Water, sanitation, hygiene and waste disposal practices as COVID-19 response strategy: insights from Bangladesh

Water pollution, cholera, and the role of probiotics: a comprehensive review in relation to public health in Bangladesh

Cholera, a disease caused by Vibrio cholerae, remains a pervasive public health threat, particularly in regions with inadequate water sanitation and hygiene infrastructure, such as Bangladesh. This review explores the complex interplay between water pollution and cholera transmission in Bangladesh, highlighting how contaminated water bodies serve as reservoirs for V. cholerae. A key focus is the potential role of probiotics as a novel intervention approach for cholera prevention and management. Probiotics are promising as an adjunctive approach to existing therapies as they can enhance gut barrier function, induce competitive exclusion of pathogens, and modulate host immune responses. Recent probiotic advancements include engineering strains that disrupt V. cholerae biofilms and inhibit their virulence. Integrating probiotics with traditional cholera control measures could significantly enhance their effectiveness and provide a multifaceted approach to combating this persistent disease. This review aims to shed light on the potential of probiotics in revolutionizing cholera management and to offer insights into their application as both preventive and therapeutic tools in the fight against this enduring public health challenge.

Reconciling and contextualising multi-dimensional aspects for consolidated water security index: A synthesis

The present paper aims to review and develop a Consolidated Water Security Index (CWSI) as a tool to evaluate water security status within river basins by considering five key dimensions, namely (i) water supply and sanitation, (ii) water demand and socio-economic, (iii) water ecosystem and environment, (iv) water-related disaster and (v) water governance. This index is a holistic assessment since it aims to capture the interconnected and complex nature of water-related issues by considering multiple dimensional aspects which helps stakeholders and policymakers to understand the overall status of water security. This framework uses the Analytic Hierarchy Process (AHP), involving pairwise comparison, normalisation and weighting. Then, a CWSI will be calculated using the Linear Aggregation method. The robustness of this consolidated index is validated using sensitivity analysis by modifying the weight in the linear aggregation formula. By following each step cautiously, a CWSI can be constructed and interpreted correctly, thus, becoming a powerful tool for conveying complex information to the different stakeholders and assessing the status of water security with river basins. The CWSI allows decision-makers to prioritise areas that are most at risk and facilitate sustainable planning and management of water resources.

Assessing the impact of COVID-19 lockdown on surface water quality in Ireland using advanced Irish water quality index (IEWQI) model

The COVID-19 pandemic has significantly impacted various aspects of life, including environmental conditions. Surface water quality (WQ) is one area affected by lockdowns imposed to control the virus's spread. Numerous recent studies have revealed the considerable impact of COVID-19 lockdowns on surface WQ. In response, this research aimed to assess the impact of COVID-19 lockdowns on surface water quality in Ireland using an advanced WQ model. To achieve this goal, six years of water quality monitoring data from 2017 to 2022 were collected for nine water quality indicators in Cork Harbour, Ireland, before, during, and after the lockdowns. These indicators include pH, water temperature (TEMP), salinity (SAL), biological oxygen demand (BOD5), dissolved oxygen (DOX), transparency (TRAN), and three nutrient enrichment indicators-dissolved inorganic nitrogen (DIN), molybdate reactive phosphorus (MRP), and total oxidized nitrogen (TON). The results showed that the lockdown had a significant impact on various WQ indicators, particularly pH, TEMP, TON, and BOD5. Over the study period, most indicators were within the permissible limit except for MRP, with the exception of during COVID-19. During the pandemic, TON and DIN decreased, while water transparency significantly improved. In contrast, after COVID-19, WQ at 7% of monitoring sites significantly deteriorated. Overall, WQ in Cork Harbour was categorized as "good," "fair," and "marginal" classes over the study period. Compared to temporal variation, WQ improved at 17% of monitoring sites during the lockdown period in Cork Harbour. However, no significant trend in WQ was observed. Furthermore, the study analyzed the advanced model's performance in assessing the impact of COVID-19 on WQ. The results indicate that the advanced WQ model could be an effective tool for monitoring and evaluating lockdowns' impact on surface water quality. The model can provide valuable information for decision-making and planning to protect aquatic ecosystems.

Determinants of proper disposal of single-use masks: knowledge, perception, behavior, and intervention measures

Background

Although many studies testify to consumer behavior's role in the context of waste-related sustainability objectives, little research examined what people know, think, and feel about the environmental impacts of their personal protective equipment (PPE) or their behavior towards them, in general. Therefore, the present article complements existing information about the public perceptions, knowledge, and behavior of single-use masks in a context where the pandemic has put increasing pressure on waste management public services. From February to June 2020, municipal solid waste increased ten times in Romania. The study identified the factors that predicted the proper disposal of single-use masks and the measures preferred to prevent or minimize the negative impact of single-use mask waste.

Method

Data from a representative sample of 705 Romanians were collected using a structured questionnaire. The data were analyzed with SPSS and SmartPLS. The Cochran's Q test was run to determine the existence of differences between percentages of people who preferred various measures. Dunn's test with a Bonferroni correction was used to identify the exact pair of groups where the differences were located. The study utilized structural equation models (SEM) based on at least partial squares with SmartPLS software (3.2.8) to investigate causal links between constructs. The model considered that the dependent variable (environmentally friendly behavior: proper disposal of single-use masks) could be influenced by the knowledge, perception, behavior, and demographics variables.

Results

The findings indicated that knowledge of the type of material of single-use masks had a direct positive (β = 0.173) and significant effect on their proper disposal. The perception of mask waste impact has a negative and significant (β = -0.153, p < 0.001) impact on the proper disposal of single-use masks. This path coefficient illustrates that the worse the perceived impact of single-use masks on waste management activity, the higher the proper disposal of single-use masks. Gender has a positive (β = 0.115) and significant (p < 0.001) effect on the proper disposal of single-use masks.

Conclusions

It was concluded that the 5Rs waste management approach should be reconsidered for single-use mask waste. For example, "Reuse" and the classic "Recycle" have limited applications since they may lead to virus transmission and possible infection. "Reducing" the use of single-use masks could have repercussions on one's health. Summing up, the study outlined recommendations for effective interventions for the proper disposal of single-use masks from the perspective of behavioral studies.

Removal of Malachite Green using carbonized material derived from disposable facemasks: optimization of removal process through Box-Behnken design

Water resources are being heavily contaminated due to the huge load of toxic pollutants released by industrial activities. Among various physical and chemical methods, adsorption is considered as a promising method for rapidly removing contaminants from wastewater. In the present study, a novel carbon-based adsorbent was prepared through controlled pyrolysis of disposable facemasks. The properties of carbonized compound (CC) were characterized by FTIR, XRD, SEM and EDX. The pollutant removal efficiency of CC was initially investigated with synthetic dyes Malachite Green (MG) and Congo Red (CR). The peaks observed in FTIR spectra corresponding to C=O and C=C and C-N functional groups on adsorbed CC surface confirm the interaction between dye and CC. The XRD spectra of CC showed strong peaks at 2θ = 26.629, 27.488, 27.810 and 29.404 which correspond to the disordered graphitic plane. The SEM images of CC showed good porosity nature. A quadratic model was developed through response surface methodology by conducting a series of Box-Behnken design experiments. Adequacy of this model variables was ensured by ANOVA tests at P-value <0.05. The lower P-value (<0.0001) and higher F-value (44.54) of the quadratic model showed it was a significant model for dye removal. Finally, the optimal condition to obtain maximum MG removal (rate >99%) was identified by desirability function as CC 1000 and MG 212 mg/L and adsorption time 180 min. Adsorption kinetic study indicates that a pseudo second-order kinetic model showed the best fit with R²=  0.999.

Personal protective equipment (PPE) disposal during COVID-19: An emerging source of microplastic and microfiber pollution in the environment

Waste generated by healthcare facilities during the COVID-19 pandemic has become a new source of pollution, particularly with the widespread use of single-use personal protective equipment (PPE). Releasing microplastics (MPs) and microfibers (MFs) from discarded PPE becomes an emerging threat to environmental sustainability. MPs/MFs have recently been reported in a variety of aquatic and terrestrial ecosystems, including water, deep-sea sediments, air, and soil. As COVID-19 spreads, the use of plastic-made PPE in healthcare facilities has increased significantly worldwide, resulting in massive amounts of plastic waste entering the terrestrial and marine environments. High loads of MPs/MFs emitted into the environment due to excessive PPE consumption are easily consumed by aquatic organisms, disrupting the food chain, and potentially causing chronic health problems in humans. Thus, proper management of PPE waste is critical for ensuring a post-COVID sustainable environment, which has recently attracted the attention of the scientific community. The current study aims to review the global consumption and sustainable management of discarded PPE in the context of COVID-19. The severe impacts of PPE-emitted MPs/MFs on human health and other environmental segments are briefly addressed. Despite extensive research progress in the area, many questions about MP/MF contamination in the context of COVID-19 remain unanswered. Therefore, in response to the post-COVID environmental remediation concerns, future research directions and recommendations are highlighted considering the current MP/MF research progress from COVID-related PPE waste.

Waste management beyond the COVID-19 pandemic: Bibliometric and text mining analyses

The outbreak of the COVID-19 pandemic has significantly increased the demand for personal protective equipment, in particular face masks, thus leading to a huge amount of healthcare waste generated worldwide. Consequently, such an unprecedented amount of newly emerged waste has posed significant challenges to practitioners, policy-makers, and municipal authorities involved in waste management (WM) systems. This research aims at mapping the COVID-19-related scientific production to date in the field of WM. In this vein, the performance indicators of the target literature were analyzed and discussed through conducting a bibliometric analysis. The conceptual structure of COVID-19-related WM research, including seven main research themes, were uncovered and visualized through a text mining analysis as follows: (1) household and food waste, (2) personnel safety and training for waste handling, (3) sustainability and circular economy, (4) personal protective equipment and plastic waste, (5) healthcare waste management practices, (6) wastewater management, and (7) COVID-19 transmission through infectious waste. Finally, a research agenda for WM practices and activities in the post-COVID-19 era was proposed, focusing on the following three identified research gaps: (i) developing a systemic framework to properly manage the pandemic crisis implications for WM practices as a whole, following a systems thinking approach, (ii) building a circular economy model encompassing all activities from the design stage to the implementation stage, and (iii) proposing incentives to effectively involve informal sectors and local capacity in decentralizing municipal waste management, with a specific focus on developing and less-developed countries.

COVID-19 and household water insecurities in vulnerable communities in the Mekong Region

Access to sufficient clean water is important for reducing the risks from COVID-19. It is unclear, however, what influence COVID-19 has had on water insecurities. The objective of this study was to assess the associations between COVID-19 control measures and household water insecurities. A survey of 1559 individuals living in vulnerable communities in five countries (Cambodia, Laos, Myanmar, Thailand, Vietnam) showed that increased needs for clean water to wash hands or facemasks made it more likely a person was water insecure along those dimensions. Water insecurities with respect to handwashing and drinking, in turn, made adoption of the corresponding good practices less likely, whereas in the case of washing facemasks there was no association. Water system infrastructure, environmental conditions such as floods and droughts, as well as gender norms and knowledge, were also important for water insecurities and the adoption of good practices. As domestic water insecurities and COVID-19 control measures are associated with each other, efforts should therefore be directed at identifying and assisting the water insecure at high risk when COVID-19 reaches their communities.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10668-022-02182-0.

Water, sanitation, hygiene practices, health and nutritional status among children before and during the COVID-19 pandemic: longitudinal evidence from remote areas of Dailekh and Achham districts in Nepal

BACKGROUND

The COVID-19 pandemic drew hygiene to the center of disease prevention. The provision of adequate water, sanitation, and hygiene (WASH) services is crucial to protect public health during a pandemic. Yet, access to levels of water supply that support adequate hygiene measures are deficient in many areas in Nepal. We examined WASH practices and their impact on child health and nutritional status in two districts before and during the COVID-19 pandemic.

METHODS

A longitudinal and mixed method study was conducted in March-May 2018 and November-December 2021. In total, 715 children aged 0-10 years were surveyed at baseline. Of these, 490 children were assessed at endline. Data collection methods included observations, a questionnaire, stool analysis, anthropometric measurements, water quality analysis, and an assessment of clinical signs of nutritional deficiencies. We conducted 10 in-depth interviews to understand major problems related to COVID-19.

RESULTS

Most respondents (94.2%) had heard about COVID-19; however, they did not wear face masks or comply with any social distancing protocols. Almost 94.2% of the households self-reported handwashing with soap 5-10 times per day at endline, especially after defecation, compared to 19.6% at baseline. Water quality was better at endline than at baseline with median 12 to 29 CFU Escherichia coli/100 mL (interquartile range at baseline [IQR] = 4-101) at the point of collection and 34 to 51.5 CFU Escherichia coli/100 mL (IQR = 8-194) at the point of consumption. Fever (41.1-16.8%; p = 0.01), respiratory illness (14.3-4.3%; p = 0.002), diarrhea (19.6-9.5%; p = 0.01), and Giardia lamblia infections (34.2-6.5%, p = 0.01) decreased at endline. In contrast, nutritional deficiencies such as bitot's spots (26.7-40.2%; p = 0.01), pale conjunctiva (47.0-63.3%; p = 0.01), and dermatitis (64.8-81.4%; p = 0.01) increased at endline. The inadequacy of the harvest and the lack of household income to meet households' nutritional needs increased drastically (35.0-94.2%; p = 0.01).

CONCLUSION

We found that improved water quality and handwashing practices were associated with a decrease in infectious diseases. However, food security also decreased resulting in a high prevalence of nutritional deficiencies. Our findings underline that disaster preparedness should consider access to adequate WASH, nutrition, and health supplies.

Recent incidence of infectious conjunctivitis in Bangladesh: Are we aware?

Bangladesh has seen a recent surge of infectious conjunctivitis nationwide for the last few weeks. Reported by journalists of daily newspapers, the incidence is now 33.33% in some eye outpatient departments (OPDs) of the country, which is surprisingly higher than the usual expected rate of the disease. In some districts, educational institutions have been shut down and it is greatly hampering the daily life of the citizens. Though the causative agent of the infection is yet unknown, the higher disease notification rate solicits rapid epidemiological studies and microbial assessment. Also, Bangladesh should be more aware in its hygiene practice and take adequate measures to halt the transmission of the disease to its South Asian neighbouring countries.

Evaluating knowledge, awareness and associated water usage towards hand hygiene practices influenced by the current COVID-19 pandemic in Bangladesh

Hand hygiene is considered as one of the most effective ways for preventing transmissible diseases, especially for preventing virus-borne diseases. The study has been conducted to evaluate changes in knowledge, awareness and practices of hand hygiene due to the outbreak of the coronavirus disease (COVID-19) in Bangladesh. The potential factors influencing human behaviours for maintaining hand hygiene have also been explored. Moreover, a probable increase in daily water demand associated with the changed situation has been assessed. An online survey was performed among a total of 367 Bangladeshi residents about their practices of hand hygiene during pre-corona, corona, and of their perceived future practices at post-corona period. It has been observed that a significant percentage (62.1%) of the respondents have received basic hygiene education at any level of their academic education. Nevertheless, their hygiene practices were very poor before the COVID-19 pandemic. The outbreak of the COVID-19 has reinforced their previous knowledge and greatly influenced their behavioural changes towards practicing hand hygiene as per World Health Organization guidelines for preventing the virus outbreak. The changes, however, have created increased water demand. The estimated water usage is found to be 2.68 times (9.15 L/c/d) and 2.52 times (8.59 L/c/d) higher in the corona and post-corona period respectively than that of the pre-corona situation (3.41 L/c/d). The principal component analysis (PCA) elucidated that an individual's practice of hand hygiene was associated with income, level of academic and hygiene education, and the COVID-19 outbreak itself. Moreover, the influence of hygiene education and COVID-19 outbreak affecting the duration of handwashing are found highly significant (p-value < 0.001) from the regression analysis. Raising awareness towards behavioural change of an individual about water usage, improvement of academic curriculum regarding hand hygiene and provision of water pricing are recommended to attain sustainable development goals of the country.

A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Using the concept of circular economy to reduce the environmental impact of COVID-19 face mask waste

COVID-19 pandemic has posed severe threats to the society globally. World Health Organization (WHO) guidelines suggest that people wear face masks as a precautionary measure daily. This has resulted in the generation of massive amounts of mask-associated waste in the environment. Owing to the criticality of the epidemic, there has not been a large-scale investigation on where to discard masks, making this situation daunting. As the pandemic continues, the use of masks continues to increase; repeated use and disposal of masks has become an imperative issue. Most disposable masks comprise chemical fibers in the filter layer. Without proper treatment and disposal, these large amounts of chemical waste will eventually flow into rivers or oceans, leading to serious pollution. Therefore, to reduce the negative effects on the marine environment, it is crucial that we produce reusable masks and reduce disposable wearing habits. This study aimed to resolve this challenge using textile materials created by recycling fish-scale waste. Functional and comfortable masks manufactured without chemical additives to achieve multiple functions can increase the willingness to wear and be reused. Hence, product use can be prolonged, and the use of disposable masks can be curtailed. The product manufactured herein is biodegradable in nature, thus conforming to the green sustainable initiative.

Jerarquización de zonas de atención prioritaria para la minimización del riesgo biológico en situación de crisis

Objetivo Proponer una herramienta para identificar sectores de población que requieren mayor atención por parte de autoridades locales o gubernamentales en situaciones de crisis biológica, considerando los factores que influyen en la adherencia a las normas de minimización de riesgos. Metodología Se implementó un algoritmo de ordenamiento, tomando como referencia las restricciones de julio del 2021 en Ecuador. El contexto del estudio se resume en siete sectores urbanos de la ciudad de Guayaquil, con una población caracterizada por un nivel de educación promedio por debajo de la educación secundaria superior (70%) y más del 50% entre 20-34 años, con alguna ocupación en el medio de una economía popular debilitada. Siete factores de riesgo fueron identificados después de un análisis estructural de la hipóótesis de adherencia (χ2/gl=3,6; CFI≥0,91; TLI≥0,90; RMSEA≤0,05), basado en una muestra aleatoria de n=515 adultos viviendo en las áreas afectadas. Resultados El seguimiento de las normas está influenciado por la percepción del clima de seguridad, el riesgo percibido y el entendimiento del riesgo. El umbral de ordenmiento (h) permite establecer relaciones unidireccionales entre variables. Conclusiones Los resultados muestran que Vergeles, Norte y Fertisa representan los sectores con mayor prioridad de atención en materia de salud pública {A4,A5,A6}>{A2}>{A3}>{A1}>{A7}. Se requiere identificar más factores para garantizar una diferenciación óptima.

Stakeholder Perspectives on COVID-19 and Household Water Access in Vulnerable Communities in the Mekong Region

The COVID-19 pandemic has underlined the importance of safe access to sufficient clean water in vulnerable communities, renewing interest in water, sanitation and hygiene (WASH) programs and related targets under Sustainable Development Goal 6 (SDG 6). The purpose of this study was to better understand the obstacles to water access in vulnerable communities and identify ways they might be addressed in five countries in the Mekong Region (Cambodia, Laos, Myanmar, Thailand, Vietnam). To this end, qualitative interviews with 50 government officials and development or health experts were complimented with a quantitative survey of the experiences and views of individuals in 15 vulnerable communities. There were several key findings. First, difficulties in accessing sufficient clean water for drinking and hygiene persist in certain vulnerable communities, including informal urban settlements, remote minority villages, and migrant worker camps. Second, limited rights, high prices, and remote locations were common obstacles to household access to improved water sources. Third, seasonal differences in the availability of clean water, alongside other disruptions to supply such as restrictions on movement in COVID-19 responses, drove households towards lower quality sources. Fourth, there are multiple threats to water quality from source to consumption that should be addressed by monitoring, treatment, and watershed protection. Fifth, stakeholder groups differ from each other and residents of vulnerable communities regarding the significance of water access, supply and quality difficulties, and how they should be addressed. The paper ends with a set of program suggestions addressing these water-related difficulties.

Virtual Methodology for Household Waste Characterization During The Pandemic in An Urban District of Peru: Citizen Science for Waste Management

The Covid-19 pandemic has caused the alteration of many aspects of the solid waste management chain, such as variations in the waste composition, generation and disposal. Various studies have examined these changes with analysis of integrated waste management strategies; qualitative studies on perceived variations and statistical evaluations based on waste collected or disposed in landfills. Despite this information there is a need for updated data on waste generation and composition, especially in developing countries. The objective of this article is to develop a data sampling and analytical approach for the collection of data on household waste generation and composition during the pandemic; and, in addition, estimate the daily generation of masks in the study area. The proposed methodology is based on the principles of citizen science and utilizes virtual tools to contact participants, and for the training and collection of information. The study participants collected the information, installed segregation bins in their homes and trained their relatives in waste segregation. The article presents the results of the application of the methodology in an urban district of Lima (Peru) in August 2020. The results suggest an apparent decrease in household waste per capita and a slight increase in plastics composition in the study area. It is estimated that each participant generates 0.124 masks per day and 0.085 pairs of gloves per day. The method developed and results presented can be used as a tool for public awareness and training on household waste characterization and segregation. Furthermore it can provide the necessary evidence to inform policy directives in response household waste issues and Covid-19 restrictions.

Communicating Water, Sanitation, and Hygiene under Sustainable Development Goals 3, 4, and 6 as the Panacea for Epidemics and Pandemics Referencing the Succession of COVID-19 Surges

WASH (water, sanitation, and hygiene) has become the most crucial amenity in the past decade for every individual on the planet. In the UN agenda for 2030, which created 17 Sustainable Development Goals (SDGs), SDGs 3, 4, and 6 directly correlate with WASH practices and management for creating a good health hygiene environment for all. The dearth of WASH facilities has created barriers for averting the transmission of COVID-19, motivating the concept of WASH as the primary step of precaution and prevention, which includes WASH practices, communication for literacy, and positive behavioral changes primarily in developing and low-income countries. This Review deals with the complex concept of correlation of WASH and SDGs 3, 4, and 6 while defining elaborate WASH practices, including the prominence of clean water, the need for sanitation facilities, and health hygiene for good health and immunity for preparedness for and during epidemics and pandemics. Certain risk factors explain the sectors in which the gaps exist, creating a gap for implementation of WASH practices in epidemics and pandemics across the globe. Further, COVID-19 surge succession is presented along with data of different variants that have occurred. The need of WASH understanding is required using different tools (audio-visual, social media, print media, and mass media) and strategies (communication, advocacy, and positive behavioral changes) for every individual as an act to counter consequences during and after the COVID-19 pandemic and as a routine practice for future preparedness. This Review gives a detailed concept of WASH understanding for every sector from community to government agencies and research professionals to act immediately for the sustainable future of humanity.

Water Quality and Water Pollution in Time of COVID-19: Positive and Negative Repercussions

On 11 March 2020, the World Health Organization declared the new COVID-19 disease a pandemic. Most countries responded with a lockdown to reduce its effects, which brought beneficial consequences to the environment in many regions, but the pandemic also raised a series of challenges. This review proposes an assessment of the COVID-19 pandemic positive and negative impacts on water bodies on different continents. By applying a search protocol on the Web of Science platform, a scientific bank of 35 compatible studies was obtained out of the 62 open-access articles that were initially accessible. Regarding the positive impacts, the SARS-CoV-2 monitoring in sewage waters is a useful mechanism in the promptly exposure of community infections and, during the pandemic, many water bodies all over the world had lower pollution levels. The negative impacts are as follows: SARS-CoV-2 presence in untreated sewage water amplifies the risk to human health; there is a lack of adequate elimination processes of plastics, drugs, and biological pollution in wastewater treatment plants; the amount of municipal and medical waste that pollutes water bodies increased; and waste recycling decreased. Urgent preventive measures need to be taken to implement effective solutions for water protection.

Escalating SARS-CoV-2 circulation in environment and tracking waste management in South Asia

The novel coronavirus disease of 2019 (COVID-19) pandemic has caused an exceptional drift of production, utilization, and disposal of personal protective equipment (PPE) and different microplastic objects for safety against the virus. Hence, we reviewed related literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected from household, biomedical waste, and sewage to identify possible health risks and status of existing laws, regulations, and policies regarding waste disposal in South Asian (SA) countries. The SARS-CoV-2 RNA was detected in sewage and wastewater samples of Nepal, India, Pakistan, and Bangladesh. Besides, this review reiterates the enormous amounts of PPE and other single-use plastic wastes generated from healthcare facilities and households in the SA region with inappropriate disposal, landfilling, and/or incineration techniques wind-up polluting the environment. Consequently, the Delta variant (B.1.617.2) of SARS-CoV-2 has been detected in sewer treatment plant in India. Moreover, the overuse of non-biodegradable plastics during the pandemic is deteriorating plastic pollution condition and causes a substantial health risk to the terrestrial and aquatic ecosystems. We recommend making necessary adjustments, adopting measures and strategies, and enforcement of the existing biomedical waste management and sanitation-related policy in SA countries. We propose to adopt the knowledge gaps to improve COVID-19-associated waste management and legislation to prevent further environmental pollution. Besides, the citizens should follow proper disposal procedures of COVID-19 waste to control the environmental pollution.

Challenges in Preventive Practices and Risk Communication towards COVID-19: A Cross-Sectional Study in Bangladesh

Bangladesh recently experienced a COVID-19 second wave, resulting in the highest number of new cases and deaths in a single day. This study aims to identify the challenges for COVID-19 preventive practices and risk communications and associated factors among Bangladeshi adults. A cross-sectional survey was conducted between December 2020 and January 2021 involving 1382 Bangladeshi adults (aged ≥ 18-years) in randomly selected urban and rural areas from all eight divisions in Bangladesh. Descriptive data analysis was conducted to highlight the challenges for preventive practices and risk communications for COVID-19. Multiple logistic regression analysis was used to determine the sociodemographic groups vulnerable to these challenges. Lack of availability of protective equipment (44.4%), crowded living situations/workspaces (36.8%), inadequate information on the proper use of protective measures (21.9%), inadequate handwashing and sanitation facilities (17.6%), and negative influences on family/friends (17.4%) were identified as barriers to COVID-19 preventive practices. It was also found that males (OR = 1.3, 95% CI = 1.01, 1.7), rural residents (OR = 1.5, 95% CI = 1.2, 2), respondents with a low level of education: no schooling vs. ≥higher secondary (OR = 3.5, 95% CI = 2.3, 5.2), primary vs. ≥higher secondary (OR = 2.5, 95% CI = 1.7, 3.8), respondents engaged in agricultural (OR = 1.7, 95% CI = 1.2, 2.4), laboring (OR = 3.2, 95% CI = 2, 5), and domestic works (OR = 1.6, 95% CI = 1.07, 2.5), and people with disabilities (OR = 1.7, 95% CI = 1.1, 2.6) were all likely to have difficulty in practicing effective COVID-19 protective behaviors. Respondents' education and occupation were significant predictors of inadequate understanding of COVID-19 risk communications and was identified as a problem among 17.4% of the respondents. A substantial percentage of Bangladeshi adults have difficulty practising COVID-19 protective behaviours and have poor comprehension of risk communications, particularly in rural areas and among those with low education. This research can aid policymakers in developing tailored COVID-19 risk communications and mitigation strategies to help prevent future waves of the pandemic.

Extended Ecological Restoration of Bacterial Communities in the Godavari River During the COVID-19 Lockdown Period: a Spatiotemporal Meta-analysis

The unprecedented COVID-19 pandemic has had major impact on human health worldwide. Whilst national and international COVID-19 lockdown and travel restriction measures have had widespread negative impact on economies and mental health, they may have beneficial effect on the environment, reducing air and water pollution. Mass bathing events (MBE) also known as Kumbh Mela are known to cause perturbations of the ecosystem affecting resilient bacterial populations within water of rivers in India. Lockdowns and travel restrictions provide a unique opportunity to evaluate the impact of minimum anthropogenic activity on the river water ecosystem and changes in bacterial populations including antibiotic-resistant strains. We performed a spatiotemporal meta-analysis of bacterial communities of the Godavari River, India. Targeted metagenomics revealed a 0.87-fold increase in the bacterial diversity during the restricted activity of lockdown. A significant increase in the resilient phyla, viz. Proteobacteria (70.6%), Bacteroidetes (22.5%), Verrucomicrobia (1.8%), Actinobacteria (1.2%) and Cyanobacteria (1.1%), was observed. There was minimal incorporation of allochthonous bacterial communities of human origin. Functional profiling using imputed metagenomics showed reduction in infection and drug resistance genes by - 0.71-fold and - 0.64-fold, respectively. These observations may collectively indicate the positive implications of COVID-19 lockdown measures which restrict MBE, allowing restoration of the river ecosystem and minimise the associated public health risk.

Transfer learning for mobile real-time face mask detection and localization

Objective

Due to the COVID-19 pandemic, our daily habits have suddenly changed. Gatherings are forbidden and, even when it is possible to leave the home for health or work reasons, it is necessary to wear a face mask to reduce the possibility of contagion. In this context, it is crucial to detect violations by people who do not wear a face mask.

Materials and Methods

For these reasons, in this article, we introduce a method aimed to automatically detect whether people are wearing a face mask. We design a transfer learning approach by exploiting the MobileNetV2 model to identify face mask violations in images/video streams. Moreover, the proposed approach is able to localize the area related to the face mask detection with relative probability.

Results

To asses the effectiveness of the proposed approach, we evaluate a dataset composed of 4095 images related to people wearing and not wearing face masks, obtaining an accuracy of 0.98 in face mask detection.

Discussion and Conclusion

The experimental analysis shows that the proposed method can be successfully exploited for face mask violation detection. Moreover, we highlight that it is working also on device with limited computational capability and it is able to process in real time images and video streams, making our proposal applicable in the real world.

Improved Water, Sanitation and Utilization of Maternal and Child Health Services in South Asia-An Analysis of Demographic Health Surveys

Globally, many millions of people still lack access to safe drinking water and sanitation facilities. Here, we examined associations between household availability of improved drinking water and sanitation, respectively, and use of maternal and child health (MCH) services in South Asian countries. Demographic and Health Survey population-based data from Bangladesh, Nepal, India, and Pakistan were used, restricted to women with a child aged 0-36 months (n = 145,262). Types of households' water source and sanitation facilities were categorized based on the World Health Organization and UNICEF's definitions of "improved" and "unimproved". We applied logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) for improved water and sanitation, respectively, and reported antenatal care visits, having a skilled attendant at birth, and infant vaccination coverage, stratified by maternal education. Among lower educated women, access to improved water source was associated with greater ORs for presence of a skilled attendant at delivery and their children having up-to-date immunizations (OR: 1.29; 95% CI: 1.17, 1.42). Among lower and higher educated women, improved sanitation (vs. unimproved) was associated with greater ORs for having had adequate antenatal care visits (OR: 1.74; 95% CI: 1.62, 1.88; OR: 1.71; 95% CI: 1.62, 1.80), and similarly for having had a skilled attendant at birth, and children with up-to-date immunizations. Approaches addressing water/sanitation and MCH services across sectors could be a suggested public health strategy.

Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine: a cross-sectional study

BACKGROUND

This study determined the knowledge, attitudes, and practice regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among healthcare workers and the general population.

METHODS

A web-based, cross-sectional study was conducted using convenience sampling in Libya from December 1 to 18, 2020 among the general population and healthcare workers. Data on demographic characteristics, COVID-19 vaccination-related concerns, knowledge, attitudes, and practice regarding COVID-19, and knowledge, attitudes, and acceptance regarding the COVID-19 vaccine were collected using a self-administered survey. A binomial logistic regression was performed with 70% efficacy to determine the association between acceptance of the vaccine and study variables.

RESULTS

Valid and complete responses were collected from 15,087 participants. Of these, 6227 (41.3%) were male and 8860 (58.7%) were female, with a mean (SD) age of 30.6 ± 9.8 years. Moreover, 485 (3.2%) participants were infected with COVID-19 at the time of the study, while 2000 (13.3%) had been previously infected. Overall, 2452 (16.3%) participants agreed, and 3127 (20.7%) strongly agreed, with "having concerns about serious vaccine-related complications." Mask-wearing adherence was reported by 10,268 (68.1%) of the participants. Most participants (14,050, 93.1%) believed that the vaccine should be provided for free, while 7272 (48.2%) were willing to buy it. Regarding vaccine acceptance and efficacy, 12,006 (79.6%) reported their willingness to take the vaccine with an efficacy of 90% or more, 9143 (60.6%) with an efficacy of 70% or more, and only 6212 (41.2%) with an efficacy of 50%. The binomial logistic regression revealed that vaccine acceptance was not associated with belonging to the medical field versus the general population. Acceptance was statistically associated with younger age groups, especially 31-40 (OR = 1.3 [1.09, 1.55]) and 41-50 years (OR = 1.29, [1.09, 1.54]). However, having a family member or friend infected with COVID-19 was positively associated with the likelihood of vaccine acceptance (OR = 1.09 [1.02, 1.18]), while having a friend or family member who died due to COVID-19 was negatively associated with it (OR = 0.89 [0.84, 0.97]).

CONCLUSIONS

Acceptance of the COVID-19 vaccine is an essential determinant of vaccine uptake and the likelihood of controlling the COVID-19 pandemic. Developing strategies to decrease public hesitation and increase trust is vital for implementing vaccination programs.