Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices

Factors associated with SARS-CoV2 infection and care pathways among the most vulnerable populations living in Marseille: a case control study

BACKGROUND

The Covid-19 pandemic has led to substantial and unexpected increases in morbidity and mortality in France. Vulnerable populations housed in accommodation centres have a greater risk of infection because collective housing and their dependence on social support services mean it is more difficult to apply preventive measures. They are also at greater risk of developing severe forms of Covid-19 and waiting longer before seeking healthcare (for Covid-19 or other) treatment. We aimed to identify the factors associated with SARS-CoV2 infection in the most vulnerable populations in the city of Marseille.

METHODS

The study sample comprised users of various services provided by the association AAJT in Marseille, France, some presenting symptoms suggestive of Covid-19 and others not. All had routine health surveillance provided by AAJT's dedicated healthcare team between March 2020 and May 2020. Using univariate and multivariate analyses, we studied the influence of several variables on morbidity associated with Covid-19.

RESULTS

The study included 64 participants, 29 of whom tested positive for Covid-19 and 35 control subjects. Median age was 21.16 years old. Individuals in the 'Covid-19 case' group (p < 0.005) - which included persons testing positive and those suspected of being infected - were younger. The study sample's male/female ratio was seven. In our multivariate analyses, living in a shared apartment and poor adherence to social distancing measures were factors associated with Covid-19 infection. Furthermore, mental health problems - such as anxiety disorder - were very frequent in the study sample.

CONCLUSIONS

Allocating more and specific housing units to structures providing accommodation services to the most vulnerable people would seem to be a decisive factor in controlling the spread of SARS-CoV2, and deserves more attention from public authorities.

Primary school students' poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis

Background

The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students’ malaria poems.

Methods

A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations.

Results

A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as ‘a trap’ to mosquitoes.

Conclusions

The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11641-8.

Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model

BACKGROUND

There are only limited studies on access to COVID-19 vaccines and identifying the most appropriate health centres for performing vaccination in metropolitan areas. This study aimed to measure potential spatial access to COVID-19 vaccination centres in Mashhad, the second-most populous city in Iran.

METHODS

The 2021 age structure of the urban census tracts was integrated into the enhanced two-step floating catchment area model to improve accuracy. The model was developed based on three different access scenarios: only public hospitals, only public healthcare centres and both (either hospitals or healthcare centres) as potential vaccination facilities. The weighted decision-matrix and analytic hierarchy process, based on four criteria (i.e. service area, accessibility index, capacity of vaccination centres and distance to main roads), were used to choose potential vaccination centres looking for the highest suitability for residents. Global Moran's index (GMI) was used to measure the spatial autocorrelation of the accessibility index in different scenarios and the proposed model.

RESULTS

There were 26 public hospitals and 271 public healthcare centres in the study area. Although the exclusive use of public healthcare centres for vaccination can provide the highest accessibility in the eastern and north-eastern parts of the study area, our findings indicate that including both public hospitals and public healthcare centres provide high accessibility to vaccination in central urban part. Therefore, a combination of public hospitals and public healthcare centres is recommended for efficient vaccination coverage. The value of GMI for the proposed model (accessibility to selected vaccination centres) was calculated as 0.53 (Z = 162.42, P < 0.01). Both GMI and Z-score values decreased in the proposed model, suggesting an enhancement in accessibility to COVID-19 vaccination services.

CONCLUSIONS

The periphery and poor areas of the city had the least access to COVID-19 vaccination centres. Measuring spatial access to COVID-19 vaccination centres can provide valuable insights for urban public health decision-makers. Our model, coupled with geographical information systems, provides more efficient vaccination coverage by identifying the most suitable healthcare centres, which is of special importance when only few centres are available.

Who should receive treatment? Healthcare professionals' perspectives surrounding the medical management of patients with COVID-19

Background

The COVID-19 pandemic has resulted in unprecedented challenges for healthcare systems worldwide. This pandemic is much more than a health crisis; it has also raised many ethical challenges. The large number of infected patients amid scarce resources has placed healthcare professionals in a critical situation in which they have to make difficult decisions about how to prioritize their patients. Therefore, the aim of this study is to explore the ethical challenges experienced and perceived by healthcare professionals working in healthcare institutions and research centers in Saudi Arabia.

Methods

Semi-structured face-to-face interviews were conducted individually with frontline healthcare providers (physicians and nurses), researchers, and decision-makers involved in the management of COVID-19 cases. Each interview lasted up to 90 minutes. The thematic analysis technique was used to analyse the interview data.

Findings

The participants’ rich experiences, which revealed a number of ethical challenges concerning the provision of medical care to infected patients, were framed around four main themes: treatment challenges related to COVID-19 patients, uncertainty of the medical outcome, medical care discrimination, and decision to discontinue medical treatment.

Conclusion

The COVID-19 pandemic has posed huge ethical challenges for healthcare professionals that might lead to psychological issues given the emotional toll related to making life-and-death decisions.

Recommendation

In a situation where no reliable and certain treatment is known or well tested, establishing centralized and responsive ethical committees could help reassure and guide practitioners and address their concerns.

Motivational Antecedents, Value Co-Creation Process, and Behavioral Consequences in Participatory Sport Tourism

This study was designed to examine the structural relationships among tourists’ participation motivations, the value co-creation process (VCCP), and value co-creation behavior (VCCB) in terms of in-role and extra-role contributions. Based on a comprehensive review of literature, participation motivations were measured with four constructs, including need for uniqueness, need for self-control, need for social interaction, and need for leisure and entertainment. Research participants (N = 445) who had participated in two or more marathon events in China were recruited to respond to an on-site or online survey. Conducting structural equation modeling analyses, three motivational factors of need for uniqueness, need for social interaction, and need for leisure and entertainment were found to exert significant (p < 0.05) and positive impact on VCCP, which in turn had significant (p < 0.05) influence on in-role and extra-role contributions associated with VCCB. Discussions are centered on promoting specific areas of participants’ motivations in an effort to empower and energize the process of value co-creation and to ultimately activate and sustain participants’ in-role and extra-role behaviors.

Gender inequality and health disparity amid COVID-19

Gender inequalities could lead to grave human and economic consequences, especially amid global health crises of the coronavirus 2019's (COVID-19) scale. The COVID-19 pandemic exacerbated gender inequalities women face and introduced new challenges that are unprecedented to society at large. Adverse effects of COVID-19, compounded by unintended consequences caused by public health policies such as lockdowns (e.g., delayed or canceled health services), have forced women to face issues ranging from COVID-19 infections and deaths, prolonged unemployment, to unparalleled scale and severity of domestic violence. However, though women face a canopy of debilitating challenges, there is a shortage of research that examines health solutions that can mitigate, if not offset, challenges women experience amid COVID-19. In this paper, we aim to shed light on why timely solutions are needed to mitigate gender inequalities and health disparities women face amid COVID-19 promptly. Furthermore, we underscore the imperative for cost-effective interventions that could shed light on the current health crisis and future pandemics.

Transportation, the pathogen vector to rule them all: Evidence from the recent coronavirus pandemic

INTRODUCTION

It is common knowledge that mobility refers to a distinct vector for pathogens, but the importance of prevention and the infusion of public health practices within transportation systems is not manifest. Replication studies of this effect are important because transportation remains veiled in modern societies, since its demand is not direct, but derived.

METHODS

Variables mirroring transportation and logistics' systems intensity (trade data, the logistics performance index, and investment in transportation) are cross-tabulated with epidemiological data from the recent coronavirus pandemic. As the samples of the data pertain to a dependent commonality, the statistical hypothesis test applicable is McNemar's test. In addition, the statistical power of the test(s) is calculated as a marker of methodological validity and reliability. To further strengthen the analytical methodology, a plethora of descriptive statistics have been calculated and multiple correspondence analysis (MCA) has been conducted.

RESULTS

This work confirms that the domain of transportation bears a strong association with not only mortality of a disease, but its recovery rates as well. All crosstabs provide statistically significant results and the statistical power calculated is very high, signifying the appropriateness of the methodology and the very low probability of Type II error. The MCA results are significant, as well.

CONCLUSIONS

The impact, or even the presence of transportation is veiled, as transportation comprises of derived demand dynamics. As such, its activities and even the prerequisites for its efficient operations many times go unnoticed. This work replicates a known effect, that mobility exacerbates the presence of a pathogen. The significance of this research lies on the fact that distinct indicators that reflect transportation and logistics are (though a robust calculatory methodology) statistically associated with epidemiological data.

The Psychological Consequences of COVID-19 Pandemic in Tourism Sector: A Systematic Review

BACKGROUND

The COVID-19 pandemic-induced changes have threatened the psychological wellbeing of travelling. This review aims to appraise a range of perceived psychological variables used to realize how the pandemic has influenced tourist behavior.

METHODS

A systematic review was conducted to identify the mechanisms behind tourists' behavioral change during the pandemic. The papers were extracted from four databases: PubMed, SCOPUS, Web of Science, and EMBASE, published since 2020 to 2021. The results are summarized narratively due to the heterogeneity of the studies.

RESULTS

A total of 369 citations were identified through an electronic search of databases, of which nine publications met the inclusion criteria. The extracted information determines the significant factors contributing to the psychological changes of travelling behavior during the pandemic.

CONCLUSION

The tourists' perception of COVID-19 has influenced the intentions and motivation in the tourism sector and has changed travel behavior. The mental health outcome of travelling has been replaced by globally recognized fear and anxiety. Yet, there are several motivators to travel during the pandemic. At the same time, the socio-demographic characteristics contribute to all the identified changes.

Perception of the Movement Control Order during the COVID-19 Pandemic: A Qualitative Study in Malaysia

Malaysia implemented its first Movement Control Order (MCO) during the early phase of the COVID-19 pandemic to slow the transmission of the virus. This study aimed to explore the public perception of the MCO implementation and people’s experiences during this period. The study employed qualitative explorative in-depth interviews conducted with 23 Malaysian adults from various demographic backgrounds. Thematic analysis was performed using NVivo 12. Three main themes were identified: a period of information surge, heterogeneous emotional response, and attempts to adapt. During the MCO, the participants obtained information from multiple platforms. They suggested the need for clear and repeated instructions to avoid confusion and misinformation. They also acknowledged the importance of the MCO in breaking the chain of transmission and safeguarding high-risk groups; however, they also expressed that stricter enforcement from the authorities was warranted. The changes in the participants’ work–life routines, lack of physical interaction, and uncertainty about their health and the economy due to the MCO negatively impacted their psychological states. Despite these challenges, the participants attempted to adapt to life under the MCO in different ways. The findings imply that during a crisis, the public tends to seek clear and reliable information, experience emotional turmoil, and adapt to changes. The MCO implementation can be improved through an effective communication strategy and efforts to battle misinformation.

Authorized, clear and timely communication of risk to guide public perception and action: lessons of COVID-19 from China

Backgrounds

This study examined the dynamic association between risk communication and the public’s risk perception and action across the COVID-19 outbreak timeline in China.

Methods

This study collected publicly available information on COVID-19 released on official channels (e.g., government websites and official media) by the Parehub tool. Also, the study used the Zhongyun Big Data Platform to search public datasets about released COVID-19 information on Chinese social media, such as TikTok and Weibo. An online survey was conducted via WeChat to Chinese citizens using a snowball sampling method. The questionnaire assessed changes in participants’ risk perception and action against COVID-19. The data analysis examined information content and release-time trajectories against the public’s risk perception and actions over time.

Results

Altogether, the collected data includes 1477 pieces of authorized information and 297,000 short videos on COVID-19. Of 1362 participants recruited from 33 provinces and municipalities of China, 1311 respondents (25–60 years, 42% male) were valid for future analysis. The study indicated that 85.7% of participants mainly relied on official channels to obtain information. Alongside the outbreak’s progress, there was a gradual rise in information quantity, publishing frequency, and content variation. Correspondingly, the public’s risk perception that “take it seriously” rose from 13 to 80%, 87.1% of those who took “multiple actions” compared to 25.9% initially.

Conclusions

Our findings indicated that insufficient information freely-accessible at the early stages of the outbreak might lead to the lack of risk awareness and the public’s inadequate protective actions. Given the current global situation of COVID-19, the study highlights authorized, transparent, and timely two-way risk communication is vital to guide public perception and actions. Furthermore, our study provides risk communication recommendations and may contribute to developing full measures to address future crises.

Religious Affiliation, Daily Spirituals, and Private Religious Factors Promote Marital Commitment Among Married Couples: Does Religiosity Help People Amid the COVID-19 Crisis?

Religious studies are a vital branch of social science that seeks to explain the beliefs of human society and deals with the practices and beliefs of individuals. This distinctive study focuses on such influential aspects of a healthy life, which could play a vital role in the marital quality and matrimonial commitment of individuals. The study principally focused on inspecting the role of religiosity in healthy marital commitment among individuals. It is a distinctive and central value in regulating a healthy social life. This research designed a conceptual model for assessing marital commitment, and the study model comprised two primary variables. The study received datasets through a survey questionnaire based on participants from five private and public sectors. The research study conducted an empirical analysis to test the proposed conceptual framework. The findings exhibited that the value of the R 2 model was 0.484, meaning the level of religiosity had a substantial impression on healthy and lasting marital commitment. According to the final outline of the model factors associated with building religious support factors (β = 0.491), the marital commitment had a better and healthier impact. The goodness-of-fit of the measurement of the conceptual model showed a value of 0.51, which indicated that the theoretical model had sufficient consistency and rationality, and accurately fitted the data. Such an advanced statistical model is missing from the previous literature. The study results provide helpful insight to elucidate the social dynamics of marital commitment. The findings designate that religious practices strengthen and promote nuptial commitment. The study is novel in the context of religiosity impact on martial commitment with a cultural background of Pakistan. The generalizability of the study does not apply to the entire population or other regions. Future studies can investigate other religious variables to explore further research findings. The findings are helpful for decision-makers and policymakers to concentrate on marital issues and challenges confronted by couples worldwide.

With Great Hopes Come Great Expectations: Access and Adoption Issues Associated With COVID-19 Vaccines

Although COVID-19 vaccines are becoming increasingly available, their ability to effectively control and contain the spread of the COVID-19 pandemic is highly contingent on an array of factors. This paper discusses how limitations to vaccine accessibility, issues associated with vaccine side effects, concerns regarding vaccine efficacy, along with the persistent prevalence of vaccine hesitancy among the public, including health care professionals, might impact the potential of COVID-19 vaccines to curb the pandemic. We draw insights from the literature to identify practical solutions that could boost people’s adoption of COVID-19 vaccines and their accessibility. We conclude with a discussion on health experts’ and government officials’ moral and ethical responsibilities to the public, even in light of the urgency to adopt and endorse “the greatest amount of good for the greatest number” utilitarian philosophy in controlling and managing the spread of COVID-19.

Perceived fear of COVID-19 and its associated factors among Nepalese older adults in eastern Nepal: A cross-sectional study

BACKGROUND

Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal.

METHODS

A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear.

RESULTS

The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear.

CONCLUSION

Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.

Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran

BACKGROUND

Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics.

METHODS

Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase-polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease.

RESULTS

Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040-1.057). Despite a high burden of Covid-19 infections in the 30-39 and 40-49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0-14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases.

CONCLUSIONS

The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

Anxiety, OCD, delusions, and religiosity among the general public during the COVID-19 pandemic

The COVID-19 outbreak has not only affected the physical health of the public but also resulted in severe psychological outcomes. This study aims to investigate the psychological effects of the COVID-19 outbreak on Pakistan's general public. In order to identify the main psychological factors that have emerged due to the current pandemic, extensive literature and opinion pieces of psychologists were reviewed. After a thorough study of the existing scholarship, four main psychological factors were investigated: stress and anxiety, obsessive compulsive disorder (OCD), delusions of getting infected from the disease, and religiosity. A research survey was circulated among the sample population online. A total 356 valid responses were received in the period of two to three weeks. Findings showed that the respondents reported a moderate level of anxiety, occasional symptoms of OCD, and delusions. However, respondents showed a high inclination toward religion during the current pandemic situation. Furthermore, respondents highlighted a few other psychological factors, such as financial strain and loneliness, in the survey. The primary sources of COVID-19-related information were social media and television among the general public of Pakistan. Finally, guidelines and tips from the reviewed psychologists and psychiatrists on overcoming the highlighted psychological problems that have arisen due to the COVID-19 outbreak were summarised.

What can internet users' behaviours reveal about the mental health impacts of the COVID-19 pandemic? A systematic review

Objectives

At the end of 2019, an acute infectious pneumonia (coronavirus disease 2019 [COVID-19]) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China, and subsequently spread around the world starting a pandemic. Globally, to date, there have been >118 million confirmed cases, including >2 million deaths. In this context, it has been shown that the psychological impact of the pandemic is important and that it can be associated with an increase in internet searches related to fear, anxiety, depression, as well as protective behaviours, health knowledge and even maladaptive behaviours.

Study design

This is a systematic review.

Methods

This review aims to collect, analyse and synthesise available evidence on novel data streams for surveillance purposes and/or their potential for capturing the public reaction to epidemic outbreaks, particularly focusing on mental health effects and emotions.

Results

At the end of the screening process, 19 articles were included in this systematic review. Our results show that the COVID-19 pandemic had a great impact on internet searches for mental health of entire populations, which manifests itself in a significant increase of depressed, anxious and stressed internet users’ emotions.

Conclusions

Novel data streams can support public health experts and policymakers in establishing priorities and setting up long-term strategies to mitigate symptoms and tackle mental health disorders.

Considering COVID-19 through the Lens of Hazard and Disaster Research

Decades of social science research have taught us much about how individuals, groups, and communities respond to disasters. The findings of this research have helped inform emergency management practices, including disaster preparedness, response, recovery, and mitigation. In the context of the COVID-19 pandemic, most of us—researchers or not—have attempted or are attempting to make sense of what is going on around us. In this article, we assert that we need not examine the pandemic in a vacuum; rather, we can draw upon scholarly and practical sources to inform our thinking about this 21st century catastrophe. The pandemic has provided an “unfortunate opportunity” to revisit what we know about disaster phenomena, including catastrophes, and to reconsider the findings of research from over the years. Drawing upon academic research, media sources, and our own observations, we focus on the U.S. and employ disaster characteristics framework of (1) etiology or origins; (2) physical damage characteristics; (3) disaster phases or cycles; (4) vulnerability; (5) community impacts; and (6) individual impacts to examine perspectives about the ways in which the ongoing pandemic is both similar and dissimilar to conceptualizations about the social dimensions of hazards and disasters. We find that the COVID-19 pandemic is not merely a disaster; rather, it is a catastrophe.

Mental health solutions for domestic violence victims amid COVID-19: a review of the literature

BACKGROUND

Due to COVID-19, domestic violence victims face a range of mental health challenges, possibly resulting in substantial human and economic consequences. However, there is a lack of mental health interventions tailored to domestic violence victims and in the context of COVID-19. In this study, we aim to identify interventions that can improve domestic violence victims' mental health amid the COVID-19 pandemic to address the research gap.

MAIN TEXT

Drawing insights from established COVID-19 review frameworks and a comprehensive review of PubMed literature, we obtained information on interventions that can address domestic violence victims' mental health challenges amid COVID-19. We identified practical and timely solutions that can be utilized to address mental health challenges domestic violence victims face amid COVID-19, mainly focusing on (1) decreasing victims' exposure to the abuser and (2) increasing victims' access to mental health services.

CONCLUSION

Domestic violence is a public health crisis that affects all demographics and could result in significant morbidity and mortality. In addition to emphasizing mental health challenges faced by domestic violence victims, multidisciplinary interventions are identified that could provide timely and practical solutions to domestic violence victims amid the pandemic, which range from tailored shelter home strategies, education programs, escape plans, laws and regulations, as well as more technology-based mental health solutions. There is a significant need for more multipronged and multidisciplinary strategies to address domestic violence amid and beyond the pandemic, particularly interventions that could capitalize on the ubiquity and cost-effectiveness of technology-based solutions.

Development of the 12-Item Social Media Disinformation Scale and its Association With Social Media Addiction and Mental Health Related to COVID-19 in Tunisia: Survey-Based Pilot Case Study

BACKGROUND

In recent years, online disinformation has increased. Fake news has been spreading about the COVID-19 pandemic. Since January 2020, the culprits and antidotes to disinformation have been digital media and social media.

OBJECTIVE

Our study aimed to develop and test the psychometric properties of the 12-item Social Media Disinformation Scale (SMDS-12), which assesses the consumption, confidence, and sharing of information related to COVID-19 by social media users.

METHODS

A total of 874 subjects were recruited over two phases: the exploratory phase group had a mean age of 28.39 years (SD 9.32) and the confirmatory phase group had a mean age of 32.84 years (SD 12.72). Participants completed the SMDS-12, the Internet Addiction Test, the COVID-19 Fear Scale, and the 10-item Perceived Stress Scale. The SMDS-12 was initially tested by exploratory factor analysis and was subsequently tested by confirmatory factor analysis.

RESULTS

The test supported the three-factor structure. In addition, no items were removed from the measurement scale, with three factors explaining up to 73.72% of the total variance, and the items had a lambda factor loading ranging from 0.73 to 0.85. Subsequently, confirmatory factor analysis confirmed the robustness of the measure by referring to a wide range of goodness-of-fit indices that met the recommended standards. The construct validity of the scale was supported by its convergent and discriminant validity. The reliability of the instrument examined by means of three internal consistency indices, and the corrected item-total correlation, demonstrated that the three dimensions of the instrument were reliable: Cronbach α values were .89, .88, and .88 for the consumption, confidence, and sharing subscales, respectively. The corrected item-total correlation ranged from 0.70 to 0.78. The correlation of the instrument's dimensions with internet addiction and mental health factors showed positive associations.

CONCLUSIONS

The SMDS-12 can be reliably utilized to measure the credibility of social media disinformation and can be adapted to measure the credibility of disinformation in other contexts.

Does cultural distance energize employees? The moderating role of psychological safety

The increasingly globalized workforce and the growing need for boosting employee energy have engendered both practical and research interest in stimulating employee energy in intercultural interactions. Yet neither the culture research nor the energy literature has explored the link between cultural distance and employee relational energy-the heightened level of psychological resources in social relations. This paper presents empirical evidence of cultural distance stimulating relational energy. Further, building upon the threat-rigidity theory, I propose that cultural distance stimulates relational energy more when employees perceive high levels of psychological safety. Two studies were conducted to test these two hypotheses. One laboratory experiment on 202 international students at a Dutch university provided causal evidence of the positive relationship between cultural distance and relational energy. Next, a two-wave field study on 373 international employees was conducted to replicate this main effect of cultural distance and further investigate the moderating role of psychological safety. Results supported that employees with higher levels of psychological safety are more prone to experience enhanced relational energy as a result of cultural distance. These findings contribute to the scarce research on possible positive influence of cross-cultural communication at work, and also advance the growing research on the antecedents of employee relational energy. The implications for practitioners to energize employees are also discussed.

Innovative human resource management strategies during the COVID-19 pandemic: A systematic narrative review approach

BACKGROUND

The spread of COVID-19 creates disruption, uncertainty, complexity, and ambiguity in all organizations. People are the primary asset of any organization and help achieve their goals. Accordingly, to manage human resources sustainably, the organizational strategy review is an appropriate retort.

OBJECTIVE

The purpose of this comprehensive review study is to identify unknown challenges, strategies, and unusual decisions related to human resource management other than clinical organizations during the COVID-19 pandemic.

METHODS

The study applied a narrative review approach dissection based on organizations' human resource management strategies to combat the COVID-19 impacts. The review study conducted published literature research through the electronic databases at Web of Science, PubMed, Scopus, PsycINFO, and LISTA. The study extracted 1281 articles from the mentioned databases from November 2021 to the first quarter of 2021. This study reviewed selected papers, included 15 relevant articles, and removed duplicates according to inclusion and exclusion criteria. Finally, the study developed a conceptual framework of human resource management strategies based on the literature findings to fight against the COVID-19 pandemic.

RESULTS

The COVID-19 pandemic posed numerous adverse consequences, such as economic shock, global health crisis, change in social behaviors, and challenges at the organization level to continue business operations. Besides, the strategies included flexibility, strengthening internal efficiency, talent acquisition, and making innovative changes based on organizational assessment and needs for smooth business activities.

CONCLUSION

The appropriate human resource management strategies implementations would increase employees' mental well-being, satisfaction, productivity, motivation, and health safety at the workplace.

Addressing Biodisaster X Threats With Artificial Intelligence and 6G Technologies: Literature Review and Critical Insights

BACKGROUND

With advances in science and technology, biotechnology is becoming more accessible to people of all demographics. These advances inevitably hold the promise to improve personal and population well-being and welfare substantially. It is paradoxical that while greater access to biotechnology on a population level has many advantages, it may also increase the likelihood and frequency of biodisasters due to accidental or malicious use. Similar to "Disease X" (describing unknown naturally emerging pathogenic diseases with a pandemic potential), we term this unknown risk from biotechnologies "Biodisaster X." To date, no studies have examined the potential role of information technologies in preventing and mitigating Biodisaster X.

OBJECTIVE

This study aimed to explore (1) what Biodisaster X might entail and (2) solutions that use artificial intelligence (AI) and emerging 6G technologies to help monitor and manage Biodisaster X threats.

METHODS

A review of the literature on applying AI and 6G technologies for monitoring and managing biodisasters was conducted on PubMed, using articles published from database inception through to November 16, 2020.

RESULTS

Our findings show that Biodisaster X has the potential to upend lives and livelihoods and destroy economies, essentially posing a looming risk for civilizations worldwide. To shed light on Biodisaster X threats, we detailed effective AI and 6G-enabled strategies, ranging from natural language processing to deep learning-based image analysis to address issues ranging from early Biodisaster X detection (eg, identification of suspicious behaviors), remote design and development of pharmaceuticals (eg, treatment development), and public health interventions (eg, reactive shelter-at-home mandate enforcement), as well as disaster recovery (eg, sentiment analysis of social media posts to shed light on the public's feelings and readiness for recovery building).

CONCLUSIONS

Biodisaster X is a looming but avoidable catastrophe. Considering the potential human and economic consequences Biodisaster X could cause, actions that can effectively monitor and manage Biodisaster X threats must be taken promptly and proactively. Rather than solely depending on overstretched professional attention of health experts and government officials, it is perhaps more cost-effective and practical to deploy technology-based solutions to prevent and control Biodisaster X threats. This study discusses what Biodisaster X could entail and emphasizes the importance of monitoring and managing Biodisaster X threats by AI techniques and 6G technologies. Future studies could explore how the convergence of AI and 6G systems may further advance the preparedness for high-impact, less likely events beyond Biodisaster X.

Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection

INTRODUCTION

There have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19.

METHODS

Data were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses.

RESULTS

A total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective.

CONCLUSION

Psychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.

The impact of COVID-19 on clinical research: the PIPPRA and MEDRA experience

Background: Coronavirus disease 2019 (COVID-19) has had a significant impact on clinical research. This paper aims to provide an insight into how the COVID-19 pandemic, associated public health restrictions and international guidance on the conduct of clinical research impacted two clinical rheumatology research trials - the Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis (PIPPRA) and the MEDiterranean diet in Rheumatoid Arthritis (MEDRA) projects. Methods: The March 2019 public health restrictions imposed to mitigate the risk of COVID-19 occurred at a time when PIPPRA was in the process of delivering assessment and intervention on a face-to-face basis (n=48) and MEDRA had commenced recruitment. Participants in PIPPRA and MEDRA had a diagnosis of rheumatoid arthritis, with some being immunosuppressed and thus at a higher risk for COVID-19. The decision-making processes of both trials is outlined to demonstrate the required amendments to continue in the context of the COVID-19 pandemic. Results: Amendments to PIPPRA and MEDRA trial protocols were agreed and received ethical and funder approval. Both trials switched from a face-to-face delivery to a telehealth using online platforms. The PIPPRA study was paused for five months (April-August 2020), resulting in n=33 (60%) deviations from assessment protocol. MEDRA switched from face-to-face to online recruitment with 20% (n=35/44) deviation in recruitment. Of the n=18 participants who consented to participating in a face-to-face trial, just n=2 (11%) opted to engage with telehealth delivery of the intervention. MEDRA assessment and intervention deviations were 100% as no sessions were completed as planned in 2020. Conclusions: The COVID-19 pandemic has severely impacted the PIPPRA and MEDRA clinical trials. Moving face-to-face clinical research to telehealth delivery may not be the panacea it is purported to be. Our experiences may be of benefit to researchers, clinicians, and funders in seeking to continue clinical research during a global pandemic.

The Role of Social Media in the Advent of COVID-19 Pandemic: Crisis Management, Mental Health Challenges and Implications

BACKGROUND

This study focuses on how educating people through social media platforms can help reduce the mental health consequences of the COVID-19 to manage the global health crisis. The pandemic has posed a global mental health crisis, and correct information is indispensable to dispel uncertainty, fear, and mental stress to unify global communities in collective combat against COVID-19 disease worldwide. Mounting studies specified that manifestly endless coronavirus-related newsfeeds and death numbers considerably increased the risk of global mental health issues. Social media provided positive and negative data, and the COVID-19 has resulted in a worldwide infodemic. It has eroded public trust and impeded virus restraint, which outlived the coronavirus pandemic itself.

METHODS

The study incorporated the narrative review analysis based on the existing literature related to mental health problems using the non-pharmaceutical interventions (NPIs) approach to minimize the COVID-19 adverse consequences on global mental health. The study performed a search of the electronic databases available at PsycINFO, PubMed, and LISTA. This research incorporates the statistical data related to the COVID-19 provided by the WHO, John Hopkins University, and Pakistani Ministry of Health.

RESULTS

Pakistan reported the second-highest COVID-19 cases within South Asia, the fifth-highest number of cases in Asia after Iran, India, Russia, Saudi Arabia, and the 14th highest recorded cases, as of October 14, 2020. Pakistan effectively managed the COVID-19 pandemic in the second wave. It stands at the eighth-highest number of confirmed cases in Asia, the 3rd-highest in South Asia, and the 28th-highest number of established patients globally, as of February20, 2021.

CONCLUSION

The COVID-19 has resulted in over 108.16 million confirmed cases, deaths over 2.374 million, and a recovery of 80.16 million people worldwide, as of February 12, 2021. This study focused on exploring the COVID-19 pandemic's adverse effects on global public health and the indispensable role of social media to provide the correct information in the COVID-19 health crisis. The findings' generalizability offers helpful insight for crisis management and contributes to the scientific literature. The results might provide a stepping-stone for conduct future empirical studies by including other factors to conclude exciting developments.

The effect of education based on health belief model on promoting preventive behaviors of hypertensive disease in staff of the Iran University of Medical Sciences

BACKGROUND

Hypertension is one of the major causes of many diseases, such as heart attack, strokes, kidney failure, and many internal disorders. This presentresearch study aimed to investigate the impact of educational programs based on the health belief model to promote hypertension prevention behavior of Iran University of Medical Sciences staff.

METHODS

This study has incorporated pretest-posttest quasi-experimental based on 128 staff members and randomly assigned the recruited and involved participants to an intervention (n = 64) and a control group (n = 64). The data collection tool was based on a questionnaire related to health belief model constructs based on 42 questions. The study interpreted the results using ANCOVA and robust ANCOVA as suitable approaches.

RESULTS

ANCOVA showed improvement in the cues to participants' action following educational interventional (p = 0.011). the robust ANCOVA specified that the intervention was successful for participants with low to moderate initial levels of knowledge, perceived susceptibility, perceived severity, perceived barriers, and self-efficacy scores. The levels of these components did not change in participants with very high baseline scores. Compared to a control group, regardless of baseline score, the perceived benefits and practice (behavior) of participants at the intervention group were improved significantly (P <  0.05).

CONCLUSION

This current study specified that the education-based health belief model effectively promotes hypertension preventive behaviors among Iran University of Medical Sciences staff.

Prevalence, risk and protective factors associated with suicidal ideation during the COVID-19 pandemic in U.S. military veterans with pre-existing psychiatric conditions

The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the mental health of the general population. However, less is known about its impact on vulnerable populations, such as veterans with pre-existing psychiatric conditions. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative cohort of U.S. veterans. Pre-pandemic and 1-year peri-pandemic risk and protective factors associated with suicidal ideation (SI) were examined in veterans with pre-existing psychiatric conditions. 19.2% of veterans screened positive for SI peri-pandemic. Relative to veterans without SI, they had lower income, were more likely to have been infected with COVID-19, reported greater COVID-19-related financial and social restriction stress, and increases in psychiatric symptoms and loneliness during the pandemic. A multivariable analysis revealed that older age, greater pre-pandemic psychiatric symptom severity, past-year SI, lifetime suicide attempt, psychosocial difficulties, COVID-19 infection, and past-year increase in psychiatric symptom severity were linked to peri-pandemic SI, while pre-pandemic higher income and purpose in life were protective. Among veterans who were infected with COVID-19, those aged 45 or older and who reported lower purpose in life were more likely to endorse SI. Monitoring for suicide risk and worsening psychiatric symptoms in older veterans who have been infected with COVID-19 may be important. Interventions that enhance purpose in life may help protect against SI in this population.

Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study

Background

People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India.

Methods

Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analyzed using thematic analysis.

Results

One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90–5.53), having diabetes (2.42, 1.81–3.25) and hypertension (1.70,1.27–2.27), and loss of income (2.30,1.62–3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52–5.35), and job loss (1.90,1.25–2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services.

Conclusion

People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10708-w.

Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol

BACKGROUND

Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19.

METHODS

A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process.

CONCLUSIONS

COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196301.

Vaccines are not yet a silver bullet: The imperative of continued communication about the importance of COVID-19 safety measures

COVID-19 vaccines are by no means a silver bullet. With more COVID-19 vaccines expecting approval in the coming months, it is necessary to note that vaccine availability does not equate to vaccine accessibility, nor vaccine efficacy. Some research suggests that approximately 9 out of 10 individuals living in lower-income countries will not have access to COVID-19 vaccines until 2023 or later. For higher-income countries, such as the United States, the prevalence of vaccine hesitancy may further compound the situation. These insights combined, in turn, emphasize the fact that even though COVID-19 vaccines are becoming more available, safety measures (e.g., face masks, personal hygiene, and social distancing) are still of pivotal importance in protecting personal and public health against COVID-19. Furthermore, this paper argues for the continued imperative for health experts and government officials to communicate and emphasize the importance of COVID-19 safety measures with the public, to make sure people are protected against COVID-19 till the pandemic ceases to pose a threat to personal or public health.

Food Safety Knowledge, Attitudes, and Self-Reported Practices Among Medical Staff in China Before, During and After the COVID-19 Pandemic

PURPOSE

To compare food safety knowledge, attitudes, and self-reported practices among medical staff in China before, during, and after the COVID-19 pandemic.

PATIENTS AND METHODS

The questionnaire was anonymous. All respondents were Chinese medical personnel. A Chi-square contingency table was used to compare the knowledge and attitudes of Chinese medical staff before, during and after COVID-19. R statistical software (v4.0.0) was used for analysis.

RESULTS

A total of 1431 valid responses (57.3% from female respondents) were included in our analysis. Medical professionals were geographically distributed as follows: eastern China, 55.5%; central China, 19.7%; western China, 24.1%; Hong Kong, Macau, or Taiwan, 0.05%. Medical professionals reported that they paid greater attention to food safety after the COVID-19 pandemic compared with before the epidemic. Self-reported knowledge of and attitudes toward food safety among medical staff were significantly different before, during, and after the COVID-19 pandemic (both P<0.001).

CONCLUSION

After the COVID-19 pandemic, medical professionals paid increasing attention to food safety, which is a clinically important change. Because medical professionals can influence public understanding of food safety, their increased attention to this subject may enable them to promote food safety knowledge more actively in their work. This may in turn promote a better understanding of food safety and protect the health of the general public.

A Comparative NLP-Based Study on the Current Trends and Future Directions in COVID-19 Research

COVID-19 is a global health crisis that has altered human life and still promises to create ripples of death and destruction in its wake. The sea of scientific literature published over a short time-span to understand and mitigate this global phenomenon necessitates concerted efforts to organize our findings and focus on the unexplored facets of the disease. In this work, we applied natural language processing (NLP) based approaches on scientific literature published on COVID-19 to infer significant keywords that have contributed to our social, economic, demographic, psychological, epidemiological, clinical, and medical understanding of this pandemic. We identify key terms appearing in COVID literature that vary in representation when compared to other virus-borne diseases such as MERS, Ebola, and Influenza. We also identify countries, topics, and research articles that demonstrate that the scientific community is still reacting to the short-term threats such as transmissibility, health risks, treatment plans, and public policies, underpinning the need for collective international efforts towards long-term immunization and drug-related challenges. Furthermore, our study highlights several long-term research directions that are urgently needed for COVID-19 such as: global collaboration to create international open-access data repositories, policymaking to curb future outbreaks, psychological repercussions of COVID-19, vaccine development for SARS-CoV-2 variants and their long-term efficacy studies, and mental health issues in both children and elderly.

Profiles in COVID-19: peritraumatic stress symptoms and their relation with death anxiety, anxiety sensitivity, and emotion dysregulation

BACKGROUND

The COVID-19 pandemic might be experienced as an ongoing traumatic event and could result in peritraumatic stress symptoms. Evidence implies that individuals' levels of death anxiety, anxiety sensitivity, and difficulties in emotion regulation may contribute to their peritraumatic stress symptomatology in the aftermath of trauma exposure.

OBJECTIVE

The current study aimed to explore these hypotheses in the context of the COVID-19 pandemic.

METHOD

An online survey was conducted among a convenience sample of 846 Israeli adults from April 2 to 19 April 2020. COVID-19-related stressors, death anxiety, anxiety sensitivity, difficulties in emotion regulation, and peritraumatic stress symptoms were assessed via self-report questionnaires.

RESULTS

Analyses indicated significant relations between death anxiety, anxiety sensitivity, and emotion regulation difficulties, on the one hand, and peritraumatic stress symptoms, on the other. Three distinct profiles were identified. Furthermore, profile type - namely having low, medium, and high levels of death anxiety, anxiety sensitivity, and emotion dysregulation - had a significant effect in explaining peritraumatic stress symptoms.

CONCLUSIONS

Results suggest that during the pandemic, levels of death anxiety, anxiety sensitivity, and emotion dysregulation may explain heterogeneity in individuals' trauma-related symptomatology.

Global Financial Crisis, Smart Lockdown Strategies, and the COVID-19 Spillover Impacts: A Global Perspective Implications From Southeast Asia

This present study primarily emphasizes to seek the COVID-19 adverse impacts posing health challenges and global economic crisis. The pandemic (COVID-19) continues to hit the global economies adversely. Pakistan is the 5th-most-populous nation, and recorded positive cases with the third-highest positivity ratio in South Asia, and 26th-highest deaths toll of 21,450 and 29th number of most COVID-19 positive cases with 933,750 worldwide, as of June 6, 2021. The first wave appeared at the end of May 2020, and mid of June reported its peak, which ended by mid-July 2020. Early November 2020 witnessed the second wave with low intensity reached the climax by mid-December. The COVID-19's third wave severely affected the country during mid-March 2021. It exhibited the highest positivity rate, around 20%. New positive patients and deaths toll commenced to skyrocket and reported peak by April 15, 2021. Then situation gradually improved with effective measures and restrictions. The pandemic coronavirus (COVID-19) has affected 220 territories, regions, and countries and resulted in more than 174.116 million infections, deaths, 3.75 million, and 157.157 million positive cases fully recovered from this infectious disease, as of June 7, 2021. The pandemic has caused a severe crisis of healthcare facilities and economic challenges worldwide. Pakistani economy reported GPD's negative growth (-0.05) for the first time over the last 60 years in 2020, which caused a massive financial crisis. The Government's relief package intervened to reduce public mental stress and improve the quality of their lives. IMF reported that Pakistan's GPD bounced back at 4% growth by June 2021. This article determines that economic instability and health burden happened in Pakistan for a longer time than financial disequilibrium that occurred globally. Pakistan encountered this crisis due to its feeble healthcare systems and fragile economy. This study explores adverse health issues and spillover consequences on the economic crisis in Pakistan with global implications. It recommends smart lockdown restrictions in most affected areas to reopen the economic cycle with strict preventive measures to minimize the COVD-19 adverse consequences.

Mental Health Status of the Elderly Chinese Population During COVID-19: An Online Cross-Sectional Study

Background: COVID-19 not only threatened the public's physical health but also brought unbearable psychological pressure, especially for those vulnerable groups like the elderly. However, studies on the psychological status of older adults during this public health emergency remained scant. This study aims to investigate the mental health status among the elderly Chinese population during COVID-19 pandemic and determine the influencing factors of psychological symptoms. Methods: From February 19 to March 19, 2020, an online survey was administered to Chinese older adults using a convenience sampling method. Information on demographic data, health status and other epidemic related factors were collected. Specifically, the study defined the psychological status as five primary disorder-depression, neurasthenia, fear, anxiety, and hypochondria-which were assessed by the Psychological Questionnaire for Emergent Event of Public Health (PQEEPH). Standard descriptive statistics and multiple logistic regression analyses were conducted to analyze the data. Results: Of 1,501 participants recruited from 31 provinces in China, 1,278 were valid for further analysis. Participants' scores on each sub-scale were described in median and interquartile [M(Q)]: depression [0.00 (0.33)], neurasthenia [0.00 (0.40)], fear [1.00 (0.83)], anxiety [0.00 (0.17)], hypochondria [0.00 (0.50)]. Chronic diseases (depression p = 0.001; neurasthenia p < 0.001; fear p = 0.023; anxiety p < 0.001; hypochondria p = 0.001) and the BMI index (depression p = 0.015; neurasthenia p = 0.046; fear p = 0.016; anxiety p = 0.015; hypochondria p = 0.013) had significant impacts on all of the five sub-scales. Specifically, the rural dwellers had a higher level of neurasthenia, fear, and hypochondria. Besides, education level (p = 0.035) and outbreak risk level (p = 0.004) had significant impacts on the depression. Higher household monthly income per capita (p = 0.031), and the community-level entry/exit control (p = 0.011) are factors against anxiety. Conclusions: Most elderly residents reported mild negative emotions during COVID-19 and more attention should be paid to the recognition and alleviation of fear. Our findings also identified factors associated with the mental health status of the elderly, which is of practical significance in the design and implementation of psychological interventions for this vulnerable population during COVID-19 and future emerging diseases.