The Peru Approach against the COVID-19 Infodemic: Insights and Strategies

Covid-19 hotlines, helplines and call centers: a systematic review of characteristics, challenges and lessons learned

BACKGROUND

During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic.

METHODS

PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist.

RESULTS

In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 (n = 19). Providing psychological support (n = 23), reliable information about Covid-19 (n = 10), healthcare advices about Covid-19 (n = 8), and triage (n = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators.

CONCLUSION

According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.

Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru

Background

Peru has reported one of the highest mortality rates from COVID-19 worldwide. The Chincha province has been one of the most affected regions in Peru and the leading promoter of the use of ivermectin for the treatment of COVID-19. Therefore, our study aimed to evaluate the frequency of use and factors associated with the use of ivermectin for COVID-19 in Chincha.

Methods

A cross-sectional study was conducted during the second wave of COVID-19 in Peru. For statistical analyses, frequencies and percentages were reported. Prevalence ratios (PR) with a 95% confidence interval (CI), and a p-value of 0.05 were used to determine statistical significance. SPSS version 22 (IBM Corp) program was used for the analyses.

Results

A total of 432 participants were included in the study. A total of 67.6% (n = 292) of the participants used ivermectin during the COVID-19 pandemic. Of these, 20.20% (n=59) of the people used ivermectin for prophylactic purposes only, while 41.79% (n=122) used it as treatment for COVID-19 only, and 38.01% (n=111) used it for both reasons. The consumption of ivermectin was associated with being 50 years or older (PR:1.27, 95% CI:1.04-1.54), having a technical education level (PR:1.16, 95% CI:1.01-1.34), having had symptoms of COVID-19 with negative/no diagnosis (PR: 1.28, 95% CI: 1.07-1.53) or positive diagnosis (PR:1.38, 95% CI:1.18-1.61), or having had contact with infected people (PR:1.45, 95% CI:1.06-1.98).

Conclusions

Most people in Chincha used ivermectin during the second wave of the COVID-19 pandemic. The main factors associated with the use of ivermectin for the prevention/treatment of COVID-19 were age ≥50 years, having a technical education level, having had symptoms with negative/no diagnosis or positive diagnosis, and contact with people infected with SARS-CoV-2.

The role of social media in public health crises caused by infectious disease: a scoping review

IMPORTANCE

The onset of the COVID-19 global pandemic highlighted the increasing role played by social media in the generation, dissemination and consumption of outbreak-related information.

OBJECTIVE

The objective of the current review is to identify and summarise the role of social media in public health crises caused by infectious disease, using a five-step scoping review protocol.

EVIDENCE REVIEW

Keyword lists for two categories were generated: social media and public health crisis. By combining these keywords, an advanced search of various relevant databases was performed to identify all articles of interest from 2000 to 2021, with an initial retrieval date of 13 December 2021. A total of six medical and health science, psychology, social science and communication databases were searched: PubMed, Web of Science, Scopus, Embase, PsycINFO and CNKI. A three-stage screening process against inclusion and exclusion criteria was conducted.

FINDINGS

A total of 338 studies were identified for data extraction, with the earliest study published in 2010. Thematic analysis of the role of social media revealed three broad themes: surveillance monitoring, risk communication and disease control. Within these themes, 12 subthemes were also identified. Within surveillance monitoring, the subthemes were disease detection and prediction, public attitude and attention, public sentiment and mental health. Within risk communication, the subthemes were health advice, information-seeking behaviour, infodemics/misinformation circulation, seeking help online, online distance education and telehealth. Finally, within disease control, the subthemes were government response, public behaviour change and health education information quality. It was clear that the pace of research in this area has gradually increased over time as social media has evolved, with an explosion in attention following the outbreak of COVID-19.

CONCLUSIONS AND RELEVANCE

Social media has become a hugely powerful force in public health and cannot be ignored or viewed as a minor consideration when developing public health policy. Limitations of the study are discussed, along with implications for government, health authorities and individual users. The pressing need for government and health authorities to formalise evidence-based strategies for communicating via social media is highlighted, as well as issues for individual users in assessing the quality and reliability of information consumed on social media platforms.

Curbing the COVID-19 digital infodemic: strategies and tools

A problematic manifestation of the COVID-19 pandemic is a related digital 'infodemic' with widespread dissemination of rumors, conspiracy theories, and other misinformation about the impact of the crisis on aspects of political and socio-economic life. Those spreading the misleading information did so through social media. In response, public, private and non-government stakeholders around the world have proposed a wide range of e-government policy approaches to combat this new digital phenomenon. For this Viewpoint I identified, analyzed, and classified the most interesting strategies, platforms, and tools proposed or already used by public decision-makers to combat the spread of false information related to the pandemic in a digital society.

Prioritized reconstruction of healthcare facilities after earthquakes based on recovery of emergency services

Earthquakes can disrupt the healthcare system heavily, leading to long wait times and many untreated patients for years after the event. Emergency services, in particular, must return to preearthquake functionality as soon as possible such that patients, especially critically injured ones, can be treated promptly. However, reconstruction and restoration of emergency services can take years. Due to limited reconstruction resources, decision-makers cannot reconstruct all hospitals simultaneously. They are typically forced to prioritize the reconstruction order, and this process is often poorly planned. This article models emergency services as an M/M/s queuing system that accounts for prioritized treatment of critical patients and formulates a greedy algorithm to plan for an effective healthcare system reconstruction. The algorithm finds the reconstruction ordering of hospital buildings such that emergency patients have the shortest time to receiving medical care possible. We show our greedy algorithm's good performance for small problem instances, with average deviations from the optimal solution below 16%. Further, we apply our methodology to a case study of Lima, Peru, under a hypothetical M8.0 earthquake. The application demonstrates that compared to typically implemented policies, a policy guided by our formulation results in shorter time to treatment and reduces the number of untreated patients over the course of the reconstruction period by more than a factor of 3 in a worst-case scenario with 70% hospital capacity disruption. Finally, we demonstrate that our formulation can be integrated into risk analysis through Monte Carlo simulations to inform decision-makers of reconstruction plans after future earthquakes.

The Impact of Meso-Level Factors on SARS-CoV-2 Vaccine Early Hesitancy in the United States

The extant literature on the U.S. SARS-CoV-2 virus indicates that the vaccination campaign was lagging, insufficient, and uncoordinated. This study uses the spatial model to identify the drivers of vaccine hesitancy (in the middle of the pandemic), one of the critical steps in creating impactful and effective interventions to influence behavioral changes now and in the future. The applied technique accounted for observed and unobserved homogeneity and heterogeneity among counties. The results indicated that political and religious beliefs, quantified by Cook's political bipartisan index and the percentage of the population affiliated with the main Christian groups, were the main drivers of the SARS-CoV-2 vaccine hesitancy. The past vaccination experience and other variables determining the demand and supply of vaccines were also crucial in influencing hesitancy. The results imply that vaccination campaigns require engaging community leaders at all levels rather than depending on politicians alone and eliminating barriers to the supply and demand of vaccines at all levels. Coordination among religious and community leaders would build a practical institutional arrangement to facilitate (rather than frustrate) the vaccination drives.

Crowdsourcing Knowledge Production of COVID-19 Information on Japanese Wikipedia in the Face of Uncertainty: Empirical Analysis

BACKGROUND

A worldwide overabundance of information comprising misinformation, rumors, and propaganda concerning COVID-19 has been observed in addition to the pandemic. By addressing this data confusion, Wikipedia has become an important source of information.

OBJECTIVE

This study aimed to investigate how the editors of Wikipedia have handled COVID-19-related information. Specifically, it focused on 2 questions: What were the knowledge preferences of the editors who participated in producing COVID-19-related information? and How did editors with different knowledge preferences collaborate?

METHODS

This study used a large-scale data set, including >2 million edits in the histories of 1857 editors who edited 133 articles related to COVID-19 on Japanese Wikipedia. Machine learning methods, including graph neural network methods, Bayesian inference, and Granger causality analysis, were used to establish the editors' topic proclivity and collaboration patterns.

RESULTS

Overall, 3 trends were observed. Two groups of editors were involved in the production of information on COVID-19. One group had a strong preference for sociopolitical topics (social-political group), and the other group strongly preferred scientific and medical topics (scientific-medical group). The social-political group played a central role (contributing 16,544,495/23,485,683, 70.04% of bits of content and 57,969/76,673, 75.61% of the references) in the information production part of the COVID-19 articles on Wikipedia, whereas the scientific-medical group played only a secondary role. The severity of the pandemic in Japan activated the editing behaviors of the social-political group, leading them to contribute more to COVID-19 information production on Wikipedia while simultaneously deactivating the editing behaviors of the scientific-medical group, resulting in their less contribution to COVID-19 information production on Wikipedia (Pearson correlation coefficient=0.231; P<.001).

CONCLUSIONS

The results of this study showed that lay experts (ie, Wikipedia editors) in the fields of science and medicine tended to remain silent when facing high scientific uncertainty related to the pandemic. Considering the high quality of the COVID-19-related articles on Japanese Wikipedia, this research also suggested that the sidelining of the science and medicine editors in discussions is not necessarily a problem. Instead, the social and political context of the issues with high scientific uncertainty is more important than the scientific discussions that support accuracy.

Social Media Sentiment about COVID-19 Vaccination Predicts Vaccine Acceptance among Peruvian Social Media Users the Next Day

Drawing upon theories of risk and decision making, we present a theoretical framework for how the emotional attributes of social media content influence risk behaviors. We apply our framework to understanding how COVID-19 vaccination Twitter posts influence acceptance of the vaccine in Peru, the country with the highest relative number of COVID-19 excess deaths. By employing computational methods, topic modeling, and vector autoregressive time series analysis, we show that the prominence of expressed emotions about COVID-19 vaccination in social media content is associated with the daily percentage of Peruvian social media survey respondents who are vaccine-accepting over 231 days. Our findings show that net (positive) sentiment and trust emotions expressed in tweets about COVID-19 are positively associated with vaccine acceptance among survey respondents one day after the post occurs. This study demonstrates that the emotional attributes of social media content, besides veracity or informational attributes, may influence vaccine acceptance for better or worse based on its valence.

Geo-sentiment trends analysis of tweets in context of economy and employment during COVID-19

To effectively design policies and implement measures for addressing problems faced by people during these difficult times of pandemic, it is critical to have a clear vision of the problems people are freely talking about. One of the ways is to analyze social media feeds e.g., tweets, which has become one of the primary ways people express their views on various socioeconomic issues and on-ground effectiveness of measures adopted to address these issues. In this work, we attempt to uncover various socioeconomic issues, which are giving rise to negative and positive sentiments and their trends across geographies over a course of one year of the pandemic. We also try identifying similarities and differences in opinions as they vary across gender as the time passes through the crisis. Many previous works have analyzed sentiments in context of vaccines, fatalities, and lockdowns; however, socioeconomic issues did not receive full attention. We found that sentiments of people with respect to economy are negative across geographies during starting of pandemic. Thereafter, gradually sentiments lift towards positive direction reflecting a sense of improvement in situation. Females appeared to have slightly different concerns and hopes in comparison to males and especially across globe people expressed positive sentiments during new year time. Finally, this work, together with many other similar works on social media analysis gives ground for wide scale adoption of geo-temporal sentiments trend analysis of social media as a tool for uncovering key concerns and effectiveness of measures.

Evidence-based policies in public health to address COVID-19 vaccine hesitancy

A fundamental basis for effective health-related policymaking of any democratic nation should be open and transparent communication between a government and its citizens, including scientists and healthcare professionals, to foster a climate of trust, especially during the ongoing COVID-19 mass vaccination campaign. Since misinformation is a leading cause of vaccine hesitancy, open data sharing through an evidence-based approach may render the communication of health strategies developed by policymakers with the public more effective, allowing misinformation and claims that are not backed by scientific evidence to be tackled. In this narrative review, we debate possible causes of COVID-19 vaccine hesitancy and links to the COVID-19 misinformation epidemic. We also put forward plausible solutions as recommended in the literature.

A decision-making framework for COVID-19 infodemic management strategies evaluation in spherical fuzzy environment

100 years after the Spanish flu, the COVID-19 crisis showed that large-scale epidemics and pandemics do not belong to the past. On the report of the World Health Organization, COVID-19 is the most significant public health problem of the twenty-first century. Like previous epidemics, the current crisis is accompanied by uncertainty, mistrust, doubt and fear, and this has led to an infodemic connection to the epidemic. So not only are we fighting an epidemic, but also, we are brawling an infodemic. To reduce the social and economic consequences and harmful effects of infodemic health, and to overcome it, we need to implement strategies against infodemic. Evaluating strategies based on multiple characteristics can be considered multi-criteria decision-making (MCDM) problem. According to the literature, there is no study that aims on proposing an integrated approach to evaluate infodemic management strategies under uncertain environment. Therefore, in this paper, an integrated framework based on the extended version of best-worst method (BWM) and Combined Compromise Solution (CoCoSo) methods under a spherical fuzzy set (SFS) is developed for the first time to address the COVID-19 infodemic management strategies selection. Initially, the criteria are weighted using the developed SFS BWM which reduces uncertainty in pairwise comparisons. In the next step, the 15 selected strategies are analyzed and ranked using SFS CoCoSo. The outputs of this paper illustrate that online tools for fact checking COVID-19 information and engage and empower communities are placed in the first and second priorities, respectively. The comparison of ranking results SFS-CoCoSo with other MCDM methods demonstrates the performance of the proposed approach and its ranking stability.

Life Satisfaction of Nurses during the COVID-19 Pandemic in Poland

BACKGROUND

Health care practitioners are at highest risk of COVID-19 disease. They experience an enormous overload of work and time pressures. The objective of the study was to assess nurses' life satisfaction.

METHOD

The study included professionally active nurses. The research method was an author's questionnaire and a standardized questionnaire, the Satisfaction with Life Scale (SWLS).

RESULTS

The study group included 361 working nurses. The mean raw score and the sten score of the nurses' responses to the statements on the SWLS questionnaire were 21.0 (SD ± 5.6, range = 5-35) and 5.73 (SD ± 1.94, range = 1-10), respectively. It was shown that lower life satisfaction was experienced by nurses aged 51 to 60 (raw score: p = 0.003, sten score: p = 0.005), as well as nurses with secondary and undergraduate nursing education (raw score: p = 0.061, sten score: p = 0.043). Nurses who had a higher self-evaluation of the level of knowledge about SARS-CoV-2 infection experienced greater life satisfaction (raw score: p = 0.008, sten score: p = 0.022).

CONCLUSIONS

The majority of Polish nurses surveyed during the COVID-19 pandemic had a low or medium level of life satisfaction. The low response rate to the survey was most likely due to work overloads during the pandemic. Working in a public service profession, a nurse is exposed to stressful conditions related to protecting human health. Constant difficult and stressful situations and total fatigue experienced by nursing professionals can be the cause of a lack of motivation, occupational burnout, listlessness and mental and physical disease. Further research is necessary to assess the factors positively influencing the level of life satisfaction.

Factors Associated With Drug Consumption Without Scientific Evidence in Patients With Mild COVID-19 in Peru

OBJECTIVE

This study aimed to evaluate the factors associated with the consumption of drugs without scientific evidence in patients with mild COVID-19 infection in Peru.

METHODS

An analytical cross-sectional study was carried out including 372 adult patients with a history of mild COVID-19 disease. Factors associated with drug consumption were evaluated by Poisson regressions with robust variance adjustment using the bootstrapping resampling method.

RESULTS

Seventy-two percent consumed some medication without scientific evidence, with antibiotics (71%) and ivermectin for human use (68%) being the most commonly used. Factors associated with the consumption of drugs to treat mild COVID-19 infection were thinking that the drugs are not effective (adjusted prevalence ratio, 0.55; 95% confidence interval, 0.41-0.74) and not being informed about the efficacy of the drugs (adjusted prevalence ratio, 0.48; 95% confidence interval, 0.36-0.65).

CONCLUSIONS

Education of the population seems to be the main factor that increases the consumption of drugs without scientific evidence in the Peruvian population to treat mild COVID-19.

Effectiveness of Whole-Virus COVID-19 Vaccine among Healthcare Personnel, Lima, Peru

In February 2021, Peru launched a COVID-19 vaccination campaign among healthcare personnel using an inactivated whole-virus vaccine. The manufacturer recommended 2 vaccine doses 21 days apart. We evaluated vaccine effectiveness among an existing multiyear influenza vaccine cohort at 2 hospitals in Lima. We analyzed data on 290 participants followed during February-May 2021. Participants completed a baseline questionnaire and provided weekly self-collected nasal swab samples; samples were tested by real-time reverse transcription PCR. Median participant follow-up was 2 (range 1-11) weeks. We performed multivariable logistic regression and adjusted for preselected characteristics. During the study, 25 (9%) participants tested SARS-CoV-2-positive. We estimated adjusted vaccine effectiveness at 95% (95% CI 70%-99%) among fully vaccinated participants and 100% (95% CI 88%-100%) among partially vaccinated participants. These data can inform the use and acceptance of inactivated whole-virus vaccine and support vaccination efforts in the region.

Post-vaccination seropositivity against SARS-CoV-2 in peruvian health workers vaccinated with BBIBP-CorV (Sinopharm)

OBJECTIVE

To estimate the prevalence of post-vaccination seropositivity against SARS-CoV-2 and identify its predictors in Peruvian Social Health Insurance (EsSalud) personnel in 2021.

METHODS

We conducted a cross-sectional study in a representative simple stratified sample of EsSalud workers. We evaluated IgG anti-SARS-CoV-2 antibodies response (seropositivity) by passive (previous infection) and active immunization (vaccination), and epidemiological and occupational variables obtained by direct interview and a data collection form. Descriptive and inferential statistics were used with correction of sample weights adjusted for non-response rate, and crude and adjusted odds ratio (OR) and geometric mean ratio (GMR) with their respective 95% confidence intervals (95%CI) were estimated.

RESULTS

We enrolled 1077 subjects. Seropositivity was 67.4% (95%CI: 63.4-71.1). Predictors of seropositivity were age (negative relation; p < 0.001), previous infection (aOR = 11.7; 95%CI: 7.81-17.5), working in COVID-19 area (aOR = 1.47; 95%CI: 1.02-2.11) and time since the second dose. In relation to antibody levels measured by geometric means, there was an association between male sex (aGMR = 0.77; 95%CI: 0.74-0.80), age (negative relation; p < 0.001), previous infection (aGMR = 13.1; 95%CI:4.99-34.40), non-face-to-face/licensed work modality (aGMR = 0.78; 95%CI: 0.73-0.84), being a nursing technician (aGMR = 1.30; 95%CI: 1.20-1.41), working in administrative areas (aGMR = 1.17; 95%CI: 1.10-1.25), diagnostic support (aGMR = 1.07; 95%CI: 1.01-1.15), critical care (aGMR = 0.85; 95%CI: 0.79-0.93), and in a COVID-19 area (aGMR = 1.30; 95%CI: 1.24-1.36) and time since receiving the second dose (negative relation; p < 0.001).

CONCLUSIONS

Seropositivity and antibody levels decrease as the time since receiving the second dose increases. Older age and no history of previous infection were associated with lower seropositivity and antibody values. These findings may be useful for sentinel antibody surveillance and the design of booster dose strategies.

Web search behaviors and infodemic attitudes regarding COVID-19 in Turkey: A framework study for improving response and informing policy on the COVID-19 infodemic

Objective

This study aimed to develop a framework regarding COVID-19 infodemic response and policy informing through focusing on infodemic concepts circulating on the online search engine in Turkey in relation to the COVID-19 outbreak and comparing the contents of these concepts with Maslow's hierarchy of needs and disaster stages.

Materials and methods

The universe of this descriptive epidemiological research consists of internet search activities on COVID-19 circulating online on Google Trends between March 10, 2020, when the first case was seen in Turkey, and June 01, 2020, when the lockdown restrictions were lifted.

Findings

There was no internet trend regarding a misinformed attitude within the given date range. While an infodemic attitude toward superficial attitude and racist attitude in the internet environment was detected for 1 week, an infodemic attitude toward definitive attitude was detected for 2 weeks. The non-infodemic concepts were more common than the other infodemic attitudes. The infodemic concepts were able to reach Maslow's physiological, safety, and social need levels. With the infodemic concepts obtained, a COVID-19 development process framework was developed. The framework consists of three domains (COVID-19, applications and outcomes), including disaster phases and health/social impacts, built on seven public health epochs.

Results

A systematized COVID-19 development process framework was modeled in order to conceptualize COVID-19 internet searches and to reveal the development processes and outcomes.

Overview of Tools and Measures Investigating Vaccine Hesitancy in a Ten Year Period: A Scoping Review

The challenge of vaccine hesitancy, a growing global concern in the last decade, has been aggravated by the COVID-19 pandemic. The need for monitoring vaccine sentiments and early detection of vaccine hesitancy in a population recommended by the WHO calls for the availability of contextually relevant tools and measures. This scoping review covers a ten year-period from 2010–2019 which included the first nine years of the decade of vaccines and aims to give a broad overview of tools and measures, and present a summary of their nature, similarities, and differences. We conducted the review using the framework for scoping reviews by Arksey and O’Malley (2005) and reported it following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews’ guidelines. Of the 26 studies included, only one was conducted in the WHO African Region. Measures for routine childhood vaccines were found to be the most preponderant in the reviewed literature. The need for validated, contextually relevant tools in the WHO Africa Region is essential, and made more so by the scourge of the ongoing pandemic in which vaccination is critical for curtailment.

Infodemic Challenges During COVID-19 Pandemic and the Strategies to Deal with Them: A Review Article

Context: The phenomenon of infodemic following the outbreak of COVID-19 has led to several adverse public health consequences. Infodemic poses challenges at the community level, and identifying and adopting effective strategies against it can address many of these challenges. The present study aimed to determine the infodemic challenges of COVID-19 and the strategy to deal with them. Evidence acquisition: We searched PubMed and Scopus scientific databases using related keywords up to April 2022. The article selection process was based on the study’s inclusion and exclusion criteria. Data extraction was carried out using a data extraction form. We analyzed the extracted data through the content analyses method. Results: We identified infodemic challenges from related studies and classified them into nine main categories. These challenges included social hazards, improper health behavior, and scientific hazards. Other results show that strategies to deal with COVID-19 and other similar conditions can be classified into seven main categories, including the active confrontation with centers and scientific sources, the effective intervention of health care professionals, responsible participatory actions, actions of governments and authorities, monitoring and identifying incorrect information, heightening people’s awareness, and encouragement for vaccination. Conclusions: In this study, we identified and reported different coping strategies from all around the world that are very broad, and different countries and societies can use appropriate methods according to their situations and characteristics. Efforts to disseminate accurate information and prevent the propagation of incorrect information during a pandemic crisis can be vital.

Socio-ecological Resilience Relates to Lower Internalizing Symptoms among Adolescents during the Strictest Period of COVID-19 Lockdown in Perú

The COVID-19 pandemic has touched the lives of adolescents around the world. This short-term longitudinal, observational study followed 1,334 adolescents (11–17 yo) to investigate whether social-ecological resilience relates to intra- and inter-personal resources and/or the caregiver relationship relates to changes in internalizing symptoms during five stressful weeks of COVID-19 lockdown in Perú. In this work, we contextualize social-ecological resilience in relation to culturally-relevant personal and caregiver resources that youth can use to adapt to stressful situations. We found that adolescents who reported higher levels of personal, caregiver, and overall resilience had lower levels of anxiety and depressive symptoms at week six. We also find that personal, caregiver, and overall resilience moderated the change in anxiety symptoms from week 6 to week 11 of lockdown in 2020. Our findings underscore the importance of social-ecological resilience related to both intra/interpersonal resources and the caregiver relationship for minimizing the harmful impacts of COVID-19 on adolescent internalizing symptoms.

Labeling of Genetically Modified (GM) Foods in Peru: Current Dogma and Insights of the Regulatory and Legal Statutes

The COVID-19 pandemic has affected and afflicted human lives and been a transformative catalyst leading to closure of many companies, disrupting mental health, and reducing access to food and exacerbating food insecurity. This presents an opportunity to reflect on and examine genetically modified (GM) foods and their effective legislative regulation for the benefit of consumers. This review presents a detailed analysis of GM foods' regulation in Peru and the analysis of certain specific cases that show the need for greater regulation of the industry.

Factors associated with prevention practices against COVID-19 in the Peruvian population: Disparities between rural and urban areas

Objective

To determine the factors associated with prevention practices against COVID-19 in the Peruvian population according to rural vs. urban locations.

Methods

Analytical cross-sectional study, secondary analysis based on a previously collected database. A sample of individuals over 18 years of age, residing in Peru and with no history of COVID-19was evaluated. Factors associated with prevention practices were evaluated using Poisson regressions with variance adjustment by region cluster and stratified by rurality.

Results

Of 3231 participants included, 2741 (84.8%) were from urban areas and 490 (15.2%) from rural areas. The frequency of good prevention practices against COVID-19 was 27.8% in our total sample. In urban areas the frequency of good prevention practices was 28.8% and in rural areas it was 22.5%. Factors associated with prevention practices against COVID-19 in both urban and rural areas were male sex (urban: aPR 0.64, 95%CI 0.55–0.75; rural: aPR 0.66, 95%CI 0.54–0.80) and self-considering adequately carrying out prevention practices (urban: aPR 2.48, 95%CI 2.13–2.89; rural: aPR 2.70, 95%CI 2.27–3.19).

Conclusion

The frequency of good prevention practices against COVID-19 was less than 30% in both urban and rural areas. There are differences in the factors associated with good preventive practice against COVID-19. Only sex and considering that preventive measures were adequately carried out were associated with good prevention practices in both areas. In view of this, prevention measures should be promoted taking into account cultural principles and considering geographical location in the face of present and future outbreaks or pandemics.

A complex network model for a society with socioeconomic classes

People's attitudes and behaviors are partially shaped by the socioeconomic class to which they belong. In this work, a model of scale-free graph is proposed to represent the daily personal contacts in a society with three social classes. In the model, the probability of having a connection between two individuals depends on their social classes and on their physical distance. Numerical simulations are performed by considering sociodemographic data from France, Peru, and Zimbabwe. For the complex networks built for these three countries, average values of node degree, shortest-path length, clustering coefficient, closeness centrality, betweenness centrality, and eigenvector centrality are computed. These numerical results are discussed by taking into account the propagation of information about COVID-19.

The Impact of COVID-19 Pandemic on Halting Sustainable Development in the Colca y Volcanes de Andagua UNESCO Global Geopark in Peru—Prospects and Future

Events, such as the COVID-19 pandemic, that rapidly impact global communication and travel have significant consequences for the tourism industry, which is one of the pillars of global development. We assess the impacts of the COVID-19 crisis on the Colca y Volcanes de Andagua UNESCO Global Geopark in Peru. The Colca y Volcanes de Andagua Geopark was established immediately prior to the pandemic in October 2019. The instability of the government in Peru during the pandemic and the difficult living conditions in the high Andes, such as the lack of drinking water, cleaning agents, medical care, and the high levels of poverty, particularly in the geopark region, has contributed to the significantly high COVID-19 infection rates. In addition, detrimental impacts faced by the local community are a direct result of a reduction in travellers to the area due to legislative restrictions, which have had negative consequences on the local tourism industry. There is an urgent need for the recovery of the local tourism industry to prevent the permanent closure of tourism facilities and to minimise poverty rates.

Validating the Digital Health Literacy Instrument in Relation to COVID-19 Information (COVID-DHL-K) among South Korean Undergraduates

Digital health literacy is crucial in accessing and applying health information in the COVID-19 pandemic period. Young college students are exposed daily to digital technologies, and they have further increased the use of digital information during the COVID-19 period. This study aimed to adapt DHLI into Korean and to assess the psychometric properties, during the COVID-19 pandemic period. A cross-sectional, nationwide, and web-based survey was conducted among 604 Korean undergraduates from 23 December 2020 to 8 January 2021. On the basis of the Digital Health Literacy Instrument (DHLI) by the Global COVID HL Network, the Korean questionnaire was developed by group translation, expert reviews, and forward-backward translation for validation. The scale reliability and validity were examined using Cronbach's alpha and confirmatory factor analysis. Results support the theoretical and empirical four-factor structure (search, express, evaluate, use) in the coronavirus-related DHL among Korean University students. Internal reliability of the overall scale was high (Cronbach's α = 0.908). The four-factor model was supported by confirmatory factor analysis (GFI = 0.972, CFI = 0.984, TLI = 0.978, RMSEA = 0.045). This study revealed that the COVID-DHL-K is a valid and reliable measure with appropriate psychometric characteristics.

An Analysis of the Deleterious Impact of the Infodemic during the COVID-19 Pandemic in Brazil: A Case Study Considering Possible Correlations with Socioeconomic Aspects of Brazilian Demography

Due to COVID-19, a huge amount of incorrect information has been disseminated on the internet, which may interfere with the disease’s advance. This study analyzes the behavior of the Brazilian population during the pandemic, employing queries of infodemic data searched on Google Trends and relating them to socioeconomic and political indicators in the country. The z-score technique was used to standardize the data; and for multivalued analysis, dendrograms and the Elbow method detected similar patterns among Brazilian states. The result was divided into three analyses. In the analysis of the research trend of infodemic terms, the themes “Prevention and Beliefs” and “Treatment” prevailed. In the exploratory analysis, socioeconomic indicators related to income and education, as well as government programs, showed no impact on infodemic searches; but the results suggest that the states that supported the Brazilian president in the 2018 election, where he obtained more than 50% of the votes, were the states that most searched for infodemic terms: a total of 46.58% more infodemic searches than in the other states. In the multivalued analysis, the socioeconomic indicators used showed similarities in the patterns, highlighting a cluster containing 77% of all Brazilian states. The study concludes that denial about the pandemic and the influence of political leadership can influence infodemic information searches, contributing to a disorganization in the control of disease control and prevention measures.

The allometric propagation of COVID-19 is explained by human travel

We analyzed the number of cumulative positive cases of COVID-19 as a function of time in countries around the World. We tracked the increase in cases from the onset of the pandemic in each region for up to 150 days. We found that in 81 out of 146 regions the trajectory was described with a power-law function for up to 30 days. We also detected scale-free properties in the majority of sub-regions in Australia, Canada, China, and the United States (US). We developed an allometric model that was capable of fitting the initial phase of the pandemic and was the best predictor for the propagation of the illness for up to 100 days. We then determined that the power-law COVID-19 exponent correlated with measurements of human mobility. The COVID-19 exponent correlated with the magnitude of air passengers per country. This correlation persisted when we analyzed the number of air passengers per US states, and even per US metropolitan areas. Furthermore, the COVID-19 exponent correlated with the number of vehicle miles traveled in the US. Together, air and vehicular travel explained 70% of the variability of the COVID-19 exponent. Taken together, our results suggest that the scale-free propagation of the virus is present at multiple geographical scales and is correlated with human mobility. We conclude that models of disease transmission should integrate scale-free dynamics as part of the modeling strategy and not only as an emergent phenomenological property.

Self-medication and the ‘infodemic’ during mandatory preventive isolation due to the COVID-19 pandemic

Aim:

Quarantine due to the COVID-19 pandemic altered the supply and demand of health services. This, together with the ‘infodemic’ and generalized panic, could alter the patterns of self-medication in the population. The objective was to characterize the patterns of self-medication in four cities of Colombia during mandatory preventive isolation in 2020.

Methods:

This was a cross-sectional study done in four Colombian cities during mandatory national preventive isolation between June and September 2020. A sample of 397 adults who responded to an online survey, based on the Instrument for Systematic Data Collection for Self-medication (Instrumento de Recolección Sistemática de Datos para la Automedicación–IRIS-AM), was obtained. The use of social networks (including WhatsApp) as the source of information about medications was explored.

Results:

The 397 people surveyed had a median age of 31.0 years, and 58.2% were women. The prevalence of self-medication during lockdown was 34.3% (n = 136). Medications targeting the nervous system (n = 117; 86.0% of those participants with self-medication) and the musculoskeletal system (n = 68; 50.0%) were the most commonly used. Ten (7.4%) of the self-medicated patients reported doing so to prevent COVID-19, and 15 (11.0%) named social networks as the source of information.

Conclusion:

More than one-third of the participants reported self-medication during COVID-19 lockdown, mainly with analgesic-type nervous system medications. People who reported self-medication to prevent COVID-19 often got their information from social networks, the Internet, and WhatsApp.

Plain Language Summary

COVID-19 infodemic and depressive symptoms: The impact of the exposure to news about COVID-19 on the general Paraguayan population

INTRODUCTION

The COVID-19 pandemic has led to an increase of social stressors and mental health issues in the general population as well as among mentally ill patients. A COVID-19- related "infodemic", including too much information in digital and physical environments, has been recognized globally.

AIM

This study aimed to describe the impact of COVID-19 infodemic (exposure to news related to COVID-19) in terms of depressive symptoms in the Paraguayan general population.

METHODS

This was a descriptive and cross-sectional study. An online survey, designed in Google Forms, has been launched nationwide through the most popular social networks (Facebook, Twitter, Instagram) and messaging applications (WhatsApp, Telegram) in April (1st-30th) 2021. The Mental Health Inventory-5 (MHI-5) was employed for detecting depressive symptoms.

RESULTS

The survey included 1102 responders aged 35.4 ± 12.9 years old, 74.9% were women. MHI-5 mean score was 44.07 ± 14.16 in the general population with 34.4% (n = 379) of responders suffering from severe symptoms of depression (>52, as cut-off point). 53.5% of sample reported to have been exposed between 1 and 3 h to COVID-19 news, daily. An OR 1.933 (95% CI 1.48 - 2.52) was found between the exposure to news and depressive symptoms.

CONCLUSIONS

This study suggests that people exposed to a higher number of hours of COVID-19 news were 93.3% more likely to develop depressive symptoms.

Conspiracy beliefs and vaccination intent for COVID-19 in an infodemic

BACKGROUND

The massive, free and unrestricted exchange of information on the social media during the Covid-19 pandemic has set fertile grounds for fear, uncertainty and the rise of fake news related to the virus. This "viral" spread of fake news created an "infodemic" that threatened the compliance with public health guidelines and recommendations.

OBJECTIVE

This study aims to describe the trust in social media platforms and the exposure to fake news about COVID-19 in Lebanon and to explore their association with vaccination intent.

METHODS

In this cross-sectional study conducted in Lebanon during July-August, 2020, a random sample of 1052 participants selected from a mobile-phone database responded to an anonymous structured questionnaire after obtaining informed consent (response rate = 40%). The questionnaire was conducted by telephone and measured socio-demographics, sources and trust in sources of information and exposure to fake news, social media activity, perceived threat and vaccination intent.

RESULTS

Results indicated that the majority of participants (82%) believed that COVID-19 is a threat and 52% had intention to vaccinate. Exposure to fake/ unverified news was high (19.7% were often and 63.8% were sometimes exposed, mainly to fake news shared through Watsapp and Facebook). Trust in certain information sources (WHO, MoPH and TV) increased while trust in others (Watsapp, Facebook) reduced vaccination intent against Covid-19. Believing in the man-made theory and the business control theory significantly reduced the likelihood of vaccination intent (Beta = 0.43; p = 0.01 and Beta = -0.29; p = 0.05) respectively.

CONCLUSION

In the context of the infodemic, understanding the role of exposure to fake news and of conspiracy believes in shaping healthy behavior is important for increasing vaccination intent and planning adequate response to tackle the Covid-19 pandemic.

Os caminhos da ciência para enfrentar fake news sobre covid-19

Resumo Paralelamente à pandemia de covid-19, a Organização Mundial da Saúde alerta para uma infodemia de fake news relacionadas à doença. Objetiva-se, neste trabalho, conhecer a dimensão do fenômeno e alguns caminhos já identificados pela ciência para enfrentá-lo. Trata-se de uma revisão integrativa da literatura, realizada nas bases Scopus/Elsevier e Medline/PubMed, que incluiu 23 artigos. Por meio de análise da literatura, identificou-se que fake news oferecem falso suporte social e mobilizam sentimentos capazes de torná-las mais aceitáveis do que notícias verdadeiras. Dessa forma, as redes sociais e a internet despontam como plataformas disseminadoras de informações falsas. As pesquisas sugerem que instituições governamentais e midiáticas podem utilizar os canais de comunicação como aliados, com tecnologias de monitoramento e infovigilância para alertar, esclarecer e remover conteúdo enganoso. Também deve haver investimentos em ações de alfabetização científica e digital, de forma que as pessoas tenham condições de avaliar a qualidade das informações recebidas. Propõe-se a adoção de estratégias criativas, que despertem a capacidade de raciocínio, aliadas a informações científicas traduzidas em linguagem acessível, de preferência com aprovação de autoridades sanitárias e institucionais.

Health Information Crisis during COVID-19 in the South Asian Region: Challenges, Experiences, Resilience, and Collaborative Efforts

The fight against the COVID-19 pandemic is as much an information war as it is a medical war. Members from South Asia and the Asia Pacific countries share their experiences and challenges faced with collaborative responses for the ASIS&T Special Chapter funded project on "Dealing with COVID-19 and saving people's lives in South Asia (SA) areas & beyond-A Health Informatics Promotion Project" awarded to the South Asia Chapter in 2021. The panel discusses the challenges faced within the context of geopolitical, socio-economic, religious, and cultural conditions prevalent within their countries. In the first 40 minutes, panel members narrate their own experiences by sharing their personal stories about this collaborative project and share the challenges of content creation and promotion from within the context of their respective countries. The next 30 minutes will be facilitated by the panel chair inviting a discussion between panel members and the audience to engage and come up with innovative ideas, discuss challenges in creating multilingual content and suggestions for improving the project outcome as well as shed light on initiating future health informatics project in similar regions. The last 20 minutes will culminate with the summarization of these collaborative experiences.

Scientific ways to confront covid-19 fake news

Abstract Parallel to the covid-19 pandemic, the World Health Organization warns of an infodemic of fake news related to the disease. This integrative review investigates the dimension of this phenomenon and how science found ways to confront it. A bibliographic search was conducted on the Scopus/Elsevier and Medline/PubMed databases, retrieving 23 articles. Literature analysis found that fake news provide false social support and mobilize feelings which make them more acceptable than the truth. Hence, social media and the internet emerge as platforms to spread false information. Research suggests that government and media institutions can use communication channels and monitoring and infoveillance technologies as allies to alert, elucidate, and remove misleading content. We find the need of investments in scientific and digital literacy actions so people may assess the quality of the information they receive. Finally, this study proposes the adoption of creative strategies to foster reasoning skills together with scientific information translated into an accessible language, preferably approved by health and institutional authorities.

Sociodemographic Predictors Associated with the Willingness to Get Vaccinated against COVID-19 in Peru: A Cross-Sectional Survey

During the race for the development of a vaccine against COVID-19, even before its commercialization, part of the population has already shown a growing fear of its application. We designed an analytical cross-sectional study using an anonymous survey in the 25 departments of Peru. We surveyed whether the participants were planning on getting vaccinated, as well as other characteristics that were cross-checked in a uni-, bi- and multivariate manner. Of the 1776 respondents, 70% (1251) stated that they were planning to be vaccinated, 20% (346) did not know yet or doubted it, and 10% (179) did not want to be vaccinated. We observed that those who did not get infected with COVID-19 exhibited a higher frequency to not wanting or were uncertain about getting vaccinated (aPR: 1.40; 95% CI: 1.09-1.81; p-value = 0.008). In contrast, there was a lower frequency of vaccine refusal among university students (aPR: 0.75; 95% CI: 0.61-0.92; p-value = 0.005) and healthcare workers (aPR: 0.59; 95% CI: 0.44-0.80; p-value = 0.001); adjusted by place of residence. There is still an important percentage of respondents who do not want to be vaccinated or are hesitant to do it, which was associated with educational level, being a healthcare worker and if they were previously infected with COVID-19. Our results could offer useful information about COVID-19 vaccination campaigns.

Cost estimates of COVID-19 clinical management in Myanmar

Objective

This study aims to estimate the cost of clinical management of COVID-19 infected patients based on their severity by exploring the resources used in health care provision in Myanmar.

Methods

A multicenter retrospective cost analysis of COVID-19 patients was performed using the micro-costing approach from the perspective of the health system. It covered two cost components, namely direct and indirect cost of treating a patient. Input data and their quantities were obtained from COVID-19 Standard Treatment Guidelines of Ministry of Health and Sports, and administrative and financial records of resource utilization of three designated health facilities in Yangon Region. Valuation of these resources was based on the price list from the Procurement Section of the Ministry.

Results

This study estimated the unit cost of clinical management of COVID-19 infected patients with no symptom to be 953,552 MMK(717 USD), with mild-moderate symptoms to be 1,155,222 MMK(869 USD) and with severe-critically ill conditions to be 5,705,052 MMK(4290 USD). Average cost for a patient par day was 86,687 MMK(65 USD) for asymptomatic patients, 105,020 MMK(79 USD) for mild-moderate patients and 283,252 MMK(214 USD) for severe-critically ill patients. Since the first case detected till December 31, 2020, COVID-19 clinical management cost was accounted for 139 Billion MMK (104 Million USD) for total 124,630 confirmed cases.

Conclusions

COVID-19 pandemic has caused health systems to incur the significant health care expenses. Timely implementation of the sustainable, affordable and efficient policy for COVID-19 responses is of utmost important for every nation especially in the face of a pandemic. This study provides the fundamental inputs for strategic planning, for future economic evaluations of different policy interventions, and policy recommendations for health systems to remain resilient during and after the COVID-19 pandemic in Myanmar.

COVID-19 symptomatology and compliance with community mitigation strategies in Latin America early during the COVID-19 pandemic

Introduction

Community mitigation strategies (CMS) have demonstrated to be effective in the reduction of transmission and incidence of COVID-19, especially in the population with symptoms associated with the disease. The aim of this study was to evaluate the association between the presence of COVID-19 symptoms and adherence to CMS in Latin American adults.

Methods

We carried out a secondary analysis of a database developed by the University of Maryland and Facebook social network during the COVID-19 pandemic. We included Latin American adults that used the Facebook platform and participated in a survey conducted from April 23 to May 23, 2020. The principal outcome variable was reported compliance with the three main CMS (physical distancing, use of face masks, and hand washing). The exposure variable included symptoms suspicious for COVID-19 defined as the presence of three or more symptoms of an acute clinical case of COVID-19. We performed generalized linear models of the Poisson family with a logarithmic link function to evaluate the association between the presence of COVID-19 symptoms and reported compliance with CMS. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95%CI).

Results

We analyzed 1,310,690 adults from Latin America; 48.1% were male and 42.9% were under 35 years of age. The prevalence of suspicious symptoms of COVID-19 was 18.5% and reported compliance with the three CMS was 45.3%. The countries with the highest proportion of reported compliance with the three CMS were Peru, Bolivia and Panama, while those with the lowest reported compliance were Costa Rica, Nicaragua and Honduras. In the adjusted model, people with suspicious symptoms for COVID-19 had a 14% lower compliance with the three CMS (aPR = 0.86; 95%CI: 0.85-0.87; p < 0.001).

Conclusions

Less than half of the participants complied with the CMS, and those presenting suspicious symptoms for COVID-19 had lower reported compliance with the three CMS.

Contextual modulation of preferred social distance during the Covid-19 pandemic

Social distancing during a pandemic might be influenced by different attitudes: people may decide to reduce the risk and protect themselves from viral contagion, or they can opt to maintain their habits and be more exposed to the infection. To better understand the underlying motivating attitudes, we asked participants to indicate in an online platform the interpersonal distance from different social targets with professional/social behaviors considered more or less exposed to the virus. We selected five different social targets: a cohabitant, a friend working in a hospital, a friend landed from an international flight, a friend who is back from a cycling ride, or a stranger. In order to measure the realistic and the symbolic perceived threat, we administered the Brief 10-item COVID-19 threat scale. Moreover, in order to measure the risk attitude in different domains, the participants were also asked to fill in the Domain-Specific Risk-Taking DOSPERT scale. Results reveal a general preference for an increased distance from a stranger and the friends who are considered to be more exposed to the virus: the friend working in a hospital or landed from an international flight. Moreover, the interpersonal distance from friends is influenced by the perception of Realistic Threat measured through the Integrated Covid Threat Scale and the Health/Safety Risk Perception/Assumption as measured by the DOSPERT scale. Our results show the flexible and context-dependent nature of our representation of other people: as the social categories are not unchangeable fixed entities, the bodily (e.g., spatial) attitudes towards them are an object of continuous attunement.

Ações governamentais para enfrentamento da crise de desinformação durante a pandemia da Covid-19

RESUMO A profusão de notícias falsas disseminadas no contexto da pandemia da Covid-19 colocou novos desafios a governos, gestores e profissionais de saúde, mídia e entidades de defesa da saúde e da vida. As ações governamentais de diferentes países frente a esse problema são o objeto deste estudo de revisão integrativa, que analisou 16 artigos, após busca em três bases de dados bibliográficos, no período de novembro de 2020 a janeiro de 2021, utilizando critérios de inclusão e exclusão. Agrupados por continentes (Ásia, Europa e América Latina), os resultados apontaram: existência de dispositivos reguladores; criminalização da desinformação; regulamentação da comunicação digital; uso de tecnologias para aproximar governo e cidadãos; monitoramento e verificação de notícias falsas; uso de plataformas refutadoras; redes digitais para identificação e remoção de notícias e contas; crise de desinformação como fomento para a divergência política; entre outros. Diferenças e desigualdades marcam as ações governamentais frente à desinformação no contexto da pandemia da Covid-19, refletindo coesão social, liderança, confiança institucional ou força coercitiva. Sugerem-se estudos aprofundados, que permitam compreender como as sociedades, com diferentes tipos de governo, economias e regimes políticos, definem as ações desenvolvidas para o controle da desinformação e seu potencial de eficiência.

Government actions to address the disinformation crisis during the COVID-19 pandemic

ABSTRACT The profusion of fake news disseminated in the context of the COVID-19 pandemic posed new challenges to governments, health care managers and professionals, media and entities committed to protect health and life. Government actions from different countries faced with this problem are the object of this integrative review study which analyzed 16 articles, after searching three bibliographic databases, from November 2020 to January 2021 using inclusion and exclusion criteria. Grouped by continents (Asia, Europe and Latin America), the results pointed to: the existence of regulatory devices; criminalization of disinformation; digital communication regulation; use of technologies to bring closer government and citizens; monitoring and verification of fake news; creation of rebuttal news platforms; digital network approaches for identification and removal of news and accounts; disinformation crisis as a foment for political divergence; among other issues. Differences and inequalities marked government actions against disinformation in the context of the COVID-19 pandemic reflecting social cohesion, leadership, institutional trust or coercive force. In-depth studies are suggested to understand how societies with different types of government, economies, and political regimes define the actions taken to control disinformation and their potential effectiveness.

Factors associated with the consumption of chlorine dioxide to prevent and treat COVID-19 in the Peruvian population: a cross-sectional study

BACKGROUND

Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population.

METHODS

Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method.

RESULTS

Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09-1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35-0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02-1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40-0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01-1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45-0.74), using medications (aPR: 1.59; 95% CI: 1.25-2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21-2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18-0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16-0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33-0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12-0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07-0.32).

CONCLUSIONS

The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.

Prevalence and Factors Associated with Parents' Non-Intention to Vaccinate Their Children and Adolescents against COVID-19 in Latin America and the Caribbean

We aimed to estimate the prevalence and factors associated with parents' non-intention to vaccinate their children and adolescents against COVID-19 in Latin America and the Caribbean (LAC). We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc., Menlo Park, CA, USA). We included adult (18 and over) Facebook users residing in LAC who responded to the survey between 20 May 2021 and 14 July 2021. We included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated the crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95%CI. We analyzed a sample of 227,740 adults from 20 LAC countries. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.8% (n = 15,196). An age above 35 years old, educational level above college, compliance with physical distancing, use of masks, having economic insecurity, having had COVID-19, anxiety symptoms, depressive symptoms, having a chronic condition or two or more comorbidities, and being vaccinated were associated with a lower prevalence of non-intention to vaccinate children and adolescents against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. Approximately nine out of ten parents in LAC intended to vaccinate their children and adolescents against COVID-19. Our results allow for understanding parents' intentions to vaccinate children and adolescents and help promote and develop education strategies for national vaccination plans against COVID-19.

Characterization of non-adopters of COVID-19 non-pharmaceutical interventions through a national cross-sectional survey to assess attitudes and behaviours

Adoption of non-pharmaceutical interventions (NPIs) remains critical to curtail the spread of COVID-19. Using self-reported adherence to NPIs in Canada, assessed through a national cross-sectional survey of 4498 respondents, we aimed to identify and characterize non-adopters of NPIs, evaluating their attitudes and behaviours to understand barriers and facilitators of adoption. A cluster analysis was used to group adopters separately from non-adopters of NPIs. Associations with sociodemographic factors, attitudes towards COVID-19 and the public health response were assessed using logistic regression models comparing non-adopters to adopters. Of the 4498 respondents, 994 (22%) were clustered as non-adopters. Sociodemographic factors significantly associated with the non-adoption cluster were: (1) being male, (2) age 18–34 years, (3) Albertans, (4) lower education level and (5) higher conservative political leaning. Participants who expressed low concern for COVID-19 and distrust towards several institutions had greater odds of being non-adopters. This information characterizes individuals at greatest odds for non-adoption of NPIs to inform targeted marketing interventions.

The causes, impacts and countermeasures of COVID-19 "Infodemic": A systematic review using narrative synthesis

An unprecedented infodemic has been witnessed to create massive damage to human society. However, it was not thoroughly investigated. This systematic review aims to (1) synthesize the existing literature on the causes and impacts of COVID-19 infodemic; (2) summarize the proposed strategies to fight with COVID-19 infodemic; and (3) identify the directions for future research. A systematic literature search following the PRISMA guideline covering 12 scholarly databases was conducted to retrieve various types of peer-reviewed articles that reported causes, impacts, or countermeasures of the infodemic. Empirical studies were assessed for risk of bias using the Mixed-Methods Appraisal Tool. A coding theme was iteratively developed to categorize the causes, impacts, and countermeasures found from the included studies. Social media usage, low level of health/eHealth literacy, and fast publication process and preprint service are identified as the major causes of the infodemic. Besides, the vicious circle of human rumor-spreading behavior and the psychological issues from the public (e.g., anxiety, distress, fear) emerges as the characteristic of the infodemic. Comprehensive lists of countermeasures are summarized from different perspectives, among which risk communication and consumer health information need/seeking are of particular importance. Theoretical and practical implications are discussed and future research directions are suggested.

COVID-19 information dissemination in Uganda: Perspectives from sub-national health workers

BACKGROUND

In many places, health workers at the sub-national level are on the frontlines of disseminating information about coronavirus (COVID-19) to communities. To ensure communities are receiving timely and accurate information, it is vital health workers are kept abreast of the most recent recommendations, and guidance.

METHODS

An electronic survey was implemented to provide insights about the dissemination and utilisation of information and evidence related to the COVID-19 pandemic by health workers engaged at sub-national levels of the Ugandan health system. The aim of this survey was to provide insights about the dissemination and utilisation of information and evidence related to the coronavirus (COVID-19) pandemic by individuals engaged at sub-national levels of the health system.

RESULTS

Mass media and public health campaigns and outreach activities were deemed the most suitable means to reach communities with COVID-19 information. Given the reported disruption to public outreach campaigns, this is a particularly important consideration for the provision of information to communities. All materials should be adapted to the local context. The need for information on homecare of COVID-19 patients was highlighted, along with the need for updated local statistics as to COVID-19 cases to be relayed for health workers at sub-national levels.

CONCLUSIONS

Understanding the sources of information used by health workers can facilitate the transfer of relevant and timely information, which in turn increases the use of such information by the Ugandan population. It is vital that these issues are continued to be monitored, and communication modes and content are actively responsive to the time- and place-specific needs of health workers and community members.

Public Sentiment and Discourse on Domestic Violence During the COVID-19 Pandemic in Australia: Analysis of Social Media Posts

BACKGROUND

Measuring public response during COVID-19 is an important way of ensuring the suitability and effectiveness of epidemic response efforts. An analysis of social media provides an approximation of public sentiment during an emergency like the current pandemic. The measures introduced across the globe to help curtail the spread of the coronavirus have led to the development of a situation labeled as a "perfect storm," triggering a wave of domestic violence. As people use social media to communicate their experiences, analyzing public discourse and sentiment on social platforms offers a way to understand concerns and issues related to domestic violence during the COVID-19 pandemic.

OBJECTIVE

This study was based on an analysis of public discourse and sentiment related to domestic violence during the stay-at-home periods of the COVID-19 pandemic in Australia in 2020. It aimed to understand the more personal self-reported experiences, emotions, and reactions toward domestic violence that were not always classified or collected by official public bodies during the pandemic.

METHODS

We searched social media and news posts in Australia using key terms related to domestic violence and COVID-19 during 2020 via digital analytics tools to determine sentiments related to domestic violence during this period.

RESULTS

The study showed that the use of sentiment and discourse analysis to assess social media data is useful in measuring the public expression of feelings and sharing of resources in relation to the otherwise personal experience of domestic violence. There were a total of 63,800 posts across social media and news media. Within these posts, our analysis found that domestic violence was mentioned an average of 179 times a day. There were 30,100 tweets, 31,700 news reports, 1500 blog posts, 548 forum posts, and 7 comments (posted on news and blog websites). Negative or neutral sentiment centered on the sharp rise in domestic violence during different lockdown periods of the 2020 pandemic, and neutral and positive sentiments centered on praise for efforts that raised awareness of domestic violence as well as the positive actions of domestic violence charities and support groups in their campaigns. There were calls for a positive and proactive handling (rather than a mishandling) of the pandemic, and results indicated a high level of public discontent related to the rising rates of domestic violence and the lack of services during the pandemic.

CONCLUSIONS

This study provided a timely understanding of public sentiment related to domestic violence during the COVID-19 lockdown periods in Australia using social media analysis. Social media represents an important avenue for the dissemination of information; posts can be widely dispersed and easily accessed by a range of different communities who are often difficult to reach. An improved understanding of these issues is important for future policy direction. Heightened awareness of this could help agencies tailor and target messaging to maximize impact.

Education system of Nepal: impacts and future perspectives of COVID-19 pandemic

The academic sectors are badly affected by the COVID-19 pandemic globally. The studies regarding the implications of COVID-19 in education in Nepal were minimal, thus, this paper aims to highlight the impacts of the pandemic on the education sector of Nepal. It is revealed that the Nepalese academia has been facing problems due to lack of adequate and appropriate sustainable infrastructure for the online system, including skilled human resources. In addition, limited internet facilities in remote and rural areas were the other challenging tasks for virtual academic activities. Therefore, the concerned stakeholders should provide necessary services and appropriate strategies for virtual means of the education system to compensate the repercussion caused by the pandemic. This study could be helpful to identify the critical needs emerged due to the pandemic at present and in future and also contribute to adopt appropriate policy for the revival of educational institutions.

Use of medicinal plants for COVID-19 prevention and respiratory symptom treatment during the pandemic in Cusco, Peru: A cross-sectional survey

BACKGROUND

The burden of the COVID-19 pandemic in Peru has led to people seeking alternative treatments as preventives and treatment options such as medicinal plants. This study aimed to assess factors associated with the use of medicinal plants as preventive or treatment of respiratory symptom related to COVID-19 during the pandemic in Cusco, Peru.

METHOD

A web-based cross-sectional study was conducted on general public (20- to 70-year-old) from August 31 to September 20, 2020. Data were collected using a structured questionnaire via Google Forms, it consisted of an 11-item questionnaire that was developed and validated by expert judgment using Aiken's V (Aiken's V > 0.9). Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to assess factors associated with the use of medicinal plants for COVID-19 prevention and respiratory symptom treatment during the pandemic. Prevalence ratios (PR) with 95% Confidence Interval (CI), and a P-value of 0.05 was used to determine statistical significance.

RESULTS

A total of 1,747 respondents participated in the study, 80.2% reported that they used medicinal plants as preventives, while 71% reported that they used them to treat respiratory symptoms. At least, 24% of respondents used medicinal plants when presenting with two or more respiratory symptoms, while at least 11% used plants for malaise. For treatment or prevention, the multivariate analysis showed that most respondents used eucalyptus (p < 0.001 for both), ginger (p < 0.022 for both), spiked pepper (p < 0.003 for both), garlic (p = 0.023 for prevention), and chamomile (p = 0.011 for treatment). The respondents with COVID-19 (p < 0.001), at older ages (p = 0.046), and with a family member or friend who had COVID-19 (p < 0.001) used more plants for prevention. However, the respondents with technical or higher education used less plants for treatment (p < 0.001).

CONCLUSION

There was a significant use of medicinal plants for both prevention and treatment, which was associated with several population characteristics and whether respondents had COVID-19.

Assessment of Government Intervention Effectiveness in Scrubbing COVID-19 Pandemic and Its Pros and Cons on Educational Activities, the Case of Dire Dawa City

BACKGROUND

Coronaviruses are known as a large family of viruses known to cause respiratory infections which are considered as a pandemic by WHO and widely distributed all over the globe; causing several damages to all aspects of human being's life.

OBJECTIVE

To assess and identify the determinants of government intervention effectiveness in scrubbing COVID-19 and its pros and cons on educational activity in Dire Dawa City.

METHODS

Stratified random sampling was hired to draw a sample of teachers from a list of teachers that were taught at both selected private and public educational institutes.

RESULTS

A 57.6% of educators responded as the government was effective in mitigating the pandemic. Out of 250 educators, 9.6%, 10.8%, 8.4%, 38.4%, and 32.8% were reported that they have very poor, poor, neutral, good, and very good level of knowledge about COVID-19, respectively. The respondents' perceptions about the pandemic were rated as not very fear inducing, not fear inducing, neutral, fear inducing, and very fear inducing 3.2%, 6.4%, 6.8%, 55.2% and 28.4%, respectively. Logistic regression indicates nine predictors were significant: avoiding touching one's body with unwashed hands, disinfecting surfaces, fatigue, getting flu vaccine, individual limitation in cooperating to cease the disease, how to maintain one's mental health during the isolation, and washing for at least 20 seconds, family care, and self-isolation.

PROS

Reading, family care, watching movies and physical exercise were importance brought by the pandemic to the educators.

CONS

Teachers are obligated to stay at home, unemployment, stress, unable to conduct professional activities, cancellation of training, and loss of motivation.

CONCLUSION

The results implied us eighty-four variables were significantly associated with government intervention effectiveness, and nine predictors were significantly related with the government's intervention effectiveness in halting the pandemic from logistic regression model.