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COVID-19 and the Future of Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 22076

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Dr. Ana Rita Goes

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Guest Editor

1. Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
2. NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
Interests: health literacy; health behaviours; mental health; childhood obesity; parenting; participatory research

Dr. Ana Rita Pedro

E-Mail Website
Guest Editor

1. Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
2. NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
Interests: health literacy; access to health care; health policy; shared decision making; health information systems; surveys; validation studies; public health; medication adherence

Special Issue Information

Dear Colleagues,

COVID-19 has presented unprecedented challenges to society, with global health, economic and social impacts. Here, we aim to assess the long-term impacts of SARS-CoV-2 infection (post-COVID-19 condition), difficulties in the care and management of NCDs, a rise in mental health problems, healthcare workforce burnout, and signs of deepening inequalities, among several other impacts. Meanwhile, the virus is still spreading, and populations continue to live with daily restrictions and changes to their routines, with authorities struggling to determine the best ways to keep people involved in prevention efforts, despite pandemic fatigue. Thus, evidence is needed regarding the diverse health impacts, challenges and hardships of the pandemic, so that we can learn how to support better health in the future and how to engage people during a pandemic.

This Special Issue of the International Journal of Environmental Research and Public Health focuses on the evidence regarding the experiences, impacts and challenges of the pandemic, with an eye toward the future. We intend to draw a multilevel portrait of these issues, considering the experiences of individuals, groups, communities, organizations, health services, and the whole society, encouraging discussion around the lessons we can learn from COVID-19 for the future of public health. Original research papers, reviews, and case reports are welcome. We will accept manuscripts from different scientific fields, including epidemiology, environmental and occupational health, global health, health policy, health economics, health management, and socio-behavioural sciences. This Special Issue aims to publish evidence regarding the impacts and challenges, as well as the successes and innovations, that can improve the future of health. Potential topics include:

Post-COVID-19 condition;
Health professionals’ wellbeing during the pandemic;
Mental health during the pandemic;
Delayed diagnosis and routine care during the pandemic;
NCDs care and management during the pandemic;
COVID-19-related inequalities;
COVID-19 protection/preventive behaviours;
COVID-19-related health policies.

Dr. Ana Rita Goes
Dr. Ana Rita Pedro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

COVID-19
non-communicable diseases
mental health
wellbeing
healthcare
health policy
health inequalities
protection behaviours

Published Papers (12 papers)

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Research

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8 pages, 286 KiB

Open AccessArticle

Patient Care in Community Pharmacies during the COVID-19 (SARS-CoV-2) Pandemic: Effectiveness of Post-Graduate Education and Further Training Courses on Revenues

by Francesca Baratta, Elena Folpini, Michele Ciccolella and Paola Brusa

Int. J. Environ. Res. Public Health 2023, 20(5), 3774; https://doi.org/10.3390/ijerph20053774 - 21 Feb 2023

Viewed by 1013

Abstract

Thanks to their distribution throughout the territory and extended opening hours, community pharmacists are among the healthcare specialists most easily accessible to the public and often represent the first point of consultation both for the treatment of acute health conditions and, more generally, for health and therapy advice. The objective of the present study was to evaluate whether post-graduate courses/further training courses for pharmacists might influence the quality of patient management and care and, consequently, the satisfaction of the users who entered the pharmacy. We used the revenues of the pharmacies (Group A) in which these pharmacists are employed as a performance indicator. We compared the data for this group with the national averages for Italian pharmacies (Group B) and with those of a group (Group C) of selected pharmacies as similar as possible to the pharmacies in Group A based on a number of well-defined parameters. The comparison of revenues, year-on-year changes, and the average number of sales by the pharmacies in the three groups indicates that the pharmacies in Group A had the best performance, not only when compared with the national average but especially compared with the control group, specifically selected to make the comparison as significant as possible. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

13 pages, 397 KiB

Open AccessArticle

by Binhui Wang, Beiting Liang, Qiuyi Chen, Shu Wang, Siyi Wang, Zhongguo Huang, Yi Long, Qili Wu, Shulin Xu, Pranay Jinna, Fan Yang, Wai-Kit Ming and Qian Liu

Int. J. Environ. Res. Public Health 2023, 20(4), 3007; https://doi.org/10.3390/ijerph20043007 - 9 Feb 2023

Cited by 2 | Viewed by 1567

Abstract

The COVID-19 outbreak at the end of December 2019 spread rapidly all around the world. The objective of this study is to investigate and understand the relationship between public health measures and the development of the pandemic through Google search behaviors in the United States. Our collected data includes Google search queries related to COVID-19 from 1 January to 4 April 2020. After using unit root tests (ADF test and PP test) to examine the stationary and a Hausman test to choose a random effect model, a panel data analysis is conducted to investigate the key query terms with the newly added cases. In addition, a full sample regression and two sub-sample regressions are proposed to explain: (1) The changes in COVID-19 cases number are partly related to search variables related to treatments and medical resources, such as ventilators, hospitals, and masks, which correlate positively with the number of new cases. In contrast, regarding public health measures, social distancing, lockdown, stay-at-home, and self-isolation measures were negatively associated with the number of new cases in the US. (2) In mild states, which ranked one to twenty by the average daily new cases from least to most in 50 states, the query terms about public health measures (quarantine, lockdown, and self-isolation) have a significant negative correlation with the number of new cases. However, only the query terms about lockdown and self-isolation are also negatively associated with the number of new cases in serious states (states ranking 31 to 50). Furthermore, public health measures taken by the government during the COVID-19 outbreak are closely related to the situation of controlling the pandemic. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

12 pages, 366 KiB

Open AccessArticle

by Walaa Kinaan, Patrícia Soares, João Victor Rocha, Paulo Boto, Rui Santana and Sílvia Lopes

Int. J. Environ. Res. Public Health 2023, 20(2), 1207; https://doi.org/10.3390/ijerph20021207 - 10 Jan 2023

Viewed by 1276

Abstract

The COVID-19 pandemic has affected the use of emergency departments (ED) worldwide. This study identifies the pandemic-related factors associated with the number of ED visits in mainland Portugal and each of its regions. We collected data on ED visits from March 2020 to March 2022. Data on incidence, vaccination, mobility, containment index, and Google search volume were retrieved from open online sources at different time points. We fitted a quasi-Poisson generalized linear regression model, and each variable was modeled separately and adjusted for time and month. There was a positive ED trend throughout the two years of the pandemic in mainland Portugal and each of its regions. In the mainland, during months with high workplace mobility, there were 10.5% more ED visits compared to months with average mobility. ED visits decreased in months with low mobility for retail and recreation, groceries and pharmacies, and transit compared to months of medium mobility. Portugal saw a reduction in ED utilization during the pandemic period, but with a positive trend from March 2020 to March 2022. The change in the population’s behavior of seeking the ED throughout the pandemic might be associated with mobility, incidence, and pandemic fatigue. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

13 pages, 490 KiB

Open AccessArticle

COVID-19-Specific Mortality among World Trade Center Health Registry Enrollees Who Resided in New York City

by Janette Yung, Jiehui Li, Rebecca D. Kehm, James E. Cone, Hilary Parton, Mary Huynh and Mark R. Farfel

Int. J. Environ. Res. Public Health 2022, 19(21), 14348; https://doi.org/10.3390/ijerph192114348 - 2 Nov 2022

Cited by 1 | Viewed by 1106

Abstract

We examined the all-cause and COVID-19-specific mortality among World Trade Center Health Registry (WTCHR) enrollees. We also examined the socioeconomic factors associated with COVID-19-specific death. Mortality data from the NYC Bureau of Vital Statistics between 2015–2020 were linked to the WTCHR. COVID-19-specific death was defined as having positive COVID-19 tests that match to a death certificate or COVID-19 mentioned on the death certificate via text searching. We conducted step change and pulse regression to assess excess deaths. Limiting to those who died in 2019 (n = 210) and 2020 (n = 286), we examined factors associated with COVID-19-specific deaths using multinomial logistic regression. Death rate among WTCHR enrollees increased during the pandemic (RR: 1.70, 95% CL: 1.25–2.32), driven by the pulse in March–April 2020 (RR: 3.38, 95% CL: 2.62–4.30). No significantly increased death rate was observed during May–December 2020. Being non-Hispanic Black and having at least one co-morbidity had a higher likelihood of COVID-19-associated mortality than being non-Hispanic White and not having any co-morbidity (AOR: 2.43, 95% CL: 1.23–4.77; AOR: 2.86, 95% CL: 1.19–6.88, respectively). The racial disparity in COVID-19-specific deaths attenuated after including neighborhood proportion of essential workers in the model (AOR:1.98, 95% CL: 0.98–4.01). Racial disparities continue to impact mortality by differential occupational exposure and structural inequality in neighborhood representation. The WTC-exposed population are no exception. Continued efforts to reduce transmission risk in communities of color is crucial for addressing health inequities. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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15 pages, 367 KiB

Open AccessArticle

Meeting the Needs of Rural Veterans: A Qualitative Evaluation of Whole Health Coaches’ Expanded Services and Support during COVID-19

by J. Hale-Gallardo, Consuelo M. Kreider, Gail Castañeda, Kelsea LeBeau, Deepthi S. Varma, Cheri Knecht, Diane Cowper Ripley and Huanguang Jia

Int. J. Environ. Res. Public Health 2022, 19(20), 13447; https://doi.org/10.3390/ijerph192013447 - 18 Oct 2022

Cited by 4 | Viewed by 2703

Abstract

The purpose of this qualitative study was to explore perspectives of Whole Health (WH) coaches at the Veterans Health Administration (VHA) on meeting the needs of rural Veterans during the COVID-19 pandemic. The evaluation design employed a qualitative description approach, employing focus groups and in-depth interviews with a convenience sample of WH coaches across the VHA system. Fourteen coaches who work with rural Veterans participated in either one of three focus groups, individual interviews, or both. The focus group data and in-depth interviews were analyzed separately using thematic analysis, and findings were then merged to compare themes across both datasets. Four primary themes were identified: bridging social risk factors for rural Veterans, leveraging technology to stay connected with Veterans at-a-distance, redirecting Veterans to alternate modes of self-care, and maintaining flexibility in coaching role during COVID-19. One overarching theme was also identified following a post-hoc analysis driven by interdisciplinary team discussion: increased concerns for Veteran mental health during COVID-19. Coaches reported using a variety of strategies to respond to the wide-ranging needs of rural Veterans during the pandemic. Implications of findings for future research and practice are discussed. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

19 pages, 12809 KiB

Open AccessArticle

Seating Behaviour of Students before and after the COVID-19 Pandemic: Findings from Occupancy Monitoring with PIR Sensors at the UCL Bartlett Library

by Gizem Izmir Tunahan and Hector Altamirano

Int. J. Environ. Res. Public Health 2022, 19(20), 13255; https://doi.org/10.3390/ijerph192013255 - 14 Oct 2022

Cited by 2 | Viewed by 1767

Abstract

Since the first case of COVID-19 was confirmed in China, social and physical distancing has been promoted worldwide as an effective community mitigation strategy. However, our understanding remains limited regarding how students would resume their activities and use of libraries when the restrictions to manage the spread of coronavirus were lifted. Understanding students’ seating behaviour in libraries is required to guarantee that the libraries meet the needs and preferences of students and promote students’ health and well-being and satisfaction with the library. This paper aims to explore the changes in the use of study spaces before and after the pandemic. Occupancy data from the UCL Bartlett Library collected at 10-min intervals from motion sensors located underneath desks was used to assess the occupancy within the library and which was then compared to characteristics of the space. This study revealed that the COVID-19 pandemic significantly impacted students’ use of the library as well as how much time they spent there. While seats with a good combination of daylight, outdoor view and privacy were in most demand before the pandemic, distance from other students seems to be the priority after the pandemic. Students’ seating preferences appear to be also influenced by the position of desk dividers after COVID-19. Future research should focus on assessing and proposing new seating arrangements and developing strategies to promote students’ satisfaction with libraries in response to changes in students’ seating behaviours. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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10 pages, 341 KiB

Open AccessArticle

Preliminary Analysis of COVID-19 Vaccination Factors among Native and Foreign-Born Hispanic/Latine Adults Residing in South Florida, U.S.A.

by María Eugenia Contreras-Pérez, Janet Diaz-Martinez, Robbert J. Langwerden, Michelle M. Hospital, Staci L. Morris, Eric F. Wagner and Adriana L. Campa

Int. J. Environ. Res. Public Health 2022, 19(20), 13225; https://doi.org/10.3390/ijerph192013225 - 14 Oct 2022

Cited by 1 | Viewed by 1443

Abstract

This study explored barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among Hispanic/Latine individuals. Hispanic/Latine is a broad social construct that encompasses people from heterogeneous countries and cultures. In the U.S., foreign-born Hispanics/Latines tend to have better health outcomes than U.S.-born individuals. Thus, the study examined whether nativity is a significant factor in COVID-19 vaccine hesitancy. Binary logistic regression and linear regression analyses were employed and revealed that, regardless of nativity, Hispanic/Latine participants face similar barriers and find similar sources of information trustworthy. Controlling for age and race, vaccination rates or perceived likelihood of getting vaccinated did not differ between the two groups. The two groups significantly differed in specific motivators for vaccination: foreign-born Hispanic/Latine individuals were more motivated to get the vaccine to keep themselves, their families, and their community safe, and more often believed vaccination is needed for life to return to normal. Study results provide important insights into similarities and differences in barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among native and foreign-born Hispanic/Latine individuals. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

14 pages, 542 KiB

Open AccessArticle

Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021

by Steven Ndugwa Kabwama, Rhoda K. Wanyenze, Suzanne N. Kiwanuka, Alice Namale, Rawlance Ndejjo, Fred Monje, William Wang, Siobhan Lazenby, Susan Kizito, Christopher Troeger, Anne Liu, Helena Lindgren, Neda Razaz, John Ssenkusu, William Sambisa, Rebecca Bartlein and Tobias Alfvén

Int. J. Environ. Res. Public Health 2022, 19(19), 12522; https://doi.org/10.3390/ijerph191912522 - 30 Sep 2022

Cited by 7 | Viewed by 2956

Abstract

Introduction: The COVID-19 pandemic overwhelmed health systems globally and affected the delivery of health services. We conducted a study in Uganda to describe the interventions adopted to maintain the delivery of other health services. Methods: We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. Results: Governance strategies included the establishment of coordination committees and the development and dissemination of guidelines. Infrastructure and commodity strategies included the review of drug supply plans and allowing emergency orders. Workforce strategies included the provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included the designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and the leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma. Conclusions: Health service maintenance during emergencies requires coordination to harness existing health system investments. The essential services continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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24 pages, 753 KiB

Open AccessArticle

Determinants of COVID-19 Outcome as Predictors of Delayed Healthcare Services among Adults ≥50 Years during the Pandemic: 2006–2020 Health and Retirement Study

by Hind A. Beydoun, May A. Beydoun, Brook T. Alemu, Jordan Weiss, Sharmin Hossain, Rana S. Gautam and Alan B. Zonderman

Int. J. Environ. Res. Public Health 2022, 19(19), 12059; https://doi.org/10.3390/ijerph191912059 - 23 Sep 2022

Viewed by 1685

Abstract

Background: The coronavirus disease 19 (COVID-19) was declared a global pandemic on 11 March 2020. To date, a limited number of studies have examined the impact of this pandemic on healthcare-seeking behaviors of older populations. This longitudinal study examined personal characteristics linked to COVID-19 outcomes as predictors of self-reported delayed healthcare services attributed to this pandemic, among U.S. adults, ≥50 years of age. Methods: Secondary analyses were performed using cross-sectional data (1413 participants) and longitudinal data (2881 participants) from Health and Retirement Study (HRS) (2006–2018) linked to the 2020 HRS COVID-19 Project (57% female, mean age: 68 years). Demographic, socioeconomic, lifestyle and health characteristics were evaluated in relation to delayed overall, surgical and non-surgical healthcare services (“Since March 2020, was there any time when you needed medical or dental care, but delayed getting it, or did not get it at all?” and “What type of care did you delay”) using logistic regression and Ensemble machine learning for cross-sectional data as well as mixed-effects logistic modeling for longitudinal data. Results: Nearly 32.7% delayed healthcare services, 5.8% delayed surgical services and 31.4% delayed non-surgical services. Being female, having a college degree or higher and 1-unit increase in depression score were key predictors of delayed healthcare services. In fully adjusted logistic models, a history of 1 or 2 cardiovascular and/or metabolic conditions (vs. none) was associated with 60–70% greater odds of delays in non-surgical services, with distinct findings for histories of hypertension, cardiovascular disease, diabetes and stroke. Ensemble machine learning predicted surgical better than overall and non-surgical healthcare delays. Conclusion: Among older adults, sex, education and depressive symptoms are key predictors of delayed healthcare services attributed to the COVID-19 pandemic. Delays in surgical and non-surgical healthcare services may have distinct predictors, with non-surgical delays more frequently observed among individuals with a history of 1 or 2 cardiovascular and/or metabolic conditions. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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15 pages, 505 KiB

Open AccessArticle

Making It Work: The Experiences of Delivering a Community Mental Health Service during the COVID-19 Pandemic

by Leanne Burton, Abbie Wall and Elizabeth Perkins

Int. J. Environ. Res. Public Health 2022, 19(19), 12056; https://doi.org/10.3390/ijerph191912056 - 23 Sep 2022

Cited by 2 | Viewed by 1546

Abstract

The COVID-19 pandemic forced rapid innovative change to healthcare delivery. Understanding the unique challenges faced by staff may contribute to different approaches when managing future pandemics. Qualitative interviews were conducted with 21 staff from a Community Mental Health Team in the North West of England, UK, three months after the first wave of the pandemic. Thematic analysis was used to examine data reporting the challenges arising when working to deliver a service during the pandemic. Data is discussed under four headings; “senior trust managers trying to make it work”, “individuals making it work”, “making it work as a team”, and “making it work through working at home”. Clear communication was essential to ensure adherence to guidelines while providing safe care delivery. The initial response to the pandemic involved the imposition of boundaries on staff by senior leadership to ensure that vulnerable service users received a service while maintaining staff safety. The data raises questions about how boundaries were determined, the communication methods employed, and whether the same outcome could have been achieved through involving staff more in decision-making processes. Findings could be used to design interventions to support mental health staff working to deliver community services during future crises. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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10 pages, 370 KiB

Open AccessConcept Paper

Transitional Justice after the COVID-19 Pandemic

by Bruno Rodríguez Reveggino and Ángel Becerra-Bolaños

Int. J. Environ. Res. Public Health 2022, 19(19), 12388; https://doi.org/10.3390/ijerph191912388 - 29 Sep 2022

Cited by 2 | Viewed by 1454

Abstract

The COVID-19 pandemic has been a real challenge for health systems and public policies. Both the pandemic and the measures taken to mitigate it have affected the freedoms and rights of the different sectors of society, especially the most vulnerable ones, and have increased the already existing structural inequalities. Consequently, the pandemic must be analyzed from the perspective of human rights. Transitional Justice (TJ) has proven to be useful after conflict situations, helping societies to confront abuses perpetrated and to find solutions for the future, as well as repairing damages that have arisen as a consequence of these conflicts in different areas. Thus, TJ processes have been successfully used after armed conflicts and during peace negotiations, to respond to abuses perpetrated in consolidated democracies, and even after environmental crises. Therefore, the creation of a “Truth and Reconciliation Commission for the COVID-19 pandemic”, which launches the TJ processes of truth, justice, reparation and guarantees of non-repetition can help to find solutions to conflicts arising from the pandemic in a simple way. In addition, it would establish the foundations to prevent the violation of human rights in similar situations to come. Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

8 pages, 1109 KiB

Open AccessBrief Report

The Impact of Three Communication Channels on the Dissemination of a Serious Game Designed to Enhance COVID-19 Prevention

by Mélanie Suppan, Loric Stuby, Christophe Alain Fehlmann, Mohamed Abbas, Sophia Achab, Stephan Harbarth and Laurent Suppan

Int. J. Environ. Res. Public Health 2022, 19(16), 10143; https://doi.org/10.3390/ijerph191610143 - 16 Aug 2022

Cited by 1 | Viewed by 1905

Abstract

Infection prevention interventions can only be effective if they are both well known and easily accessible. A randomized controlled trial showed that a serious game, “Escape COVID-19”, was significantly more effective at improving the intention of adopting adequate infection prevention behavior than regular guidelines among long-term care facility employees. However, less than a fifth of all potential participants were finally recruited in this study. To determine whether a specific communication intervention was more effective than another, we carried out a retrospective analysis of account creation data over a six-month period. During the first period (53 days), information about the serious game was disseminated by a part-time worker. The second period (15 days) corresponded to a press release, while the third period (15 days) reflected an official communication from the Swiss Federal Office of Public Health. A total of 3995 accounts were created during the study period. Most accounts were created by health care workers (2699/3995, 67.6%). Median daily account creation was highest during the press release period (25; Q1:Q3 9:172) and lowest during the official communication period (6; Q1:Q3 4:20). The association between communication intervention and account creation was statistically significant both when considering the overall population (p = 0.013) and when only analyzing health care workers (p = 0.036). Full article

(This article belongs to the Special Issue COVID-19 and the Future of Health)

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