COVID

The Coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented demands on the whole of society. The public sector human resources (HR) function has played a key role in responding to COVID-19. This paper considers: How did public sector HR organizations in Northwest Florida respond during the COVID-19 pandemic? What are lessons learned from the perspectives of resilience and vulnerability? Interviews were conducted with HR professionals in Northwest Florida in early 2021. Responses suggested many points that show resilience, sensemaking, and adaptive capacity. However, some aspects of responses indicate the presence of vulnerability, as well as concerns with leadership and management. Full article

During the first UK national COVID-19 lockdown, there were fears that increased online gaming and gambling could negatively impact wellbeing. Using a cross-sectional retrospective change survey of 631 UK adult gamers and/or gamblers during the week the UK lockdown was partially lifted (June 2020), we investigated participation in gaming/gambling and relationships with problem gaming, problem gambling and wellbeing (using the following previously validated scales: the Internet Gaming Disorder Short Form; a short-form version of the Problem Gambling Severity Index; a short-form of the Warwick–Edinburgh Mental Well-Being Scale). Results indicated a near-doubling in gaming activity during lockdown and significant increases in problem gaming scores, but not in numbers of disordered gamers. Aggregate changes to gambling participation and problem gambling were negligible: decreases in offline and sports gambling were balanced by increases in online gambling. Wellbeing scores decreased during lockdown across the sample, particularly amongst women, and path analysis revealed moderate correlations between increases in problem gaming and gambling scores and reductions in wellbeing. We conclude that for some, maladaptive gaming/gambling coping strategies during the lockdown may have exacerbated its negative effects. Full article

Background: Observational studies of the long-term effects of COVID-19 infection generally focus on individual symptoms rather than health status. Objective: Longitudinal assessment of general health status following COVID-19 infection. Design: Observational study, with data collected from two telephone surveys at 32 ± 10 and 89 ± 25 days after discharge from the hospital or emergency department (ED) for a COVID-19 infection. Medicaid or no insurance was our marker of low socioeconomic status (SES). Acute disease severity was determined by summing 10 severity markers (yes-no) from the health encounter. Baseline comorbidity was a modified Charlson Index. Participants: 40 patients. Mean age was 54 ± 15 years, 50% were female, and 40% had low socioeconomic status. Main Measures: (1) the 20-item Medical Outcomes Study Short-Form General Health Survey (SF-20); (2) Dyspnea (modified Medical Research Council); (3) Psychological symptoms (Patient Health Questionnaire for Anxiety and Depression); (4) Cognitive function (Cognitive Change Questionnaire); (5) Fatigue (Short Fatigue Questionnaire); (6) A 10-item review of systems (ROS) questionnaire. Key Results: Percentages with abnormal symptoms at the first and second surveys were (respectively): Dyspnea (40, 33), Fatigue (53, 50), Anxiety (33, 18), Depression (20, 10), PHQ-4 Composite (25, 13), and Cognitive (18, 10). Mean scores on the SF-20 subscales, Physical Functioning, Role Functioning, Social Functioning, Health Perception, Mental Health, and Pain were numerically lower than means from a published study of elderly outpatients. With the exception of Pain, all SF-20 subscale scores improved significantly by the second survey. In multivariable analyses, dyspnea was predictive of impairment in all SF-20 subscales at the second survey. Conclusions: COVID-19 infection causes persistent abnormality across multiple patient-reported outcome areas, including health status. The persistence of impairment in each health status component is influenced by baseline dyspnea. Full article

Ivermectin was first approved for human use as an endectocide in the 1980s. It remains one of the most important global health medicines in history and has recently been shown to exert in vitro activity against SARS-CoV-2. However, the macrocyclic lactone family of compounds has not previously been evaluated for activity against SARS-CoV-2. The present study aims at comparing their anti-viral activity in relevant human pulmonary cell lines in vitro. Here, in vitro antiviral activity of the avermectins (ivermectin and selamectin) and milbemycins (moxidectin and milbemycin oxime) were assessed against a clinical isolate from a CHU Montpellier patient infected with SARS-CoV-2 in 2020. Ivermectin, like the other macrocyclic lactones moxidectin, milbemycin oxime and selamectin, reduced SARS-CoV-2 replication in vitro (EC50 of 2–5 μM). Immunofluorescence assays with ivermectin and moxidectin showed a reduction in the number of infected and polynuclear cells, suggesting a drug action on viral cell fusion. However, cellular toxicity of the avermectins and milbemycins during infection showed a very low selectivity index of <10. Thus, none of these agents appears suitable for human use for its anti-SARS-CoV-2 activity per se, due to low selectivity index. Full article

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a pandemic and caused a huge burden to healthcare systems worldwide. One of the characteristic symptoms of COVID-19 is asymptomatic hypoxemia, also called happy hypoxia, silent hypoxemia, or asymptomatic hypoxemia. Patients with asymptomatic hypoxemia often have no subjective symptoms, such as dyspnea, even though hypoxemia is judged by objective tests, such as blood gas analysis and pulse oximetry. Asymptomatic hypoxemia can lead to acute respiratory distress syndrome, and the delay in making a diagnosis and providing initial treatment can have fatal outcomes, especially during the COVID-19 pandemic. Thus far, not many studies have covered asymptomatic hypoxemia. We present a review on the human response to hypoxemia, focusing on the respiratory response to hypoxemia rather than the pathophysiology of lung injury arising from SARS-CoV-2 infection. We have also discussed whether asymptomatic hypoxemia is specific to SARS-CoV-2 infection or a common phenomenon in lung-targeted viral infections. Full article

For fighting the COVID-19 pandemic, countries used control measures of different severity, from “relaxed” to lockdown. Drastic lockdown measures are considered more effective but also have a negative impact on the economy. When comparing the financial value of lost lives to the losses of an economic disaster, the better option seems to be lockdown measures. We developed a new parameter, the effectiveness of control measures, calculated from the 2nd time derivative of daily case data, for 92 countries, states and provinces. We compared this parameter, and also the mortality during and after the effective phase, for countries with and without lockdowns measures by means of the Mann–Whitney test. We did not find any statistically significant difference in the effectiveness between countries with and without lockdowns (p > 0.76). There was also no significant difference in mortality during the effective phase (p > 0.1); however, a significant difference after the effective phase, with higher mortality for lockdown countries, was identified. The effectiveness correlated well with a parameter derived from the reproductive number (R² = 0.9480). The average duration of the effective phase was 17.3 ± 10.5 days. The results indicated that lockdown measures are not necessarily superior to relaxed measures, which in turn are not necessarily a recipe for failure. Relaxed measures are, however, more economy-friendly. Full article

Human coronaviruses (HCoVs) are associated with a range of respiratory symptoms. The discovery of severe acute respiratory syndrome (SARS)-CoV, Middle East respiratory syndrome, and SARS-CoV-2 pose a significant threat to human health. In this study, we developed a method (HCoV-MS) that combines multiplex PCR with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), to detect and differentiate seven HCoVs simultaneously. The HCoV-MS method had high specificity and sensitivity, with a 1–5 copies/reaction detection limit. To validate the HCoV-MS method, we tested 163 clinical samples, and the results showed good concordance with real-time PCR. Additionally, the detection sensitivity of HCoV-MS and real-time PCR was comparable. The HCoV-MS method is a sensitive assay, requiring only 1 μL of a sample. Moreover, it is a high-throughput method, allowing 384 samples to be processed simultaneously in 30 min. We propose that this method be used to complement real-time PCR for large-scale screening studies. Full article

Recently, it was reported that near-sourced COVID-19 convalescent plasma (CP) is more efficient than distantly sourced CP. What was left behind in this analysis is the investigation of the possible causes of mortality associated with the CP transfusion itself. Knowing this information is important for determining whether not receiving CP of near source is the main cause of high rate of death in the group of patients who received distantly sourced CP. We argue that the thrombotic and thromboembolic events may act as risk factors for adverse complications and death associated with CP transfusion. Therefore, they have to be considered and carefully accounted for in population studies as they can affect the CP safety profiles and change the interpretation of the cause of death in the studied groups. Full article

Quick and reliable identification of severe acute respiratory syndrome coronavirus SARS-CoV-2 in the population is required to manage the COVID-19 pandemic. This is a prospective observational study of diagnostic accuracy. Paired swab samples from 317 asymptomatic individuals referring to a drive-in testing facility were tested in parallel by means of the rapid antigen test developed by Jiangsu Bioperfectus Technologies and routine nucleic acid detection. Overall specificity was 100% and sensitivity was 49% but reached 87% at higher viral loads (Ct < 25). In this study, the antigen detection test showed high specificity and good sensitivity in asymptomatic individuals carrying higher viral loads. The assay performance worsened with lower viral loads, making it useful when a rapidly deployable test is essential and to assess a potential risk of immediate transmission in the community, but not recommended for testing asymptomatic individuals. Full article

Antigen detection rapid diagnostic tests have been developed for first-line large-scale screening given their rapidity, simplicity, and accuracy. This study evaluates the diagnostic performance of an antigen detection rapid diagnostic test (BLOK BioScience, London, UK) detecting SARS-CoV-2 nucleocapsid protein. Serially diluted SARS-CoV-2 isolate and 110 NPS from COVID-19 patients were tested to determine the test’s sensitivity, and other viral isolates and 20 NPS from non-infected individuals were, for specificity, also tested. Ten clinical samples from COVID-19 patients with SARS-CoV-2 variants, including alpha, beta, gamma, delta, and eta variants, were collected to evaluate the test’s potential application in detecting emerging variants. Overall sensitivity was 92%, and stratifying into viral loads yielded 100% for Ct < 25 samples including SARS-CoV-2 variants, but 11.11% for Ct ≥ 30 samples. The analytical sensitivity of log₁₀ TCID₅₀/mL 2.0 was identified for SARS-CoV-2. Ninety-seven percent specificity with only SARS-CoV cross-reactivity lead to the Youden index of 0.89. The rapid diagnostic test has a high sensitivity for detecting SARS-CoV-2 in high viral load samples, possibly including emerging SARS-CoV-2 variants, but reduced sensitivity in low viral load samples suggests its optimized usage as a complementary testing method to other tests, including RT-PCR or a point-of-care test for large-scale screening, particularly for pandemic areas or airport border infection control. Full article

Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-CoV-2), including the recently reported severe variant B.1.617.2, has been reported to attack the respiratory tract with symptoms that may ultimately lead to death. While studies have been conducted to evaluate therapeutic interventions against the virus, this study evaluated the inhibitory potential of virtually screened novel derivatives and structurally similar compounds towards SARS-CoV-2 via a computational approach. A molecular docking simulation of the inhibitory potentials of the compounds against the SARS-CoV-2 drug targets—main protease (Mpro), spike protein (Spro), and RNA-dependent RNA polymerase (RdRp)—were evaluated and achieved utilizing AutoDock Vina in PyRx workspace. The absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties of these compounds were assessed using SwissADME and ADMETLab servers. All the compounds displayed high binding affinities for the SARS-CoV-2 drug targets. However, the C13 exhibited the highest binding affinity for the drug targets, Spro and RdRp, while C15 exhibited the highest binding affinity for Mpro. The compounds interacted with the LEU A:271, LEU A:287, ASP A:289, and LEU A:272 of Mpro and the HIS A:540, PRO A:415, PHE A:486, and LEU A:370 of the Spro receptor binding motif and some active site amino acids of RdRp. The compounds also possess a favourable ADMET profile and showed no tendency towards hERG inhibition, hepatotoxicity, carcinogenicity, mutagenicity, or drug-liver injury. These novel compounds could offer therapeutic benefits against SARS-CoV-2, and wet laboratory experiments are necessary to further validate the results of this computational study. Full article

Studies comparing cause-of-death patterns across countries during the COVID-19 outbreak are still lacking although such studies would contribute to the understanding of the direct and indirect effect of the virus on mortality. In this report, we compare the mortality pattern observed in Italy during the first pandemic wave (March–April 2020) with that of some European countries. We calculated cause-specific, age-standardized mortality ratios (SMR) for Spain, England, and Sweden for the two mentioned months from 2016 to 2020, using already published data. Although Italy presented the highest crude overall mortality rate (267 per 100,000 population), age-adjusted ratios showed that all-cause and COVID-19 mortality in Italy were higher than in Sweden but lower than in the other two countries. Some causes had a similar increase in 2020 compared to previous years in all countries, i.e., endocrine diseases (especially diabetes), dementia and Alzheimer’s (in general mental disorders), and hypertensive heart diseases. Conversely, respiratory diseases, in particular pneumonia and influenza, increased to a greater extent in Italy. This latter result could be, in part, related to the underreporting of COVID-19 on death certificates during the first period of the pandemic, when Italy was the first European country severely hit by the virus. Full article

Background: The coronavirus disease 2019 (COVID-19) has impacted the utilisation of Emergency Department (ED) services worldwide. This study aims to describe the changes in attendance at a single ED and corresponding patient visit characteristics before and during the COVID-19 period. Methods: In a single-centre retrospective cohort study, we used descriptive statistics to compare ED attendance, patient demographics and visit characteristics during the COVID-19 period (1 January–28 June 2020) and its corresponding historical period in 2019 (2 January–30 June 2019). Results: The mean ED attendance decreased from 342 visits/day in the pre-COVID-19 period to 297 visits/day in the COVID-19 period. This was accompanied by a decline in presentations in nearly every ICD-10-CM diagnosis category except for respiratory-related diseases. Notably, we observed reductions in visits by critically ill patients and severe disease presentations during the COVID-19 period. We also noted a shift in the ED patient case-mix from ‘Non-fever’ cases to ‘Fever’ cases, likely giving rise to two distinct trough-to-peak visit patterns during the pre-Circuit Breaker and Circuit Breaker period. Conclusions: This descriptive study revealed distinct ED visit trends across different time periods. The COVID-19 pandemic caused a reduction in ED attendances amongst patients with low-acuity conditions and those with highest priority for emergency care. This raises concern about treatment-seeking delays and the possible impact on health outcomes. The downward trend in low-acuity presentations also presents learning opportunities for ED crowd management planning in a post-COVID-19 era. Full article

The scale and duration of the worldwide SARS-COVID-2 virus-related quarantine measures presented the global scientific community with a unique opportunity to study the accompanying psychological stress. Since March 2020, numerous publications have reported similar findings from diverse international studies on psychological stress, depression, and anxiety, which have increased during this pandemic. However, there remains a gap in interpreting the results from one country to another despite the global rise in mental health problems. The objective of our study was to identify global indicators of pandemic-related stress that traverse geographic and cultural boundaries. We amalgamated data from two independent global surveys across twelve countries and spanning four continents collected during the first wave of the mandated public health measures aimed at mitigating COVID-19. We applied machine learning (ML) modelling to these data, and the results revealed a significant positive correlation between PSS-10 scores and gender, relationship status, and groups. Confinement, fear of contagion, social isolation, financial hardship, etc., may be some reasons reported being the cause of the drastic increase in mental health problems worldwide. The decline of the typical protective factors (e.g., sleep, exercise, meditation) may have amplified existing vulnerabilities/co-morbidities (e.g., psychiatric history, age, gender). Our results further show that ML is an apropos tool to elucidate the underlying predictive factors in large, complex, heterogeneous datasets without invalidating the model assumptions. We believe our model provides clinicians, researchers, and decision-makers with evidence to investigate the moderators and mediators of stress and introduce novel interventions to mitigate the long-term effects of the COVID-19 pandemic. Full article

(1) Background: With vaccination and new variants of SARS-CoV-2 on the horizon, efficient testing in schools may enable prevention of mass infection outbreaks, keeping schools safe places and buying time until decisions on feasibility and the necessity of vaccination in children and youth are made. We established, in the course of the WICOVIR (Where Is the COrona VIRus) study, that gargle-based pool-PCR testing offers a feasible, efficient, and safe testing system for schools in Germany when applied by central university laboratories. (2) Objectives: We evaluated whether this approach can be implemented in different rural and urban settings. (3) Methods: We assessed the arrangements required for successful implementation of the WICOVIR approach in a variety of settings in terms of transport logistics, data transfer and pre-existing laboratory set-up, as well as the time required to establish the set-up. (4) Results: We found that once regulatory issues have been overcome, all challenges pertaining to logistics, data transfer, and laboratory testing on different platforms can be solved within one month. Pooling and depooling of samples down to the individual test result were achievable within one working day in all settings. Local involvement of the community and decentralized set-ups were keys for success. (5) Conclusion: The WICOVIR gargle-based pool-PCR system is so robust and simple that it can be implemented within one month in all settings now or in future pandemics. Full article

The COVID-19 pandemic has been associated with unprecedented changes to societal structure. School closures, unstable employment, and inaccessible health services have caused enormous disruptions to child and family wellbeing. This study identifies major themes illustrating how child and family wellness were impacted by COVID-19, including unique effects experienced by Indigenous families. In-depth interviews were conducted with key informants (n = 31) recruited from organizations providing healthcare and social services in Kingston, Ontario. Interview transcripts and written survey responses were analyzed using a phenomenological approach to explore themes related to child and family wellbeing. Three major themes identified include school closures, home safety, and outdoor spaces. School closures were generally reported as negatively impacting learning and social development; however, school closures allowed for some Indigenous children to be removed from a colonized education system, contributing to cultural and spiritual growth. Second, respondents reported increased severity and frequency of domestic violence, which negatively impacted child wellbeing. Third, the closure of public outdoor spaces created barriers to maintaining good physical health for children. This study recommends the prioritization of (1) child learning and development by avoiding school closures in pandemic settings and (2) the safety of Indigenous students by decolonizing education. To address the increased exposure to adverse childhood experiences (ACEs) during COVID-19, we recommend improved training for identifying and reporting domestic violence amongst service providers. Our study also reflects the broader need to redefine “essential services”, considering culturally specific services for Indigenous Peoples. Full article

We construct a spatially-compartmental, individual-based model of the spread of SARS-CoV-2 in indoor spaces. The model can be used to predict the infection rates in a variety of locations when various non-pharmaceutical interventions (NPIs) are introduced. Tasked by the Welsh Government, we apply the model to secondary schools and to Further and Higher Education environments. Specifically, we consider student populations mixing in a classroom and in halls of residence. We focus on assessing the potential efficacy of Lateral Flow Devices (LFDs) when used in broad-based screens for asymptomatic infection or in ‘test-to-release’ scenarios in which individuals who have been exposed to infection are released from isolation after a negative LFD result. LFDs are also compared to other NPIs; we find that, although LFD testing can be used to mitigate the spread of SARS-CoV-2, it is more effective to invest in personal protective equipment, e.g., masks, and in increasing ventilation quality. In addition, we provide an open-access and user-friendly online applet that simulates the model, complete with user tutorials to encourage the use of the model to aid educational policy decisions as input infection data becomes available. Full article

SARS-CoV-2 has high infectivity and some of its variants have higher transmissibility. To explore the high infectivity mechanism, the charge distributions of SARS-CoV, SARS-CoV-2, and variants of concern were calculated through a series of net charge calculation formulas. The results showed that the SARS-CoV-2 spike protein had more positive charges than that of SARS-CoV. Further results showed that the variants had similar but higher positive charges than preexisting SARS-CoV-2. In particular, the Delta variant had the greatest increase in positive charges in S₁ resulting in the highest infectivity. In particular, the S₁ positive charge increased greatly in the Delta variant. The S₁ positive charge increased, and due to the large negative charge of angiotensin-converting enzyme-2 (ACE2), this resulted in a large increase in Coulomb’s force between S₁ and ACE2. This finding agrees with the expectation that the positive charges in the spike protein result in more negative charges on SARS-CoV-2 antibodies than that of SARS-CoV. Thus, the infectivity of a novel SARS-CoV-2 variant may be evaluated preliminarily by calculating the charge distribution. Full article

This study evaluated the knowledge, attitude and perception (KAP) towards COVID-19 pandemic control among veterinarians in Nigeria. A nation-wide web-based cross-sectional survey was conducted. Information on KAP towards the COVID-19 pandemic was gathered (April 23 and May 31, 2020) and multivariate logistic regression was performed to identify associated factors. A total of 368 veterinarians participated in the study. The majority of respondents were males (72.8%), between the ages of 30–39 years (39.7%). Generally, respondents displayed a good level of knowledge about COVID-19 (72.4% ± 9.9%, range 44.1–91.2%), while the general attitude level was poor (65.4% ± 10.8, range 35.3–94.1%). Various determinants for good attitude among respondents were: if they were above 60 years old (aOR = 4.49, 95% CI: 1.379–14.594, p = 0.013), possessed postgraduate qualification (aOR = 1.63, 95 CI: 1.045–2.553, p = 0.031), worked over 30 years post DVM (aOR = 5.63, 95% CI: 1.966–16.100, p = 0.001), had household members between five and 10 (aOR = 1.73, 95% CI: 1.130–2.641, p = 0.012), and if respondents’ residence was on total lockdown (aOR = 1.66, 95% CI: 1.070–2.590, p = 0.024). The pandemic had moderate impacts on social, financial and physical status of the participants. Stricter policy measures and educational programs should be implemented to keep veterinarians and the populace informed about the best practices recommended for COVID-19 management. Full article