Socio-behavioural impact of COVID-19 on general population: A cross-sectional survey of one thousand seventy-nine participants across India between the first and the second wave of pandemic

Background and aimsCOVID-19 is expected to have a significant impact on the socio-behavioural aspect of citizens’ lives, although the effects are expected to manifest differently in different population groups. The current study was conducted to assess the socio-behavioural impact of COVID-19 among the general population across India between the first and the second wave of pandemic.MethodsA web-based cross-sectional study was conducted from 15th March ?25th March 2021 using a pre-validated validated questionnaire upon the general population using e-survey, telephonic and face-to-face interview. The participants were recruited from the different regions of India by the purposive and snowball sampling technique following the principle of maximum diversity. Appropriate statistical tests were applied to study the association between the various sociodemographic variables and different behaviours.ResultsA total of 1079 responses were analysed for the study. Almost half of the participants feared contracting the COVID-19 infection. Overall, female participants, elderly people (more than 60 years of age) and urban dwellers reported a greater fear in the survey. More than half of the participants (53.39%) reported significant difficulties due to home confinement. People have become more inclined to adopt healthy lifestyles. There are mixed responses in the area of following preventive practices.ConclusionPeople have a significant amount of fear and anxiety related to the pandemic, leading to several social and behavioural changes that might have a considerable impact on their everyday lives.     

Lifestyle changes as a result of COVID-19 containment measures: Bodyweight and glycemic control in patients with diabetes in the Japanese declaration of a state of emergency

To clarify the association between lifestyle changes as a result of coronavirus disease 2019 containment measures and changes in metabolic and glycemic status in patients with diabetes, a cross-sectional, single-center, observation study was carried out. A self-reported questionnaire was provided to ascertain the frequency of various lifestyle activities before and after the coronavirus disease 2019 containment measures in Japan. Among 463 patients, change in glycated hemoglobin was significantly associated with change in bodyweight. After stratification by age 65 years, binary logistic regression analysis showed that increased frequency of snack eating increased bodyweight (odds ratio 1.709, P = 0.007) and glycated hemoglobin (odds ratio 1.420, P = 0.025) in the younger group, whereas in the older patients, reduced walking activities resulted in weight gain (odds ratio 0.726, P = 0.010). In conclusion, changes in eating behavior and physical activity increased bodyweight and reduced glycemic control among diabetes patients, but by different processes depending on age under the coronavirus disease 2019 containment measures in Japan.     

The Impact of COVID-19 Pandemic on the Hospital Management of TAVI Patients: TAVI Team Thoughts and Recommendation

The COVID-19 Pandemic has put enormous pressure on the healthcare system globally, causing many healthcare organizations all over the world to cancel or stop elective procedures in their cardiac catheterization laboratoires. This delay in elective procedures with no doubt has led to a suspension of patient care primarily to those with severe aortic stenosis, which might place them at higher risk for cardiovascular complications like sudden death and heart failure.Health Care Worker are faced with the uncertainty of contracting infections while performing procedures in patients with a confirmed diagnosis of COVID-19 or suspected cases. This unprecedented situation is very challenging for the safety of Health Care Worker. Hence, in this article, we aim to summarize some of the current guidelines as to how to triage patients in need for Trans Catheter Aortic Valve Implantation (TAVI), during this ongoing pandemic, and will address some necessary considerations related to the preparation of catheterization laboratories and personal during the COVID-19 pandemic.     

Impact of COVID-19 outbreak on lifestyle behaviour: A review of studies published in India

Background and aimsThe entire globe is undergoing an unprecedented challenge of COVID-19 which has affected the lifestyle behaviour of individuals. The present review is an attempt to summarize the effect of pandemic COVID-19 on lifestyle behaviour among the Indian population.MethodsA review was carried out to summarize the effect of pandemic COVID-19 on lifestyle behaviour focusing on changes in dietary or eating behaviour, stress, sleep pattern, and level of physical activity among the Indian population. Literature searches were conducted in PubMed and Google Scholar from inception till October 2020 to identify all relevant studies.ResultsA total of 11 studies (n = 5957, age group 18–70 years, comprising both genders) consisting of 1 hospital and 10 community based, were included in the present review. A change in lifestyle behaviour was observed due to COVID-19. Psychosocial or any kind of mental stress among the participants was found to be prevalent. Weight gain and decline in physical activity were also observed. Not only sleep quantity but sleep quality was also found to be affected due to COVID-19.ConclusionThe present review indicates the need for lifestyle behaviour programmes via using the platform of E-media and also for the dissemination of health education.     

Effects of COVID-19 lockdown on type 2 diabetes,lifestyle and psychosocial health: A hospital-based cross-sectional survey from South India

Background and aimsLockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health.MethodsThe pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology.ResultThe overall physical activity and dietary adherence remained unchanged in more than 80% of the participants. There was increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications. No significant change was noted in the mean HbA1c and body weight before and after lockdown. Most of them (99%) watched television and 73.6% of them spent time with their family members. Those with mental stress and poor sleep had unhealthy dietary habits. Poor glycemic control was seen in those with less physical activity and an unhealthy diet.ConclusionLockdown did not cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times.     

Impact of an inclusive COVID-19 visitation policy on patient satisfaction and visitor safety

BackgroundThe COVID-19 pandemic presented unique and unprecedented challenges due to limited knowledge regarding the virus's transmissibility. With guidance from the Center for Disease Control (CDC), healthcare systems instituted widespread visitor restrictions. Hospitalization is a stressful time for patients. Visitor support can help minimize this during and after discharge.MethodsA telephone interview was conducted among hospitalized COVID-19 positive patients discharged between March 1st and August 31st, 2021 to explore the patients and visitors’ experiences and the impact of the visitor policy during their hospitalization.ResultsA total of 238 patients were interviewed. For patients with visitors, 98% felt that the presence of visitors improved their overall wellbeing and satisfaction. Additionally, 86% reported that visitors were involved in helping with their care upon discharge. For patients with no visitors, 59% felt that having a visitor would have improved their hospital stay. Nearly 50% reported that the absence of visitors made it difficult for family members to remain updated and informed of their hospital care.ConclusionThis study demonstrates that visitation for COVID-19 patients can be done safely and that there is a positive impact on patient wellbeing with increased visitor access. As we move towards COVID-19 endemicity, implementing evidence-based visitation policies that maximize patient wellbeing will be essential.     

Knowledge,barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: A cross-sectional survey from one thousand two hundred and forty-nine participants

Background and aimsThe success of the COVID-19 vaccination program is dependent on people's knowledge and attitude regarding the vaccination program. Higher vaccine acceptance can be ensured by strengthening the facilitators and limiting the barriers being observed among the general population.Material and methodsIndexed study is a cross-sectional web-based survey using a pre-validated questionnaire to assess knowledge, barriers and facilitators of COVID-19 vaccine and vaccination programme administered on adults across India using a Google online survey platform.ResultsA total of 1294 responses (age: 38.02 ± 13.34 years) were collected. Most of the participants had limited knowledge regarding the eligibility of vaccines in vulnerable population groups such as people with allergies (57.89%) and immune-compromised patients (62.98%), pregnant and lactating women (41.89%) and patients with chronic illness (34.78%). Older participants (>45 years) were more willing to take the COVID-19 vaccine (p < 0.001) as they believed the vaccine is not harmful and considered it as societal responsibility. Younger participants (<45 years) and those residing in urban settings raised concerns on the availability of the vaccine and authenticity of the vaccine (p < 0.001).ConclusionThere is a scope for improvement in people's knowledge regarding COVID-19 vaccine and the vaccination programme by addressing the barriers and facilitators which can improve the participants' turnover at vaccination centres.     

Impact of lockdown on bed occupancy rate in a referral hospital during the COVID-19 pandemic in northeast Brazil

Coronaviruses are known to be responsible for infections in humans since the 1960s and have accounted for epidemics in recent human history. More recently, in 2019, a disease caused by a new coronavirus appeared in China, in the province of Wuhan, with a characteristic of greater infectivity, called COVID-19, which has caused a new world pandemic. Considering the need to contain the advance in the number of cases, based on the high rate of transmissibility, several countries have adopted extreme social distancing measures, including the so-called ‘lockdown’. Despite the socioeconomic side effects, the aforementioned measure reduced the progression of the pandemic in countries that adopted it. In Brazil, the state of Ceará was one of the first epicenters of the disease in the country and the state capital city of Fortaleza, on May 8, implemented the lockdown measure to contain the increase in the number of cases. It was then observed, in a tertiary hospital, which is a referral for COVID-19 cases, a decrease in the daily occupancy rate of beds reserved for the pandemic after the lockdown onset, evidencing that this measure leads to a sustainable reduction in bed occupation rates, thus preventing the collapse and overload in health services.     

Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease

AimsCoV-19/SARS-CoV-2 is a highly pathogenic virus that is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of infection, several governments have enforced restrictions on outdoor activities or even collective quarantine on the population. The present commentary briefly analyzes the effects of quarantine on lifestyle, including nutrition and physical activity and the impact of new technologies in dealing with this situation.Data synthesisQuarantine is associated with stress and depression leading to unhealthy diet and reduced physical activity. A diet poor in fruit and vegetables is frequent during isolation, with a consequent low intake of antioxidants and vitamins. However, vitamins have recently been identified as a principal weapon in the fight against the Cov-19 virus. Some reports suggest that Vitamin D could exert a protective effect on such infection. During quarantine, strategies to further increase home-based physical activity and to encourage adherence to a healthy diet should be implemented. The WHO has just released guidance for people in self-quarantine, those without any symptoms or diagnosis of acute respiratory illness, which provides practical advice on how to stay active and reduce sedentary behavior while at home.ConclusionQuarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine, a global action supporting healthy diet and physical activity is mandatory to encourage people to return to a good lifestyle routine.     

Impact of COVID-19 on the surgical volume of general surgery residents as main surgeons in a National Training Program in Costa Rica: A cross-sectional study

To quantify the impact of coronavirus disease 19 (COVID-19) on the surgical volume of residents’ medical practice in Costa Rica''s General Surgery Residency Program.The COVID-19 pandemic has caused a significant disruption in people''s lives. Health systems worldwide have been forced to adapt to the new normal, which has posed a challenge for medical residency programs, especially in the surgical field.This transversal study includes the surgical records of all residents of the General Surgery program who worked as main surgeons at the Mexico Hospital of the Costa Rican Social Security between December 23, 2019, and June 25, 2020.As main surgeons, a total of 10 residents performed 291 pre-pandemic surgeries and 241 pandemic surgeries.When comparing the distribution of procedures performed by residency levels, it is observed that the postgraduate year -2 increased the number of procedures performed during the pandemic period (pre-pandemic 19% vs pandemic 27%, P = .028). There was no statistically significant difference between the pre-pandemic and pandemic periods in the remaining levels.When comparing the procedures by unit, a statistically significant decrease was observed in the Endocrine-Abdominal Wall Unit (pre-pandemic 18.3% vs pandemic 5.4%, P < .001). Conversely, a statistically significant increase was identified in Surgical Emergencies Unit procedures (40.0% vs post 51.7%, P = .007). No statistically significant differences were observed in the remaining the Units.The COVID-19 pandemic had no statistically significant effect on surgeries performed by residents of the General Surgery Residency Program as main surgeons in a national training center in Costa Rica. The Department''s timely measures and pro-resident attitude were the key reasons for the above results.     

新型冠状病毒肺炎疫情干预措施对惠州市结核病防控工作的影响

目的 了解新型冠状病毒肺炎疫情干预措施对广东省惠州市结核病防控工作的影响。方法 通过《中国疾病预防控制信息系统》子系统《结核病信息管理系统》收集广东省惠州市2019年1—6月和2020年1—6月初诊肺结核患者登记信息、肺结核患者耐药筛查和治疗转归信息。通过惠州市基本公共卫生服务项目(结核病患者健康管理)报表,获取结核病患者督导访视和规则服药情况。根据我国新型冠状病毒肺炎疫情的实际状况,设定2020年1—6月为疫情期,设定2019年1—6月为基线期,比较疫情期间和基线期间惠州市肺结核患者发现、随访检查、服药管理和督导访视等的变化情况。结果 新型冠状病毒肺炎疫情期间,惠州市肺结核患者检出率由基线期的26.32%(881/3347)上升到27.45%(794/2893),但差异无统计学意义(χ²=0.997,P=0.318);病原学阳性肺结核患者耐药筛查率由基线期间的95.66%(375/392)上升到99.73%(372/373),差异有统计学意义(χ²=13.771,P=0.000);确诊患者随访检查率由基线期间的96.37%(849/881)下降到96.10%(763/794),差异无统计学意义(χ²=0.085,P=0.770);督导访视率由基线期的99.16%(8037/8105)上升到99.25%(7290/7345),差异无统计学意义(χ²=0.529,P=0.397);规则服药率由基线期的95.46%(841/881)上升到96.10%(763/794),差异无统计学意义(χ²=0.416,P=0.519)。结论 新型冠状病毒肺炎疫情干预措施未对惠州市结核病防控工作造成影响,结核病防治服务体系运行良好,未来应该继续强化保障结核病服务体系,以确保在任何情况下都能提供正常的诊疗管理服务。     

Are health care workers following preventive practices in the COVID-19 pandemic properly? - A cross-sectional survey from India

Background and aimsHealth care workers (HCWs) are at increased risk of getting infected with Coronavirus disease 2019 (COVID-19) and suboptimal preventive practices have been identified as an important risk factor in this regard. This study was done to evaluate the preventive practices being followed by health care workers and identify reasons for suboptimal compliance.MethodsA cross-sectional survey was done in HCWs belonging to various occupational roles and socio-cultural backgrounds across India through online platforms and telephonic interviews from July 30, 2020 to August 30, 2020. A scientifically designed and pre-validated questionnaire with good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach’s alpha coefficient = 0.85) was used.ResultsThe responses of 956 participants were analysed. Various suboptimal practices like touching outer surface of masks, lack of social distancing in cafeteria and duty rooms, inability to wash hands for adequate duration and properly follow steps of hand hygiene, inability to don and doff PPE properly, carrying PPE to duty rooms before completely doffing, use of personal mobile phones during duty and improper sleep were identified. Lack of knowledge, long duty hours, shortage of PPE, high patient workload, and casual attitude regarding own safety were identified as important barriers. Resident doctors and paramedical staff in the age group 18–30 years reported lower adherence.ConclusionsSuboptimal compliance in preventive practices like handling PPE, distancing in cafeteria/duty rooms and hand hygiene is not uncommon in HCWs. Certain barriers are identified which should be addressed to ensure adequate safety of HCWs against COVID-19.     

Knowledge,attitude, perceptions,and concerns of pregnant and lactating women regarding COVID-19 vaccination: A cross-sectional survey of 313 participants from a tertiary care centre of North India

AimThe study aimed to assess the knowledge, attitude, perceptions, and concerns of pregnant and lactating women regarding COVID-19 vaccination.MethodsA cross-sectional survey was conducted using a pre-validated questionnaire to assess the knowledge, attitude, perceptions, and concerns about COVID 19 vaccination among pregnant and lactating women.ResultsMost (90%) of the study participants(n =313) agreed that it was essential to get vaccinated for COVID-19 and were aware that pregnant (72.2%) or lactating women (65.2%) are eligible for vaccination. There was a significant positive association between willingness to pay for the vaccine and the socio-economic status (p<0.01). Women residing in rural areas wanted to wait to see the effect of the vaccine on other pregnant and lactating women (p<0.001). The major factors associated with vaccine hesitancy were unforeseen future effects of vaccines on the foetus (58.6%) and rapid development and approval of vaccine without including pregnant and lactating women in vaccine trials (53.6%). These factors were positively associated with socioeconomic status (p<0.05) and residence (p<0.01)ConclusionThe safety concerns regarding the COVID-19 vaccine is a major reason for vaccine hesitancy. The policymakers should advocate, investigate, and publicize relevant data on vaccine efficacy and safety among these women.     

Impact of COVID-19 and comorbidities on health and economics: Focus on developing countries and India

Background and aimsPresence of comorbidities in patients with Coronavirus disease 2019 (COVID-19) have often been associated with increased in-hospital complications and mortality. Intriguingly, several developed countries with a higher quality of life have relatively higher mortality with COVID-19, compared to the middle- or low-income countries. Moreover, certain ethnic groups have shown a higher predilection to contract COVID-19, with heightened mortality. We sought to review the available literature with regards to impact of COVID-19 and comorbidities on the health and economics, especially in context to the developing countries including India.MethodsA Boolean search was carried out in PubMed, MedRxiv and Google Scholar databases up till August 23, 2020 using the specific keywords, to find the prevalence of comorbidities and its outcome in patients with COVID-19.ResultsAll available evidence consistently suggests that presence of comorbidities is associated with a poor outcome in patients with COVID-19. Diabetes prevalence is highest in Indian COVID-19 patients, compared to other countries. Majority of the patients with COVID-19 are asymptomatic ranging from 26 to 76%.ConclusionsUniversal masking is the need of hour during unlock period. Low-income countries such as India, Brazil and Africa with less resources and an average socio-economic background, must adopt a strict policy for an affordable testing programs to trace, test, identify and home quarantine of asymptomatic cases. Despite the huge number of COVID-19 patients, India still has low volume research at the moment.     

Impact of nationwide lockdown on cancer care during COVID-19 pandemic: A retrospective analysis from western India

Background and aimsCOVID-19 has impacted healthcare system worldwide including cancer case. Aim of this study was to describe the experience of lockdown on cancer care concerning patient's visit and reception of treatment in western India.MethodsThis is a retrospective observational study conducted in patients with cancer attending a tertiary care center pre-lockdown and during lockdown (from January to May 2020). Data related to demographic parameters, type of tumor, type of treatment received and functional status of patients were retrieved from hospital medical records of patients.ResultsOf the 5258 patients included, 4363 visited hospital pre-lockdown (median age, 50 years) and 895 visited during the lockdown period (median age, 47 years). A total of 1168 and 106 patients visiting hospital before and during lockdown, respectively, had comorbidities. Breast cancer (25.6% and 29.7%), head and neck cancer (21.3% and 16.9%) were the most common type of solid tumors; leukemia (58.0% and 73.0%), lymphoma (18.8% and 13.5%) and multiple myeloma (18.6% and 12.2%) were the most common type of hematological malignancies observed in patients visiting pre-lockdown and during lockdown, respectively. Chemotherapy was most commonly received treatment (pre-lockdown, 71.8%; during lockdown, 45.9%). Other therapies reported includes supportive/palliative, targeted, hormonal, and immunotherapy. The majority of patients who visited the hospital pre-lockdown (68.4%) and during lockdown (62.8%) had 0 or 1 Eastern Cooperative Oncology Group (ECOG) score.ConclusionOverall observations highlight a substantial impact of an imposed nationwide lockdown during COVID-19 pandemic on cancer care of patients in terms of reduced patient visits and number of treatments received.     

The impact of COVID-19 and masking practices on pertussis cases at a large academic medical center (2019-2021)

We reviewed cases of Bordatella pertussis (B. pertussis) cases in ambulatory clinics at a large academic health care institution in Los Angeles from 2019-2021. Public health prevention measures during the Coronavirus disease 19 (COVID-19) pandemic impacted the number of pertussis cases identified.