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Zlotnick C, Cohen Castel O. Vaccine hesitancy throughout the COVID-19 vaccination trajectory among immigrant and non-immigrant older adults: a cohort study. Public Health 2024; 234:105-111. [PMID: 38972228 DOI: 10.1016/j.puhe.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/16/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES The aims of this study were to examine vaccine hesitancy for COVID-19 vaccinations, comparing immigrant and non-immigrant older adults (aged ≥60 years), after accounting for group-level and individual-level characteristics, and the interaction between immigrant and socio-economic status. STUDY DESIGN This study used a retrospective cohort design. METHODS Analyses were conducted using R version 4.3.2. Logistic regression models had the dependent variables of obtained any COVID-19 vaccinations vs not and obtained all four required COVID-19 vaccinations vs not. The linear regression model's dependent variable was the interval in days between the COVID-19 vaccination availability and the date of obtaining the first COVID-19 vaccination. RESULTS In the cohort of older adults (n = 35,109), immigrants were less likely than non-immigrants to obtain a single COVID-19 vaccination (P < 0.001) or the full series of required COVID-19 vaccinations (P < 0.001); however, immigrants vs non-immigrants delayed only in obtaining the first vaccination (P < 0.001) but not the remaining required COVID-19 vaccinations. In the linear regression model, a longer interval before obtaining the first COVID-19 vaccination was associated with immigrant status (P < 0.001), lower socio-economic status (SES; P < 0.001), and the interaction between immigrant status and low SES (P < 0.001), while a shorter interval was associated with preventive behaviours of obtaining seasonal influenza (P < 0.001) or pneumococcal (P < 0.001) vaccinations previously. CONCLUSIONS Immigrant status in general, and especially when combined with low SES, is a major risk factor for vaccination hesitancy. Reorienting immigrants to embrace preventive healthcare behaviours is key. Culturally appropriate communication campaigns may improve the dissemination of effective vaccination-related information to immigrant communities.
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Affiliation(s)
| | - O Cohen Castel
- Maccabi Healthcare Services, Division of Family Medicine, The Rappaport Faculty of Medicine, The Technion, Haifa, Israel
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2
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Ghanamah R, Eghbaria-Ghanamah H, Abu-Saleh N, Kitany S. Parents' Perceptions of Changes in Sleep Duration, Physical Activity, and Sedentary Behavior in Arab Israeli Children during the COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6041. [PMID: 37297644 PMCID: PMC10252515 DOI: 10.3390/ijerph20116041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic led many countries to apply lockdown measures that could prevent children from achieving the physical activity, sedentary behavior, and sleep levels suggested for their psychophysical health. The current study tested changes in physical activity, sedentary behavior, and sleep length of children and the incidence of achieving the 24 h movement standards through the limitations of COVID-19. A total of 490 Arab Israeli parents were surveyed. An electronic cross-sectional survey was performed, including questions addressing engagement in physical activities, use of screens, and sleep duration. Throughout the COVID-19 outbreak, time spent participating in physical activity was reduced, sedentary behavior and sleep duration were increased, and the percentage of the sample who met the physical activity and sedentary behavior suggestions lessened. The percentage of participants who attained the overall 24 h movement recommendations was very low during the pandemic; school children met the guideline recommendations for physical activity and sleep duration more than preschool children, and girls spent more time in physical activity. These findings highlight the need for strategies to enhance physical activity and decrease sedentary behavior in children to prevent long-term effects of limitations imposed by COVID-19. Efforts to perceive and encourage healthy routines in Arab Israeli children in the case of pandemic limitations are expected to serve as a precedence.
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Affiliation(s)
- Rafat Ghanamah
- Early Childhood Education Department, Oranim Academic College of Education, Kiryat Tevo’n 3600600, Israel
- Israel Ministry of Education, Jerusalem 91911, Israel
| | | | | | - Sujood Kitany
- Israel Ministry of Education, Jerusalem 91911, Israel
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Nouman H. Community organizing during the COVID-19 pandemic: How should we act when it comes to minority communities? AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 71:423-436. [PMID: 36745066 DOI: 10.1002/ajcp.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/22/2022] [Accepted: 01/03/2023] [Indexed: 06/06/2023]
Abstract
Minority communities have borne a disproportionate burden of adverse health outcomes during the COVID-19 pandemic. Notwithstanding, there is a lack of empirical evidence regarding efforts to reduce health inequalities through community organizing. It is also unclear under what conditions professionals act as external assistance providers for community organizing as part of their role. Through multimethod research conducted among social workers who provide services to ultra-Orthodox minority communities in Israel during the pandemic, this study identified that the combination of critical awareness of social justice, weakened social cohesion, and work environment expectations led professionals to assist communities in their community organizing efforts. These strategies include an intercommunity component-building trust in the community and promoting collective efficacy; an interactional component-creating multidimensional platforms that support action; and a behavioral component-increasing the involvement of communities in decision-making spaces in public arenas. The crucial characteristic of providing assistance and support in community organizing lies in the adoption of cultural perspectives. It requires knowledge about and familiarity with the different types of communities within which the professionals operate. This vital understanding can promote critical awareness among a wide range of professionals to promote health equity at the present time when the pandemic is still ongoing.
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Affiliation(s)
- Hani Nouman
- Faculty of Social Welfare and Health Sciences, School of Social Work, University of Haifa, Haifa, Israel
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Sarid M, Kalman-Halevi M, Tutian R, Gilat-Yihyie S, Sarid A. Uncovering Resilience Disparities among Religious Groups in Israel's Mass COVID-19 Vaccination Drive: Lessons Learned to the Post-COVID Era. Behav Sci (Basel) 2023; 13:bs13050398. [PMID: 37232635 DOI: 10.3390/bs13050398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of the current study was to examine the emotional resilience, satisfaction with life, social support, and anxiety during the vaccination process of the Israeli population after the end of the third lockdown, according to religiosity degree. We hypothesized that a higher degree of religiosity (ultra-Orthodox and religious participants) would be associated with higher levels of resilience and with lower levels of anxiety than in secular individuals. In addition, it was hypothesized that satisfaction with life, social support, anxiety, and religiosity will predict resilience and anxiety. Nine hundred and ninety-three native Jewish Hebrew-speaking respondents representing ultra-Orthodox, religious, observant, and secular Jews participated in this study. Ultra-Orthodox participants showed higher resilience and satisfaction with life than other groups, and lower levels of anxiety. Satisfaction with life and social support predicted higher resilience. It is suggested that religious faith as well as satisfaction with life may provide a source of strength and resilience in stressful life events.
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Affiliation(s)
- Miri Sarid
- Department of Education, Western Galilee College, Acre 2412101, Israel
| | | | - Rony Tutian
- Department of Education, Western Galilee College, Acre 2412101, Israel
| | | | - Adi Sarid
- Sarid Institute, Haifa 2626047, Israel
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Kaim A, Saban M. Dynamic Trends in Sociodemographic Disparities and COVID-19 Morbidity and Mortality—A Nationwide Study during Two Years of a Pandemic. Healthcare (Basel) 2023; 11:healthcare11070933. [PMID: 37046860 PMCID: PMC10094509 DOI: 10.3390/healthcare11070933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Social epidemiological research has documented that health outcomes, such as the risk of becoming diseased or dying, are closely tied to socioeconomic status. The aim of the current study was to investigate the impact of socioeconomic status on morbidity, hospitalization, and mortality outcomes throughout five waves of the pandemic amongst the Israeli population. A retrospective archive study was conducted in Israel from March 2020 to February 2022 in which data were obtained from the Israeli Ministry of Health’s (MOH) open COVID-19 database. Our findings, though requiring careful and cautious interpretation, indicate that the socioeconomic gradient patterns established in previous COVID-19 literature are not applicable to Israel throughout the five waves of the pandemic. The conclusions of this study indicate a much more dynamic and complex picture, where there is no single group that dominates the realm of improved outcomes or bears the burden of disease with respect to morbidity, hospitalization, and mortality. We show that health trends cannot necessarily be generalized to all countries and are very much dynamic and contingent on the socio-geographical context and must be thoroughly examined throughout distinct communities with consideration of the specific characteristics of the disease. Furthermore, the implications of this study include the importance of identifying the dynamic interplay and interactions of sociodemographic characteristics and health behavior in order to enhance efforts toward achieving improved health outcomes by policymakers and researchers.
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Child and Adolescent Mental Health during the COVID-19 Pandemic: Challenges of Psychiatric Outpatient Clinics. Healthcare (Basel) 2023; 11:healthcare11050765. [PMID: 36900770 PMCID: PMC10000553 DOI: 10.3390/healthcare11050765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients. METHODS a cross-sectional study focusing on visits as recorded in electronic medical records of eight heterogeneous C&A psychiatric outpatient clinics. The assessment was based on visits held from March to December of 2019 (before the pandemic) in comparison to visits held in 2020 (during the pandemic). RESULTS The number of visits was similar for both periods. However, in 2020, 17% of the visits used telepsychiatry (N = 9885). Excluding telepsychiatry reveals a monthly decrease in traditional in-person activities between 2020 and 2019 (691.6 ± 370.8 in 2020 vs. 809.1 ± 422.8 in 2019, mean difference = -117.5, t (69) = -4.07, p = 0.0002, Cohen's d = -0.30). Acceptation of new patients declined during 2020, compared to 2019 (50.0 ± 38.2 in 2020 vs. 62.8 ± 42.9 in 2019; Z = -3.12, p = 0.002, r = 0.44). Telepsychiatry was not used for new patients. CONCLUSIONS The activity of C&A psychiatric outpatient clinics did not rise but was guarded due to the use of telepsychiatry. The decline in visits of new patients was explained by the lack of use of telepsychiatry for these patients. This calls for expanding the use of telepsychiatry, especially for new patients.
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Reges O, Test T, Hoshen M, Cicurel A, Saliba W, Greenland P, Dicker D, Lavie G. Time-varying association of acute and post-acute COVID-19 with new-onset diabetes mellitus among hospitalized and non-hospitalized patients. BMJ Open Diabetes Res Care 2023; 11:e003052. [PMID: 36669793 PMCID: PMC9871869 DOI: 10.1136/bmjdrc-2022-003052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/12/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Previous studies have shown disruption of glycometabolic control and new diabetes mellitus (DM) diagnosis among patients with COVID-19. It is still unclear how the association of COVID-19 and new-onset DM may be modified by disease severity or vary over time, during acute and post-acute phases. RESEARCH DESIGN AND METHODS In this retrospective matched cohort study, 157 936 patients with COVID-19 (aged ≥25 years, diagnosis date between March 01, 2020 and August 31, 2021) were compared with individuals without COVID-19, separately for non-hospitalized, hospitalized, and severe hospitalized patients. Stratified Cox proportional hazards models, with changing baseline time (starting at the date of COVID-19 diagnosis, and at 1, 2, 3, and 4 months afterwards), were used to evaluate the occurrence of new DM in relation to COVID-19 infection in different time frames-from each landmark date until end of study. RESULTS During mean follow-up time of 10.9 months, there were 1145 (0.72%) new diagnoses of DM compared with 1013 (0.64%) in the individuals without COVID-19 (p=0.004). Non-hospitalized patients with COVID-19 were not at higher risk of new DM neither during the acute phase nor afterward. Hospitalized patients with COVID-19 had a higher risk of developing DM, with the highest risk among severe hospitalized patients. This risk among hospitalized patients was highest in the acute phase (HR 2.47 (95% CI 1.86 to 3.29)), attenuated over time, but remained significant at 4-month landmark analysis (HR 1.60 (95% CI 1.12 to 2.29)). CONCLUSIONS Acute and post-acute COVID-19 were associated with new DM only among hospitalized patients, with the highest risk among those hospitalized with severe disease. Those patients should be followed and monitored post-discharge for new DM. Patients who were not hospitalized did not have higher risk of new-onset DM.
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Affiliation(s)
- Orna Reges
- Department of Health System Management, Ariel University, Ariel, Israel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Tsafnat Test
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Beer-Sheva, Israel
| | - Moshe Hoshen
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Bioinformatics Department, Jerusalem College of Technology, Tal Campus, Jerusalem, Israel
| | - Assi Cicurel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Beer-Sheva, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dror Dicker
- Internal Medicine D Department, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Erez G, Yakubovich S, Sadeh H, Shoval G, Schoen G, Meiri G, Hertz-Palmor N, Butler T, Barzilai Y, Mosheva M, Gothelf D, Bloch Y. Pediatric psychiatric emergency rooms during COVID-19: a multi-center study. BMC Psychiatry 2022; 22:828. [PMID: 36575441 PMCID: PMC9793352 DOI: 10.1186/s12888-022-04371-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/05/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The COVID-19 (SARS-CoV-2) pandemic has been a major stressor for the mental health and well-being of children and adolescents. Surveys and reports from hotlines indicate a significant rise in mental health problems. As the psychiatric emergency room (ER) is a first-line free-of-charge facility for psychiatric emergencies, we expected to see a significant increase in visits, specifically of new patients suffering from anxiety, depression, or stress-related disorders. METHODS Data from two psychiatric hospital ERs and one general hospital were included. All visits of children and adolescents from the computerized files between March and December of 2019 were analyzed anonymously and compared to the same months in 2020, using multilevel linear modeling. RESULTS There was a significant decline in the total number of visits (p = .017), specifically among those diagnosed as suffering from stress-related, anxiety, and mood disorder groups (p = .017), and an incline in the proportion of visits of severe mental disorders (p = .029). DISCUSSION The limited use of child and adolescent psychiatric emergency facilities during the pandemic highlights the importance of tele-psychiatry as part of emergency services. It also suggests the importance of the timeline of the emergence of clinically relevant new psychiatric diagnoses related to the pandemic. Future studies are needed to establish the long-term effects of the pandemic and the expeditious use of tele-psychiatry.
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Affiliation(s)
- Galit Erez
- grid.415607.10000 0004 0631 0384Shalvata Mental Health Center and Tel Aviv University, Hod Hasharon, Israel
| | - Sol Yakubovich
- grid.415607.10000 0004 0631 0384Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Hadar Sadeh
- grid.7489.20000 0004 1937 0511Soroka Medical Center and Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Gal Shoval
- grid.415340.70000 0004 0403 0450Geha Mental Health Center and Tel Aviv University, Petah Tikva, Israel
| | - Gila Schoen
- grid.415340.70000 0004 0403 0450Geha Mental Health Center and Tel Aviv University, Petah Tikva, Israel
| | - Gal Meiri
- grid.7489.20000 0004 1937 0511Soroka Medical Center and Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Nimrod Hertz-Palmor
- grid.413795.d0000 0001 2107 2845Sheba Medical Center and Tel Aviv University, Ramat Gan, Israel
| | - Tali Butler
- grid.415739.d0000 0004 0631 7092Ziv Medical Center (Safed) and Bar-Ilan University, Safed, Israel
| | - Yael Barzilai
- grid.415607.10000 0004 0631 0384Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Mariela Mosheva
- grid.413795.d0000 0001 2107 2845Sheba Medical Center and Tel Aviv University, Ramat Gan, Israel
| | - Doron Gothelf
- grid.413795.d0000 0001 2107 2845Sheba Medical Center and Tel Aviv University, Ramat Gan, Israel
| | - Yuval Bloch
- Shalvata Mental Health Center and Tel Aviv University, Hod Hasharon, Israel.
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Dror C, Hertz-Palmor N, Barzilai Y, Gila S, Tali BZ, Alex G, Tal L, Maya KL, Talia S, Doron G, Bloch Y. Youth Psychiatric Hospitalization in Israel during COVID-19: A Multi-Center Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9870. [PMID: 36011509 PMCID: PMC9407708 DOI: 10.3390/ijerph19169870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
During the COVID-19 pandemic there have been numerous reports of increases in psychiatric morbidity and a deterioration of status among existing patients. There is little information about how this increase has affected youth and rates of adolescent psychiatric hospitalization. Our study was aimed at examining trends in youth psychiatric hospitalization during the first year of the COVID-19 pandemic. Method: We used medical records to compare trends in hospitalization rates from 2019 to 2020, among psychiatric youth wards from five different centers in Israel. Results: The number of patients that were hospitalized in youth psychiatric wards decreased significantly from 2019 (Mean ± SD=52.2 ± 28.6 per month) to 2020 (M ± SD = 40.8 ± 22.0; unstandardized B = −11.4, 95% CI = −14.4 to −8.3, p < 0.0001). There was a significant decrease in the number of patients that were hospitalized due to internalizing disorders from 2019 (M ± SD = 22.3 ± 9.3 per month) to 2020 (M ± SD = 16.8 ± 7.7; B = −5.5, 95% CI = −8.0 to −3.0, p = 0.0002) and a marginally significant increase in the number of restraints per month (2019: M ± SD = 2.8 ± 6.8, 2020: M ± SD = 9.0 ± 14.5; Z = −1.96, Rosenthal’s r = 0.36, p = 0.07). Conclusions: There was a significant decline in psychiatric hospitalizations during the pandemic, specifically among patients suffering from internalizing disorders. The reasons for this decline, and the future impact these changes had on hospitalizations during the pandemic demand further research. Study limitations: This is a retrospective multicenter study from five medical centers in Israel, therefore generalizability of our findings is limited.
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Affiliation(s)
- Chen Dror
- The Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod Hasharon 45100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Nimrod Hertz-Palmor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Sheba Medical Center, Ramat Gan 52621, Israel
| | - Yael Barzilai
- The Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod Hasharon 45100, Israel
| | - Schoen Gila
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Geha Mental Health Center, Petah Tikva 49100, Israel
| | - Bretler-Zager Tali
- Ziv Medical Center (Safed), Safed 13100, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Poriya 15208, Israel
| | - Gizunterman Alex
- Eitanim Mental Health Center, Harav Rafael Katzalbogen, Jerusalem 9097200, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Lahav Tal
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Nes-ziona Mental Health Center, Beer Yaakov 70350, Israel
| | - Kritchmann-Lupo Maya
- The Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod Hasharon 45100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Saker Talia
- The Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod Hasharon 45100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Gothelf Doron
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Sheba Medical Center, Ramat Gan 52621, Israel
| | - Yuval Bloch
- The Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod Hasharon 45100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
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Fallach N, Segal Y, Agassy J, Perez G, Peretz A, Chodick G, Gazit S, Patalon T, Ben Tov A, Goldshtein I. Pregnancy outcomes after SARS-CoV-2 infection by trimester: A large, population-based cohort study. PLoS One 2022; 17:e0270893. [PMID: 35857758 PMCID: PMC9299339 DOI: 10.1371/journal.pone.0270893] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/18/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Data regarding women infected with SARS-CoV-2 during early trimesters are scarce. We aimed to assess preterm birth (PTB) and small-for-gestational-age (SGA) rates in a large and unselected cohort by trimester at infection and overall. Design A retrospective cohort study including all women with a positive SARS-CoV-2 RT-PCR test during a non-ectopic singleton pregnancy between February 21st 2020 and July 2nd 2021 (N = 2753). Each infected woman was matched to a non-infected pregnant woman by age, last menstruation date, sector, and socioeconomic status. Methods Logistic regression was conducted to assess the risks of PTB and SGA including an interaction between group and trimester of infection. Multivariable models included underlying diseases, previous abortions and null parity. Subgroup analyses were conducted on symptomatic infected women and matched non-infected women. Results A total of 2753 /2789 (98.7%) eligible women that were infected during pregnancy could be matched, among them, 17.4% and 48.4% were infected during the first and third trimesters, respectively. While first and second trimester infections were not associated with PTB (p>0.8), third trimester infections and in particular after 34 weeks of gestation had a greater risk of PTB with adjusted ORs of 2.76 (95% CI 1.63–4.67) and 7.10 (95% CI 2.44–20.61), respectively. PTB risk was further heightened in symptomatic third trimester infections (OR = 4.28, 95% CI 1.94–9.25). SGA risk was comparable between study groups across all trimesters of infection. Pregnancy loss incidence was similar in both groups (adjusted OR = 1.16; 95% CI 0.90–1.50). Conclusion SARS-CoV-2 infection was associated with increased risk of PTB only among women infected during late pregnancy, particularly among symptomatic women.
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Affiliation(s)
- Noga Fallach
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- * E-mail:
| | - Yaakov Segal
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Jeny Agassy
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Galit Perez
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Asaf Peretz
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Gabriel Chodick
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tal Patalon
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Amir Ben Tov
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Inbal Goldshtein
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Dror C, Hertz-Palmor N, Yadan-Barzilai Y, Saker T, Kritchmann-Lupo M, Bloch Y. Increase in Referrals of Children and Adolescents to the Psychiatric Emergency Room Is Evident Only in the Second Year of the COVID-19 Pandemic-Evaluating 9156 Visits from 2010 through 2021 in a Single Psychiatric Emergency Room. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158924. [PMID: 35897293 PMCID: PMC9332552 DOI: 10.3390/ijerph19158924] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
Introduction: The COVID-19 pandemic affected the wellbeing of children and adolescents. The psychiatric emergency room (ER) is the hub of psychiatric emergencies and reflects clinically significant mental problems. Previous studies compared 2019 and 2020 and observed a decline in ER referrals. The current study focused on the continuous trend of referrals from 2010 to the end of 2021. Method: In our observational retrospective study, we procured data from 9156 child and adolescent referrals to our psychiatric ER. The comparison was made based on similar months of each year. Results: There was a significant positive trend in monthly referrals between 2010 and 2021, representing a similar increase in referrals per month in comparison to that month in the preceding year (unstandardized β = 4.21, 95% CI = 3.44 to 4.98, p < 0.0001). Between March 2020 and February 2021 (monthly visits = 72.5 + 16.6 [median = 79.5], annual referrals = 870), we observed no additive effect beyond this general trend after controlling for population growth. Conversely, between March and December 2021 (monthly referrals = 106.1 + 31.8 [median = 105.5], overall referrals = 1061) we observed a significant additive effect beyond the projected incline, as predicted by previous years (β = 21.61, 95% CI = 12.12 to 31.06, p < 0.0001). Conclusions: The first year of the COVID-19 pandemic was no different from the continuous decade long rise of referrals to the children and adolescents’ psychiatric ER. Conversely, the second year showed an additional incline beyond the general trend. The complexity in this rising need demands the awareness of clinicians and policy makers alike.
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Affiliation(s)
- Chen Dror
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (C.D.); (N.H.-P.)
| | - Nimrod Hertz-Palmor
- The Child and Adolescent Psychiatry Division, Sheba Medical Center, Edmund and Lily Safra’s Children Hospital, Ramat Gan 52621, Israel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (C.D.); (N.H.-P.)
| | - Yael Yadan-Barzilai
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
| | - Talia Saker
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Maya Kritchmann-Lupo
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuval Bloch
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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12
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Ali-Saleh O, Obeid S. Compliance with COVID-19 Preventive Guidelines Among Minority Communities: the Case of Israeli Arabs. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01344-0. [PMID: 35679011 PMCID: PMC9179224 DOI: 10.1007/s40615-022-01344-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022]
Abstract
Objectives The Arab ethnic minority makes up 21% of Israel’s population and accounted for 40.5% of confirmed cases during the second wave of COVID-19. This study aims to assess the characteristics of compliance with the guidelines of the Ministry of Health and related factors that can explain the outbreak of COVID-19 among the Arab population during the second wave. Methods A cross-sectional online survey was conducted among 810 respondents from the Arab community during October 2020. The survey was distributed via social media such as Facebook and WhatsApp. The health belief model items, the theory of reasoned action items, trust in formal institutions, and pandemic fatigue were assessed, and a path analysis was performed. Results Positive correlations were demonstrated between both personal and social networks compliance (nuclear family, extended family, friends, etc.) and perceived severity of COVID-19, trust in formal institutions, attitudes toward compliance, and subjective norms (r = .12 to r = .64, p < .001, N = 810). Pandemic fatigue was negatively correlated with personal and social networks compliance, perceived severity of COVID-19, trust in institutions, attitudes toward compliance, and subjective norms (r = − .21 to r = − .48, p < .001). Positive correlations were evident between compliance with quarantine and perceived severity of COVID-19 and attitudes (r = .31 and r = .28, p < .001, respectively). Personal compliance was significantly lower among men (M = 3.93, SD = 0.94) and younger respondents (M = 4.14, SD = 0.71), while social networks compliance was lower among Muslims (M = 3.78, SD = 0.75). The negative relationship between pandemic fatigue and personal compliance was mediated by lower perceived severity of COVID-19, attitudes toward compliance, and subjective norms (p < .001). The negative relationship between pandemic fatigue and social network compliance was mediated by lower trust in institutions and subjective norms (p < .001). Lower perceived severity of COVID-19 mediated the relationship between higher pandemic fatigue and lower quarantine compliance (p = .003). Conclusions The results highlight the important of perception of the disease severity, social and subjective norms, and the central role of trust in determining adherence to guidelines. Thus, increasing trust on authorities and planning tailored-maid interventions can raise compliance with the preventive guidelines and prevent the spread of the virus. Such interventions will address the characteristics of minority populations and take into account the implications of the guidelines and the possibility that may lead to fatigue, which in turn will lead to non-compliance with those guidelines.
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Affiliation(s)
- Ola Ali-Saleh
- Department of Nursing, The Max Stern Yezreel Valley Academic College, Emek Yezreel, Israel
| | - Samira Obeid
- Department of Nursing, The Max Stern Yezreel Valley Academic College, Emek Yezreel, Israel. .,Health Promotion Department, the Ministry of Health, Northern District, Nof Hagalil, Israel.
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13
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Adini B, Cohen Y, Spitz A. The Relationship between Religious Beliefs and Attitudes towards Public Health Infection Prevention Measures among an Ultra-Orthodox Jewish Population during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052988. [PMID: 35270681 PMCID: PMC8910423 DOI: 10.3390/ijerph19052988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023]
Abstract
The ultra-Orthodox population in Israel was heavily impacted by COVID-19; it is important to understand the factors that contributed to this. There may be a friction between religious versus governmental guidelines that may reduce adherence to COVID mitigation guidelines, such as social distancing and masking. The purpose of this study is to explore this tension and the extent to which it existed in the surveyed sample. The study identified attitudes of ultra-Orthodox individuals concerning religious and public health measures to mitigate COVID-19 infection. A closed-ended questionnaire was completed by 405 ultra-Orthodox Jews. Most respondents believe that religious learning protects from harm (91%); 74% believe that periodically there are inconsistencies between religious guidelines and medical guidelines; 59% believe that preventive medicine may clash with “Divine protection”. Some public health measures applied to contain the pandemic threaten religious lifestyle; this is a source of dissonance among ultra-religious populations, which may substantially decrease willingness to comply with public health measures.
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Affiliation(s)
- Bruria Adini
- Department of Emergency and Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
- Correspondence: ; Tel.: +972-54-8045700
| | - Yoel Cohen
- Moskowitz School of Communication, Ariel University, Ariel 4077625, Israel;
| | - Ahuva Spitz
- School of Nursing, Jerusalem College of Technology, Jerusalem 91160, Israel;
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14
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Hananel R, Fishman R, Malovicki-Yaffe N. Urban diversity and epidemic resilience: The case of the COVID-19. CITIES (LONDON, ENGLAND) 2022; 122:103526. [PMID: 34908641 PMCID: PMC8660207 DOI: 10.1016/j.cities.2021.103526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 08/20/2021] [Accepted: 11/21/2021] [Indexed: 05/12/2023]
Abstract
The spread of the coronavirus pandemic offers a unique opportunity to improve our understanding of the role of urban planning strategies in the resilience of urban communities confronting a pandemic. This study examines the relationship between urban diversity and epidemiological resilience by empirically assessing the relation between the level of neighborhood homogeneity and the probability of being infected by the coronavirus. We focus on the ultra-Orthodox Jewish community in Israel, a relatively closed community that was disproportionately and severely affected by the pandemic. The findings indicate a monotonic but nonlinear relationship between the level of ultra-Orthodox prevalence in a neighborhood and a resident's probability of contracting COVID-19. As the fraction of ultra-Orthodox individuals in the neighborhood decreases, the fraction of infected population decreases significantly and more strongly that can be explained without recourse to urban diversity considerations. This relationship is found to be significant and strong, even when other variables are accounted for that had hitherto been perceived as central to coronavirus distribution, such as housing density, socioeconomic level of the neighborhood, and number of people per household. The findings are important and relevant to many societies around the globe in which a variety of populations have a separatist lifestyle.
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Affiliation(s)
- Ravit Hananel
- Department of Public Policy, School of Social and Policy Studies, Gerson H Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Ram Fishman
- Department of Public Policy, School of Social and Policy Studies, Gerson H Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Nechumi Malovicki-Yaffe
- Department of Public Policy, School of Social and Policy Studies, Gerson H Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
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15
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Sun Q, McMahon DE, Ugwu-Dike PO, Sun Q, Tang K, Zhang H, Suchonwanit P, Oh CC, Chong AH, Willems A, Galván C, Dodiuk-Gad RP, Fantini F, Recalcati S, Avancini J, Miyamoto D, Sanches JA, Raboobee N, Bravo F, Freeman EE. How Coronavirus Disease 2019 Changed Dermatology Practice in 1 Year Around the World: Perspectives from 11 Countries. Dermatol Clin 2021; 39:639-651. [PMID: 34556253 PMCID: PMC8452267 DOI: 10.1016/j.det.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Qisi Sun
- Department of Dermatology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Devon E McMahon
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Pearl O Ugwu-Dike
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Keyun Tang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Thanon Rama VI, Khwaeng Thung Phaya Thai, Khet Ratchathewi, Krung Thep Maha Nakhon 10400, Thailand
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Outram Rd, Singapore 169608, Singapore
| | - Alvin H Chong
- Skin Health Institute, level 1/80 Drummond St, Carlton, VIC 3053, Australia; Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, University of Melbourne, Parkville, VIC 3010, Australia
| | - Anneliese Willems
- Skin Health Institute, level 1/80 Drummond St, Carlton, VIC 3053, Australia
| | - Cristina Galván
- Department of Dermatology, Hospital Universitario de Móstoles, Calle Río Júcar, S/N, 28935 Móstoles, Madrid, Spain
| | - Roni P Dodiuk-Gad
- Bruce Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, 3200003, Israel; Department of Dermatology, Emek Medical Center, Yitshak Rabin Boulevard 21, Afula, 1834111, Israel; Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Fabrizio Fantini
- Department of Dermatology, Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Via dell'Eremo, 9/11, 23900 Lecco LC, Italy
| | - Sebastiano Recalcati
- Department of Dermatology, Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Via dell'Eremo, 9/11, 23900 Lecco LC, Italy
| | - Joao Avancini
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Denise Miyamoto
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Jose A Sanches
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Noufal Raboobee
- Department of Dermatology, Westville Hospital, 7 Harry Gwala Rd, Westville, Durban, 3630, South Africa
| | - Francisco Bravo
- Department of Dermatology, Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres 15102, Peru; Department of Pathology, Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, 1 CV Zac, Av. Honorio Delgado 262, San Martín de Porres 15102, Peru
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
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16
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Saban M, Myers V, Peretz G, Avni S, Wilf-Miron R. COVID-19 morbidity in an ethnic minority: changes during the first year of the pandemic. Public Health 2021; 198:238-244. [PMID: 34487867 PMCID: PMC8437684 DOI: 10.1016/j.puhe.2021.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 11/08/2022]
Abstract
Objectives During the COVID-19 pandemic, ethnic minorities have been more susceptible to infection and demonstrated poorer outcomes. This study describes COVID-19 morbidity and mortality by ethnic group, represented by Arab and Jewish localities in Israel, during the different waves of the outbreak and addresses sociocultural aspects of the pandemic. Study design A retrospective national archive study was conducted in Israel. Methods Data were obtained from the Ministry of Health's database, including daily information on Arab, Jewish or mixed localities, from February 2020 to February 2021. Results During the first wave of the pandemic, the incidence of COVID-19 in Arab compared with Jewish localities was 67% lower and mortality was 85% lower, in addition to lower rates of severe disease requiring hospitalisation. During the second and third waves, these trends reversed, with the proportion of positive tests, incidence and mortality in Arab localities reaching and then surpassing rates in Jewish localities. By September 2020, COVID-19 mortality was twice as high in Arab compared with Jewish localities. Conclusions After low morbidity during the first wave of the COVID-19 pandemic, a surge in infections occurred in the Arab population during subsequent waves, to match and surpass the high incidence seen in the Jewish population. This unique pattern highlights the changing experiences of a minority group as the pandemic progressed and demonstrates how COVID-19 exacerbates existing disparities.
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Affiliation(s)
- M Saban
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - V Myers
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - G Peretz
- Strategic and Economic Planning Administration, Ministry of Health, Jerusalem, Israel
| | - S Avni
- Strategic and Economic Planning Administration, Ministry of Health, Jerusalem, Israel
| | - R Wilf-Miron
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel; School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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17
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Rosen B, Waitzberg R, Israeli A, Hartal M, Davidovitch N. Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel's COVID-19 vaccination program. Isr J Health Policy Res 2021; 10:43. [PMID: 34340714 PMCID: PMC8326649 DOI: 10.1186/s13584-021-00481-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
As of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) - far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that had received at least one vaccination (61%) and the share that had been fully vaccinated (55%). Among Israelis aged 16 and over, the comparable figures were 81 and 74%, respectively. In light of this, the objectives of this article are: 1. To describe and analyze the vaccination uptake through the end of March 2021 2. To identify behavioral and other barriers that likely affected desire or ability to be vaccinated 3. To describe the efforts undertaken to overcome those barriers Israel's vaccination campaign was launched on December 20, and within 2.5 weeks, 20% of Israelis had received their first dose. Afterwards, the pace slowed. It took an additional 4 weeks to increase from 20 to 40% and yet another 6 weeks to increase from 40 to 60%. Initially, uptake was low among young adults, and two religious/cultural minority groups - ultra-Orthodox Jews and Israeli Arabs, but their uptake increased markedly over time.In the first quarter of 2021, Israel had to enhance access to the vaccine, address a moderate amount of vaccine hesitancy in its general population, and also address more intense pockets of vaccine hesitancy among young adults and religious/cultural minority groups. A continued high rate of infection during the months of February and March, despite broad vaccination coverage at the time, created confusion about vaccine effectiveness, which in turn contributed to vaccine hesitancy. Among Israeli Arabs, some residents of smaller villages encountered difficulties in reaching vaccination sites, and that also slowed the rate of vaccination.The challenges were addressed via a mix of messaging, incentives, extensions to the initial vaccine delivery system, and other measures. Many of the measures addressed the general population, while others were targeted at subgroups with below-average vaccination rates. Once the early adopters had been vaccinated, it took hard, creative work to increase population coverage from 40 to 60% and beyond.Significantly, some of the capacities and strategies that helped Israel address vaccine hesitancy and geographic access barriers are different from those that enabled it to procure, distribute and administer the vaccines. Some of these strategies are likely to be relevant to other countries as they progress from the challenges of securing an adequate vaccine supply and streamlining distribution to the challenge of encouraging vaccine uptake.
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Affiliation(s)
- Bruce Rosen
- Myers-JDC-Brookdale Institute, JDC Hill, Jerusalem, Israel
- Hebrew University Paul Baerwald School of Social Work and Social Welfare, Jerusalem, Israel
| | - Ruth Waitzberg
- Myers-JDC-Brookdale Institute, JDC Hill, Jerusalem, Israel
- Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Berlin, Germany
| | - Avi Israeli
- Hebrew University Hadassah Medical School, Jerusalem, Israel
- Ministry of Health, Jerusalem, Israel
| | - Michael Hartal
- Myers-JDC-Brookdale Institute, JDC Hill, Jerusalem, Israel
| | - Nadav Davidovitch
- Faculty of Health Sciences, Ben-Gurion University of the Negev, School of Public Health, Beersheba, Israel
- Taub Center for Social Policy Studies in Israel, Jerusalem, Israel
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18
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Both high and low pre-infection glucose levels associated with increased risk for severe COVID-19: New insights from a population-based study. PLoS One 2021; 16:e0254847. [PMID: 34293038 PMCID: PMC8297851 DOI: 10.1371/journal.pone.0254847] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/03/2021] [Indexed: 01/19/2023] Open
Abstract
Importance Patients with diabetes are known to be at increased risk for infections including severe coronavirus disease 2019 (COVID-19) but the relationship between COVID-19 severity and specific pre-infection glucose levels is not known. Objective To assess the differential effects of pre-infection glucose levels on the risk for severe COVID-19 amongst patients with and without diabetes. Design Population based historical cohort study. Setting National state-mandated HMO. Patients All adult patients with a positive SARS-COV2 test between March-October 2020. Exposure Recent fasting blood glucose (FBG) and glycated hemoglobin (HBA1C), age, gender, body mass index (BMI) and diagnoses of diabetes, hypertension, ischemic heart disease. Outcome Risk for severe COVID-19, defined as resulting in ≥10 hospitalization days, ICU admission or death. Results 37,121 patients with a positive SARS-COV2 test were identified; 707 defined as severe (1.9%). Unadjusted risk factors for severe disease were age (OR = 1.1 for every year increase; 95% CI 1.09–1.11, p < 0.001), male gender (OR = 1.34, 95% CI 1.06–1.68, p = 0.012); BMI (OR = 1.02 for 1 kg/m2 increase, 95% CI 1.00–1.04, p = 0.025). Controlling for these factors, we found an association between pre-infection FBG and the risk of severe COVID-19, with a differential effect in patients with and without a diagnosis of diabetes. For patients without diabetes, elevated FBG in the pre-diabetes range (106–125 mg/dl) was associated with severe COVID-19 (OR 1.55 95% CI 1.04–2.26 p = 0.027). For patients with a diagnosis of diabetes, we found a J-shaped association between pre-infection glucose control and the risk for severe COVID-19 where the lowest risk for was for patients with FBG 106–125 mg/dl; the risk increased with higher pre-infection glucose levels but strikingly also for patients with a low pre-infection FBG (<100mg/dl) or HbA1C (<5.7%). Conclusions and relevance Elevated pre-infection blood glucose is a risk factor for severe COVID-19 even in non-diabetics. For patients with a diagnosis of diabetes both high as well as low pre-infection glucose levels are risk factors for severe COVID-19. Further research is required to assess whether these associations are causal, but we believe these findings can already have clinical implications for COVID-19 risk assessment and stratification.
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19
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Luxenburg O, Saban M, Myers V, Vaknin S, Boldor N, Wilf-Miron R. National and regional trends in MRI utilization in the face of the ongoing COVID-19 pandemic. Isr J Health Policy Res 2021; 10:40. [PMID: 34266476 PMCID: PMC8280577 DOI: 10.1186/s13584-021-00472-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Marked reductions in imaging exams have been documented during the COVID-19 pandemic. The study aimed to examine the effect of the two waves of COVID-19 on magnetic resonance imaging (MRI) utilization at the national and regional level. MATERIALS AND METHODS A retrospective-archive study was conducted in Israel, comparing March-December 2020 with March-December 2018 and 2019. Data on MRI utilization were obtained from the national MRI registry, while data on confirmed COVID-19 cases, by place of residence, were obtained from the Israeli Ministry of Health open COVID-19 database. RESULTS The number and rate of MRI examinations decreased during the first COVID-19 wave, with the steepest drop in April 2020: 47.5% relative decrease compared to April 2019, and 42.2% compared to 2018. This was followed by a compensatory increase between the waves and a return to almost pre-pandemic levels of use, with just a modest decrease, during the second, more intense COVID wave, compared with the previous year. Existing differences between regions increased during the pandemic. The rate ratio of MRI exams between Tel-Aviv and the Northern periphery increased from 2.89 in April 2019 to 3.94 in April 2020. Jerusalem metropolitan region, with the largest burden of COVID disease, demonstrated only a modest decrease (1%) in MRI utilization during the first 10 months of the pandemic. CONCLUSIONS At the national level, time trends in reduced MRI utilization followed the first wave of COVID-19, and were accompanied by increased regional disparities. These changes were not explained by differences in the burden of COVID-19 disease but might be explained by unequal distribution of MRI scanners among regions. Reduced utilization was not evident during the second wave, nor at the beginning of the third wave, despite higher COVID-19 case load, demonstrating adaptation to the new normal. Patterns of MRI utilization might help policy-makers and healthcare managers predict the behavior of imaging as well as other sectors, such as elective surgical procedures, during an ongoing pandemic. This forecast might help to manage the lasting effects of the pandemic, including extended waiting times, in the months and years following its remission. In preparation for future national emergencies, timely and detailed data on MRI utilization can serve as a "sensor" for a wide array of diagnostic and interventional medical activities, providing policy-makers with an updated snapshot to guide their response at the regional and national levels.
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Affiliation(s)
- Osnat Luxenburg
- Medical Technology, Health Information and Research Directorate, Ministry of Health, Jerusalem, Israel
| | - Mor Saban
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Vicki Myers
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Sharona Vaknin
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Noga Boldor
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Rachel Wilf-Miron
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Gaskell KM, Johnson M, Gould V, Hunt A, Stone NRH, Waites W, Kasstan B, Chantler T, Lal S, Roberts CH, Goldblatt D, Eggo RM, Marks M. SARS-CoV-2 seroprevalence in a strictly-Orthodox Jewish community in the UK: A retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 6:100127. [PMID: 34308409 PMCID: PMC8291041 DOI: 10.1016/j.lanepe.2021.100127] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ethnic and religious minorities have been disproportionately affected by SARS-CoV-2 worldwide. The UK strictly-Orthodox Jewish community has been severely affected by the pandemic. This group shares characteristics with other ethnic minorities including larger family sizes, higher rates of household crowding and relative socioeconomic deprivation. We studied a UK strictly-Orthodox Jewish population to understand transmission of COVID-19 within this community. METHODS We performed a household-focused cross-sectional SARS-CoV-2 serosurvey between late-October and early December 2020 prior to the third national lockdown. Randomly-selected households completed a standardised questionnaire and underwent serological testing with a multiplex assay for SARS-CoV-2 IgG antibodies. We report clinical illness and testing before the serosurvey, seroprevalence stratified by age and sex. We used random-effects models to identify factors associated with infection and antibody titres. FINDINGS A total of 343 households, consisting of 1,759 individuals, were recruited. Serum was available for 1,242 participants. The overall seroprevalence for SARS-CoV-2 was 64.3% (95% CI 61.6-67.0%). The lowest seroprevalence was 27.6% in children under 5 years and rose to 73.8% in secondary school children and 74% in adults. Antibody titres were higher in symptomatic individuals and declined over time since reported COVID-19 symptoms, with the decline more marked for nucleocapsid titres. INTERPRETATION In this tight-knit religious minority population in the UK, we report one of the highest SARS-CoV-2 seroprevalence levels in the world to date, which was markedly higher than the reported 10% seroprevalence in London at the time of the study. In the context of this high force of infection, all age groups experienced a high burden of infection. Actions to reduce the burden of disease in this and other minority populations are urgently required. FUNDING This work was jointly funded by UKRI and NIHR [COV0335; MR/V027956/1], a donation from the LSHTM Alumni COVID-19 response fund, HDR UK, the MRC and the Wellcome Trust.
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Affiliation(s)
- Katherine M Gaskell
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Marina Johnson
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London, UK
| | - Victoria Gould
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Adam Hunt
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London, UK
| | - Neil RH Stone
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Hospital for Tropical Diseases, University College London Hospital NHS Foundation Trust, London, UK
| | - William Waites
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT UK
- School of Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AB
| | - Ben Kasstan
- Centre for Health, Law and Society, University of Bristol Law School, Bristol BS1 1RJ, UK
- Department of Sociology and Anthropology, Hebrew University of Jerusalem, Jerusalem 9190501, UK
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Sham Lal
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Chrissy H. Roberts
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - David Goldblatt
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London, UK
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT UK
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Hospital for Tropical Diseases, University College London Hospital NHS Foundation Trust, London, UK
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21
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COVID-Related Concerns, the Need for Help, and Perceived Microaggression among Young Ultra-Orthodox Jewish Respondents in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126445. [PMID: 34198680 PMCID: PMC8296258 DOI: 10.3390/ijerph18126445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022]
Abstract
Minority groups are especially vulnerable to the negative psychological and economic consequences of the COVID-19 pandemic. This study focused on one prominent minority group in Israel: ultra-Orthodox Jews. It examined the rate of exposure to COVID-19, adherence to COVID-19 mitigation guidelines, difficulties with adherence to COVID-19 guidelines, COVID-related concerns, financial hardships, the need for help, and microaggression during the first wave of the pandemic (April–May 2020). It then examined multivariate prediction of COVID-related concerns, the need for help, and microaggression. The sample comprised 252 respondents, with 67% female and a mean age of 32.85 (SD = 10.63). Results showed that 78.8% of the participants knew at least one person who had tested positive for COVID-19, and 31.4% knew at least one person who had passed away from COVID-19. Only 59.7% of the participants reported high adherence to social distancing guidelines. Perceived microaggression was predicted by the difficulties with adherence to COVID-19 guidelines, the level of stress associated with exposure to the media, and financial hardships. The study’s implications point to the centrality of perceived microaggression and the necessity of adopting culturally sensitive approaches to engage minorities in public efforts to fight the spread of viruses.
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22
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Ghanamah R, Eghbaria-Ghanamah H. Impact of COVID-19 Pandemic on Behavioral and Emotional Aspects and Daily Routines of Arab Israeli Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062946. [PMID: 33805644 PMCID: PMC7999135 DOI: 10.3390/ijerph18062946] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/22/2022]
Abstract
Negative psychological effects of the coronavirus disease (COVID-19) have been identified in adults and children, such as anxiety and sleep disorders. However, research about the impact of this pandemic on children from ethnical minorities is scarce. We tested the effects of COVID-19 outbreak on psychological aspects and daily routines among Arab Israeli Children. An online cross-sectional survey was conducted among Arab Israeli parents, including behavioral and emotional aspects questionnaire and questions addressing using of screens, sleep, and physical activities. The results showed that, during the COVID-19 outbreak, 55.8% of the children asked to sleep in their parents' bed and 45% expressed fears they did not have before. Most of the children showed increased irritability, constant mood swings and nervousness about limits and messages, and 41.4% showed sleep difficulties. Concerning adaptive behaviors, more than 50% of the parents reported that their child became wiser, lazier, and was able to adapt the limits and restriction of the COVID-19 outbreak. Moreover, the children tended to increase their use of screens, used to sleep more time, and were less active physically. The results suggest that children are vulnerable to the COVID-19 outbreak psychological effects and highlight the need to reduce the psychological burden of this pandemic and the necessity of immediate intervention.
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Affiliation(s)
- Rafat Ghanamah
- Early Childhood Education Department, Oranim Academic College of Education, Kiryat Tevo’n 3600600, Israel
- Edmond. J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa 3498838, Israel;
- Correspondence:
| | - Hazar Eghbaria-Ghanamah
- Edmond. J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa 3498838, Israel;
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