV-GFP on stainless steel, laminate wood, and porcelain surfaces using standardized methods after recovery and toxicity testing. During the main trials, we placed 100 µL spots of VSV-GFP at viral titers of 108, 107, and 106 PFU/mL on each surface prior to disinfection. Trials were completed in triplicate and post-disinfection measurements on each surface were compared to the measurements of non-disinfected surfaces. Disinfectants were considered efficacious when ≥3-log10 reduction in the number of infectious VSV-GFP virus units was observed on a given surface during all trials. Both disinfectants produced a ≥3.23-log10 reduction in infectious VSV-GFP virus unit numbers, with all trials showing no viable, replication-competent VSV-GFP present on any tested surface. The two disinfectants eliminated the presence, viability, and later replication of VSV-GFP, our SARS-CoV-2 surrogate, on all surfaces. This information suggests that, if following manufacturer instructions, overcleaning surfaces with multiple disinfectant solutions may be unnecessary. Full article
Article
Which National Factors Are Most Influential in the Spread of COVID-19?
Int. J. Environ. Res. Public Health 2021, 18(14), 7592; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147592 - 16 Jul 2021
Cited by 1 | Viewed by 718
Abstract
The outbreak of the novel COVID-19, declared a global pandemic by WHO, is the most serious public health threat seen in terms of respiratory viruses since the 1918 H1N1 influenza pandemic. It is surprising that the total number of COVID-19 confirmed cases and [...] Read more.
The outbreak of the novel COVID-19, declared a global pandemic by WHO, is the most serious public health threat seen in terms of respiratory viruses since the 1918 H1N1 influenza pandemic. It is surprising that the total number of COVID-19 confirmed cases and the number of deaths has varied greatly across countries. Such great variations are caused by age population, health conditions, travel, economy, and environmental factors. Here, we investigated which national factors (life expectancy, aging index, human development index, percentage of malnourished people in the population, extreme poverty, economic ability, health policy, population, age distributions, etc.) influenced the spread of COVID-19 through systematic statistical analysis. First, we employed segmented growth curve models (GCMs) to model the cumulative confirmed cases for 134 countries from 1 January to 31 August 2020 (logistic and Gompertz). Thus, each country’s COVID-19 spread pattern was summarized into three growth-curve model parameters. Secondly, we investigated the relationship of selected 31 national factors (from KOSIS and Our World in Data) to these GCM parameters. Our analysis showed that with time, the parameters were influenced by different factors; for example, the parameter related to the maximum number of predicted cumulative confirmed cases was greatly influenced by the total population size, as expected. The other parameter related to the rate of spread of COVID-19 was influenced by aging index, cardiovascular death rate, extreme poverty, median age, percentage of population aged 65 or 70 and older, and so forth. We hope that with their consideration of a country’s resources and population dynamics that our results will help in making informed decisions with the most impact against similar infectious diseases. Full article
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Article
Development of a Codebook of Online Anti-Vaccination Rhetoric to Manage COVID-19 Vaccine Misinformation
Int. J. Environ. Res. Public Health 2021, 18(14), 7556; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147556 - 15 Jul 2021
Cited by 1 | Viewed by 1937
Abstract
Vaccine hesitancy (delay in obtaining a vaccine, despite availability) represents a significant hurdle to managing the COVID-19 pandemic. Vaccine hesitancy is in part related to the prevalence of anti-vaccine misinformation and disinformation, which are spread through social media and user-generated content platforms. This [...] Read more.
Vaccine hesitancy (delay in obtaining a vaccine, despite availability) represents a significant hurdle to managing the COVID-19 pandemic. Vaccine hesitancy is in part related to the prevalence of anti-vaccine misinformation and disinformation, which are spread through social media and user-generated content platforms. This study uses qualitative coding methodology to identify salient narratives and rhetorical styles common to anti-vaccine and COVID-denialist media. It organizes these narratives and rhetorics according to theme, imagined antagonist, and frequency. Most frequent were narratives centered on “corrupt elites” and rhetorics appealing to the vulnerability of children. The identification of these narratives and rhetorics may assist in developing effective public health messaging campaigns, since narrative and emotion have demonstrated persuasive effectiveness in other public health communication settings. Full article
Article
COVID-19 Mortality Rate and Its Incidence in Latin America: Dependence on Demographic and Economic Variables
Int. J. Environ. Res. Public Health 2021, 18(13), 6900; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136900 - 27 Jun 2021
Cited by 3 | Viewed by 790
Abstract
The pandemic caused by COVID-19 has left millions infected and dead around the world, with Latin America being one of the most affected areas. In this work, we have sought to determine, by means of a multiple regression analysis and a study of [...] Read more.
The pandemic caused by COVID-19 has left millions infected and dead around the world, with Latin America being one of the most affected areas. In this work, we have sought to determine, by means of a multiple regression analysis and a study of correlations, the influence of population density, life expectancy, and proportion of the population in vulnerable employment, together with GDP per capita, on the mortality rate due to COVID-19 in Latin American countries. The results indicated that countries with higher population density had lower numbers of deaths. Population in vulnerable employment and GDP showed a positive influence, while life expectancy did not appear to significantly affect the number of COVID-19 deaths. In addition, the influence of these variables on the number of confirmed cases of COVID-19 was analyzed. It can be concluded that the lack of resources can be a major burden for the vulnerable population in combating COVID-19 and that population density can ensure better designed institutions and quality infrastructure to achieve social distancing and, together with effective measures, lower death rates. Full article
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Article
Fear and Coping in Students during the Early Stages of the COVID-19 Pandemic: A Combined Cross-Sectional and Longitudinal Study
Int. J. Environ. Res. Public Health 2021, 18(12), 6551; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126551 - 18 Jun 2021
Viewed by 815
Abstract
The overwhelming impacts of the COVID-19 pandemic have been experienced by individuals across the world. Additional circumstances unique to students affected their studies during the early stages of the pandemic, with changes in living and studying mid-semester. The current study aimed to investigate [...] Read more.
The overwhelming impacts of the COVID-19 pandemic have been experienced by individuals across the world. Additional circumstances unique to students affected their studies during the early stages of the pandemic, with changes in living and studying mid-semester. The current study aimed to investigate predictors of fear of COVID-19 in college students during this acute phase using cross-sectional and longitudinal samples. In total, 175 undergraduate students completed an online questionnaire in the spring 2020 semester following lockdown. A subset of 58 students completed a separate survey in fall 2019, which served as a baseline. For the cross-sectional sample, pre-COVID-19 and current living situations did not predict COVID-19 fears. However, a propensity to experience panic was significantly associated with greater COVID-19 fears. How students coped with the pandemic was not associated with COVID-19 fears, although a greater propensity to use denial as a coping style tended to be related to greater COVID-19 fears. In the longitudinal subsample, students showed decreased positive mood and social stress load while depressive mood increased after lockdown. Their preferred coping styles changed, utilizing more self-distraction and acceptance, and less self-blame and substance use. Findings reflect both positive and negative consequences of the pandemic. The unique changes in students’ lifestyles will need to be met by tailored interventions. Full article
Article
Sources of Sleep Disturbances and Psychological Strain for Hospital Staff Working during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(12), 6289; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126289 - 10 Jun 2021
Cited by 2 | Viewed by 777
Abstract
Hospital staff members reported increased stress-related workload when caring for inpatients with COVID-19 (“frontline hospital staff members”). Here, we tested if depression, anxiety, and stress were associated with poor sleep and lower general health, and if social support mediated these associations. Furthermore, we [...] Read more.
Hospital staff members reported increased stress-related workload when caring for inpatients with COVID-19 (“frontline hospital staff members”). Here, we tested if depression, anxiety, and stress were associated with poor sleep and lower general health, and if social support mediated these associations. Furthermore, we compared current insomnia scores and general health scores with normative data. A total of 321 full-time frontline hospital staff members (mean age: 36.86; 58% females) took part in the study during the COVID-19 pandemic. They completed a series of questionnaires covering demographic and work-related information, symptoms of depression, anxiety, stress, social support, self-efficacy, and symptoms of insomnia and general health. Higher symptoms of depression, anxiety, and stress were associated with higher symptoms of insomnia and lower general health. Higher scores of depression, anxiety, and stress directly predicted higher insomnia scores and lower general health scores, while the indirect effect of social support was modest. Compared to normative data, full-time frontline hospital staff members had a 3.14 higher chance to complain about insomnia and a significantly lower general health. Symptoms of insomnia and general health were unrelated to age, job experience, educational level, and gender. Given this background, it appears that the working context had a lower impact on individuals’ well-being compared to individual characteristics. Full article
Article
“People Will Continue to Suffer If the Virus Is Around”: A Qualitative Analysis of Sub-Saharan African Children’s Experiences during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(11), 5618; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115618 - 25 May 2021
Viewed by 937
Abstract
Children are particularly impressionable and at risk during a global public health crisis, making it important to examine their unique perspectives. To hear and understand sub-Saharan African children’s experiences with the COVID-19 pandemic, we conducted an exploratory qualitative analysis based on interviews with [...] Read more.
Children are particularly impressionable and at risk during a global public health crisis, making it important to examine their unique perspectives. To hear and understand sub-Saharan African children’s experiences with the COVID-19 pandemic, we conducted an exploratory qualitative analysis based on interviews with 51 children, ages 9 to 13, from Nigeria, Tanzania, and Sierra Leone. Applying the organization of Bronfenbrenner’s ecological systems theory, we reveal how COVID-19 affected children’s daily lives and domestic challenges, schooling and neighborhood issues, media use (and its relationship to knowledge and fear of the disease), perceptions of the country and government response, and thoughts of religion and hope. Children’s responses differed greatly, but patterns emerged across sex, age, household size, religion, and country. This study offers guidance and recommendations for meeting the needs of children, especially in times of crisis. Full article
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Article
COVID-19—Related Assault on Asians: Economic Hardship in the United States and India Predicts Diminished Support for Victim Compensation and Assailant Punishment
Int. J. Environ. Res. Public Health 2021, 18(10), 5320; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105320 - 17 May 2021
Viewed by 663
Abstract
Background: There has been an alarming increase in discrimination and violence towards Asians during the coronavirus (COVID-19) pandemic amid reports that the virus was first detected in China. In an incident involving a COVID-19-related physical assault, this study examined whether economic hardship [...] Read more.
Background: There has been an alarming increase in discrimination and violence towards Asians during the coronavirus (COVID-19) pandemic amid reports that the virus was first detected in China. In an incident involving a COVID-19-related physical assault, this study examined whether economic hardship experienced by participants during the pandemic and the race of the victim (Chinese, White) would influence support to compensate a victim and punish the assailant. The study also explored whether the perception that the victim experienced emotional and physical suffering due to the assault would mediate the relationships. Method: Participants in India and the United States reported on their own economic hardship due to the pandemic. They then read about an incident in which an innocent person suffered a COVID-19-related physical and verbal attack, and indicated if they would support punishing the assailant and financially compensating the victim. Results: When the victim was Chinese, participants experiencing a high degree of COVID-19 economic hardship were less likely to support financially compensating the victim or punishing the assailant compared to when the victim was White. Furthermore, when the victim was Chinese, the negative associations between economic hardship and financially compensating the victim and punishing the assailant were mediated by reduced recognition that the victim suffered emotional trauma and pain as a result of the attack. Conclusions: COVID-19-driven economic hardship experienced by participants predicted an array of reactions that reflected reduced recognition of the civil and human rights of a victim of a COVID-19-related assault. These findings have significant implications for mental health, public health, and the justice system, and underscore the pressing need for prompt action to mitigate economic hardship and to address racism and discrimination. Full article
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Review
Factors Associated with the Implementation of Non-Pharmaceutical Interventions for Reducing Coronavirus Disease 2019 (COVID-19): A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(8), 4274; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084274 - 17 Apr 2021
Cited by 5 | Viewed by 1570
Abstract
There has been much discussion recently about the importance of implementing non-pharmaceutical interventions (NPIs) to protect the public from coronavirus disease 2019 (COVID-19) infection. Different governments across the world have adopted NPIs (e.g., social distancing, quarantine, isolation, lockdowns, curfews, travel restrictions, closures of [...] Read more.
There has been much discussion recently about the importance of implementing non-pharmaceutical interventions (NPIs) to protect the public from coronavirus disease 2019 (COVID-19) infection. Different governments across the world have adopted NPIs (e.g., social distancing, quarantine, isolation, lockdowns, curfews, travel restrictions, closures of schools and colleges). Two fundamental strategies, namely a strict containment strategy—also called suppression strategy—and a mitigation strategy have been adopted in different countries, mainly to reduce the reproduction number (R0) to below one and hence to reduce case numbers to low levels or eliminate human-to-human transmission, as well as to use NPIs to interrupt transmission completely and to reduce the health impact of epidemics, respectively. However, the adoption of these NPI strategies is varied and the factors impacting NPI are inconsistent and unclear. This study, therefore, aimed to review the factors associated with the implementation of NPIs (social distancing, social isolation and quarantine) for reducing COVID-19. Following PRISMA guidelines, we searched for published and unpublished studies, undertaking a systematic search of: MEDLINE, EMBASE, Allied and Complementary Medicine, COVID-19 Research, WHO database on COVID-19, and Google Scholar. Thirty-three studies were included in the study. Seven descriptive themes emerged on enablers and barriers to NPIs: the positive impact of NPIs, effective public health interventions, positive change in people’s behaviour and concerns about COVID-19, the role of mass media, physical and psychological impacts, and ethnicity/age associated with COVID-19. This study has highlighted that the effectiveness of NPIs in isolation is likely to be limited, therefore, a combination of multiple measures e.g., SD, isolation and quarantine, and workplace distancing appeared more effective in reducing COVID-19. Studies suggest that targeted approaches alongside social distancing might be the way forward, and more acceptable. Further research to promote country- and context-specific adoption of NPIs to deliver public health measures is needed. Studies comparing the effectiveness of interventions and strategies will help provide more evidence for future pandemics. Full article
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Article
Changes in Alcohol Consumption during the COVID-19 Pandemic—Small Change in Total Consumption, but Increase in Proportion of Heavy Drinkers
Int. J. Environ. Res. Public Health 2021, 18(8), 4231; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084231 - 16 Apr 2021
Cited by 8 | Viewed by 1347
Abstract
Little is known about possible changes in alcohol consumption distribution during the COVID-19 pandemic. We estimated how individual changes in alcohol consumption during the pandemic translated into changes in: (i) mean consumption; (ii) dispersion of consumption distribution; and (iii) prevalence of heavy drinkers. [...] Read more.
Little is known about possible changes in alcohol consumption distribution during the COVID-19 pandemic. We estimated how individual changes in alcohol consumption during the pandemic translated into changes in: (i) mean consumption; (ii) dispersion of consumption distribution; and (iii) prevalence of heavy drinkers. We employed data from two independent web-surveys of Norwegian adults collected between April and July 2020 and limited to those reporting past year alcohol consumption (N1 = 15,267, N2 = 1195). Self-reports of changes in drinking behavior were quantified, assuming change being relative to baseline consumption level. During the pandemic, we found a small increase (Survey 1) or no change (Survey 2) in estimated mean alcohol consumption (which parallels to total consumption). However, in both surveys, the dispersion of the distribution increased significantly (p < 0.001). For most respondents, an average modest decline in consumption was found. However, the small fraction with the highest baseline consumption increased their consumption substantially, and in effect, the proportion of heavy drinkers increased markedly (p < 0.001). In conclusion, quantifications of reported changes in alcohol consumption during the pandemic suggest that the upper 5 to 10% of the drinkers increased their consumption and hence the prevalence of heavy drinkers increased, despite little or no change in total alcohol consumption. Full article
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Article
The Impact of the COVID-19 Pandemic on Mental Health: Evidence from Cyprus
Int. J. Environ. Res. Public Health 2021, 18(8), 3868; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083868 - 07 Apr 2021
Cited by 1 | Viewed by 1255
Abstract
The aim of the current study was to examine mental health effects of the first wave of COVID-19 (Corona Virus Disease-19) in Cyprus. Accordingly, 388 individuals aged 18–65+ responded to the Components of Mental Health Questionnaire that was distributed via social media for [...] Read more.
The aim of the current study was to examine mental health effects of the first wave of COVID-19 (Corona Virus Disease-19) in Cyprus. Accordingly, 388 individuals aged 18–65+ responded to the Components of Mental Health Questionnaire that was distributed via social media for two weeks assessing how emotional distress, support and interest in self and others, lifestyle changes, engagement in protective measures, and avoidant behaviors were related to participants’ gender, age, and place of residency. Additionally, we measured the level of concern of individuals during and after the first wave outbreak of the pandemic. The results suggest that (a) females experience higher levels of anxiety, stress, fear, worry, and despair than males and are more likely to undertake protective measures, (b) older individuals and those who live in urban areas perceive greater social support and interest in the emotional experience of significant others, (c) emotional distress and support and interest in self and others are associated with all other variables, indicating the importance of these constructs to the experience of a pandemic, and (d) there was a decrease in participants’ concern after the end of the first wave of the pandemic. Mental health professionals could find this information useful when developing and implementing prevention programs that aim to offer psychological support during this stressful period. Full article
Brief Report
COVID-19 and Heat Illness in Tokyo, Japan: Implications for the Summer Olympic and Paralympic Games in 2021
Int. J. Environ. Res. Public Health 2021, 18(7), 3620; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073620 - 31 Mar 2021
Cited by 1 | Viewed by 2167
Abstract
The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July–September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowledged as a potentially [...] Read more.
The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July–September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowledged as a potentially large health threat for maintaining health services. We examined the number of COVID-19 admissions and the Tokyo rule for emergency medical care, in Tokyo, from March to September 2020, and investigated the weekly number of emergency transportations due to heat illness and weekly averages of the daily maximum Wet Bulb Globe Temperature (WBGT) in Tokyo in the summer (2016–2020). The peak of emergency transportations due to heat illness overlapped the resurgence of COVID-19 in 2020, and an increase of heat illness patients and WBGT has been observed. Respect for robust science is critical for the decision-making process of mass gathering events during the pandemic, and science-based countermeasures and implementations for COVID-19 will be warranted. Without urgent reconsiderations and sufficient countermeasures, the double burden of COVID-19 and heat-related illnesses in Tokyo will overwhelm the healthcare provision system, and maintaining essential health services will be challenging during the 2021 summer Olympic and Paralympic Games. Full article
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Article
Mental Health during the Second Wave of the COVID-19 Pandemic—Polish Studies
Int. J. Environ. Res. Public Health 2021, 18(7), 3423; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073423 - 25 Mar 2021
Cited by 6 | Viewed by 1520
Abstract
The presented research aimed to identify the impacts of the second wave of the coronavirus disease 2019 (COVID-19) pandemic on respondents’ mental health state and identify variables related to the respondents’ symptoms of anxiety and depression; 618 subjects participated in the research. A [...] Read more.
The presented research aimed to identify the impacts of the second wave of the coronavirus disease 2019 (COVID-19) pandemic on respondents’ mental health state and identify variables related to the respondents’ symptoms of anxiety and depression; 618 subjects participated in the research. A specially prepared survey and Polish adaptations of the following methods were used: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS 10), MINI-COPE Questionnaire (Brief COPE Inventory), Alcohol Use Disorder Identification Test (AUDIT), Scale of Death Anxiety (SDA), The Fear of COVID-19 Scale (FCV-19S). Over 24% of the respondents reported having experienced suicidal thoughts since the start of the pandemic. Almost 16% drank alcohol in a risky or harmful way. The average value of perceived stress indicated its high and very high intensity. Over 20% had symptoms of anxiety disorders, and almost 19% had anxiety and depression symptoms. It means that almost 40% of the respondents probably have mental disorders. More women, younger people, and those with disorders prior to the onset of the pandemic were among those who manifested these disorders. They also used passive and avoidance stress coping strategies more frequently. In conclusion, the second wave of the pandemic negatively affected the mental health of the respondents. A high percentage of the respondents manifested anxiety and anxiety-depressive disorders and declared having of suicidal thoughts. Full article
Article
Possible Roles of Permafrost Melting, Atmospheric Transport, and Solar Irradiance in the Development of Major Coronavirus and Influenza Pandemics
Int. J. Environ. Res. Public Health 2021, 18(6), 3055; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063055 - 16 Mar 2021
Cited by 2 | Viewed by 1383
Abstract
Major pandemics involving respiratory viruses develop semi-regularly and require a large flux of novel viruses, yet their origination is equivocal. This paper explores how natural processes could give rise to this puzzling combination of characteristics. Our model is based on available data regarding [...] Read more.
Major pandemics involving respiratory viruses develop semi-regularly and require a large flux of novel viruses, yet their origination is equivocal. This paper explores how natural processes could give rise to this puzzling combination of characteristics. Our model is based on available data regarding the emergence of historic influenzas, early COVID-19 cases and spreading, the microbiome of permafrost, long-distance airborne transport of viruses reaching stratospheric levels, ultraviolet immunosuppression, sunlight variations, weather patterns, Arctic thawing, and global warming. Atmospheric conveyance is supported by hemispheric distribution disparities, ties of COVID-19 cases to air pollution particulate concentrations, and contemporaneous animal infections. The following sequence is proposed: (1) virus emergence after hot Arctic summers, predominantly near solar irradiance maxima or involving wildfires, indicates release of large amounts of ancient viruses during extensive permafrost melting, which are then incorporated in autumn polar air circulation, where cold storage and little sunlight permit survival. (2) Pandemics onset in winter to spring at rather few locations: from climate data on Wuhan, emergence occurs where the North Polar Jet stream hovers while intersecting warmer, moist air, producing rain which deposits particulates with the viral harvest on a vulnerable human population. (3) Spring and summer increases in COVID-19 cases link to high solar irradiance, implicating ultraviolet immune suppression as one means of amplification. (4) Viruses multiplied by infected humans at close range being incorporated in atmospheric circulation explains rapid global spread, periodic case surges (waves), and multi-year durations. Pollution and wind geography affect uptake and re-distribution. Our model can be tested, e.g., against permafrost stored in laboratories as well as Artic air samples, and suggests mitigating actions. Full article
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Article
Reduction of Human Mobility Matters during Early COVID-19 Outbreaks: Evidence from India, Japan and China
Int. J. Environ. Res. Public Health 2021, 18(6), 2826; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18062826 - 10 Mar 2021
Viewed by 1167
Abstract
Mobility restrictions have been a heated topic during the global pandemic of coronavirus disease 2019 (COVID-19). However, multiple recent findings have verified its importance in blocking virus spread. Evidence on the association between mobility, cases imported from abroad and local medical resource supplies [...] Read more.
Mobility restrictions have been a heated topic during the global pandemic of coronavirus disease 2019 (COVID-19). However, multiple recent findings have verified its importance in blocking virus spread. Evidence on the association between mobility, cases imported from abroad and local medical resource supplies is limited. To reveal the association, this study quantified the importance of inter- and intra-country mobility in containing virus spread and avoiding hospitalizations during early stages of COVID-19 outbreaks in India, Japan, and China. We calculated the time-varying reproductive number (Rt) and duration from illness onset to diagnosis confirmation (Doc), to represent conditions of virus spread and hospital bed shortages, respectively. Results showed that inter-country mobility fluctuation could explain 80%, 35%, and 12% of the variance in imported cases and could prevent 20 million, 5 million, and 40 million imported cases in India, Japan and China, respectively. The critical time for screening and monitoring of imported cases is 2 weeks at minimum and 4 weeks at maximum, according to the time when the Pearson’s Rs between Rt and imported cases reaches a peak (>0.8). We also found that if local transmission is initiated, a 1% increase in intra-country mobility would result in 1430 (±501), 109 (±181), and 10 (±1) additional bed shortages, as estimated using the Doc in India, Japan, and China, respectively. Our findings provide vital reference for governments to tailor their pre-vaccination policies regarding mobility, especially during future epidemic waves of COVID-19 or similar severe epidemic outbreaks. Full article
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Article
Pattern Recognition of the COVID-19 Pandemic in the United States: Implications for Disease Mitigation
Int. J. Environ. Res. Public Health 2021, 18(5), 2493; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052493 - 03 Mar 2021
Viewed by 1088
Abstract
The novel coronavirus (COVID-19) pandemic presents a severe threat to human health worldwide. The United States (US) has the highest number of reported COVID-19 cases, and over 16 million people were infected up to the 12 December 2020. To better understand and mitigate [...] Read more.
The novel coronavirus (COVID-19) pandemic presents a severe threat to human health worldwide. The United States (US) has the highest number of reported COVID-19 cases, and over 16 million people were infected up to the 12 December 2020. To better understand and mitigate the spread of the disease, it is necessary to recognize the pattern of the outbreak. In this study, we explored the patterns of COVID-19 cases in the US from 1 March to 12 December 2020. The county-level cases and rates of the disease were mapped using a geographic information system (GIS). The overall trend of the disease in the US, as well as in each of its 50 individual states, were analyzed by the seasonal-trend decomposition. The disease curve in each state was further examined using K-means clustering and principal component analysis (PCA). The results showed that three clusters were observed in the early phase (1 March–31 May). New York has a unique pattern of the disease curve and was assigned one cluster alone. Two clusters were observed in the middle phase (1 June–30 September). California, Texas and Florida were assigned in the same cluster, which has the pattern different from the remaining states. In the late phase (1 October–12 December), California has a unique pattern of the disease curve and was assigned a cluster alone. In the whole period, three clusters were observed. California, Texas and Florida still have similar patterns and were assigned in the same cluster. The trend analysis consolidated the patterns identified from the cluster analysis. The results from this study provide insight in making disease control and mitigation strategies. Full article
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Article
COVID-19 Pandemic Lockdown and Religious Mediatization of Social Sustainability. A Case Study of Romania
Int. J. Environ. Res. Public Health 2021, 18(5), 2287; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052287 - 25 Feb 2021
Cited by 3 | Viewed by 1435
Abstract
This article presents an empirical study on the institutional audiovisual mediatization of social sustainability made by the eighteen religious denominations officially recognized in Romania during the period of the COVID-19 pandemic onset. Research is undertaken based on the mediatization theories. Specifically, it highlights [...] Read more.
This article presents an empirical study on the institutional audiovisual mediatization of social sustainability made by the eighteen religious denominations officially recognized in Romania during the period of the COVID-19 pandemic onset. Research is undertaken based on the mediatization theories. Specifically, it highlights and discusses the conditions for producing the meaning of social sustainability as a result of religious mediatization during the months of March, April and May 2020, a period with strong religious connotations since it involved the dates of the major annual feasts celebrated by the three majority monotheistic religions, i.e., the Christian Easter, the Muslim Ramadan and the Jewish Passover. As a result, we noticed that the production of meaning in terms of social sustainability was simultaneously anchored in the accumulation of four contextual “social worlds”: (a) that of social transformation induced by mediatization, (b) that of the COVID-19 pandemic, a crisis that is neither social, economic, or environmental, but with consequences on the three levels of reality mentioned above, (c) that of spirituality during the time of the great monotheistic religious feasts and (d) that of the national culture of Romania, statistically the most religious country of the European Union. Full article
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Article
Cross-Country Differences in Stay-at-Home Behaviors during Peaks in the COVID-19 Pandemic in China and the United States: The Roles of Health Beliefs and Behavioral Intention
Int. J. Environ. Res. Public Health 2021, 18(4), 2104; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18042104 - 21 Feb 2021
Cited by 3 | Viewed by 1367
Abstract
The novel coronavirus disease 2019 (COVID-19) rapidly escalated to a global pandemic. To control the rate of transmission, governments advocated that the public practice social distancing, which included staying at home. However, compliance with stay-at-home orders has varied between countries such as China [...] Read more.
The novel coronavirus disease 2019 (COVID-19) rapidly escalated to a global pandemic. To control the rate of transmission, governments advocated that the public practice social distancing, which included staying at home. However, compliance with stay-at-home orders has varied between countries such as China and the United States, and little is known about the mechanisms underlying the national differences. Based on the health belief model, the theory of reasoned action, and the technology acceptance model, health beliefs and behavioral intention are suggested as possible explanations. A total of 498 Chinese and 292 American college students were recruited to complete an online survey. The structural equation modeling results showed that health beliefs (i.e., perceived susceptibility, severity, and barriers) and behavioral intention played multiple mediating roles in the association between nationality and actual stay-at-home behaviors. Notably, the effect via perceived barriers → behavioral intention was stronger than the effects via perceived susceptibility and severity → behavioral intention. That is, American participants perceived high levels of susceptibility whereas Chinese participants perceived high levels of severity, especially few barriers, which further led to increased behavioral intention and more frequent stay-at-home behaviors. These findings not only facilitate a comprehensive understanding of cross-country differences in compliance with stay-at-home orders during peaks in the COVID-19 pandemic but also lend support for mitigation of the current global crisis and future disease prevention and health promotion efforts. Full article
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Article
The Psychological Impact of Strict and Prolonged Confinement on Business Students during the COVID-19 Pandemic at a Spanish University
Int. J. Environ. Res. Public Health 2021, 18(4), 1710; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041710 - 10 Feb 2021
Cited by 9 | Viewed by 1668
Abstract
The study was carried out to examine the situation of university students from one month after the beginning of a very strict confinement process in Spain during the COVID-19 pandemic. Students responded to a survey which included the 7-item Generalized Anxiety Disorder Scale [...] Read more.
The study was carried out to examine the situation of university students from one month after the beginning of a very strict confinement process in Spain during the COVID-19 pandemic. Students responded to a survey which included the 7-item Generalized Anxiety Disorder Scale (GAD-7) together with other questions relating to their general well-being from the European Quality of Life Survey (EQLS). A total of 198 university students answered the web-based survey. The questionnaire was generated using Microsoft Forms and was explained and distributed online. The results indicated that around 18.7% of students were suffering from severe anxiety and 70.2% were suffering either mild or moderate anxiety at this point of the strict confinement process. The findings show that when emotional well-being (quality of sleep, the perception of feeling fear, death of a relative) is reduced and material well-being is negatively affected (income level) anxiety levels are increased. On the other hand, the results show that having good interpersonal relationships with family members and taking care of personal development (routines and habits that make them feel good) help reduce anxiety levels. The female students in the sample also suffered higher levels of anxiety than males during strict confinement. Full article
Article
The Utilization of Protective Face Masks among Polish Healthcare Workers during COVID-19 Pandemic: Do We Pass the Exam?
Int. J. Environ. Res. Public Health 2021, 18(2), 841; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020841 - 19 Jan 2021
Cited by 4 | Viewed by 1362
Abstract
Relevant personal protective measures during the COVID-19 pandemic include face masks, possibly decreasing the risk of infection among the general population and healthcare workers (HCW) if utilized properly. The aim of the study was to assess whether different Polish HCW utilize face masks [...] Read more.
Relevant personal protective measures during the COVID-19 pandemic include face masks, possibly decreasing the risk of infection among the general population and healthcare workers (HCW) if utilized properly. The aim of the study was to assess whether different Polish HCW utilize face masks according to the 2020 World Health Organization guidance (WHO) criteria. This cross-sectional study included 1156 respondents who participated in an internet survey evaluating mask-related behaviors. All the WHO criteria were complied with by 1.4% of participants, regardless of medical profession, specialty or place of employment. HCW mostly adhered to criterion 1 (C1; strict covering of the face and mouth with the mask; 90.8%), C4 (washing/disinfecting the hands after touching/taking off the mask; 49%) and C3 (taking off the mask properly without touching the anterior surface; 43.4%), whereas C2 (avoidance of touching the mask with hands) was complied with least commonly (6.8%). HCW with mask-induced itch (31.6%) complied to C2 less often (odds ratio 0.53; p = 0.01). The study reveals that Polish HCW rarely adhere to all the 2020 WHO guidance criteria on the use of masks, whereas the adherence to particular criteria is variable and may be associated with the presence of skin-related conditions and other factors. Better compliance with the recommendations in the future is necessary to increase personal safety of HCW and prevent the transmission of SARS-CoV-2. Full article

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Reply
A Flexible Lockdown by Integrating Public Health and Economic Reactivation to Response the Crisis of COVID-19: Responses to Comments by Alvaro J Idrovo on “An Examination on the Transmission of COVID-19 and the Effect of Response Strategies: A Comparative Analysis”
Int. J. Environ. Res. Public Health 2020, 17(21), 8068; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218068 - 02 Nov 2020
Cited by 3 | Viewed by 853
Abstract
We greatly appreciate Idrovo’s comments on our research and wish to specifically respond to his comments. Idrovo indicates that rapid increases in the number of confirmed cases in the past few weeks were observed in Latin America, where some countries had implemented stringent [...] Read more.
We greatly appreciate Idrovo’s comments on our research and wish to specifically respond to his comments. Idrovo indicates that rapid increases in the number of confirmed cases in the past few weeks were observed in Latin America, where some countries had implemented stringent lockdowns for more than three months since the second half of March 2020. In his comments, Idrovo expresses his suspicion on the reality of lockdowns implemented in Latin America and worries about the negative impacts of lockdowns on economies. We thank the Editor for providing us with the opportunity to respond to Idrovo’s comments and explain parts of our study. Full article
Comment
Long but Unreal Lockdowns in Latin America. Comment on Chen, Y.T.; Yen, Y.F.; Yu, S.H.; Su, E.C. An Examination on the Transmission of COVID-19 and the Effect of Response Strategies: A Comparative Analysis. Int. J. Environ. Res. Public Health 2020, 17, E5687
Int. J. Environ. Res. Public Health 2020, 17(21), 8064; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218064 - 02 Nov 2020
Cited by 4 | Viewed by 987
Abstract
Lockdowns have been important elements of epidemic control over time. During the COVID-19 pandemic, they have been implemented in many countries, at very different times, and accompanied by school or workplace closures, restrictions on mass gatherings, and public transport closure in different combinations. [...] Read more.
Lockdowns have been important elements of epidemic control over time. During the COVID-19 pandemic, they have been implemented in many countries, at very different times, and accompanied by school or workplace closures, restrictions on mass gatherings, and public transport closure in different combinations. Recent evidence published in the International Journal of Environmental Research and Public Health suggests that SARS-CoV-19 transmission is diminished when strict lockdowns, contact tracing, and good public cooperation are implemented. However, in Latin America, not all lockdowns are real, and rapid increases in a few weeks in the number of infected, hospitalized, and deceased populations have been observed. In these cases, the effect of lockdowns is weakening of democracy. Full article
Article
The Recommended and Excessive Preventive Behaviors during the COVID-19 Pandemic: A Community-Based Online Survey in China
Int. J. Environ. Res. Public Health 2020, 17(19), 6953; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17196953 - 23 Sep 2020
Cited by 11 | Viewed by 1487
Abstract
COVID-19 presents unprecedented challenges to the global public health response. Preventive behaviors and keeping social distance are regarded as compelling ways to prevent COVID-19. This study focused on the sociological and psychological factors associated with proper and excessive preventive behaviors of the COVID-19 [...] Read more.
COVID-19 presents unprecedented challenges to the global public health response. Preventive behaviors and keeping social distance are regarded as compelling ways to prevent COVID-19. This study focused on the sociological and psychological factors associated with proper and excessive preventive behaviors of the COVID-19 outbreak in China. For the sample, we collected the data of 4788 participants who were surveyed between 4 April and 15 April 2020 from eight provinces in China. This study designed a self-filled questionnaire that included demographic information, six components of the Health Belief Model, and target preventive behaviors. Descriptive analysis, Chi-square test, logistic regression analysis, Mantel–Haenszel hierarchical analysis, and propensity score matching were employed in this study. The results showed that 54.7% of the participants had adequate basic prevention, 63.6% of the participants had adequate advanced prevention, and 5.8% of the participants practiced excessive prevention. The elder participants were less likely to engage in proper preventive behaviors. Perceived susceptibility, perceived benefits, perceived barriers, cues to action, and knowledge levels were associated with preventive behaviors. Excessive preventive behaviors in high-risk groups with suspected symptoms were associated with their extreme psychological condition, while the support from the community and family plays an important role in avoiding these behaviors. Full article
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Article
Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan
Int. J. Environ. Res. Public Health 2020, 17(18), 6671; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186671 - 13 Sep 2020
Cited by 23 | Viewed by 3642
Abstract
This study assessed university students’ knowledge and precaution practices of Novel Coronavirus (COVID-19) in South Korea, China, and Japan, and investigated their depressive states during the pandemic. This cross-sectional survey collected data from 821 respondents, using an anonymous online questionnaire designed by the [...] Read more.
This study assessed university students’ knowledge and precaution practices of Novel Coronavirus (COVID-19) in South Korea, China, and Japan, and investigated their depressive states during the pandemic. This cross-sectional survey collected data from 821 respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from 23 March to 20 April 2020, which included socio-demographic questions, knowledge and perceptions of COVID-19, preventative practices, and the Patient Health Questionnaire-9 (PHQ-9) scale to assess mental health. High proportions of respondents showed good knowledge of the transmission pathways and information related to COVID-19. Contact history as well as concerns about family members and the disease showed statistically significant distinctions by nationality and gender. On the whole, all participants reported good levels of preventative practices. The Chinese group reported the highest preventative practice scores; and females scored higher than males. Moreover, the Japanese group showed the most severe depressive states; overall, females experienced more severe depression than males. Thus, authorities should especially emphasize the importance of COVID-19 precautions to males. Educational departments and health authorities should observe the mental health of university adults during the pandemic and plan interventions to improve it. Full article
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Article
Relationships between Physical and Social Behavioural Changes and the Mental Status of Homebound Residents in Hong Kong during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2020, 17(18), 6653; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186653 - 12 Sep 2020
Cited by 7 | Viewed by 2026
Abstract
In Hong Kong, social distancing has been adopted in order to minimise the spread of COVID-19. This study aims to examine the changes in physical health, mental health, and social well-being experienced by local residents who were homebound during the pandemic. An online [...] Read more.
In Hong Kong, social distancing has been adopted in order to minimise the spread of COVID-19. This study aims to examine the changes in physical health, mental health, and social well-being experienced by local residents who were homebound during the pandemic. An online questionnaire in both Chinese and English versions was completed by 590 eligible participants from 24 April to 13 May 2020. The questionnaire found that individuals aged 18 to 25 years spent more time resting and relaxing but experienced more physical strain. Working status was associated with social contact, with participants working full-time jobs scoring higher in “maintaining social communication via electronic means” and “avoiding social activities outside the home”. Additionally, approximately one third of the participants (29.7%) had moderate to severe depression, and participants aged 18 to 25 were found to have higher scores in PHQ-9. Changes in physical health and social contact were significantly associated with developing depressive symptoms. From the results, it is clear that the COVID-19 pandemic has the potential to exert a negative impact on the mental health status of individuals. Full article
Comment
Is Exercise the Best Medicine during a COVID-19 Pandemic? Comment on Constandt, B.; Thibaut, E.; De Bosscher, V.; Scheerder, J.; Ricour, M.; Willem, A. Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium. Int. J. Environ. Res. Public Health 2020, 17, 4144
Int. J. Environ. Res. Public Health 2020, 17(16), 5730; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165730 - 08 Aug 2020
Cited by 20 | Viewed by 2116
Abstract
From Constandt et al.’s survey of 13,515 Belgium respondents, regular physical activity can be successfully initiated and sustained during a lockdown, with appropriate social distancing measures. Documentation that 77% of highly active people and 58% of low active people exercised as much or [...] Read more.
From Constandt et al.’s survey of 13,515 Belgium respondents, regular physical activity can be successfully initiated and sustained during a lockdown, with appropriate social distancing measures. Documentation that 77% of highly active people and 58% of low active people exercised as much or more following the institution of a nationwide lockdown was impressive, given that the cases of COVID-19 were accelerating at that time. The Belgian government’s central promotion of exercise, to boost both the mental and physical health of the population, likely contributed to the health, tolerance, and ultimate success of lockdown. In this commentary, we wish to pose a follow-up query which highlights the potential detrimental effects of intense exercise (competition) performed without social distancing measures. The proposed graphical abstract elucidates these possible risks, in contrast to the favorable results outlined in Constandt et al.’s study. Full article
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Article
An Examination on the Transmission of COVID-19 and the Effect of Response Strategies: A Comparative Analysis
Int. J. Environ. Res. Public Health 2020, 17(16), 5687; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165687 - 06 Aug 2020
Cited by 12 | Viewed by 2249
Abstract
The major purpose of this paper was to examine the transmission of COVID-19 and the associated factors that affect the transmission. A qualitative analysis was conducted by comparing the COVID-19 transmission of six countries: China, Korea, Japan, Italy, the USA, and Brazil. This [...] Read more.
The major purpose of this paper was to examine the transmission of COVID-19 and the associated factors that affect the transmission. A qualitative analysis was conducted by comparing the COVID-19 transmission of six countries: China, Korea, Japan, Italy, the USA, and Brazil. This paper attempted to examine the mitigation effectiveness for the transmission of COVID-19 and the pandemic severity. Time to reach the peak of daily new confirmed cases and the maximum drop rate were used to measure the mitigation effectiveness, while the proportion of confirmed cases to population and the mortality rate were employed to evaluate the pandemic severity. Based on the mitigation effectiveness, the pandemic severity, and the mortality rate, the six sample countries were categorized into four types: high mitigation effectiveness vs. low pandemic severity, middle mitigation effectiveness vs. low pandemic severity, high mitigation effectiveness vs. high pandemic severity, and low mitigation effectiveness vs. high pandemic severity. The results found that Korea and China had relatively higher mitigation effectiveness and lower pandemic severity, while the USA and Brazil had the opposite. This paper suggests that viral testing together with contacts tracing, strict implementation of lockdown, and public cooperation play important roles in achieving a reduction in COVID-19 transmission. Full article
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Article
Factors Associated with Mental Health Results among Workers with Income Losses Exposed to COVID-19 in China
Int. J. Environ. Res. Public Health 2020, 17(15), 5627; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155627 - 04 Aug 2020
Cited by 16 | Viewed by 1930
Abstract
The outbreak and worldwide spread of COVID-19 has resulted in a high prevalence of mental health problems in China and other countries. This was a cross-sectional study conducted using an online survey and face-to-face interviews to assess mental health problems and the associated [...] Read more.
The outbreak and worldwide spread of COVID-19 has resulted in a high prevalence of mental health problems in China and other countries. This was a cross-sectional study conducted using an online survey and face-to-face interviews to assess mental health problems and the associated factors among Chinese citizens with income losses exposed to COVID-19. The degrees of the depression, anxiety, insomnia, and distress symptoms of our participants were assessed using the Chinese versions of the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Insomnia Severity Index-7 (ISI-7), and the revised 7-item Impact of Event Scale (IES-7) scales, respectively, which found that the prevalence rates of depression, anxiety, insomnia, and distress caused by COVID-19 were 45.5%, 49.5%, 30.9%, and 68.1%, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes among workers with income losses during COVID-19. Participants working in Hubei province with heavy income losses, especially pregnant women, were found to have a high risk of developing unfavorable mental health symptoms and may need psychological support or interventions. Full article
Article
Design and Psychometric Analysis of the COVID-19 Prevention, Recognition and Home-Management Self-Efficacy Scale
Int. J. Environ. Res. Public Health 2020, 17(13), 4653; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17134653 - 28 Jun 2020
Cited by 7 | Viewed by 3096
Abstract
In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People’s self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and [...] Read more.
In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People’s self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and psychometrically test the COVID-19 prevention, detection, and home-management self-efficacy scale (COVID-19-SES). We conducted an observational cross-sectional study. Six-hundred and seventy-eight people participated in the study. Data were collected between March and May 2020. The COVID-19-SES’ validity (content, criterion, and construct), reliability (internal consistency and test-retest reliability), and legibility were studied. The COVID-19-SES’ reliability was high (Cronbach’s alpha = 0.906; intraclass correlation coefficient = 0.754). The COVID-19-SES showed good content validity (scale’s content validity index = 0.92) and good criterion validity when the participants’ results on the COVID-19-SES were compared to their general self-efficacy (r = 0.38; p < 0.001). Construct validity analysis revealed that the COVID-19-SES’ three-factor structure explained 52.12% of the variance found and it was congruent with the World Health Organisation’s recommendations to prevent COVID-19 contagion and spread. Legibility analysis showed that the COVID-19-SES is easy to read and understand by laypeople. The COVID-19-SES is a psychometrically robust instrument that allows for a valid and reliable assessment of people’s self-efficacy in preventing, detecting symptoms, and home-managing COVID-19. Full article
Article
Differences in Preventive Behaviors of COVID-19 between Urban and Rural Residents: Lessons Learned from A Cross-Sectional Study in China
Int. J. Environ. Res. Public Health 2020, 17(12), 4437; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124437 - 20 Jun 2020
Cited by 74 | Viewed by 3268
Abstract
Purpose: The purpose of this study is to examine the differences in preventive behaviors of COVID-19 between urban and rural residents, as well as identify the factors that might contribute to such differences. Methods: Our online survey included 1591 participants from 31 provinces [...] Read more.
Purpose: The purpose of this study is to examine the differences in preventive behaviors of COVID-19 between urban and rural residents, as well as identify the factors that might contribute to such differences. Methods: Our online survey included 1591 participants from 31 provinces of China with 87% urban and 13% rural residents. We performed multiple linear regressions and path analysis to examine the relationship between rural status and behavioral intention, attitude, subjective norms, information appraisal, knowledge, variety of information source use, and preventive behaviors against COVID-19. Findings: Compared with urban residents, rural residents were less likely to perform preventive behaviors, more likely to hold a negative attitude toward the effectiveness of performing preventive behaviors, and more likely to have lower levels of information appraisal skills. We identified information appraisal as a significant factor that might contribute to the rural/urban differences in preventive behaviors against COVID-19 through attitude, subjective norms, and intention. We found no rural/urban differences in behavioral intention, subjective norms, knowledge about preventive behaviors, or the variety of interpersonal/media source use. Conclusions: As the first wave of the pandemic inundated urban areas, the current media coverage about COVID-19 prevention may not fully satisfy the specific needs of rural populations. Thus, rural residents were less likely to engage in a thoughtful process of information appraisal and adopt the appropriate preventive measures. Tailoring health messages to meet rural populations’ unique needs can be an effective strategy to promote preventive health behaviors against COVID-19. Full article
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Review
Systematic Review of Clinical Insights into Novel Coronavirus (CoVID-19) Pandemic: Persisting Challenges in U.S. Rural Population
Int. J. Environ. Res. Public Health 2020, 17(12), 4279; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124279 - 15 Jun 2020
Cited by 21 | Viewed by 4093
Abstract
(1) Introduction. A recent viral outbreak of novel coronavirus (CoVID-19) was declared as a pandemic by the World Health Organization (WHO) due to its global public health concern. There has been an aggressive growth in the number of emerging cases suggesting rapid spread [...] Read more.
(1) Introduction. A recent viral outbreak of novel coronavirus (CoVID-19) was declared as a pandemic by the World Health Organization (WHO) due to its global public health concern. There has been an aggressive growth in the number of emerging cases suggesting rapid spread of the virus. Since the first reported case of CoVID-19, there has been vast progress in understanding the dynamics of CoVID-19. However, there is an increasing evidence of epidemiological disparity in disease burden between urban and rural areas, with rural areas having minimal pandemic preparedness and their own healthcare challenges. Therefore, this review aims to provide insight on the pathogenesis and the transmission dynamics of CoVID-19 along with pharmacological and non-pharmacological intervention strategies to mitigate the clinical manifestation of this virus. This review also aims to assess existing challenges of the CoVID-19 pandemic in rural areas based on past pandemic experiences and the effect on rural population. (2) Methods. A literature review was conducted using databases such as PubMed, Science Direct, Academic Search Premier, ProQuest, and Google Scholar, along with information from governmental organizations such as Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). (3) Results. The causative virus, with its likely zoonotic origin, has demonstrated high pathogenicity in humans through increasing human-to-human transmission leading to extensive mitigation strategies, including patient quarantine and mass “social distancing” measures. Although the clinical manifestation of symptoms is mild in majority of the virus-inflicted population, critical patients may present with pneumonia and acute respiratory distress syndrome, exacerbated by pre-existing comorbidities, eventually leading to death. While effective coronavirus disease (CoVID-19)-specific vaccines and drugs are under clinical trials, several pharmacological and non-pharmacological interventions have been adapted to manage symptoms and curtail the effect of the virus to prevent increasing morbidity and mortality. Several persisting challenges have been noted for mitigating CoVID-19 in rural areas, including the poor healthcare infrastructure, health literacy, pandemic preparedness along with the fact that majority of rural population are frail subjects with pre-existing comorbidities. (4) Discussion. The increasing rate of incidence of CoVID-19 presents its own challenges, burdening healthcare institutions and the global economy, and impacting the physical and mental health of people worldwide. Given the clinical insights into CoVID-19 and the challenges presented in this review for the U.S. rural population, mitigation strategies should be designed accordingly to minimize the morbidity and mortality of this contagion. Full article
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Article
Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium
Int. J. Environ. Res. Public Health 2020, 17(11), 4144; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17114144 - 10 Jun 2020
Cited by 110 | Viewed by 8182
Abstract
Countries all over the world implemented lockdowns to counteract COVID-19. These lockdowns heavily limited people’s exercise possibilities. At the same time, experts advocated to remain physically active to prevent future health problems. Based on an online survey, this study examines adults’ exercise levels [...] Read more.
Countries all over the world implemented lockdowns to counteract COVID-19. These lockdowns heavily limited people’s exercise possibilities. At the same time, experts advocated to remain physically active to prevent future health problems. Based on an online survey, this study examines adults’ exercise levels and patterns during the COVID-19 lockdown in Belgium. Ordinal logistic regression analyses of 13,515 valid and population-weighted responses indicate a general increase in exercise frequencies, as well as in sedentary behavior. Except for people aged 55+, previously low active adults self-reported to exercise more during the lockdown. Among the people who were already high active before COVID-19, those above 55 years old, those with low education, those used to exercise with friends or in a sport club, and those who were not using online tools to exercise, self-reported to exercise less during the lockdown. Having less time, sitting more, and missing the familiar way and competitive element of exercising were the main reasons for a self-reported exercise reduction. Given the health risks associated with physical inactivity, results imply that governments should consider how those who were not reached can be encouraged to exercise during a lockdown. After all, additional COVID-19 lockdowns might be implemented in the future. Full article
Article
Prediction of Epidemic Peak and Infected Cases for COVID-19 Disease in Malaysia, 2020
Int. J. Environ. Res. Public Health 2020, 17(11), 4076; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17114076 - 08 Jun 2020
Cited by 13 | Viewed by 3433
Abstract
The coronavirus COVID-19 has recently started to spread rapidly in Malaysia. The number of total infected cases has increased to 3662 on 05 April 2020, leading to the country being placed under lockdown. As the main public concern is whether the current situation [...] Read more.
The coronavirus COVID-19 has recently started to spread rapidly in Malaysia. The number of total infected cases has increased to 3662 on 05 April 2020, leading to the country being placed under lockdown. As the main public concern is whether the current situation will continue for the next few months, this study aims to predict the epidemic peak using the Susceptible–Exposed–Infectious–Recovered (SEIR) model, with incorporation of the mortality cases. The infection rate was estimated using the Genetic Algorithm (GA), while the Adaptive Neuro-Fuzzy Inference System (ANFIS) model was used to provide short-time forecasting of the number of infected cases. The results show that the estimated infection rate is 0.228 ± 0.013, while the basic reproductive number is 2.28 ± 0.13. The epidemic peak of COVID-19 in Malaysia could be reached on 26 July 2020, with an uncertain period of 30 days (12 July–11 August). Possible interventions by the government to reduce the infection rate by 25% over two or three months would delay the epidemic peak by 30 and 46 days, respectively. The forecasting results using the ANFIS model show a low Normalized Root Mean Square Error (NRMSE) of 0.041; a low Mean Absolute Percentage Error (MAPE) of 2.45%; and a high coefficient of determination (R2) of 0.9964. The results also show that an intervention has a great effect on delaying the epidemic peak and a longer intervention period would reduce the epidemic size at the peak. The study provides important information for public health providers and the government to control the COVID-19 epidemic. Full article
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Article
Distress and Resilience in the Days of COVID-19: Comparing Two Ethnicities
Int. J. Environ. Res. Public Health 2020, 17(11), 3956; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17113956 - 03 Jun 2020
Cited by 19 | Viewed by 2422
Abstract
The COVID-19 pandemic is an ongoing epidemic of coronavirus disease, caused by severe acute respiratory syndrome, which has spread recently worldwide. Efforts to prevent the virus from spreading include travel restrictions, lockdowns as well as national or regional quarantines throughout the international community. [...] Read more.
The COVID-19 pandemic is an ongoing epidemic of coronavirus disease, caused by severe acute respiratory syndrome, which has spread recently worldwide. Efforts to prevent the virus from spreading include travel restrictions, lockdowns as well as national or regional quarantines throughout the international community. The major negative psychological outcome of the COVID-19 pandemic is the anxiety caused by it. The aim of the present study was to examine the level of concern and the contributions of modes of resilience, well-being and demographic attributes towards decreasing or enhancing anxiety and depression among two samples: Israeli Jews (majority group) and Israeli Arabs (minority group). These random samples included 605 Jews and 156 Arabs who participated in an internet survey. A previous study, which has been conducted in the context of terror attacks, has shown that compared to Israeli Jews, Israeli Arabs expressed a higher level of fear of war and lower levels of resilience supporting personality attributes. The results of the current study indicated a similar pattern that emerged in the context of the COVID-19 pandemic: the Israeli Arabs reported a higher level of distress and a lower level of resilience and well-being. Full article
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Article
The Psychological Impact of Confinement Linked to the Coronavirus Epidemic COVID-19 in Algeria
Int. J. Environ. Res. Public Health 2020, 17(10), 3604; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103604 - 21 May 2020
Cited by 18 | Viewed by 3217
Abstract
The COVID-19 pandemic continues to spread in countries around the world. The impact of this virus is very great on populations following the application of total and partial containment measures. Our study aims to study the psychological impact of total and partial containment [...] Read more.
The COVID-19 pandemic continues to spread in countries around the world. The impact of this virus is very great on populations following the application of total and partial containment measures. Our study aims to study the psychological impact of total and partial containment applied in Algeria, on 23 March 2020, following the spread of the virus COVID-19 and also studied the habits and behaviors of the Algerian population during this new way of life and this through a cross-sectional survey launched after three days from the start of confinement to quickly assess the impacts over the period from 23 March to 12 April 2020, by an online questionnaire which allowed us to obtain 678 responses from Internet users, who live in confinement in Algeria. According to the gender variable, our sample includes 405 men, or 59.7%, and 273 women, representing 40.3%. The results of the statistical analysis carried out using SPSS version 22.0 software showed that 50.3% of the respondents were in an anxious situation during these first three weeks of confinement. In addition, 48.2% feels stressed, 46.6% of the respondents confirmed to be feeling in a bad mood, and 47.4% do not stop thinking throughout the day about this epidemic and how to protect themselves. In addition, the study shows that 87.9% of the respondents in Algeria found it difficult to follow the confinement instructions. A significant change in the habits of the population was noted especially for the time of going to bed, the time of waking up, and the use of the Internet as well as the hours devoted to daily reading. Full article
Article
Emerging Adults and COVID-19: The Role of Individualism-Collectivism on Perceived Risks and Psychological Maladjustment
Int. J. Environ. Res. Public Health 2020, 17(10), 3497; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103497 - 17 May 2020
Cited by 56 | Viewed by 6533
Abstract
The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging [...] Read more.
The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging adulthood. In spite of the fact that medical reports suggest that youth are less prone to experience COVID-19 infections, emerging adults might be at higher risk for their psychological adjustment. Emerging adults showed higher concerns about their role as a possible asymptomatic carrier than being positive with COVID-19 themselves. Both worries and concerns about COVID-19 and psychological maladjustment may be related to cultural factors. Individualism, collectivism, equality, and hierarchy seem to be meaningful perspectives to take into account. A total of 1183 Italian emerging adults were asked to fill out an online survey during the second week of the national lockdown in Italy. Results showed they reported an accurate perceived knowledge about COVID-19. At the same time, they showed higher worries and concerns about COVID-19 for their relatives, followed by more general/social worries. The lowest score included worries about COVID-19 related to themselves. State anxiety and stress levels were above the normal cutoff, confirming the challenges that emerging adults are facing during the pandemic. On one hand, emerging adults’ collectivistic orientation was related to higher perceived risks of infection; on the other hand, it predicted lower psychological maladjustment, controlling for socio-demographic variables. The study suggests that to fight the COVID-19 pandemic and decrease levels of psychological maladjustment in emerging adulthood, individuals’ cultural orientation such as the wish of sharing common goals with others, interdependence, and sociability, have to be emphasized and promoted as protective factors. Full article
Review
The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality
Int. J. Environ. Res. Public Health 2020, 17(10), 3445; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103445 - 15 May 2020
Cited by 32 | Viewed by 4752
Abstract
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require [...] Read more.
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts. Full article
Article
The Predictive Capacity of Air Travel Patterns during the Global Spread of the COVID-19 Pandemic: Risk, Uncertainty and Randomness
Int. J. Environ. Res. Public Health 2020, 17(10), 3356; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103356 - 12 May 2020
Cited by 25 | Viewed by 3149
Abstract
Air travel has a decisive role in the spread of infectious diseases at the global level. We present a methodology applied during the early stages of the COVID-19 pandemic that uses detailed aviation data at the final destination level in order to measure [...] Read more.
Air travel has a decisive role in the spread of infectious diseases at the global level. We present a methodology applied during the early stages of the COVID-19 pandemic that uses detailed aviation data at the final destination level in order to measure the risk of the disease spreading outside China. The approach proved to be successful in terms of identifying countries with a high risk of infected travellers and as a tool to monitor the evolution of the pandemic in different countries. The high number of undetected or asymptomatic cases of COVID-19, however, limits the capacity of the approach to model the full dynamics. As a result, the risk for countries with a low number of passengers from Hubei province appeared as low. Globalization and international aviation connectivity allow travel times that are much shorter than the incubation period of infectious diseases, a fact that raises the question of how to react in a potential new pandemic. Full article
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Article
Analysis of Imported Cases of COVID-19 in Taiwan: A Nationwide Study
Int. J. Environ. Res. Public Health 2020, 17(9), 3311; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093311 - 09 May 2020
Cited by 31 | Viewed by 2922
Abstract
In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers [...] Read more.
In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers for Disease Control website. We analysed the characteristics, infection source, symptom presentation, and route of identification of the 321 imported cases that were identified from 21 January to 6 April 2020. They were mostly returned Taiwanese citizens who had travelled to one or more of 37 countries for tourism, business, work, or study. Half of these cases developed symptoms before arrival, most of the remainder developed symptoms 1–13 days (mean 4.0 days) after arrival, and 3.4% never developed symptoms. Three-quarters of the cases had respiratory symptoms, 44.9% had fever, 13.1% lost smell or taste, and 7.2% had diarrhoea. Body temperature and symptom screening at airports identified 32.7% of the cases. Of the remainder, 27.7% were identified during home quarantining, 16.2% were identified via contact tracing, and 23.4% were reported by hospitals. Under the strict enforcement of these measures, the incidence of locally acquired COVID-19 cases in Taiwan remains sporadic. In conclusion, proactive border control measures are effective for preventing community transmission of this disease. Full article
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Article
Modeling Impact of Word of Mouth and E-Government on Online Social Presence during COVID-19 Outbreak: A Multi-Mediation Approach
Int. J. Environ. Res. Public Health 2020, 17(8), 2954; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082954 - 24 Apr 2020
Cited by 23 | Viewed by 4121
Abstract
Although social presence plays an essential role under general conditions, its role becomes significant for societal protection during the quarantine period in epidemic outbreak. In this study, we attempted to identify the role of E-government and COVID-19 word of mouth in terms of [...] Read more.
Although social presence plays an essential role under general conditions, its role becomes significant for societal protection during the quarantine period in epidemic outbreak. In this study, we attempted to identify the role of E-government and COVID-19 word of mouth in terms of their direct impact on online social presence during the outbreak as well as their impacts mediated by epidemic protection and attitudes toward epidemic outbreaks. For this purpose, a unique multi-mediation model is proposed to provide a new direction for research in the field of epidemic outbreaks and their control. Through random sampling, an online survey was conducted and data from 683participants were analyzed. Partial least squares structural equation modeling was used to test the relationships between the variables of interest. The study results revealed that the roles of E-government and COVID-19 word of mouth are positively related to online social presence during the outbreak. Epidemic protection and attitude toward epidemic outbreak were found to positively moderate the impact of the role of E-government and COVID-19 word of mouth on online social presence during the outbreak. The key findings of this study have both practical and academic implications. Full article
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Article
Spatio-Temporal Patterns of the 2019-nCoV Epidemic at the County Level in Hubei Province, China
Int. J. Environ. Res. Public Health 2020, 17(7), 2563; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072563 - 08 Apr 2020
Cited by 21 | Viewed by 2597
Abstract
Understanding the spatio-temporal characteristics or patterns of the 2019 novel coronavirus (2019-nCoV) epidemic is critical in effectively preventing and controlling this epidemic. However, no research analyzed the spatial dependency and temporal dynamics of 2019-nCoV. Consequently, this research aims to detect the spatio-temporal patterns [...] Read more.
Understanding the spatio-temporal characteristics or patterns of the 2019 novel coronavirus (2019-nCoV) epidemic is critical in effectively preventing and controlling this epidemic. However, no research analyzed the spatial dependency and temporal dynamics of 2019-nCoV. Consequently, this research aims to detect the spatio-temporal patterns of the 2019-nCoV epidemic using spatio-temporal analysis methods at the county level in Hubei province. The Mann–Kendall and Pettitt methods were used to identify the temporal trends and abrupt changes in the time series of daily new confirmed cases, respectively. The local Moran’s I index was applied to uncover the spatial patterns of the incidence rate, including spatial clusters and outliers. On the basis of the data from January 26 to February 11, 2020, we found that there were 11 areas with different types of temporal patterns of daily new confirmed cases. The pattern characterized by an increasing trend and abrupt change is mainly attributed to the improvement in the ability to diagnose the disease. Spatial clusters with high incidence rates during the period were concentrated in Wuhan Metropolitan Area due to the high intensity of spatial interaction of the population. Therefore, enhancing the ability to diagnose the disease and controlling the movement of the population can be confirmed as effective measures to prevent and control the regional outbreak of the epidemic. Full article
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Article
Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(7), 2381; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072381 - 31 Mar 2020
Cited by 416 | Viewed by 37637
Abstract
Our study aimed to investigate the immediate impact of the COVID-19 pandemic on mental health and quality of life among local Chinese residents aged ≥18 years in Liaoning Province, mainland China. An online survey was distributed through a social media platform between January [...] Read more.
Our study aimed to investigate the immediate impact of the COVID-19 pandemic on mental health and quality of life among local Chinese residents aged ≥18 years in Liaoning Province, mainland China. An online survey was distributed through a social media platform between January and February 2020. Participants completed a modified validated questionnaire that assessed the Impact of Event Scale (IES), indicators of negative mental health impacts, social and family support, and mental health-related lifestyle changes. A total of 263 participants (106 males and 157 females) completed the study. The mean age of the participants was 37.7 ± 14.0 years, and 74.9% had a high level of education. The mean IES score in the participants was 13.6 ± 7.7, reflecting a mild stressful impact. Only 7.6% of participants had an IES score ≥26. The majority of participants (53.3%) did not feel helpless due to the pandemic. On the other hand, 52.1% of participants felt horrified and apprehensive due to the pandemic. Additionally, the majority of participants (57.8–77.9%) received increased support from friends and family members, increased shared feeling and caring with family members and others. In conclusion, the COVID-19 pandemic was associated with mild stressful impact in our sample, even though the COVID-19 pandemic is still ongoing. These findings would need to be verified in larger population studies. Full article
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Article
Prediction of Number of Cases of 2019 Novel Coronavirus (COVID-19) Using Social Media Search Index
Int. J. Environ. Res. Public Health 2020, 17(7), 2365; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072365 - 31 Mar 2020
Cited by 63 | Viewed by 7130
Abstract
Predicting the number of new suspected or confirmed cases of novel coronavirus disease 2019 (COVID-19) is crucial in the prevention and control of the COVID-19 outbreak. Social media search indexes (SMSI) for dry cough, fever, chest distress, coronavirus, and pneumonia were collected from [...] Read more.
Predicting the number of new suspected or confirmed cases of novel coronavirus disease 2019 (COVID-19) is crucial in the prevention and control of the COVID-19 outbreak. Social media search indexes (SMSI) for dry cough, fever, chest distress, coronavirus, and pneumonia were collected from 31 December 2019 to 9 February 2020. The new suspected cases of COVID-19 data were collected from 20 January 2020 to 9 February 2020. We used the lagged series of SMSI to predict new suspected COVID-19 case numbers during this period. To avoid overfitting, five methods, namely subset selection, forward selection, lasso regression, ridge regression, and elastic net, were used to estimate coefficients. We selected the optimal method to predict new suspected COVID-19 case numbers from 20 January 2020 to 9 February 2020. We further validated the optimal method for new confirmed cases of COVID-19 from 31 December 2019 to 17 February 2020. The new suspected COVID-19 case numbers correlated significantly with the lagged series of SMSI. SMSI could be detected 6–9 days earlier than new suspected cases of COVID-19. The optimal method was the subset selection method, which had the lowest estimation error and a moderate number of predictors. The subset selection method also significantly correlated with the new confirmed COVID-19 cases after validation. SMSI findings on lag day 10 were significantly correlated with new confirmed COVID-19 cases. SMSI could be a significant predictor of the number of COVID-19 infections. SMSI could be an effective early predictor, which would enable governments’ health departments to locate potential and high-risk outbreak areas. Full article
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