scholarly journals Breakthrough Infection among Fully Vaccinated Physicians Working in COVID-19 Treatment Centers; Prevalence, Presenting Symptoms, Co-Morbidities and Outcome in the Third Wave of Epidemics in Myanmar

2021 ◽  
Vol 2 (8) ◽  
pp. 721-730
Author(s):  
Khin Phyu Pyar ◽  
Sai Aik Hla ◽  
Soe Min Aung ◽  
Di Wunn ◽  
Zar Ni Htet Aung ◽  
...  

Background: Coronavirus Disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world. Breakthrough infection following COVID-19 vaccine has clinical and public health significance. The highest groups at risk of infection during the COVID-19 pandemic is health care workers; the physicians are the frontline workers. This study aimed to assess the prevalence of breakthrough COVID-19 infection and their clinical presentation, co-morbidities and outcome among physicians who were fully vaccinated, working in COVID-19 treatment centers in Myanmar. Methods: A cross-sectional descriptive study was conducted among physicians, at least 14 days after receiving second dose, working at COVID-19 treatment centers in Myanmar, during the third wave from end of May to August 2021. Data were collected by using standardized forms and analysis was done. Results: Among 410 physicians, 98.2% (221/225) received two dose of vaccination: Covaxin 90.0%, Covishield 9.5% and Sputink V 0.5%. They received first dose of vaccine in January/February 2021 and second dose in March/April 2021. In Myanmar, third wave started in end of May; the largest pandemic surge had reached its peak in July, 2021. In the third wave, most of them 72.9% (161/221) did not experience no infection. The prevalence of fully vaccinated break through infection was 27.1% (60/221); the majority 78.3% (47/60) were mild symptomatic infection. Severe infection was seen in 10% of physicians with breakthrough infection who required hospital admission and oxygen therapy. The common presenting symptoms in order of frequency were body aches and pain 62.6%, sneezing 56.6%, headache 53.5%, cough 52.5%, sore throat 45.5%, anosmia 33.3%, runny nose 23.2% and loose motion 27.3%. The uncommon symptoms were dyspnoea 9.1%, vertigo 6.1%, skin rash 5.1%, vomiting 5.1%, petechiae 3.0%, tinnitus 3.0% and silent hypoxia 3.0%, and non-per-os 1%. Most of them did not have any significant comorbidities. One out of six physicians having severe infection had diabetes mellitus and two were obese. The mean duration of hospital stay was 7 days. None of the cases was fatal. Conclusions: In this study, over 98% of physicians were fully vaccinated; majority with Covaxin. One in four physicians had breakthrough infection in third wave; mainly mild form. Nearly half of them had possible delta symptoms; aches and pain, sneezing, runny nose, headache, cough, and sore throat. Awareness of rare but important symptoms like Non-per-Os and vertigo should be highlighted both to public and health care personnel. Ten percent of physicians with breakthrough infection were severe. Mortality rate was zero.

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S556-S556
Author(s):  
A Algaba Garcia ◽  
I Guerra ◽  
S Castro ◽  
L Jiménez ◽  
D Garza ◽  
...  

Abstract Background Data about the SARS-CoV-2 infection in inflammatory bowel disease patients (IBD) are scarce. Our aim was to analyse the incidence, clinical presentation, and severity of SARS-CoV-2 infection in IBD patients in the second and the third wave of infection. Methods Cross-sectional, observational study in IBD patients with confirmed SARS-CoV-2 infection by RCP and/or antigen tests from 01 July 2020 to 01 March 2021. All data were collected by telephone interview and reviewing the electronical medical records. Results Fifty-one of 805 IBD patients followed in our Unit were diagnosed of SARS-CoV-2 infection in this period (6.3%; 95% CI 4.6–8.0). Mean age: 45±13 years old; 56.9% female, 23.5% smokers, 56.9% Crohn’s disease, 29.4% comorbidities and 17.6% asymptomatic. Digestive symptoms were reported in 22 patients (43.1%), with diarrhoea as the most common (39.2%, median duration: 4 days; IQR 1–7). The most frequent symptoms other than diarrhoea were low-grade fever/fever in 43.1% (median duration: 3 days; IQR 1–6.5) and dysosmia/dysgeusia in 39.2% (median duration: 15 days; IQR 7–30). Only one patient (2%) was diagnosed with IBD flare-up during infection. Six patients (11.8%) temporarily withdrew their IBD treatment because of COVID-19. Most of the patients had a mild disease (88.2%), no patient had to be admitted in the intensive care unit. Only one patient died (2%) due to SARS-CoV-2 infection and multiple previous comorbidities, 52 years old male with ulcerative colitis in treatment with Mesalazine and dendritic cell sarcoma, common variable inmunodefiency, and primary sclerosing cholangitis progressing to cirrhosis. In the multivariate analysis, the presence of dyspnoea was associated with more severe infection (p=0.007; OR:25.7; 95% CI 2.4–277.8). Patients on immunomodulators and/or biological therapy did not have more severe disease compared to non-immunosuppressed patients (p>0.05). Conclusion SARS-CoV-2 infection was relatively frequent is our series. Dyspnoea was associated with a more severe infection. Severity of SARS-CoV-2 infection was not related to immunosuppression or development of IBD flare-ups and only a small percentage of patients needed to modify IBD medication during infection


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2380
Author(s):  
Eduardo Sánchez-Sánchez ◽  
Jara Díaz-Jimenez ◽  
Ignacio Rosety ◽  
Maria José M. Alférez ◽  
Antonio Jesús Díaz ◽  
...  

The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the “third wave” of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress—more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the ‘third wave’ of this pandemic increased food consumption.


2021 ◽  
Vol 15 (6) ◽  
pp. 1198-1202
Author(s):  
M.l Fatima ◽  
M. Waqar ◽  
H. Qamar ◽  
M. Akram ◽  
F. Zia ◽  
...  

Background: Iatrogenic and nosocomial infections are a serious threat to a healthcare setting especially during a pandemic. Hand hygiene among the health-care workers stands out to be a pivotal preventive measure. Practical application of hand hygiene measures during third wave of COVID-19 pandemic primarily depend upon the current knowledge among the health care workers. Methods: A cross-sectional study design based on validated WHO questionnaire for hand hygiene among the health care workers was conducted during March till May2021 in the settings of Shalamar and Central Park hospital and medical colleges. Results: The sample consisted of 271 participants with 110 males and 161 females, with the mean age of 24.72+ 4.174 years. The sample consisted of 36.2% of medical students, 49.1% of doctors and 14.8% of paramedical staff. Nearly 50.6% of the individuals claim to receive formal training. 47.6% believe that “Health-care workers’ hands when not clean” are the main route of cross-transmission. Nearly 57.2% believed that the hospital environment (surfaces)the most frequent source of germs. Comparison of hand-rubbing and washing revealed that major percentage believe hand rub to be rapid however less effective causing dryness. A majority believe that hand hygiene before touching the patient, immediately after exposure to body fluids or immediate surroundings of patients prevents transmission of germs to the patient and vice versa afterwards prevents transmission to HCW. Conclusion: A large proportion of the sample has considerable knowledge regarding essential hand hygiene in a health care setting. However more frequent training sessions should be conducted to improve it further. Key words: Hand hygiene, Health-care workers, Knowledge


2021 ◽  
Vol 22 (2) ◽  
pp. 03-04
Author(s):  
Wiwatana Tanomkiat

Unlike the first and second waves of COVID-19 pandemic in Thailand which were limited among certain populations in certain areas, the third wave starting in April 2021 spread nationwide. It was from less than 10 new cases a day in 2020, to be around 2,000 a day in June and then more than 20,000 new cases a day in August 2021. Among four doctors who were killed by COVID-19 during this third wave in Thailand, the Royal College of Radiologists of Thailand lost a very active and warm member, Associated Professor Wilaiwan Bhothisuwan. When hospitals and field hospitals were full, now COVID-19 infected patients were cared in community isolation centers. Home isolation, the last and probably the final form of health care, was set in this August. The Royal College of Radiologists of Thailand had launched a project “RadioVolunteer” to interpret and report chest radiographs of COVID-19 patients in prisons, field hospitals where there were shortage of radiologists, some community isolation centers, and radiographic units for patients with home isolation.


Curationis ◽  
1984 ◽  
Vol 7 (4) ◽  
Author(s):  
O.H. Muller

A quarter of a century ago Mr Harold MacMillan delivered his famous Winds o f Change speech in Cape Town. In 1975 Dr. Wolff Bodenstein, in delivering a paper on primary health care, referred to the storms o f change. Now, a decade later, John Naisbitt speaks of megatrends when elaborating on change on a worldwide scale from an industrial society to an informational society. Alvin Toffler’s widely read The Third Wave speaks of similar trends on a scale comparable to the agricultural revolution and the industrial revolution.


2006 ◽  
Vol 25 (Suppl1) ◽  
pp. W420-W431 ◽  
Author(s):  
John E. McDonough ◽  
Brian Rosman ◽  
Fawn Phelps ◽  
Melissa Shannon

2021 ◽  
Author(s):  
Aurélie Godbout ◽  
Mélanie Drolet ◽  
Myrto Mondor ◽  
Marc Simard ◽  
Chantal Sauvageau ◽  
...  

ABSTRACTObjectivesTo describe time trends in social contacts of individuals according to comorbidity and vaccination status before and during the first three waves of the COVID-19 pandemic in Quebec, Canada.DesignRepeated cross-sectional population-based surveys.SettingGeneral population.ParticipantsNon-institutionalized adults from Quebec, Canada, recruited by random digit dialling before (2018/2019) and during the pandemic (April 2020 to July 2021). A total of 1441 and 5185 participants with and without comorbidities, respectively, were included in the analyses.Main outcome measuresNumber of social contacts (two-way conversation at a distance ≤2 meters or a physical contact, irrespective of masking) documented in a self-administered web-based questionnaire. We compared the mean number of contacts according to the comorbidity status of participants (pre-existing medical conditions with symptoms/medication in the past 12 months) and 1-dose vaccination status during the third wave. All analyses were performed using weighted generalized linear models with a Poisson distribution and robust variance.ResultsContacts significantly decreased from a mean of 6.1 (95% confidence interval 4.9 to 7.3) before the pandemic to 3.2 (2.5 to 3.9) during the first wave among individuals with comorbidities, and from 8.1 (7.3 to 9.0) to 2.7 (2.2 to 3.2) among individuals without comorbidities. Individuals with comorbidities maintained fewer contacts than those without comorbidities in the second wave, with a significant difference before the Christmas 2020/2021 holidays (2.9 (2.5 to 3.2) v 3.9 (3.5 to 4.3); P<0.001). During the third wave, contacts were similar for individuals with (4.1, 3.4 to 4.7) and without comorbidities (4.5, 4.1 to 4.9; P=0.27). This could be partly explained by individuals with comorbidities vaccinated with their first dose who increased their contacts to the level of those without comorbidities.ConclusionsThe lower level of contacts maintained by individuals with comorbidities could have influenced the burden of hospitalisations and deaths of the second wave in Quebec. It will be important to closely monitor COVID-19-related outcomes and social contacts by comorbidity and vaccination status to inform targeted or population-based interventions.


2021 ◽  
Vol 74 (1-3) ◽  
Author(s):  
Aman Ullah

ABSTRACT The current study aims to explore and investigate the relationship between the experiences of COVID-19 and health anxiety among people. The study design adopted in this study was cross-sectional and primary data were collected from 500 respondents through a structured questionnaire in District Mardan-Pakistan. Bivariate and Multivariate analyses were carried out for measuring the relationship between “COVID-19” experiences and health anxiety, while cause and effects of the mentioned variables were analysed through a logistic regression model. The findings of the study revealed that the prevalence of health anxiety was found highly significant with the “COVID-19” experience. It has been inferred from the study’s findings that those people who experienced “COVID-19” had symptoms of health anxiety. The prevalence of health anxiety was found highly significant with “COVID-19” among older people. Establishing psychological and rehabilitation centres for sustained recovery of the “COVID-19” affected people, has also been suggested.


2017 ◽  
Vol 4 (2) ◽  
pp. 591
Author(s):  
Anupam Parashar ◽  
Deepesh Barall ◽  
Anmol Gupta ◽  
Tripti Chauhan ◽  
Devender Kumar ◽  
...  

Background: Data on timing and probable causes of infant deaths are very important for the design of intervention to reduce mortality because of very limited study in the state. This study was undertaken to determine the timing and causes of infant deaths in our state using verbal autopsy. The suggestions and recommendations can be used to strengthen and improve the existing facilities and services for the better outcome of life in the early childhood.Methods: A cross sectional study was conducted in 180 selected clusters by WHO cluster sampling method, using validated verbal autopsy tool for timing and causes of infant deaths.Results: Verbal autopsy was done for 45 infant deaths. 37.8% infant deaths were early neonatal, 15.5% in late neonatal and 46.7% in post neonatal period with mean age of 5.79±6.35 days in neonatal period while it was 5.07±3.38 months in post neonatal period. Of all the infants 57.78% were females. The major causes of death were severe infection (15.5%) in neonates, pneumonia (13.3%) in post neonates followed by LBW with prematurity (11.1%) and diarrhea (11.1%). No specific cause could be determined in 13.3% cases.Conclusions: The major causes of infant deaths are preventable. It emphasizes for the robust reporting mechanism to determine the exact causes of all infant mortality, strengthening of comprehensive health care delivery and ensuring the accessibility to the health care services to have a healthy infanthood.


2021 ◽  
Vol 12 (2) ◽  
pp. 375-398
Author(s):  
Maryna Klimanska ◽  
Larysa Klymanska ◽  
Inna Haletska

Aim. Identification and construction of the typology of attitudes of health care professionals in Ukraine to the current COVID-19 situation and vaccination process. Methods. Transcripts of 49 semi-structured interviews subjected to thematic analysis constituted the subject matter of the analysis. On the basis of the categories identified within the thematic analysis process, a typology was developed, with due account of two parameters: the idea about the origin of the virus: artificial or natural, and the attitude of the informants to the policy (implementation of policy decisions) chosen by the authorities to fight the virus. Combination of these two parameters gives four standpoints—types of attitude of health care professionals to the risks associated with COVID-19. Results and conclusion. Analysis of the results has enabled to outline the problem field for assessing the risk of COVID-19, which includes three topics, as well as to point out four typical standpoints in the attitude displayed by health care professionals that are marked as “magical thinking,” “technological thinking,” “negativistic thinking,” “critical thinking.” Originality. The research was conducted during the third wave of coronavirus in Ukraine, therefore, it reflects the analysed opinions of health care professionals about the threat of COVID-19 and vaccination process. The fact that the research was performed using qualitative methods ensured focusing on subjective peculiarities of the perception of changes in the COVID-19 situation.


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