Objectives: To analyze the role of pharmacists during the COVID-19 pandemic, to measure pharmacists’ attitude toward COVID-19 safety measures (wearing masks, wearing gloves, isolation shield, good hygiene, etc.), and explore their perspectives regarding a second wave of the virus. Methods: This cross-sectional online survey study was conducted in Jordan during the COVID-19 outbreak in July 2020 to discuss Jordanian pharmacists’ awareness of safety at their workplace during the COVID-19 outbreak, their sources of information, and their predictions for COVID-19 vaccination. Results: The participants (n = 311) were all pharmacists mostly aged between 23–30 years old (45%) and female (83%). The primary source of information about COVID-19 was social networking (38.9%). Pharmacists were committed to social distancing (86.5%) and wearing masks (76.2%). They expressed levels of agreement to their role in decreasing COVID-19 spread (94.2%) and correcting false information (94.5%); they expressed levels of expectation toward concern about a second COVID-19 wave (83%) that would be more severe than the previous one (43.4%). Pharmacists expected that an influenza vaccine might be helpful in decreasing severity and spread of the COVID-19 pandemic (56.9%). Pharmacists expected COVID-19 vaccine development within 6 months of administering our study survey (84.9%) and that vaccination might be effective in preventing COVID-19 (93%) infection. Conclusion: Pharmacists expressed positive roles on COVID-19 spread through exemplary actions, self-commitment to protection measures, and public health awareness. Social media as a source of health information should be cautiously investigated, and pharmacists should always refer to evidence-based sources. The role of pharmacists is particularly important for the upcoming era of COVID-19 vaccination administration and awareness. Full article

Widespread misinformation about COVID-19 poses a significant threat to citizens long-term health and the combating of the disease. To fight the spread of misinformation, Chinese governments have used official social media accounts to participate in fact-checking activities. This study aims to investigate why citizens share fact-checks about COVID-19 and how to promote this activity. Based on the elaboration likelihood model, we explore the effects of peripheral cues (social media capital, social media strategy, media richness, and source credibility) and central cues (content theme and content importance) on the number of shares of fact-checks posted by official Chinese Government social media accounts. In total, 820 COVID-19 fact-checks from 413 Chinese Government Sina Weibo accounts were obtained and evaluated. Results show that both peripheral and central cues play important roles in the sharing of fact-checks. For peripheral cues, social media capital and media richness significantly promote the number of shares. Compared with the push strategy, both the pull strategy and networking strategy facilitate greater fact-check sharing. Fact-checks posted by Central Government social media accounts receive more shares than local government accounts. For central cues, content importance positively predicts the number of shares. In comparison to fact-checks about the latest COVID-19 news, government actions received fewer shares, while social conditions received more shares. Full article

As of June 2021, there have been more than 13,000 deaths in Japan due to the COVID-19 pandemic. Data from the Ministry of Health, Labor, and Welfare show that the mortality rate of COVID-19 greatly varies by age. In this study, using data from a questionnaire survey, an investigation was carried out to find differences in anxiety and risk perception, attitudes toward risk, and the frequency of implementation of countermeasures to infection among age groups that are prone to a greater risk of mortality, as well as the main factors that determine the frequency of implementation. Older people, who form a high-risk group, have a stronger tendency for anxiety and cautious attitudes toward COVID-19, and they more frequently implement preventive behaviors. The results of multiple regression analysis showed that the frequency of implementation of behaviors is determined not only by anxiety, cautious attitude, risk of aggravation to oneself, and perceived effectiveness of behaviors but also by regret, altruism, and conformity. In addition, almost no age-based gap was found between the determinants, suggesting that the motivation to take infection preventive behaviors is the same regardless of age. Full article

With limited COVID-19-guidelines for institutions of higher education (IHEs), colleges and universities began the 2020–2021 academic year with varying approaches. We present a comprehensive COVID-19 prevention and mitigation approach at a residential university during the 2020–2021 academic year, along with campus SARS-CoV-2 transmission during this time. Risk management of COVID-19 was facilitated through (1) a layered approach of primary, secondary, and tertiary prevention measures; (2) a robust committee structure leveraging institutional public health expertise; (3) partnerships with external health entities; and (4) an operations system providing both structure and flexibility to adapt to changes in disease activity, scientific evidence, and public health guidelines. These efforts collectively allowed the university to mitigate SARS-CoV-2 transmission on campus and complete the academic year offering in-person learning on a residential campus. We identified 36 cases of COVID-19 among the 2037 in-person learners during the fall semester, 125 cases in the inter-semester break, and 169 cases among 2095 in-person learners during the spring semester. SARS-CoV-2 infection during the academic year was associated with gender (p = 0.04), race/ethnicity (p = 0.01), and sorority/fraternity membership (p < 0.01). Infection was not associated with undergraduate vs. graduate student status, Division I athlete status, or housing type (all p > 0.05). A multi-faceted public health approach was critical for reducing the impact of COVID-19 while carrying out the university’s educational mission. Full article

This study estimated tourists’ willingness to pay (WTP) for tourist sites or facilities in the prolonged COVID-19 pandemic by applying the dichotomous choice-contingent valuation method to two different tourism destination types. A survey was conducted among domestic tourists in South Korea who had visited destinations within the last six months. We conducted a logistic regression with 1283 effective samples. The results showed differences in tourists’ WTP, depending on type, and the factors affecting WTP differed. Tourists with higher tourism attitude and knowledge of tourism risk exhibited a higher WTP. Tourists with higher perceived risk of infectious disease exhibited less WTP. Full article

The global pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is having a tremendous impact on the global economy, health care systems and the lives of almost all people in the world. The Central European country of Slovakia reached one of the highest daily mortality rates per 100,000 inhabitants in the first 3 months of 2021, despite implementing strong prophylactic measures, lockdowns and repeated nationwide antigen testing. The present study reports a comparison of the performance of the Standard Q COVID-19 antigen test (SD Biosensor) with three commercial RT-qPCR kits (vDetect COVID-19-MultiplexDX, gb SARS-CoV-2 Multiplex-GENERI BIOTECH Ltd. and Genvinset COVID-19 [E]-BDR Diagnostics) in the detection of infected individuals among employees of the Martin University Hospital in Slovakia. Health care providers, such as doctors and nurses, are classified as “critical infrastructure”, and there is no doubt about the huge impact that incorrect results could have on patients. Out of 1231 samples, 14 were evaluated as positive for SARS-CoV-2 antigen presence, and all of them were confirmed by RT-qPCR kit 1 and kit 2. As another 26 samples had a signal in the E gene, these 40 samples were re-isolated and subsequently re-analysed using the three kits, which detected the virus in 22, 23 and 12 cases, respectively. The results point to a divergence not only between antigen and RT-qPCR tests, but also within the “gold standard” RT-qPCR testing. Performance analysis of the diagnostic antigen test showed the positive predictive value (PPV) to be 100% and negative predictive value (NPV) to be 98.10%, indicating that 1.90% of individuals with a negative result were, in fact, positive. If these data are extrapolated to the national level, where the mean daily number of antigen tests was 250,000 in April 2021, it points to over 4700 people per day being misinterpreted and posing a risk of virus shedding. While mean Ct values of the samples that were both antigen and RT-qPCR positive were about 20 (kit 1: 20.47 and 20.16 for Sarbeco E and RdRP, kit 2: 19.37 and 19.99 for Sarbeco E and RdRP and kit 3: 17.47 for ORF1b/RdRP), mean Ct values of the samples that were antigen-negative but RT-qPCR-positive were about 30 (kit 1: 30.67 and 30.00 for Sarbeco E and RdRP, kit 2: 29.86 and 31.01 for Sarbeco E and RdRP and kit 3: 27.47 for ORF1b/RdRP). It confirms the advantage of antigen test in detecting the most infectious individuals with a higher viral load. However, the reporting of Ct values is still a matter of ongoing debates and should not be conducted without normalisation to standardised controls of known concentration. Full article

The COVID-19 epidemic has seriously affected global economic and social development. The extent to which insurance can play a role in preventing and transferring the risk of infectious diseases has become one of the major concerns of the community. This paper first analyzes the main contents of the U.S. Pandemic Risk Insurance Act during the COVID-19 epidemic and its insights to the global audiences. Then, on the basis of the definition of global pandemic, this paper analyzes the great challenges faced by the insurability of the infectious diseases’ catastrophe from the regional impact, risk accumulation, correlation with capital markets, and accuracy of catastrophe model, and the insurability of local infectious diseases. Finally, this paper presents the key points of the top-level design of the risk transfer mechanism of infectious disease insurance in China. This paper is informative in understanding the role of insurance in the risk transfer of infectious diseases. Full article

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. Full article

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories. Full article

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers. Full article

Different countries have introduced different urgent policies to control the spread of the novel coronavirus. The compliance behavior of these anti-epidemic policies has always been an important concern to governments, and its effects need to be tested. In recent years, many scholars have paid attention to the mechanism and intervention of policy compliance behavior, which helps to explain the mechanism of anti-epidemic compliance behavior, and to improve the effectiveness of anti-epidemic policy. Therefore, considering the characters of youth groups in the context of the novel coronavirus, this study takes campus anti-epidemic compliance behavior as the research topic, based on 680 effective samples of college students in China, in order to examine the effectiveness of these policies using an investigation experiment. This study revealed that the ‘Nudge’ policy instrument was the most effective way to guide individuals’ behavior during the coronavirus outbreak, the ‘Sermon’ instrument was the least recognized, and the ‘Whip’ instrument (a traditional and classical policy instrument) had its normal effect on individuals’ behavior. Additionally, it found that high accessibility in policy implementation results in more significant policy behavior. By taking the effects of different policy behaviors into consideration, governments may produce better and more effective policy implementation and compliance during the anti-epidemic period. Full article

Background: Healthcare workers (HCWs) have been the key players in the fight against the coronavirus disease 2019 (COVID-19) pandemic. The aim of our study was to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG anti-bodies. Methods: We conducted a cross-sectional study among workers of two hospitals and Territorial Medical and Administrative services in Northern Italy. From 8 May to 3 June 2020, 2252 subjects were tested. Seroprevalence and 95% confidence interval (CI) were calculated for all individuals who were stratified by job title, COVID-19 risk of exposure, direct contact with patients, unit ward, and intensity of care. Results: Median age was 50 years, and 72% of subjects were female. The overall seroprevalence was 17.11% [95% CI 15.55–18.67]. Around 20% of healthcare assistants were seropositive, followed by physicians and nurses (16.89% and 15.84%, respectively). HCWs with high risk of exposure to COVID-19 were more frequently seropositive (28.52%) with respect to those with medium and low risks (16.71% and 12.76%, respectively). Moreover, personnel in direct contact had higher prevalence (18.32%) compared to those who did not (10.66%). Furthermore, the IgG were more frequently detected among personnel of one hospital (19.43%). Conclusion: The high seroprevalence observed can be partially explained by the timing and the population seroprevalence; the study was conducted in an area with huge spread of the infection. Full article

The recent COVID-19 pandemic has been disrupting the daily lives of people across the world, causing a major concern for psychological well-being in children. This study aimed to examine (1) how life satisfaction and its potential predictors have been affected by the pandemic among school-aged children in Korea, and (2) which factors would predict their life satisfaction during the pandemic. We surveyed 166 fourth-graders in the Seoul metropolitan area to assess their psychological well-being and potentially related variables during the pandemic. The data were compared with those available from two pre-COVID-19 surveys, the 2018 Korean Children and Youth Panel Survey (n = 1236) and the 2019 Korean Children and Youth Well-being Index Survey (n = 334). Higher levels of stress were observed in children during the COVID-19 pandemic; however, the level of their life satisfaction remained unchanged when compared with data from the pre-COVID-19 surveys. The pandemic also affected peer relationship quality and susceptibility to smartphone addiction, but not perceived parenting style nor academic engagement. Interestingly, peer relationship quality no longer predicted life satisfaction during the pandemic; perceived parenting styles and parent-child conversation time predicted life satisfaction. The results suggest a central role of parent-child relationship in supporting the psychological well-being of school-aged children during the pandemic. Full article

The tourism sector in general and the hotel sector in particular face the challenge of managing appropriate security measures to deal with the COVID-19 pandemic. In this sense, it is useful to know which measures are most demanded by the clientele. This research, through non-parametric statistics tests, concluded that women are more demanding than men in relation to the security measures to be taken in hotels. More specifically, this research concludes that women are more demanding than men in relation to a set of measures including ensuring good hygiene conditions, the use of disinfectants, the existence of health and information checks, adapting the establishment to WHO recommendations, obtaining quality certification, measuring temperature, the need to provide information on protocols and measures, and the elimination of physical contact between people. This, as a practical application, makes it possible to know more accurately about the safety requirements of sex-segmented customers in the face of future health crises, allowing tourist managers to offer safer destinations and the hotel sector better health conditions for their clients. Full article

In February 2020, a novel coronavirus (SARS-COV2) broke out in Wuhan city of China. The Chinese government decisively imposed nationwide confinement. This study comprised a structured, online questionnaire, based on 40 items inquiring about socio-demographic information and anthropometric data (reporting weight and height), as well as changes in food intake, physical activity, and sleep during the COVID-19 outbreak. Questionnaires were distributed to residents of Jiangsu and other provinces from 29 March to 5 April. A total of 889 respondents were included, aged between 16 and 70 years (61% females). There was a significant increase in total food intake by 9.8% and a slight increase by 29.2% of respondents, and a significant decrease in physical activity by 31.5% and a slight decrease by 23.4% of respondents, especially in snacks and drinks, and outdoor activities. The rate of weight gain in the total population was 30.6% and the average weight gain was 0.5 ± 2.8 kg. The main factors contributing to weight gain were increased food intake and reduced physical activity. Additionally, normal-weight people were more likely to gain weight than people with overweight/obesity during the COVID-19 confinement. This study provided a good warning and educational reference value on lifestyle changes during the COVID-19 confinement. Full article

The COVID-19 pandemic has been the largest global health crisis in decades. Apart from the unprecedented number of deaths and hospitalizations, the pandemic has resulted in economic slowdowns, widespread business disruptions, and significant hardships. This study focused on investigating the early impacts of the COVID-19 pandemic on the U.S. construction industry since the declaration of the national emergency on 13 March 2020. The study objectives were achieved through 34 telephone interviews with project managers, engineers, designers, and superintendents that represented different states and distinct industry sectors in the United States (U.S.). The interviewees offered information on their experience with the pandemic, including the general and adverse effects experienced, new opportunities created, and risk management efforts being undertaken. The reported adverse effects included significant delays on projects, inability to secure materials on time, reduction in productivity rates, material price escalations, and others. The new opportunities that were created included projects involving the fast-track construction of medical facilities, construction of residential buildings, transportation-related work, and opportunities to recruit skilled workers. The risk management measures that were widely adopted included measures to enhance safety and reduce other project risks. The safety measures adopted included requiring employees to wear cloth face masks, adoption of social distancing protocols, staggering of construction operations, offering COVID-19-related training, administering temperature checks prior to entry into the workplace, and others. Measures to manage other project risks included the formation of a task force team to review the evolving pandemic and offer recommendations, advocating that construction businesses be deemed essential to combat delays and taking advantage of government relief programs. The study findings will be useful to industry stakeholders interested in understanding the early impacts of the pandemic on the construction industry. Industry stakeholders may also build upon the reported findings and establish best practices for continued safe and productive operations. Full article

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic. Full article

The COVID-19 pandemic stressed the importance of understanding the sources of vulnerabilities that can lead to a financial crisis and highlighted the predominant impact on health systems. Firstly, the paper aims to conduct a retrospective analysis of the Romanian health care system, over the period of time 1985–2019, based on our own computed sustainability index for public health. Secondly, using the Gregory-Hansen cointegration method, we provide new evidence on the causal relationship between health expenditure and GDP for Romania over the period of time 1985–2017. Based on the retrospective analysis of the long-run co-movement between health spending and GDP, the study allows one to prospectively examine not only the effects of the COVID-19 pandemic on health care spending, but also to reveal the government’s fiscal position and vulnerabilities. Our results highlight the intergenerational costs related to the policy incoherence roadmap and regulatory fragmentation, stressing the importance of economic system resilience through fiscal diligence and the consolidation of the institutional context. Full article

The situation associated with the growing number of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections forced ongoing monitoring of the epidemic situation, which entailed an introduction of a number of restrictions and solutions intended to isolate the infected persons on the one hand, and to minimize the risk of development of an epidemic in Poland on the other. Activity of the Polish legislator is also essential, which tried to introduce solutions that would correspond with current expectations and needs. Given the multiplicity of the introduced regulations, interpretation of provisions of statutes has not always been easy. In this paper, the author points to the issues of communication with a public authority by specific reflections on the principles of serving documents on beneficiaries of EU programs under which they were awarded funding for their implementation on the basis of EU regulations addressing the use of the European Regional Development Fund, the European Social Fund and the Cohesion Fund for programs implemented as part of the cohesion policy (Regulations of the European Parliament and of the Council (EU) of 17 December 2013: no. 1303/2013, no. 1301/2013, no. 1304/2013, no 1300/2013, and no. 1299/2013). The author focuses on the issues of communication with an authority in a situation where administrative proceedings are initiated against a beneficiary of EU funds, e.g., for returning the granted funding. The author points to the dynamics of the legislator’s work in this respect by analyzing the rules for serving documents by a public authority on beneficiaries who are public entities and those who are not. The author’s main research aim is to analyze existing provisions establishing the possibility of electronic communication with a public authority, and also to assess them critically due to the extraordinary situation caused by Coronavirus Disease 2019 (COVID-19). This is intended to verify the main research hypothesis focusing on the attempt to answer a question whether existing regulations, and those created at the time of the epidemic threat and the state of epidemic in Poland facilitate citizens’ electronic communication with a public authority. The author aims to answer a question about whether the Polish legislator responds appropriately to the numerous emerging challenges associated with the pandemic and whether it created regulations that effectively ensure the possibility of continuity of contact with a public authority for citizens who are the beneficiaries of public funds. This analysis may contribute to the understanding of whether and how it is possible to improve citizens’ contact with public authorities, which in the future may eliminate barriers and obstacles arising in this regard. The author bases her reflections on the experience resulting from providing legal services for one of the Polish Managing Authorities of the Regional Operational Programme using at the same time a number of research methods (i.e., the method of interpretation of applicable laws to establish applicable provisions of the law that regulate admissibility of electronic communication with a public authority and to establish efficiency of such communication, the analytical method, applied in reference to the relevant state of the art in the achievements of legal scholarship, and the empirical method, based on observation and analysis of practical issues resulting from the author’s cooperation with a Polish managing authority). In her conclusions, the author points to the lack of introduction of comprehensive regulations (also at the EU level—for all EU Member States) in terms of de-formalizing the principles of communication in the course of pending administrative proceedings. The author notices an absence of unambiguous regulations that allow for a scanned document signed by hand and sent my email to be qualified into the category of documents served by electronic means, through use of means of electronic communication. The author assesses this absence negatively due to the fact that such action seems the simplest in a situation caused by COVID-19. Full article

The aim of this study is to determine the anxiety and fear related to coronavirus disease 2019 (COVID-19) and their associations with travel, tourism and hospitality, in the Portuguese population. The Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 Scale (FCV-19S) were validated for the Portuguese population and correlations with issues related to travel, tourism and hospitality were established. CAS and FCV-19S presented a good adjustment model and solid reliability and validity. Correlations between CAS and FCV-19S and the perception of the impact of COVID-19 in travel, tourism and hospitality were found. Participants considered that COVID-19 mainly affected their holidays and leisure time. However, the strongest correlation established was between total FCV-19S and emotional fear FCV-19S and the fear of attending hotel facilities. The Portuguese versions of CAS and FCV-19S are reliable psychological tools to assess anxiety and fear in relation to COVID-19 for the general population. The use of hotel facilities is the most threatening issue related to travel, tourism and hospitality. The results suggest that hotels should invest in hygiene and safety measures that allow users to regain confidence in hotel equipment. Full article

Background: This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure-Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in the event of a hurricane. Specific concerns included being able to see people in person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters. Full article

Previous studies have reported the association of obesity with increased morbidity or mortality due to the coronavirus disease 2019 (COVID-19). This study aims to investigate the relationship of obesity, as defined by the body mass index (BMI), with morbidity and mortality due to COVID-19. Data from 5628 confirmed COVID-19 patients were collected by the Centers for Disease Control and Prevention of Korea. The hazard ratios (HRs) for mortality in the BMI groups were analyzed using the Cox proportional hazard model adjusted for covariates. The odds ratios (ORs) of morbidity and diabetes in the BMI groups were analyzed using logistic regression adjusted for the same covariates. Both underweight and obesity were associated with a higher HR for mortality (adjusted HR = 2.28, 95% confidence intervals [95% CI] = 1.23–4.25, p = 0.009 for underweight and adjusted HR = 1.71, 95% CI = 1.10–2.66, p = 0.017 for obese). Obesity was related to higher odds of morbidity (adjusted OR = 1.71, 95% CI = 1.32–2.21, p < 0.001). Underweight and obesity were associated with high mortality and/or morbidity due to COVID-19 in Korea. Full article

The COVID-19 pandemic has forced companies to respond to the threat of this risk and innovate in corporate governance. In order to reduce the risk of illness, one of the most applied measures by all companies was social distancing, but to avoid human interaction, companies had to adapt their communication strategies. The objective of the paper is to assess the risk management of Romanian-listed companies associated with COVID-19 focusing on their business communication with shareholders and stakeholders. To emphasis the communication we have chosen to analyze all public reports during the state of emergency of the companies listed on the main market at the Bucharest Stock Exchange. The empirical analysis consists of a panel data econometric model using maximum likelihood random-effects regression and a logistical regression to highlight the correlations between the dependent variables Public Reports and Business Continuity Plan and the analyzed independent variables. The study showed that in most cases, the companies had at least one public report, especially the one related to the annual shareholders meeting, a percentage of 21% of companies had two public reports, and only 17% of companies have published three or more reports. The companies that communicated the most were the ones belonging to the premium trading category, and the number of published reports was influenced by the communication evaluation indicator, profitability and by the announcement of the donations made. Full article

The newly discovered coronavirus (COVID-19) has become a pandemic, infecting thousands of people around the world. This study examines nurses’ demographic information (age, gender, marital status, area of practice, total years of experience in the current hospital, work region, monthly salary, educational level, workplace, nationality, working hours per day, total nursing experience, and the respondents’ main source of information on COVID-19), awareness, attitudes, prevention, and perceptions of COVID-19 during the outbreak in Saudi Arabia. A cross-sectional descriptive design of 500 nurses working at government and non-governmental hospitals in five regions in Saudi Arabia were selected using convenience sampling. The Kruskal–Wallis test was applied and the Mann–Whitney test was utilized as a post hoc test. The majority of nurses in this study, 96.85%, had excellent knowledge of COVID-19. Some (83.2%) of nurses reported significant prevention knowledge and treatment skills about COVID-19, while 7.6% had little knowledge about prevention. More than half of the nurses (60.4%) had high positive attitudes toward caring for COVID-19 patients. In conclusion, female nurses, married nurses, and bachelor’s degree nurses had greater awareness, better attitude, and prevention clinical experience towards COVID-19. Meanwhile, non-Saudi nurses had higher self-reported awareness, positive attitudes, optimal prevention, and positive perceptions compared to Saudi nurses. This study provides baseline information immediately needed to enable health authorities to prioritize training programs that support nurses during the COVID-19 pandemic. Full article

Early information on public health behaviors adopted to prevent the spread of coronavirus (COVID-19) may be useful in controlling the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission. The objective of this study was to assess the role of income level (IL) and the perception of older adults, regarding COVID-19 susceptibility and severity, on adopting stay-at-home preventive behavior during the first week of the outbreak in Mexico. Participants in this cross-sectional study were urban community dwellers, aged ≥ 65 years from Mexico City. A total of 380 interviews were conducted over the phone. The mean respondent age was 72.9 years, and 76.1% were women. Over half (54.2%) of the participants perceived their susceptibility to COVID-19 as very low or low. Similarly, 33.4% perceived COVID-19 severity as being very low or low, and 57.6% had decided to stay at home: this behavior was associated with IL (β = 1.05, p < 0.001), and its total effect was partially mediated (15.1%) by perceived severity. Educational attainment was also associated with staying at home (β = 0.10, p = 0.018) and its total effect was partially mediated (15.0%) by perceived susceptibility. Interventions aimed at low income and less educated older adults should be developed to improve preventive behaviors in this vulnerable group during the COVID-19 pandemic. Full article

This paper examines the linkages in financial markets during coronavirus disease 2019 (COVID-19) pandemic outbreak. For this purpose, daily stock market returns were used over the period of December 31, 2019–April 20, 2020 for the following economies: USA, Spain, Italy, France, Germany, UK, China, and Romania. The study applied the autoregressive distributed lag (ARDL) model to explore whether the Romanian stock market is impacted by the crisis generated by novel coronavirus. Granger causality was employed to investigate the causalities among COVID-19 and stock market returns, as well as between pandemic measures and several commodities. The outcomes of the ARDL approach failed to find evidence towards the impact of Chinese COVID-19 records on the Romanian financial market, neither in the short-term, nor in the long-term. On the other hand, our quantitative approach reveals a negative effect of the new deaths’ cases from Italy on the 10-year Romanian bond yield both in the short-run and long-run. The econometric research provide evidence that Romanian 10-year government bond is more sensitive to the news related to COVID-19 than the index of the Bucharest Stock Exchange. Granger causality analysis reveals causal associations between selected stock market returns and Philadelphia Gold/Silver Index. Full article

The stability of food supply chains is crucial to the food security of people around the world. Since the beginning of 2020, this stability has been undergoing one of the most vigorous pressure tests ever due to the COVID-19 outbreak. From a mere health issue, the pandemic has turned into an economic threat to food security globally in the forms of lockdowns, economic decline, food trade restrictions, and rising food inflation. It is safe to assume that the novel health crisis has badly struck the least developed and developing economies, where people are particularly vulnerable to hunger and malnutrition. However, due to the recency of the COVID-19 problem, the impacts of macroeconomic fluctuations on food insecurity have remained scantily explored. In this study, the authors attempted to bridge this gap by revealing interactions between the food security status of people and the dynamics of COVID-19 cases, food trade, food inflation, and currency volatilities. The study was performed in the cases of 45 developing economies distributed to three groups by the level of income. The consecutive application of the autoregressive distributed lag method, Yamamoto’s causality test, and variance decomposition analysis allowed the authors to find the food insecurity effects of COVID-19 to be more perceptible in upper-middle-income economies than in the least developed countries. In the latter, food security risks attributed to the emergence of the health crisis were mainly related to economic access to adequate food supply (food inflation), whereas in higher-income developing economies, availability-sided food security risks (food trade restrictions and currency depreciation) were more prevalent. The approach presented in this paper contributes to the establishment of a methodology framework that may equip decision-makers with up-to-date estimations of health crisis effects on economic parameters of food availability and access to staples in food-insecure communities. Full article

As the COVID-19 pandemic has had a profound impact on public health and global economies in 2020; it is crucial to understand how it developed and spread in time and space. This paper contributes to the growing literature by considering the dynamics of country-wise growth rates of infection numbers. Low-order serial correlation of growth rates is predominantly negative with cycles of two to four days for most countries. The results of fitted spatial autoregressive models suggest that there is high degree of spillover between countries. Forecast variances of many countries, in particular those with a high absolute number of infections, can to a large extent be explained by structural innovations of other countries. A better understanding of the serial and spatial dynamics of the spread of the pandemic may contribute to an improved containment and risk management. Full article

Given the volume of research and discussion on the health, medical, economic, financial, political, and travel advisory aspects of the SARS-CoV-2 virus that causes the COVID-19 disease, it is essential to enquire if an outbreak of the epidemic might have been anticipated, given the well-documented history of SARS and MERS, among other infectious diseases. If various issues directly related to health security risks could have been predicted accurately, public health and medical contingency plans might have been prepared and activated in advance of an epidemic such as COVID-19. This paper evaluates an important source of health security, the Global Health Security Index (2019), which provided data before the discovery of COVID-19 in December 2019. Therefore, it is possible to evaluate how countries might have been prepared for a global epidemic, or pandemic, and acted accordingly in an effective and timely manner. The GHS index numerical scores are calculated as the arithmetic (AM), geometric (GM), and harmonic (HM) means of six categories, where AM uses equal weights for each category. The GHS Index scores are regressed on the numerical score rankings of the six categories to check if the use of equal weights of 0.167 in the calculation of the GHS Index using AM is justified, with GM and HM providing a check of the robustness of the arithmetic mean. The highest weights are determined to be around 0.244–0.246, while the lowest weights are around 0.186–0.187 for AM. The ordinal GHS Index is regressed on the ordinal rankings of the six categories to check for the optimal weights in the calculation of the ordinal Global Health Security (GHS) Index, where the highest weight is 0.368, while the lowest is 0.142, so the estimated results are wider apart than for the numerical score rankings. Overall, Rapid Response and Detection and Reporting have the largest impacts on the GHS Index score, whereas Risk Environment and Prevention have the smallest effects. The quantitative and qualitative results are different when GM and HM are used. Full article

Coronavirus disease 2019 (COVID-19), which reported in an outbreak in 2019 in Wuhan, Hubei province, China, is caused by the SARS-CoV-2 virus. The virus belongs to the beta-coronavirus class, along with the Middle East Respiratory Syndrome coronavirus and Severe Acute Respiratory Syndrome coronavirus. Interestingly, the virus binds with angiotensin-converting enzyme-2 found in host cells, through the spike (S) protein that exists on its surface. This binding causes the entry of the virus into cells of the host organism. The actual mechanism used by the COVID-19 virus to induce disease is still speculative. A total of 44,322,504 cases, a 1,173,189 death toll and 32,486,703 recovery cases have been reported in 217 countries globally as of 28 October 2020. Symptoms from the infection of the virus include chest pain, fever, fatigue, nausea, and others. Acute respiratory stress syndrome, arrhythmia, and shock are some of the chronic manifestations recorded in severe COVID-19. Transmission is majorly by individual-to-individual through coughing, sneezing, etc. The lack of knowledge regarding the mechanism of and immune response to the virus has posed a challenge in the development of a novel drug and vaccine. Currently, treatment of the disease involves the use of anti-viral medications such as lopinavir, remdesivir, and other drugs. These drugs show some efficacy in the management of COVID-19. Studies are still on-going for the development of an ideal and novel drug for treatment. In terms of natural product intervention, Traditional Chinese Medicines (TCM) have been employed to alleviate the clinical manifestation and severity of the disease and have shown some efficacy. This review presents an updated detailed overview of COVID-19 and the virus, concerning its structure, epidemiology, symptoms and transmission, immune responses, and current interventions, and highlights the potential of TCM. It is anticipated that this review will further add to the understanding of COVID-19 and the virus, hence opening new research perspectives. Full article

Previous COVID-19 tourism research has not considered the positive impact of a low-risk perception and a perception of the benefits of regional travel on taking alternative tourism. This study attempts to fill the research gap and examine the positive effect of these perceptions on tourists’ attitudes to regional travel and intentions to undertake regional travel during the COVID-19 pandemic. A survey of 278 respondents confirmed that the perceived benefit positively influences tourists’ attitudes and travel intentions, but that a low-risk perception only positively affects their attitudes. This study contributes to tourism risk management research by introducing the concept of a low-risk perception as a positive factor. For tourism recovery, it finds that relaxation, value, and convenience are benefits to drive people to travel. Full article

Current therapy for Anderson–Fabry disease in Poland includes hospital or clinic-based intravenous enzyme replacement therapy with recombinant agalsidase alpha or beta, or oral pharmacological chaperone therapy with migalastat. Some countries around the world offer such treatment to patients in the comfort of their own homes. The 2020–2021 COVID-19 pandemic has pushed global healthcare providers to evolve their services so as to minimize the risk of COVID-19 exposure to both patients and providers; this has led to advances in telemedicine services and the increasing availability of at-home treatment for various procedures including parenteral drug administration. A total of 80% of surveyed Anderson–Fabry disease patients in Poland would prefer home-based treatment, which would be a safe and convenient alternative to clinic-based treatment if patient selection is based on our proposed algorithm. Our recommendations for home-based treatments appear feasible for the long term care of Anderson–Fabry disease patients during the COVID-19 pandemic and beyond. This may also serve as a basis for home-based treatment programs in other rare and ultra-rare genetic diseases. Full article

The Coronavirus Disease (Covid-19) pandemic is rapidly spreading across the world, representing an unparalleled challenge for health care systems. There are differences in the estimated fatality rates, which cannot be explained easily. In Italy, the estimated case fatality rate was 12.7% in mid-April, while Germany remained at 1.8%. Moreover, it is to be noted that different areas of Italy have very different lethality rates. Due to the complexity of Covid-19 patient management, it is of paramount importance to develop a well-defined clinical workflow in order to avoid the inconsistent management of patients. The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care to support patient management in the Sant’Andrea Hospital, Rome. The main objective of this pilot study was to develop a new ICP evaluated by care indicators, in order to improve the COVID-19 patient management. The suggested ICP was developed by a multi-professional team composed of different specialists and administrators already involved in clinical and management processes. After a review of current internal practices and published evidences, we identified (1) the activities performed during care delivery, (2) the responsibilities for these activities, (3) hospital structural adaptation needs and potential improvements, and (4) ICP indicators. The process map formed the basis of the final ICP document; 160 COVID-19 inpatients were considered, and the effect of the ICP implementation was evaluated over time during the exponential phase of the COVID-19 pandemic. In conclusion, a rapid adoption of ICP and regular audits of quality indicators for the management of COVID-19 patients might be important tools to improve the quality of care and outcomes. Full article