Is home isolation appropriate for preventing the spread of COVID-19

Factors associated with medication interruption among outpatients with severe mental illness exposed to COVID-19

Many patients with severe mental illness (SMI) relapsed and deteriorated during the COVID-19 pandemic, as they experienced medication interruption. This study aimed to investigate factors affecting medication interruption in patients with SMI during the COVID-19 pandemic. A total of 2,077 patients with SMI participated in an online survey on medication interruption during the COVID-19 outbreak. The questionnaire comprised six parts: basic demographic information, COVID-19 exposure, state of disease, medication compliance before COVID-19, medication interruption during COVID-19, and the specific impact and needs. A total of 2,017 valid questionnaires were collected. Nearly 50% of patients with SMI have been affected to varying degrees of life expectancy and treatment. Among them, 74 patients stopped taking medicines for more than 14 days without a prescription. Logistic regression analysis showed that cohabitant exposure [OR = 26.629; 95% CI (3.293–215.323), p = 0.002], medication partial compliance and non-compliance pre-COVID-19 [OR = 11.109; 95% CI (6.093–20.251), p < 0.001; OR = 20.115; 95% CI (10.490–38.571), p < 0.001], and disease status [OR = 0.326; 95% CI (0.188–0.564), p < 0.001] were related to medication interruption. More than 50% of the patients wanted help in taking medications, follow-up, and receiving more financial support and protective materials. We found that the daily lives of patients with SMI were much more susceptible to impact during the pandemic. Patients with a history of partial or non-medication compliance before COVID-19 and an unstable disease state are more easily affected by pandemics and epidemics and need extra attention should similar large-scale outbreaks occur in the future.

Analysis of factors affecting the construction duration of public health emergency medical facilities

Objectives

This study explores the factors influencing the construction duration of public health emergency medical facilities and the ways in which they can be enhanced.

Methods

Combining 30 relevant emergency medical facility construction cases in different cities in China from 2020 to 2021, seven condition variables and an outcome variable were selected, and necessary and sufficient condition analyses of duration influence factors were conducted using the fsQCA method.

Results

The consistency of seven condition variables was <0.9, which shows that the construction period of public health emergency medical facilities is not independently affected by a single condition variable but by multiple influencing factors. The solution consistency value of the path configurations was 0.905, indicating that four path configurations were sufficient for the outcome variables. The solution coverage of the four path configurations was 0.637, indicating that they covered ~63.7% of the public health emergency medical facility cases.

Conclusion

To reduce the construction duration, the construction of emergency medical facilities should focus on planning and design, the selection of an appropriate form of construction, the reasonable deployment of resources, and the vigorous adoption of information technology.

Effectiveness of a monitored home isolation program for COVID-19 infection during the second wave of the pandemic

Background

The rapidity of spread of COVID-19 infection during the second wave of the pandemic placed tremendous stress on healthcare resources. This study evaluated the effectiveness of a monitored home isolation (HI) program.

Methods

In this descriptive longitudinal study, symptomatic patients were screened in the HI clinic and eligible patients were followed up at home using tele-consultation, until recovery or hospitalization. HI failure was defined as need for hospitalization. Factors associated with HI failure were assessed using logistic regression analysis and expressed as odds ratio (OR) with 95% confidence interval (CI).

Results

During April and May 2021, 1957 RT-PCR confirmed patients (984 male) with mean (SD) age 40 (13.5) years were enrolled; 93.3% (n = 1825) were successfully managed at home. Of the 132 patients (6.7%) who failed HI, 57 (43.2%) required oxygen therapy and 23 needed intensive care admissions. Overall mortality was 0.4% (7/1957). On adjusted analysis, factors associated with HI failure were age ≥60 years (OR 2.24; 95%CI 1.26-3.99), male gender (OR 2.26; 95%CI 1.44-3.57), subjective reporting of breathing difficulty (OR 3.64; 95%CI 2.08-6.37), history of cough (OR 2.08; 95%CI 1.37-3.17), and higher heart rate (OR 1.04; 95%CI 1.02-1.05). Although patient status (non-healthcare workers), no prior vaccination and ≥2 comorbidities were associated with HI failure on unadjusted analysis, these were non-significant on adjusted analysis.

Conclusion

Monitored HI program can be used successfully during a pandemic wave to judicially use scare hospital resources. Older male patients presenting with breathlessness or cough may warrant closer monitoring.

Interpretation of Discrepancies between Cities in the Transmission of COVID-19: Evidence from China in the First Weeks of the Pandemic: Interpreting the Discrepancies of COVID-19 Transmission

OBJECTIVES

This study aims to examine and explain the differences at city level in cumulative Covid-19 cases and time from first to last infection, during the first six weeks of the epidemic in China.

METHODS

A quantitative study is conducted in China based on the multi-source spatial data of 315 Chinese cities. Firstly, the spatial discrepancy of COVID-19 transmission was examined based on spatial autocorrelation analysis and hot pot analysis. Next, a comprehensive indicator framework was established by including a wide range of factors such as human mobility, geographical features, public health measures and residents' awareness. Finally, multivariate regression models employing the variables were constructed to identify the determinants of Covid-19 transmission.

RESULTS

Significant spatial discrepancy of transmission was proved and ten determinants were identified.

CONCLUSIONS

The transmission consequence (measured by number of cumulative cases) was mostly correlated with the migration scale from Wuhan, followed by socio-economic factors. Transmission duration (measured by the time from the first to last case within the city) was mostly determined by total migration scale and lockdown speed, which suggests that timely implementation of public health measures facilitated fast control of transmission. Residents' attention to COVID-19 was proved to be not only helpful for reducing confirmed cases, but also in favor of rapid transmission control. Altitude produced slightly but significant effect on transmission duration. Those conclusions are expected to provide decision support for the local governments of China and other jurisdictions.

How and When Telework Improves Job Performance During COVID-19? Job Crafting as Mediator and Performance Goal Orientation as Moderator

Purpose

Literature shows that it is a paradox whether employees can achieve performance in telework, especially during COVID-19. Our aim is to clarify the relationship between telework and employees’ job performance through a moderated mediation model.

Methods

This study employed two-wave surveys with the aim of reducing the potential risk of common method bias. The 1309 participants of the survey were mainly employees who used telework during COVID-19, and they were mostly in positions such as product design and scheme planning. SEM was used to test the hypotheses.

Results

Results from two-wave surveys of 1309 Chinese employees indicated that telework positively influenced job performance via job crafting. That is, job crafting played a mediating role between telework and job performance. And performance-prove goal orientation positively moderated the relationship between telework and job crafting but performance-avoid goal orientation negatively moderated the relationship between them.

Conclusion

This study shows that telework can improve job performance through job crafting in COVID-19, in response to the paradox implied in the literature. In addition, we use COR theory to explain the role of performance goal orientation and job crafting in telework. We add these variables to the theoretical framework of COR theory, thereby enriching the theoretical research from the COR theory perspective.

Consumer preferences for health insurance, in the wake of covid-19: Ranked features and customer segments

The current study is conceptualized to assess the perception of the general population towards health insurance providers and the policy features, to segment them based on their attitudes. The mixed-method design is used in this study. One fifty health insurance users response were analyzed. The data analysis technique includes focus group discussion, henry garret ranking method, factor analysis and cluster analysis. This study concludes that health insurance providers needs to devise insurance policies incorporating the features of home health, telemedicine and income protection features. The existing users should be offered customization option due to covid-19 to prevent customer switch.

Analysis of Facility and Home Isolation Strategies in COVID 19 Pandemic: Evidences from Jodhpur, India

Purpose

Jodhpur administration directed its efforts to control and mitigate COVID 19 infection by implementing and monitoring facility isolation (FI) and home isolation (HI) measures. This study is conducted with a hypothesis that there is no difference in the quality of life and cost-effectiveness of mildly symptomatic or asymptomatic patients in HI and FI.

Patients and Methods

A mixed-method study was conducted in Jodhpur in September 2020. The purposive sampling technique was used and data from 120 individuals admitted in HI and FI were collected. The information about the status and functioning of isolation facilities was collected from various sources. Multi-stakeholder interactions with 15 personnel engaged in managing isolation facilities were done. EQ-5D version (EQ-5D-5L) which consists of the EQ-5D descriptive system and the EQ visual analog scale (EQ-VAS) was used to assess health-related quality of life.

Results

The strength of HI strategy is demonstrated by its ability to provide psychological and social support with minimal logistic requirements but the issue of sufficient household infrastructure, adequate family and societal support for implementing this strategy is of concern. The strength of FI strategy includes its ability to provide support to patients who have issues of sufficient household infrastructure, adequate family and societal support, but this strategy poses a threat of increasing human resource constraints and financial load on the health system. The respondents from HI obtained a mean EQ-5D index score of 0.90 and a mean VAS score of 85, whereas it was 0.80 and 78.5, respectively, for FI. The cost estimated for home isolation was Rs 549 (7.43 US $) per person, whereas it was Rs 2440 (33.02 US $) for facility Isolation.

Conclusion

Though HI seems advantageous in terms of a better quality of life and cost-saving over FI, both the strategies are context-specific having their own trade-offs.

Psychological distress among Italians during the 2019 coronavirus disease (COVID-19) quarantine

BACKGROUND

Quarantine as a preventive action to reduce people's exposure to a contagious disease has substantial psychological impact. We aimed to collect information on psychologically distressing experiences of Italians living in quarantine during the COVID-19 pandemic.

METHODS

From 6 to 20 April 2020 participants filled out an online questionnaire. Demographic and physical symptoms data from the prior 14 days of quarantine were collected. Psychological impact of quarantine was assessed by the COVID-19 Peritraumatic Distress Index (CPDI).

RESULTS

In all, 20,158 participants completed the online survey. Of these, 11,910 (59.1%) were from Lombardy, the region with 37.7% of positive cases identified during the survey period. 30.1% of responders were male. About half (55.9%) of responders were 18-50 years old, 54.3% had a tertiary level of education, 69.5% were workers, 84.1% were living in houses with ≥3 rooms, and 13.7% were living alone. 9.7% had had contact with COVID-19 positive people. Of all responders, 9978 (48.6%) reported a psychological impact, 8897 (43.4%) of whom reported mild or moderate and 1081 (5.2%) severe psychological impact. The multivariate analysis, after adjustments, showed that an increasing CPDI score was associated with gender (female), first-second educational level, being unemployed, living in a ≤2 room house, having had new health problems during the previous 14 days, and not having been out of the house in the previous week. Concerning the type of psychological distress, 2003 responders (9.9%) reported moderate to severe depressive symptoms, 1131 (5.5%) moderate to severe anxiety symptoms, and 802 (3.9%) moderate to severe physical symptoms. A positive correlation was found between responder rate (per 10.000 residents) and positive COVID-19 cases (per 10.000 residents) by region (r_s = + 0.83, p = < 0.0001), and between responder rate and region latitude (r_s = + 0.91, p = < 0.0001), with a greater response rate in the north. Considering Lombardy Region responders, a negative correlation between CPDI score and distance from place of residence to the red zone (Nembro-Alzano) was found. Higher prevalence of psychological distress was found up to 25 km away from the red zone and, in particular, severe distress up to 15 km.

CONCLUSIONS

Policy makers and mental health professionals should be aware of quarantine's adverse mental health consequences. Factors influencing the success of quarantine and infection control practices for both disease containment and community recovery should be identified and additional support to vulnerable persons at increased risk of adverse psychological and social consequences of quarantine should be guaranteed.

COVID-19: District level vulnerability assessment in India

Objectives

COVID-19 Pandemic has brought a threatening challenge to the world and as well as for Indian society and economy. In India, it has become a public health disaster and its' intensity increasing continuously. For the disaster risk reduction, and capacity building against the COVID-19 pandemic understanding of the relationship between socio-environmental conditions with the pandemic is very necessary. The objective of the present work is to construct a socio-environmental vulnerability index of the potential risk of community spread of COVID-19 using socio-economic and environmental variables.

Methodology

In this, cross-sectional study principal component analyses have been used to drive SoEVI. 4 uncorrelated sub-index has been extracted from 16 sub-indicators which reflects 59% of the variance. Aggregation of 4 Sub-Index has been done to obtain the final vulnerability Index.

Results

Results show that there is spatial variability in vulnerability based on environmental and socio-economic conditions. Districts of north and central India found more vulnerable then south India. Statistical significance has been tested using regression analysis, positive relation has been found between vulnerability index and confirmed and active cases.

Conclusion

The vulnerability index has highlighted environmentaly and socioeconomicallybackward districts. These areas will suffer more critical problems against COVID-19 pandemic for their socio-environmental problem.

The scientific literature on Coronaviruses, COVID-19 and its associated safety-related research dimensions: A scientometric analysis and scoping review

The COVID-19 global pandemic has generated an abundance of research quickly following the outbreak. Within only a few months, more than a thousand studies on this topic have already appeared in the scientific literature. In this short review, we analyse the bibliometric aspects of these studies on a macro level, as well as those addressing Coronaviruses in general. Furthermore, through a scoping analysis of the literature on COVID-19, we identify the main safety-related dimensions that these studies have thus far addressed. Our findings show that across various research domains, and apart from the medical and clinical aspects such as the safety of vaccines and treatments, issues related to patient transport safety, occupational safety of healthcare professionals, biosafety of laboratories and facilities, social safety, food safety, and particularly mental/psychological health and domestic safety have thus far attracted most attention of the scientific community in relation to the COVID-19 pandemic. Our analysis also uncovers various potentially significant safety problems caused by this global health emergency which currently have attracted only limited scientific focus but may warrant more attention. These include matters such as cyber safety, economic safety, and supply-chain safety. These findings highlight why, from an academic research perspective, a holistic interdisciplinary approach and a collective scientific effort is required to help understand and mitigate the various safety impacts of this crisis whose implications reach far beyond the bio-medical risks. Such holistic safety-scientific understanding of the COVID-19 crisis can furthermore be instrumental to be better prepared for a future pandemic.