COVID-19 Pandemic Response in a Migrant Farmworker Community: Excess Mortality, Testing Access and Contact Tracing in Immokalee, Florida

Introduction: We aim to estimate the impact of COVID-19 in Immokalee, FL and assess community experiences with workplace conditions, access to testing, sources of information, and contact tracing to inform and strengthen local public health sector efforts in reaching and providing high-quality care to the community. Methods: We conducted a descriptive analysis of data on COVID-19 deaths for Collier County from May-August 2020. We surveyed a cross-sectional, randomized representative sample of 318 adults living in Immokalee from March-November 2020 to assess socio-demographics, sources of information, ability to follow guidelines, and experiences with local programs. Results were compared across language groups. Results: Average excess mortality in Collier County was 108%. The majority surveyed in Immokalee had socio-demographic factors associated with higher COVID risk. Non-English speakers had higher workplace risk due to less ability to work from home. Haitian Creole speakers were less likely to be tested, though all participants were willing to get symptomatic testing and quarantine. Those participants who tested positive or had COVID-19 exposures had low engagement with the contact tracing program, and Spanish-speakers reported lower quality of contact tracing than English speakers. Conclusions: The community of Immokalee, FL is a vulnerable population that suffered disproportionate deaths from COVID-19. This study reveals language inequities in COVID testing and contact tracing should be targeted in future pandemic response in Immokalee and other migrant farmworker communities

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Resuming In-Person Classes under COVID-19: Evaluating Assigned Seating Protocols in Limiting Contacts at Postsecondary Institutions

10.1101/2021.05.07.21256844 ◽

2021 ◽

Author(s):

Daniel Daly-Grafstein ◽

Patricia Daly ◽

Reka Gustafson

Keyword(s):

Returning Students ◽

Postsecondary Institutions ◽

Contact Tracing ◽

Severe Illness ◽

Post Secondary ◽

Pandemic Response ◽

Enrollment Data ◽

The Impact ◽

Academic Year ◽

Reducing Potential

In order to limit the spread of COVID-19, Canadian postsecondary institutions are offering the majority of classes online for the 2020-21 academic year. The goal of Canada's public health pandemic response is to reduce severe illness and mortality from COVID-19 while minimizing social disruption. To achieve this goal, post secondary institutions need practical tools to limit COVID-19 spread and facilitate contact tracing while returning students to in-person instruction. In this paper, we explore the impact of assigned seating for students attending in-person classes in reducing potential contacts. We conduct a variety of seating simulations using student enrollment data and measure the number of potential contacts under each scenario. We find that assigning seats to students significantly reduces the expected number of contacts relative to random seating, making the return to in-person classes more feasible under these scenarios.

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COVID-19 Pandemic: A Challenge for Healthcare Professionals and Assessment of Anxiety Symptoms

Journal of Health Sciences ◽

10.17532/jhsci.2020.1073 ◽

2020 ◽

Author(s):

Daniel Maestro ◽

Sabina Šegalo ◽

Dinko Remić ◽

Arzija Pašalić ◽

Anes Jogunčić

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Health Centre ◽

Anxiety Symptoms ◽

Public Institution ◽

World Health ◽

Sources Of Information ◽

Cross Sectional ◽

The World ◽

The Impact

Introduction: Worldwide, COVID-19 pandemic caused millions of infected people and thousands of deaths. Due to enormous pressure on health-care systems and its inadequate preparedness, utter collapse is expected. In the current epidemic response, healthcare workers’ (HCWs) knowledge and practice are crucial, while the impact on their mental health is still unknown.Methods: The cross-sectional study was conducted among HCWs redeployed to COVID points in the Public Institution Health Centre of Sarajevo Canton. According to guidelines and information provided by the World Health Organization and Ministries of Health, a questionnaire was developed. In addition, General Anxiety Disorder-7 as a screening tool for anxiety disorders was used.Results: Of 180 respondents, 26 (14.4%) were in direct contact with the sick patient. In total, 79 (43.9%) respondents consider their personal protective equipment is in accordance with the guidelines of the world health authorities. A total of 72 (39.7%) of respondents used the same mask for several days. In general, the danger from new coronavirus was considered minimal by 59 (32,6%) HCWs. Based on the achieved score for assessing the anxiety disorder, in 63 (35%) subjects, the presence of severe symptoms was detected.Conclusion: This study found that most HCWs do not have enough knowledge about the COVID-19 pandemic. We identified that there are differences in the sources of information and gap in perceptions of the native origin of the virus. Considering the frequency of anxiety symptoms among HCWs, interventions are necessary in order to preserve their mental health.

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Excess mortality in the first COVID pandemic peak: cross-sectional analyses of the impact of age, sex, ethnicity, household size, and long-term conditions in people of known SARS-CoV-2 status in England

British Journal of General Practice ◽

10.3399/bjgp20x713393 ◽

2020 ◽

Vol 70 (701) ◽

pp. e890-e898

Author(s):

Mark Joy ◽

FD Richard Hobbs ◽

Jamie Lopez Bernal ◽

Julian Sherlock ◽

Gayatri Amirthalingam ◽

...

Keyword(s):

Excess Mortality ◽

Relative Survival ◽

Cross Sectional ◽

Sentinel Network ◽

Long Term Conditions ◽

Hazard Ratios ◽

Male Sex ◽

Nationally Representative ◽

The Impact

BackgroundThe SARS-CoV-2 pandemic has passed its first peak in Europe.AimTo describe the mortality in England and its association with SARS-CoV-2 status and other demographic and risk factors.Design and settingCross-sectional analyses of people with known SARS-CoV-2 status in the Oxford RCGP Research and Surveillance Centre (RSC) sentinel network.MethodPseudonymised, coded clinical data were uploaded from volunteer general practice members of this nationally representative network (n = 4 413 734). All-cause mortality was compared with national rates for 2019, using a relative survival model, reporting relative hazard ratios (RHR), and 95% confidence intervals (CI). A multivariable adjusted odds ratios (OR) analysis was conducted for those with known SARS-CoV-2 status (n = 56 628, 1.3%) including multiple imputation and inverse probability analysis, and a complete cases sensitivity analysis.ResultsMortality peaked in week 16. People living in households of ≥9 had a fivefold increase in relative mortality (RHR = 5.1, 95% CI = 4.87 to 5.31, P<0.0001). The ORs of mortality were 8.9 (95% CI = 6.7 to 11.8, P<0.0001) and 9.7 (95% CI = 7.1 to 13.2, P<0.0001) for virologically and clinically diagnosed cases respectively, using people with negative tests as reference. The adjusted mortality for the virologically confirmed group was 18.1% (95% CI = 17.6 to 18.7). Male sex, population density, black ethnicity (compared to white), and people with long-term conditions, including learning disability (OR = 1.96, 95% CI = 1.22 to 3.18, P = 0.0056) had higher odds of mortality.ConclusionThe first SARS-CoV-2 peak in England has been associated with excess mortality. Planning for subsequent peaks needs to better manage risk in males, those of black ethnicity, older people, people with learning disabilities, and people who live in multi-occupancy dwellings.

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Examining Vaccine Hesitancy in Sub-Saharan Africa: A Survey of the Knowledge and Attitudes among Adults to Receive COVID-19 Vaccines in Ghana

Vaccines ◽

10.3390/vaccines9080814 ◽

2021 ◽

Vol 9 (8) ◽

pp. 814

Author(s):

Theophilus Acheampong ◽

Eli A. Akorsikumah ◽

John Osae-Kwapong ◽

Musah Khalid ◽

Alfred Appiah ◽

...

Keyword(s):

Disease Transmission ◽

Online Survey ◽

Multinomial Logistic Regression ◽

Sub Saharan Africa ◽

Vaccine Hesitancy ◽

Sources Of Information ◽

Iterative Proportional Fitting ◽

Cross Sectional ◽

The Impact ◽

To Receive

The impact of COVID-19 vaccination programmes on disease transmission, morbidity and mortality relies heavily on the population’s willingness to accept the vaccine. We explore Ghanaian adult citizens’ vaccine hesitancy attitudes and identify the likelihood of participation or non-participation in the government’s effort to get citizens vaccinated. A fully anonymised cross-sectional online survey of 2345 adult Ghanaians was conducted from 23 to 28 February 2021. Differences in intentions regarding COVID-19 vaccination were explored using Pearson Chi-square tests. Additionally, multinomial logistic regression was used to analyse the factors associated with willingness to receive vaccines. Responses were weighted using the iterative proportional fitting technique to generate a representative sample. About half (51%) of mostly urban adult Ghanaians over 15 years are likely to take the COVID-19 vaccine if made generally available. Almost a fifth (21%) of the respondents were unlikely to take the vaccine, while another 28% were undecided. Additionally, we find differences in vaccine hesitancy among some socio-demographic characteristics such as age, gender, and primary sources of information. Attaining the proverbial 63% to 70% herd immunity threshold in Ghana is only possible if the preventive vaccination programmes are combined with an enhanced and coordinated public education campaign. Such a campaign should focus on promoting the individual and population-level benefits of vaccination and pre-emptive efforts towards addressing misinformation about vaccines.

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Informed Consent In Patients Undergoing ENT Surgery: What Do Patients Want To Know?

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v25i2.623 ◽

2010 ◽

Vol 25 (2) ◽

pp. 18-22

Author(s):

Bikash lal Shrestha

Keyword(s):

High School ◽

Informed Consent ◽

Formal Education ◽

Medical Information ◽

Sources Of Information ◽

Cross Sectional ◽

Specific Patient ◽

Educational Levels ◽

Written Information ◽

The Impact

Objective: To determine patient satisfaction with the informed consent process in ear, nose and throat (ENT) diseases requiring surgery. Specifically, to determine relationships between educational levels of patients and their satisfaction with information given by doctors versus self-gathered information; whether complications of the operation were explained to, and could be listed by patients; the types of complications patients expected to be informed about and the importance of this information to them; their familiarity with the term “informed consent” and their preference for written or spoken information; and whether they were convinced about what they consented to. Methods: Design: Cross-sectional Descriptive Study Setting: Tertiary Public Hospital Patients: One Hundred Results: There were 55 males and 45 females (average age 26.7 years, range 4 - 74 years). Ten percent (all children) had no formal education, 56% had primary to high school education, 23% had certificate level education, and 11% had a baccalaureate or masters degree. Ninety-five percent claimed they knew what informed consent was. Ninety percent were satisfied with the information given to them by doctors. Eighty percent, mainly with educational levels of high school and above, preferred to receive written information from doctors. Twenty three percent accessed other sources of information. Those with certificate level education talked with previously operated patients (10%) or read magazines (2%), while the internet was favored by almost all of those with baccalaureate degrees (8%) and all those with masters degrees (2%). Of those who accessed self-gathered information, 21% were not satisfied while only 2% were satisfied. Seventy percent considered the information given by doctors very important. Similarly, seventy percent (mostly from the higher educational levels) considered the impact of information provided by the doctor completely convincing for decision making, while thirty percent (mostly from lower educational levels) only found the information partly convincing. Forty nine percent (again from the lower educational levels), could not list even a single complication. Nineteen percent, with educational levels of certificate and above, wanted to know all complications of surgery, including those that were very rare while fifty six percent wanted to know most of the complications. Conclusion: We should not underestimate the importance of the outpatient consultation, the importance of written material and non medical information sources as patients’ expectations are quite high and the majority of them wanted to be informed about most complications. We should also find ways to improve the provision of patient information, and where possible and appropriate, as per specific patient groups. Key words: Informed consent, otorhinolaryngology, surgical procedures

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Inequalities in excess premature mortality in England during the COVID-19 pandemic: a cross-sectional analysis of cumulative excess mortality by area deprivation and ethnicity

BMJ Open ◽

10.1136/bmjopen-2021-052646 ◽

2021 ◽

Vol 11 (12) ◽

pp. e052646

Author(s):

Sharmani Barnard ◽

Paul Fryers ◽

Justine Fitzpatrick ◽

Sebastian Fox ◽

Zachary Waller ◽

...

Keyword(s):

Excess Mortality ◽

Minority Groups ◽

Premature Mortality ◽

Area Deprivation ◽

Cross Sectional ◽

Expected Mortality ◽

Sectional Analysis ◽

The Impact ◽

Death Data ◽

Deprived Areas

ObjectivesTo examine magnitude of the impact of the COVID-19 pandemic on inequalities in premature mortality in England by deprivation and ethnicity.DesignA statistical model to estimate increased mortality in population subgroups during the COVID-19 pandemic by comparing observed with expected mortality in each group based on trends over the previous 5 years.SettingInformation on deaths registered in England since 2015 was used, including age, sex, area of residence and cause of death. Ethnicity was obtained from Hospital Episode Statistics records linked to death data.ParticipantsPopulation study of England, including all 569 824 deaths from all causes registered between 21 March 2020 and 26 February 2021.Main outcome measuresExcess mortality in each subgroup over and above the number expected based on trends in mortality in that group over the previous 5 years.ResultsThe gradient in excess mortality by area deprivation was greater in the under 75s (the most deprived areas had 1.25 times as many deaths as expected, least deprived 1.14) than in all ages (most deprived had 1.24 times as many deaths as expected, least deprived 1.20). Among the black and Asian groups, all area deprivation quintiles had significantly larger excesses than white groups in the most deprived quintiles and there were no clear gradients across quintiles. Among the white group, only those in the most deprived quintile had more excess deaths than deaths directly involving COVID-19.ConclusionThe COVID-19 pandemic has widened inequalities in premature mortality by area deprivation. Among those under 75, the direct and indirect effects of the pandemic on deaths have disproportionately impacted ethnic minority groups irrespective of area deprivation, and the white group the most deprived areas. Statistics limited to deaths directly involving COVID-19 understate the pandemic’s impact on inequalities by area deprivation and ethnic group at younger ages.

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Perception and Feelings of Antenatal Women during COVID-19 Pandemic: A Cross-Sectional Survey

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.2020295 ◽

2020 ◽

Vol 49 (8) ◽

pp. 543-552

Author(s):

Qiu Ju Ng ◽

Krystal ML Koh ◽

Shephali Tagore ◽

Manisha Mathur

Keyword(s):

Psychological Impact ◽

Significant Proportion ◽

Fetal Distress ◽

Intrauterine Fetal Death ◽

Intrauterine Death ◽

Sources Of Information ◽

Fetal Anomalies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Impact

Introduction: To assess the level of anxiety and knowledge regarding COVID-19 amongst antenatal women. Materials and Methods: This cross-sectional survey was conducted in the antenatal clinics of KK Women’s and Children’s Hospital, Singapore, from 31 March to 25 April 2020 to assess pregnant women’s knowledge of COVID-19, their perceptions of its impact upon pregnancy and psychological impact using the validated Depression, Anxiety, and Stress Scales (DASS-21). Results: Of the 324 women who participated in the study, the mean age was 31.8 years (range, 20–45). The majority (53.7%) were multiparous with mean gestational age of 23.4 weeks (SD 10). The commonest sources of information were Internet-based social media platforms. A significant proportion were unaware, or associated COVID-19 infection during pregnancy with fetal distress (82.1%), intrauterine death (71.3%), fetal anomalies (69.8%), miscarriages (64.8%), preterm labour (67.9%) and rupture of membranes (61.4%). A total of 116 (35.8%) women screened positive for anxiety, 59 (18.2%) for depression, and 36 (11.1%) for stress. There was a significant association between household size and stress scores [B = 0.0454 (95% CI, 0.0035–0.0873)]. Women who associated COVID-19 infection with fetal anomalies and intrauterine fetal death had significantly higher anxiety scores [B = −0.395 (95% CI, −0.660 to −0.130) and B = −0.291 (95% CI, −0.562 to −0.021) respectively]. Conclusion: Our study highlights that a lack of timely and reliable information on the impact of COVID-19 on pregnancy and its outcomes results in increased levels of depression, anxiety and stress. The healthcare provider must address these issues urgently by providing evidence-based information using Internet-based resources and psychological support. Key words: Depression, Anxiety, Stress, Pregnancy, Knowledge

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Training Needs of Community Health Workers Facing the COVID-19 Pandemic in Texas: A Cross-Sectional Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.689946 ◽

2021 ◽

Vol 9 ◽

Author(s):

Courtney Byrd-Williams ◽

Mollie Ewing ◽

E. Lee Rosenthal ◽

Julie Ann St. John ◽

Paige Menking ◽

...

Keyword(s):

Community Health ◽

Health Workers ◽

Cross Sectional Study ◽

Training Needs ◽

Sources Of Information ◽

Sectional Study ◽

Cross Sectional ◽

Healthcare Workforce ◽

Survey Results ◽

The Impact

The COVID-19 pandemic has required the professional healthcare workforce not only to adjust methods of delivering care safely but also act as a trusted sources of information during a time of uncertainty and rapid research and discovery. The Community Health Worker COVID-19 Impact Survey is a cross-sectional study developed to better understand the impact of COVID-19 on this sector of the healthcare workforce, including training needs of those working through the pandemic. The survey was distributed in Texas, New Mexico, and Arizona. This study focuses on Texas, and the data presented (n = 693) is a sub-set of qualitative data from the larger survey. Results of the content analysis described in this paper are intended to inform current COVID-19-related CHW training curriculum, in addition to future infectious disease prevention and preparedness response trainings.

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A linear Mixed Model to Estimate COVID-19-induced Excess Mortality

10.1101/2021.05.10.21256942 ◽

2021 ◽

Author(s):

Johan Verbeeck ◽

Christel Faes ◽

Thomas Neyens ◽

Niel Hens ◽

Geert Verbeke ◽

...

Keyword(s):

The Netherlands ◽

Serial Correlation ◽

Excess Mortality ◽

Mixed Model ◽

Linear Mixed Model ◽

Virus Disease ◽

Mortality Data ◽

Sources Of Information ◽

Many Sources ◽

The Impact

The Corona Virus Disease (COVID-19) pandemic has increased mortality in countries worldwide. To evaluate the impact of the pandemic on mortality, excess mortality has been suggested rather than reported COVID-19 deaths. Excess mortality, however, requires estimation of mortality under non-pandemic conditions. Although many methods exist to forecast mortality, they are either complex to apply, require many sources of information, ignore serial correlation, and/or are influenced by historical excess mortality. We propose a linear mixed model that is easy to apply, requires only historical mortality data, allows for serial correlation, and down-weighs the influence of historical excess mortality. Appropriateness of the linear mixed model is evaluated with fit statistics and forecasting accuracy measures for Belgium and the Netherlands. Unlike the commonly used 5-year weekly average, the linear mixed model is forecasting the subject-specific mortality, and as a result improves the estimation of excess mortality for Belgium and the Netherlands.

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Exploring the impact of gender on challenges and coping during the COVID-19 pandemic

International Journal of Sociology and Social Policy ◽

10.1108/ijssp-08-2021-0202 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Kathryn Krase ◽

Leina Luzuriaga ◽

Donna Wang ◽

Andrew Schoolnik ◽

Chantee Parris-Strigle ◽

...

Keyword(s):

Online Survey ◽

National Level ◽

Past Research ◽

Future Research ◽

Sources Of Information ◽

Cross Sectional ◽

Content Type ◽

The Usa ◽

And Coping ◽

The Impact

PurposeRepercussions to everyday life caused by the COVID-19 pandemic disproportionately impacted certain segments of the population, including older adults, communities of color and women. The societal response to reduce the impact of the pandemic, including closing schools and working from home, has been experienced differentially by women. This study explored how individual challenges and coping mechanisms differed for women as compared to men.Design/methodology/approachThis study used an anonymous, cross-sectional, online survey early in the COVID-19 pandemic. Convenience, snowball and purposive sampling methods were used. Data were collected in June 2020 targeting adults living in Canada and the USA, with a total of 1,405 people responding, of which, the respondents were primarily women, White and with high education levels.FindingsThe results of this study confirm previous research that women struggled more to adapt to the pandemic and felt less prepared than men during the COVID-19 pandemic. Further, this study found significant differences in the sources of information and support used by women as compared to men.Originality/valueThe findings of this study not only confirm past research but also highlight that practice and policy responses to this pandemic, and future research on national level crises need to be targeted by gender, so that different needs are effectively addressed. Additionally, this article also identifies sources or challenges, as well as support, in order to inform and strengthen such responses.

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