Unique challenges to control the spread of COVID-19 in the Middle East

Sustainable response strategy for COVID-19: Pandemic zoning with urban multimodal transport data

In the post-COVID-19 era, the pandemic response is increasingly difficult and entails a high cost to society. Existing pandemic control methods, such as lockdowns, greatly affect residents' normal lives. This paper proposes a pandemic control method, consisting of the scientific delineation of urban areas based on multimodal transportation data. An improved Leiden method based on the gravity model is used to construct a preliminary zoning scheme, which is then modified by spatial constraints. The modularity index demonstrates the suitability of this method for community detection. This method can minimize cut-off traffic flows between pandemic control areas. The results show that only 24.8% of travel links are disrupted using our method, which could reduce both the impact of pandemic control on the daily life of residents and its cost. These findings can help develop sustainable strategies and proposals for effective pandemic response.

Next-generation nanophotonic-enabled biosensors for intelligent diagnosis of SARS-CoV-2 variants

Constantly mutating SARS-CoV-2 is a global concern resulting in COVID-19 infectious waves from time to time in different regions, challenging present-day diagnostics and therapeutics. Early-stage point-of-care diagnostic (POC) biosensors are a crucial vector for the timely management of morbidity and mortalities caused due to COVID-19. The state-of-the-art SARS-CoV-2 biosensors depend upon developing a single platform for its diverse variants/biomarkers, enabling precise detection and monitoring. Nanophotonic-enabled biosensors have emerged as 'one platform' to diagnose COVID-19, addressing the concern of constant viral mutation. This review assesses the evolution of current and future variants of the SARS-CoV-2 and critically summarizes the current state of biosensor approaches for detecting SARS-CoV-2 variants/biomarkers employing nanophotonic-enabled diagnostics. It discusses the integration of modern-age technologies, including artificial intelligence, machine learning and 5G communication with nanophotonic biosensors for intelligent COVID-19 monitoring and management. It also highlights the challenges and potential opportunities for developing intelligent biosensors for diagnosing future SARS-CoV-2 variants. This review will guide future research and development on nano-enabled intelligent photonic-biosensor strategies for early-stage diagnosing of highly infectious diseases to prevent repeated outbreaks and save associated human mortalities.

Treating SARS-CoV-2 Omicron variant infection by molnupiravir for pandemic mitigation and living with the virus: a mathematical modeling study

Treating severe COVID-19 patients and controlling the spread of SARS-CoV-2 are concurrently important in mitigating the pandemic. Classically, antiviral drugs are primarily developed for treating hospitalized COVID-19 patients with severe diseases to reduce morbidity and/or mortality, which have limited effects on limiting pandemic spread. In this study, we simulated the expanded applications of oral antiviral drugs such as molnupiravir to mitigate the pandemic by treating nonhospitalized COVID-19 cases. We developed a compartmental mathematical model to simulate the effects of molnupiravir treatment assuming various scenarios in the Omicron variant dominated settings in Denmark, the United Kingdom and Germany. We found that treating nonhospitalized cases can limit Omicron spread. This indirectly reduces the burden of hospitalization and patient death. The effectiveness of this approach depends on the intrinsic nature of the antiviral drug and the strategies of implementation. Hypothetically, if resuming pre-pandemic social contact pattern, extensive application of molnupiravir treatment would dramatically (but not completely) mitigate the COVID-19 burden, and thus there remains lifetime cost of living with the virus.

Pharmacovigilance regulatory actions by national pharmacovigilance centers in Arab countries following COVID-19 pandemic

BACKGROUND

Pharmacovigilance (PV) activities were affected by COVID-19. Therefore, several health authorities around the world have issued guidelines and practices to ensure that PV activities are maintained and continued during the pandemic. This study aimed to assess the impact of COVID-19 on the preparedness and performance of national PV systems in 14 Arab countries.

RESEARCH DESIGN AND METHODS

This was a cross-sectional study that was conducted between July and October 2020. National PV centers in 18 Arab countries were invited to participate in this study. Descriptive analysis was used to summarize and present the results of this study.

RESULTS

Responses were obtained from 14 (77.8%) countries. Adverse events reporting was the main PV activity that was covered by PV guidelines and practices. National guidelines and practices covered other PV activities in 8 (57.14%) of the participating countries. Performance and practices of national PV centers vary considerably among participating countries during the pandemic.

CONCLUSION

The findings highlight the differences in preparedness and performance of different national PV centers in participating Arab countries. Improving digital infrastructure among participating countries could serve as a useful tool to minimize the impact of the pandemic on PV activities.

Challenges of higher education related to e-learning in developing countries during COVID-19 spread: a review of the perspectives of students, instructors, policymakers, and ICT experts

The COVID-19 pandemic brought about many critical issues in all aspects such as economy, environment, health, and lifestyle, but people always try to find some response to crisis in different conditions. E-learning is defined as an elaborate response aiming at continuing education during the COVID-19 pandemic. It seems that developed countries have established and adjusted their technological infrastructures for the transition from a face-to-face education to a digital one. In contrast, developing countries were not completely prepared for this transition. Improper and deficient technological and practical fundamentals have been causing problems for all students, instructors, and other involved individuals. Therefore, we reviewed the challenges that have arisen from e-learning during the COVID-19 outbreak in different parts of tertiary education focusing on underprivileged countries.

Egyptian Newspapers Coverage of COVID-19 Vaccines: A Theoretically Driven Content Analysis

The Egyptian government has acquired COVID-19 vaccines from different sources; however, the vaccination rates and vaccine acceptance among the public remained low. News media play an influential role in shaping the public's understanding of medical issues and promoting health behaviors such as vaccination. Guided by the Extended Parallel Processing Model (EPPM) and the framing theory, a content analysis of COVID-19 vaccines coverage in two established Egyptian newspapers in Arabic (Al-Goumhuria and Al-Masry Al-Youm) between January 2020 and November 2021 was conducted. Findings suggested that the Egyptian newspapers focused on the efficacy of the vaccines but downplayed the severity of COVID-19. Most articles from both newspapers did not use gain or loss frames, although Al-Goumhuria was most likely to use both (loss and gain) frames simultaneously. Specific vaccine information regarding its safety, side effects, and effectiveness was minimal in both newspapers. The differences in COVID-19 vaccine coverage between the two newspapers were limited, suggesting a high level of government control of COVID-19 related content, regardless of whether it is state- or private-owned newspaper. Theoretical and practical implications of the findings were discussed.

Diagnostic Approaches For COVID-19: Lessons Learned and the Path Forward

Coronavirus disease 2019 (COVID-19) is a transmitted respiratory disease caused by the infection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although humankind has experienced several outbreaks of infectious diseases, the COVID-19 pandemic has the highest rate of infection and has had high levels of social and economic repercussions. The current COVID-19 pandemic has highlighted the limitations of existing virological tests, which have failed to be adopted at a rate to properly slow the rapid spread of SARS-CoV-2. Pandemic preparedness has developed as a focus of many governments around the world in the event of a future outbreak. Despite the largely widespread availability of vaccines, the importance of testing has not diminished to monitor the evolution of the virus and the resulting stages of the pandemic. Therefore, developing diagnostic technology that serves as a line of defense has become imperative. In particular, that test should satisfy three criteria to be widely adopted: simplicity, economic feasibility, and accessibility. At the heart of it all, it must enable early diagnosis in the course of infection to reduce spread. However, diagnostic manufacturers need guidance on the optimal characteristics of a virological test to ensure pandemic preparedness and to aid in the effective treatment of viral infections. Nanomaterials are a decisive element in developing COVID-19 diagnostic kits as well as a key contributor to enhance the performance of existing tests. Our objective is to develop a profile of the criteria that should be available in a platform as the target product. In this work, virus detection tests were evaluated from the perspective of the COVID-19 pandemic, and then we generalized the requirements to develop a target product profile for a platform for virus detection.

Tracking COVID-19 urban activity changes in the Middle East from nighttime lights

In response to the COVID-19 pandemic, governments around the world have enacted widespread physical distancing measures to prevent and control virus transmission. Quantitative, spatially-disaggregated information about the population-scale shifts in activity that have resulted from these measures is extremely scarce, particularly for regions outside of Europe and the US. Public health institutions often must make decisions about control measures with limited region-specific data about how they will affect societal behavior, patterns of exposure, and infection outcomes. The Visible Infrared Imaging Radiometer Suite Day/Night Band (VIIRS DNB), a new-generation space-borne low-light imager, has the potential to track changes in human activity, but the capability has not yet been applied to a cross-country analysis of COVID-19 responses. Here, we examine multi-year (2015–2020) daily time-series data derived from NASA’s Black Marble VIIRS nighttime lights product (VNP46A2) covering 584 urban areas, in 17 countries in the Middle East to understand how communities have adhered to COVID-19 measures in the first 4 months of the pandemic. Nighttime lights capture the onset of national curfews and lockdowns well, but also expose the inconsistent response to control measures both across and within countries. In conflict-afflicted countries, low adherence to lockdowns and curfews was observed, highlighting the compound health and security threats that fragile states face. Our findings show how satellite measurements can aid in assessing the public response to physical distancing policies and the socio-cultural factors that shape their success, especially in fragile and data-sparse regions.

Genomics in Egypt: Current Status and Future Aspects

Egypt is the third most densely inhabited African country. Due to the economic burden and healthcare costs of overpopulation, genomic and genetic testing is a huge challenge. However, in the era of precision medicine, Egypt is taking a shift in approach from “one-size-fits all” to more personalized healthcare via advancing the practice of medical genetics and genomics across the country. This shift necessitates concrete knowledge of the Egyptian genome and related diseases to direct effective preventive, diagnostic and counseling services of prevalent genetic diseases in Egypt. Understanding disease molecular mechanisms will enhance the capacity for personalized interventions. From this perspective, we highlight research efforts and available services for rare genetic diseases, communicable diseases including the coronavirus 2019 disease (COVID19), and cancer. The current state of genetic services in Egypt including availability and access to genetic services is described. Drivers for applying genomics in Egypt are illustrated with a SWOT analysis of the current genetic/genomic services. Barriers to genetic service development in Egypt, whether economic, geographic, cultural or educational are discussed as well. The sensitive topic of communicating genomic results and its ethical considerations is also tackled. To understand disease pathogenesis, much can be gained through the advancement and integration of genomic technologies via clinical applications and research efforts in Egypt. Three main pillars of multidisciplinary collaboration for advancing genomics in Egypt are envisaged: resources, infrastructure and training. Finally, we highlight the recent national plan to establish a genome center that will aim to prepare a map of the Egyptian human genome to discover and accurately determine the genetic characteristics of various diseases. The Reference Genome Project for Egyptians and Ancient Egyptians will initialize a new genomics era in Egypt. We propose a multidisciplinary governance system in Egypt to support genomic medicine research efforts and integrate into the healthcare system whilst ensuring ethical conduct of data.

Compounding inequalities: Adolescent psychosocial wellbeing and resilience among refugee and host communities in Jordan during the COVID-19 pandemic

PURPOSE

The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience.

METHODS

Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable Jordanians, living in camps, host communities and informal tented settlements. We utilize mixed-methods analysis combining multivariate regression with deductive qualitative tools to evaluate pandemic impacts and associated policy responses on adolescent wellbeing and mental health, at three and nine months after the pandemic onset. We also explore the role of support systems at individual, household, community, and policy levels.

FINDINGS

We find the pandemic has resulted in severe economic and service disruptions with far-reaching and heterogenous effects on adolescent wellbeing. Nine months into the pandemic, 19.3% of adolescents in the sample presented with symptoms of moderate-to severe depression, with small signs of improvement (3.2 percentage points [pp], p<0.001). Two thirds of adolescents reported household stress had increased during the pandemic, especially for Syrian adolescents in host communities (10.7pp higher than any other group, p<0.001). Social connectedness was particularly low for girls, who were 13.4 percentage points (p<0.001) more likely than boys to have had no interaction with friends in the past 7 days. Adolescent programming shows signs of being protective, particularly for girls, who were 8.8 percentage points (p<0.01) more likely to have a trusted friend than their peers who were not participating in programming.

CONCLUSIONS

Pre-existing social inequalities among refugee adolescents affected by forced displacement have been compounded during the COVID-19 pandemic, with related disruptions to services and social networks. To achieve Sustainable Development Goal targets to support healthy and empowered development in adolescence and early adulthood requires interventions that target the urgent needs of the most vulnerable adolescents while addressing population-level root causes and determinants of psychosocial wellbeing and resilience for all adolescent girls and boys.

Social Determinants of Adherence to COVID-19 Preventive Guidelines in Iran: A Qualitative Study

Introduction

Adherence to COVID-19 preventative guidelines may be influenced by a variety of factors at the individual, societal, and institutional levels. The current study sought to investigate the social factors of adherence to those preventive measures from the perspective of health professionals.

Methods

In October 2020, we performed qualitative research in Tehran, Iran, using the directed content analysis method. For the preparation of our interview guide and data analysis, we employed the WHO conceptual framework of socioeconomic determinants of health. Semi-structured interviews were conducted with 15 health professionals and policymakers who were chosen using a purposive sampling approach. MAXQDA-18 software was used to analyze the data. The Goba and Lincoln criteria were used to assess the quality of the results.

Results

There are 23 subcategories and 9 categories, which include socio-economic and political context (unstable macroeconomic environment, poor management of the pandemic, media and knowledge transfer), cultural and social values (fatalism, cultural norms, value conflicts, social customs), socio-economic positions (livelihood conditions), social capital (social cohesion, low trust), living conditions (housing conditions), occupational conditions (precarious employment), individual characteristics (demographic characteristics, personality traits, COVID-19 knowledge, and attitude), psycho-social factors (normalization of the disease, social pressure, and stigma), and health system leadership (health system problems, not taking evidence-based decisions, non-comprehensive preventive guidelines, non-operational guidelines, inadequate executive committee) were obtained.

Conclusion

To limit the new COVID-19 transmission, people must be encouraged to follow COVID-19 prevention instructions. Improving adherence to COVID-19 preventive guidelines necessitates dealing with the complexities of responding to social determinants of those guidelines. Increasing public health literacy and knowledge of COVID-19, informing people about the consequences of social interactions and cultural customs in the spread of COVID-19, strengthening regulatory lockdown laws, improving guarantees for adhering to preventive guidelines, providing easy access to preventive supplies, and strengthening financial support for households with precarious employment are all important.

COVID-19 pandemic in the Middle East countries: coronavirus-seeking behavior versus coronavirus-related publications

The spread of COVID-19 has created a fundamental need for coordinated mechanisms responding to outbreaks in different sectors. One of the main sectors relates to information supply and demand in the middle of this pandemic in the digital environment. It could be called an infodemiology. It is known as a promising approach to solving the challenge in the present age. At this level, the purpose of this article is to investigate the COVID-19 related search process by field research. Data were retrieved from Google Trends in Middle Eastern countries alongside scientific research output of Middle Eastern scientists towards COVID-19 in Web of Science, Scopus, and PubMed. Daily COVID-19 cases and deaths were retrieved from the World Health Organization. We searched for descriptive statistical analyses to detect coronavirus-seeking behavior versus coronavirus releases in the Middle East in 2020. Findings show that people in the Middle East use various keyword solutions to search for COVID-19 in Google. There is a significant correlation between coronavirus confirmed cases and scientific productivity (January 2020-December 2020). Also, there is a positive association between the number of deaths and the number of scientific publications (except Jordan). It was a positive and significant association between online coronavirus-seeking behavior on Google (RSVs) and the confirmed cases (except Syria and Yemen). Furthermore, it was a positive relationship between RSVs and scientific productivity in the Middle East (except Bahrain and Qatar). From an infodemiological viewpoint, there is a significant correlation between coronavirus information demand and its information provision.

Automated detection of Covid-19 disease using deep fused features from chest radiography images

The health systems of many countries are desperate in the face of Covid-19, which has become a pandemic worldwide and caused the death of hundreds of thousands of people. In order to keep Covid-19, which has a very high propagation rate, under control, it is necessary to develop faster, low-cost and highly accurate methods, rather than a costly Polymerase Chain Reaction test that can yield results in a few hours. In this study, a deep learning-based approach that can detect Covid-19 quickly and with high accuracy on X-ray images, which are common in every hospital and can be obtained at low cost, was proposed. Deep features were extracted from X-Ray images in RGB, CIE Lab and RGB CIE color spaces using DenseNet121 and EfficientNet B0 pre-trained deep learning architectures and then obtained features were fed into a two-stage classifier approach. Each of the classifiers in the proposed approach performed binary classification. In the first stage, healthy and infected samples were separated, and in the second stage, infected samples were detected as Covid-19 or pneumonia. In the experiments, Bi-LSTM network and well-known ensemble approaches such as Gradient Boosting, Random Forest and Extreme Gradient Boosting were used as the classifier model and it was seen that the Bi-LSTM network had a superior performance than other classifiers with 92.489% accuracy.

Data-Driven and Machine-Learning Methods to Project Coronavirus Disease 2019 Pandemic Trend in Eastern Mediterranean

Background: The coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis worldwide, and the Eastern Mediterranean is one of the most affected areas. Materials and Methods: We use a data-driven approach to assess the characteristics, situation, prevalence, and current intervention actions of the COVID-19 pandemic. We establish a spatial model of the spread of the COVID-19 pandemic to project the trend and time distribution of the total confirmed cases and growth rate of daily confirmed cases based on the current intervention actions. Results: The results show that the number of daily confirmed cases, number of active cases, or growth rate of daily confirmed cases of COVID-19 are exhibiting a significant downward trend in Qatar, Egypt, Pakistan, and Saudi Arabia under the current interventions, although the total number of confirmed cases and deaths is still increasing. However, it is predicted that the number of total confirmed cases and active cases in Iran and Iraq may continue to increase. Conclusion: The COVID-19 pandemic in Qatar, Egypt, Pakistan, and Saudi Arabia will be largely contained if interventions are maintained or tightened. The future is not optimistic, and the intervention response must be further strengthened in Iran and Iraq. The aim of this study is to contribute to the prevention and control of the COVID-19 pandemic.

Impact of COVID-19 on mental health and quality of life: Is there any effect? A cross-sectional study of the MENA region

The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the effect of the pandemic on mental health and quality of life among the general population in the Middle East and North Africa (MENA) region. A total of 6142 adults from eighteen countries within the MENA region completed an online questionnaire between May and June 2020. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and the social and family support impact was assessed with questions from the Perceived Support Scale (PSS). The IES-R mean score was 29.3 (SD = 14.8), corresponding to mild stressful impact with 30.9% reporting severe psychological impact. Most participants (45%-62%) felt horrified, apprehensive, or helpless due to COVID-19. Furthermore, over 40% reported increased stress from work and financial matters. Higher IES-R scores were found among females, participants aged 26-35 years, those with lower educational level, and participants residing in the North Africa region (p<0.005). About 42% reported receiving increased support from family members, 40.5% were paying more attention to their mental health, and over 40% reported spending more time resting since the pandemic started. The COVID-19 pandemic was associated with mild psychological impact while it also encouraged some positive impact on family support and mental health awareness among adults in the MENA region. Clinical interventions targeted towards vulnerable groups such as females and younger adults are needed.

COVID-19 and the scaled-down 2020 Hajj Pilgrimage - Decisive, logical and prudent decision making by Saudi authorities overcomes pre-Hajj public health concerns

The Publisher regrets that this article is an accidental duplication of an article that has already been published, DOI of original article: https://doi.org/10.1016/j.ijid.2020.08.006 . The duplicate article has therefore been withdrawn.

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