The SARS-CoV-2 Omicron (B.1.1.529) variant and the re-emergence of COVID-19 in Europe: An alarm for Bangladesh

A Strategic Framework of SARS-CoV-2 Genomic Surveillance in Bangladesh

BACKGROUND

The global pandemic caused by SARS-CoV-2 has underlined the significance of strict genomic surveillance to track virus evolution and the possible emergence of new variants, particularly in densely populated countries like Bangladesh. This study outlines a strategic framework of genomic surveillance to track the evolution of the virus in Bangladesh between June 2021 and December 2022 through the National SARS-CoV-2 Variant Surveillance (NSVS) program involving collaboration across 4 major institutes and 13 hospitals nationwide.

METHODS

We aimed to capture the variants of SARS-CoV-2 throughout the country utilizing standardized procedures, modern sequencing technology, and stringent quality control, promoting data accuracy and the timely detection of new variants of concern. We sequenced over 2200 genomes, documenting the prevalence of the Delta variant initially, followed by the emergence of Omicron variants BA.1, BA.2, BA.5, and XBB, each affecting transmission rates and vaccine efficacy differently.

RESULTS

The clinical manifestations of the variants differed, with some symptoms occurring more frequently in Delta cases and vice versa. Vaccinated individuals were more affected by Omicron cases compared to Delta cases. These variants were responsible for two major COVID-19 waves in the country, each with significant clinical effects. Phylogenetic analyses placed the local SARS-CoV-2 variants within a global context, indicating the Delta variant likely entered from India and Omicron from Europe.

CONCLUSION

This research highlights the significance of collaborative surveillance strategies for guiding public health choices and the critical role of genomic analysis in monitoring virus evolution, shaping targeted pandemic responses. Bangladesh's contributions significantly enhance global insight into COVID-19's genomic evolution.

A laboratory framework for ongoing optimization of amplification-based genomic surveillance programs

IMPORTANCE

This study provides a laboratory framework to ensure ongoing relevance and performance of amplification-based whole genome sequencing to strengthen public health surveillance during extended outbreaks or pandemics. The framework integrates regular reviews of the performance of a genomic surveillance system and highlights the importance of ongoing monitoring and the identification and implementation of improvements to whole genome sequencing methods to enhance public health responses to pathogen outbreaks.

Knowledge, attitude and practices towards SARS-CoV-2 genetic mutations and emerging variants among the population in Bangladesh: a cross-sectional study

OBJECTIVES

The coronavirus is continuously mutating and creating new SARS-CoV-2 variants. Public awareness about SARS-CoV-2 mutation is essential for effective preventive measures. The present study aimed to assess the knowledge, attitude and practices (KAP) towards SARS-CoV-2 variants among the general population in Bangladesh.

DESIGN

We conducted this online survey between 9 April 2021 and 10 May 2021 using structured questionnaires to collect the information.

SETTING

We distributed the survey link among the participants from all 64 districts of Bangladesh using social media platforms.

PARTICIPANTS

A total of 1,090 respondents completed this survey. After careful evaluation, we excluded 18 responses due to partial or incomplete information, and 1,072 responses entered into the final analysis.

PRIMARY OUTCOME

The KAP of participants towards SARS-CoV-2 variants depends on their demographic backgrounds. Associations between demographic characteristics and the likelihood of having adequate KAP were estimated using adjusted logistic regressions.

RESULTS

Among the participants, 42% had a poor knowledge level, 4% had a low attitude level and 14% had a poor practice score. The average knowledge, attitude and practice score were 2.65, 4.194 and 4.464 on a scale of 5, respectively. Only 51.8% of the participants knew about mutant strains, and only 47.6% knew about the effectiveness of vaccines against new variants. The key factors associated with poor knowledge levels were educational levels, area of residence, geographic location, and concern regarding COVID-19. Sociodemographic factors for poor attitude levels were geographic location, vaccination and concern regarding COVID-19. The pivotal factors in determining poor practice scores were the residence area of people and concern regarding COVID-19.

CONCLUSIONS

The knowledge level and positive attitude are associated with better preventive measures against SARS-CoV-2 variants. Based on these findings, we recommended several awareness programmes on SARS-CoV-2 mutations and variants for the rural population in Bangladesh to increase overall awareness levels.

A dataset on the prevalence and associated risk factors for mental health problems among female university students in Bangladesh

The data presented here relate to the article with the following title, "Prevalence and associated risk factors for mental health problems among female university students during COVID-19 pandemic: A cross-sectional study findings from Dhaka, Bangladesh" [1]. This article provides a dataset on the prevalence of psychological distress among 451 female university students during the ongoing COVID-19 pandemic. We collected their responses from October 15, 2021, to January 15, 2022, using Google survey tools (Google Forms). A structured questionnaire was prepared, consisting of sociodemographic variables and their association with mental health problems. Three psychometric scales, UCLA-3, GAD-7, and PHQ-9, were applied to measure disorders of loneliness, anxiety, and depression, respectively. We performed the statistical analysis using IBM SPSS (v. 25.0). Each respondent gave their electronic consent for the study, and anonymized data were published. Hence, policymakers of government and non-government groups may utilize the data to create a variety of initiatives to support the mental health of female university students from Dhaka, Bangladesh.

Risk evaluation and mitigation strategies for newly detected SARS-CoV-2 Omicron BF.7 subvariant: A brief report

Mutations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are always going on. The pathogenic characteristics of a virus are influenced by mutations in the viral genome. Therefore, the recently identified Omicron BF.7 subvariant might harm humans. Here we aimed to evaluate the potential risks of this newly detected variant and identify possible mitigation strategies. The frequent mutation associated with SARS-CoV-2 makes it more concerning compared to other viruses. The Omicron variant of SARS-CoV-2 has unique changes in the structural amino acid. Thus, Omicron subvariants are different from other coronavirus variants in terms of viral spread, disease severity, vaccine neutralization capacity, and immunity evade. Moreover, Omicron subvariant BF.7 is an offspring of BA.4 and BA.5. Similar S glycoprotein sequences are present among BF.7, BA.4, and BA.5. There is a change in the R346T gene in the receptor binding site of Omicron BF.7 than other Omicron subvariants. This BF.7 subvariant has created a limitation in current monoclonal antibody therapy. Omicron has mutated since it emerged, and the subvariants are improving in terms of transmission as well as antibody evasion. Therefore, the healthcare authorities should pay attention to the BF.7 subvariant of Omicron. The recent upsurge may create havoc all of a sudden. Scientists and researchers across the world should monitor the nature and mutations of SARS-CoV-2 variants. Also, they should find ways to fight the current circulatory variants and any future mutations.

Problematic internet use and depressive symptoms among the school-going adolescents in Bangladesh during the COVID-19 pandemic: A cross-sectional study findings

Background and Aims

Problematic internet use (PIU) by children and adolescents is a concern for many parents. Several factors, including students' education level, the method of instruction, the dependence on the internet, and their intended use of the internet, could all be contributing factors to PIU and depression. Disturbed mental health may be attributed to the cancellation of physical education classes because of the COVID-19 outbreak. This study aimed to assess the association of COVID-19 pandemic with PIU and depressive symptoms in adolescent students.

Methods

We performed this cross-sectional study among 491 school-going adolescents of 10 to 16 years. Self-administered questionnaires were applied to collect sociodemographic information and the internet usage pattern of the participants. We measured the prevalence of PIU and depressive symptoms using the PIU questionnaire (PIUQ-SF-6) and patient health questionnaire-9 (PHQ-9).

Results

The estimations of the risk group for PIU and depressive symptoms among school-going adolescents were 80.04% and 77.80%, respectively. The latent profiling of PIU scores for obsession, neglect, and control sub-groups were 5.82, 6.12, and 6.35, respectively. Moreover, we observed mild, moderate, and severe depressive symptoms in 48.68%, 27.70%, and 1.43% of cases. Age, education level, medium of education, financial impression, internet connection, the device used, the purpose for internet use, and the living status of respondents were significantly associated with the PIU. Reported mental health issues was associated with education level, medium of education, financial impression, and internet connection.

Conclusion

The present study revealed an association of PIU and depressive symptoms with sociodemographic factors and internet usage patterns. Therefore, these results might have practical implications in clinical psychology, psychiatry, and psychotherapy. The healthcare professional can develop a context-specific comprehensive clinical intervention plan for children and adolescents.

Burden of COVID-19 on health and wellbeing, education, and economy of Bangladesh

The long-term impact of this pandemic will continue in almost all sectors of a country such as health, economic situations, education, mental health, and violence. Therefore, the authors intended to discuss the prolonged effect of COVID-19 on the health along with wellbeing, education, and economy of Bangladesh through a mixed approach. To assess the possible scenario in health sector of Bangladesh, we conducted a short survey through online with a structured questionnaire. The impact of the pandemic is highlighted by graphical presentations and discussed the issues in light of the existing literature. It is realized that health care services and resources are always essential for predominant health conditions and fatal diseases patients. Mental health has also been impacted a lot during this pandemic. Moreover, students of only those schools located in urban areas are attended some online classes but due to the internet interruption and scarcity of devices students from rural areas cannot attend the classes and it will widen the gap between pupils from urban areas and those who live in remote rural areas. Additionally, many students terminate school. The country's youth unemployment is projected to intensify as a result of the economic effects, which would promote antisocial behavior and cause social discontent among young people. Also, the flow of remittances greatly declined in the last couple of months and a many people were jobless abroad, and the majority of them were sent back home. The demographic dividend's intended results are expected to be negatively impacted by COVID-19's overall effect as well as sustainable development goals (SDGs) in Bangladesh. Therefore, many social services systems need strategic backup resources at community, national, and global levels if any basic system may collapse due to COVID-19 and socio-economic as well as geopolitical negligence in handling post-pandemic challenges.

Prevalence and associated factors for elevated fear and depressive symptoms among the private service holders in Bangladesh during the Covid-19 pandemic: A cross-sectional study

Background and Aims

The ongoing public health emergency has created incredible fear of getting the infection and a terrible psychological burden among all levels. The pandemic has severely affected private job holders' economic status and lifestyle factors in Bangladesh. Here we aimed to assess fear and depressive symptoms among private job holders in Bangladesh during the Covid-19 pandemic and associated risk factors.

Methods

We conducted this online cross-sectional survey between January 15, 2021, and March 15, 2021, among 510 private job holders aged above 18 years. We followed the convenience sampling method for data collection. We assessed sociodemographic factors and two psychometric parameters. We applied the Fear of Covid-19 Scale and Patient Health Questionnaire-9 to assess increased fear and depressive symptoms, respectively. Chi-square test, independent sample t-test, and binary logistic regression analysis were performed for data analysis.

Results

The prevalence of increased fear and depressive symptoms were 86.27% and 42.16%, respectively. Factors associated with increased fear among private job holders during COVID-19 were economic class, obesity, on-time salary, company's downsizing policy, salary reduction, home office, and transportation facilities. However, depressive symptoms were associated with marital status, education level, residence area, the organizational practice of health safety rules, company performance, on-time salary, health insurance, downsizing, salary reduction policy, organization type, transportation, and mental health support at work. The present study also noticed some interrelations among the above factors with mental health issues.

Conclusion

Based on the present findings, we recommend actionable items to improve the mental health of private job holders in Bangladesh due to the ongoing pandemic. Authorities can develop mental health support programs and efficient Covid-19 response systems. The policymakers and regulatory bodies might take some initiatives to promote mental health in the private sector in Bangladesh.

Comparative evaluation of authorized drugs for treating Covid-19 patients

Background and Aims

Vaccines are the first line of defense against coronavirus disease 2019 (Covid-19). However, the antiviral drugs provide a new tool to fight the Covid-19 pandemic. Here we aimed for a comparative evaluation of authorized drugs for treating Covid-19 patients.

Methods

We searched in PubMed and Google Scholar using keywords and terms such as Covid, SARS-CoV-2, Coronavirus disease 2019, therapeutic management, hospitalized Covid-19 patients, Covid-19 treatment. We also gathered information from reputed newspapers, web portals, and websites. We thoroughly observed, screened, and included the studies relevant to our inclusion criteria. We included only the United States Food and Drug Administration (FDA) authorized drugs for this review.

Results

We found that molnupiravir and paxlovid are available for oral use, and remdesivir is for only hospitalized patients. Paxlovid is a combination of nirmatrelvir and ritonavir, nirmatrelvir is a protease inhibitor (ritonavir increases the concentration of nirmatrelvir), and the other two (remdesivir and molnupiravir) are nucleoside analog prodrugs. Remdesivir and molnupiravir doses do not need to adjust in renal and hepatic impairment. However, the paxlovid dose adjustment is required for mild to moderate renal or hepatic impaired patients. Also, the drug is not allowed for Covid-19 patients with severe renal or hepatic impairment. Preliminary studies showed oral antiviral drugs significantly reduce hospitalization or death among mild to severe patients. Moreover, the US FDA has approved four monoclonal antibodies for Covid-19 treatment. Studies suggest that these drugs would reduce the risk of hospitalization or severity of symptoms. World Health Organization strongly recommended the use of corticosteroids along with other antiviral drugs for severe or critically hospitalized patients.

Conclusion

All authorized drugs are effective in inhibiting viral replication for most SARS-CoV-2 variants. Therefore, along with vaccines, these drugs might potentially aid in fighting the Covid-19 pandemic.

Characteristics of the SARS-CoV-2 Omicron (B.1.1.529) Variant and Emerging Impact on Global Public Health

The discovery of the SARS-CoV-2 Omicron (B.1.1.529) variant has sparked alarm globally because of its rapid rate of infection and trespassing acquired immunity due to vaccination or natural infection. This heavily mutated variant is rapidly spreading around the world. Infected individuals with the Omicron variant may suffer from flu-like symptoms, and infected with the Delta variant frequently report low oxygen levels, high pulse rates, and a loss of smell and taste. Also, the Omicron variant causes asymptomatic or mild disease so far, and not any severe illness as like Delta, and this new variant has a 15% to 80% reduced risk of hospitalization than the Delta variant. Scientists are worried about the possibility of escaping the immunity by the Omicron variants and subvariants among fully vaccinated and recovered COVID-19 patients. Two doses of available vaccines are found to be partially ineffective in protecting this new variant, therefore, the third dose as a booster is recommended to enhance antibody level. Moreover, some antiviral drugs significantly reduce hospitalization or death among mild to severe COVID-19 patients. All authorized antiviral drugs are effective against viral replication for most SARS-CoV-2 variants, and particularly some monoclonal antibodies may not now be effective in treating COVID-19 patients. There is an urgent need to update existing vaccines, develop more effective and newer vaccines as well as additional monoclonal antibodies to counter Omicron. Therefore, along with close monitoring of Omicron characteristics, the present study suggests that health safety guidelines, mass immunization, early diagnosis, and search for effective antiviral drugs should be the approaches to fight against newer SARS-CoV-2 variants.

The Upsurge of Diarrhea Amid COVID-19 Pandemic Makes Matter Worse in Bangladesh: A Call to Action

We have seen an alarming increase in diarrhea prevalence amid Coronavirus Disease-2019 (COVID-19) in Bangladesh. Healthcare professionals might face difficulty in diagnosis as these two infectious diseases have some common symptoms. Though there are confirmatory diagnostic tests for individual cases, there are chances of misdiagnosis as co-infections occur. Here we presented distinct clinical features of diarrhea and COVID-19 for differential diagnosis. We demonstrated the common overlapping symptoms of these two infectious diseases to facilitate fast diagnosis of patients. Also, we have discussed possible reasons for this upsurge of diarrheal infections in Bangladesh. Finally, we have made some recommendations based on our findings for managing this upsurge of diarrheal disease during the COVID-19 pandemic in Bangladesh. The healthcare authorities should take immediate measures before the tremendous twin effects of these two infectious diseases.