Epidemiology and diagnosis, environmental resources quality and socio-economic perspectives for COVID-19 pandemic

"Long COVID" and Its Impact on The Environment: Emerging Concerns and Perspectives

The COVID-19 pandemic has caused unprecedented global health and economic crises. The emergence of long COVID-19 has raised concerns about the interplay between SARS-CoV-2 infections, climate change, and the environment. In this context, a concise analysis of the potential long-term effects of the COVID-19 epidemic along with the awareness aboutenvironmental issues are realized. While COVID-19 effects in the short-term have reduced environmental air pollutants and pressures, CO2 emissions are projected to increase as the economy recovers and growth rates return to pre-COVID-19 levels. This review discusses the systematic effects of both the short-term and long-term effects of the pandemic on the clean energy revolution and environmental issues. This article also discusses opportunities to achieve long-term environmental benefits and emphasizes the importance of future policies in promoting global environmental sustainability. Future directions for growth and recovery are presented to cope with long COVID-19 epidemic along with the critical findings focussing on various aspects: waste management, air quality improvement.

Healthy lifestyles in pre-service teachers in Israel: the impact of academic institutions

Purpose

This study examines the impact of academic institutions on changes to students' awareness and habits regarding a healthy lifestyle, specifically through nutrition and physical exercise, following the Covid-19 pandemic.

Design and subjects

In May 2020, quantitative online questionnaires were completed by 266 pre-service teachers (83.5% female), aged 19-63, who were studying at an academic institution in Israel.

Setting

The questionnaire, which included health-related 15 items, as well as a number of demographic questions, was distributed via social media, academic mailing lists, and the researchers' colleagues.

Methods

The respondents were asked to provide socio-demographic data and information regarding their health-related habits, such as smoking and exercising, at two timepoints: prior to the Covid-19 pandemic and during the first lockdown in Israel (March-May 2020).

Analysis

Statistical analysis included paired t-tests, Wilcoxon and McNemar tests, Pearsons's correlations, and hierarchical regressions.

Results

The academic institution's promoting of a healthy lifestyle, as perceived by students, was found to contribute to the explained variance (EPV) of their maintaining a healthy lifestyle, prior to and during the Covid-19 pandemic (R2 = 9.4%, p < .001and R2 = 2.4%, p = 0.009, respectively), beyond the respondents' demographic characteristics. Moreover, correlations were found between the institution's promoting of a healthy lifestyle at both timepoints. Respondents who perceived their institution as promoting a healthy lifestyle prior to the pandemic maintained healthier lifestyles than their peers; healthier lifestyles were also maintained by respondents who were unmarried, non-smokers, more educated, and watched less television. Finally, the institution's promoting of a healthy lifestyle prior to the pandemic significantly contributed to the students' maintaining a healthy lifestyle and healthy nutrition during the pandemic.

Conclusion

The findings of this study highlight the impact of academic institutions on maintaining healthy lifestyles, even in times of crises and emergencies, thereby contributing to public health.

Kalman-based compartmental estimation for covid-19 pandemic using advanced epidemic model

The practicality of administrative measures for covid-19 prevention is crucially based on quantitative information on impacts of various covid-19 transmission influencing elements, including social distancing, contact tracing, medical facilities, vaccine inoculation, etc. A scientific approach of obtaining such quantitative information is based on epidemic models of S I R family. The fundamental S I R model consists of S-susceptible, I-infected, and R-recovered from infected compartmental populations. To obtain the desired quantitative information, these compartmental populations are estimated for varying metaphoric parametric values of various transmission influencing elements, as mentioned above. This paper introduces a new model, named S E I R R P V model, which, in addition to the S and I populations, consists of the E-exposed, R e -recovered from exposed, R-recovered from infected, P-passed away, and V-vaccinated populations. Availing of this additional information, the proposed S E I R R P V model helps in further strengthening the practicality of the administrative measures. The proposed S E I R R P V model is nonlinear and stochastic, requiring a nonlinear estimator to obtain the compartmental populations. This paper uses cubature Kalman filter (CKF) for the nonlinear estimation, which is known for providing an appreciably good accuracy at a fairly small computational demand. The proposed S E I R R P V model, for the first time, stochastically considers the exposed, infected, and vaccinated populations in a single model. The paper also analyzes the non-negativity, epidemic equilibrium, uniqueness, boundary condition, reproduction rate, sensitivity, and local and global stability in disease-free and endemic conditions for the proposed S E I R R P V model. Finally, the performance of the proposed S E I R R P V model is validated for real-data of covid-19 outbreak.

The influence of COVID-19 pandemic and coping strategies on work operation of nonfarm household enterprises in Nigeria

The purpose of this study is to investigate how COVID-19 pandemic including some coping strategies such as hand wash with soap and food consumption influences work operation or performance of nonfarm household enterprises (NHEs) in Nigeria using 2020 Living Standard Measurement Survey data of 1728 sample size. This study departs from existing study in two ways: first, the study employs multinomial logistic regression technique to ascertain the determinants of work performance of nonfarm household enterprises in Nigeria. Second, the study focuses on nonfarm enterprises such as petty trade, road side automobile and cab drivers. The results show that COVID-19 pandemic is significant with negative influence on the work operation of NHEs in Nigeria. The result of the study also reveals that coping strategy such as hand wash with soap during the pandemic is an important driver of work performance or operation of NHEs in Nigeria. Another coping strategy like food consumption by nonfarm household enterprises shows insignificant influence on work operation which implies that there is no relationship between food consumption and work operation by NHEs in Nigeria. The policy recommendation of this study, among others, is that policies should focus on procurement of sanitary material for public use. This can be achieved through public sensitisation in terms of organising workshops and conferences.

The long-term dynamic relationship between communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures: preparing for COVID-19-like pandemics

The spread of communicable diseases, such as COVID-19, has a detrimental effect on our socio-economic structure. In a dynamic log-run world, socio-economic and environmental factors interact to spread communicable diseases. We investigated the long-term interdependence of communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures in India's densely populated economy using a variance error correction (VEC) approach. The VEC model was validated using stationarity, cointegration, autocorrelation, heteroscedasticity, and normality tests. Our impulse response and variance decomposition analyses revealed that economic prosperity (GNI) significantly impacts the spread of communicable diseases, greenhouse gas emissions, government health expenditures, and GNI. Current health expenditures can reduce the need for future increases, and the spread of communicable diseases is detrimental to economic growth. Developing economies should prioritize economic growth and health spending to combat pandemics. Simultaneously, the adverse effects of economic prosperity on environmental degradation should be mitigated through policy incentives.

Association of Molnupiravir and Nirmatrelvir-Ritonavir with preventable mortality, hospital admissions and related avoidable healthcare system cost among high-risk patients with mild to moderate COVID-19

BACKGROUND

Real-world data is currently limited on the association between oral antiviral therapy and healthcare system burden in patients with mild-to-moderate COVID-19. This study aims to evaluate the clinical and cost effectiveness of Molnupiravir and Nirmatrelvir-ritonavir use in reducing mortality in this population.

METHODS

This is a retrospective cohort study involving 54,355 COVID-19 patients during February 22-March 31,2022 in Hong Kong. Inverse probability of treatment weighting (IPTW) was used to adjust patient characteristics. Our exposure of interest was Molnupiravir/Nirmatrelvir-Ritonavir prescription, with all-cause mortality as the primary outcome. IPTW-adjusted multivariate regressions were used to estimate treatment impact on clinic re-attendance and unplanned admissions. Finally, attributed cost and incremental cost-effectiveness ratios (ICER) were estimated.

FINDINGS

In the outpatient cohort (N = 33,217, 61.1%), 16.1% used Molnupiravir and 13.4% used Nirmatrelvir-Ritonavir, while in the inpatient cohort (N = 21,138, 38.9%), 3.8% used Molnupiravir and 1.3% used Nirmatrelvir-Ritonavir. IPTW-adjusted Cox model estimated that Molnupiravir (hazard ratio (HR)(95%CI)=0.31 (0.24-0.40), P< 0.0001) and Nirmatrelvir-Ritonavir (HR=0.10 (95%CI 0.05-0.21), P< 0.0001) were significantly associated with a reduced mortality hazard. In the outpatient cohort, both antiviral prescriptions were associated with reduced odds for unplanned hospital admissions (Molnupiravir: odds ratio (OR) =0.72 (0.52-0.98), P=0.039; Nirmatrelvir-Ritonavir: OR=0.37 (0.23-0.60), P<0.0001). Among hospitalised patients, both antiviral prescriptions were associated with significant reductions in the odds ratios for 28-days readmission (Molnupiravir: OR=0.71 (0.52-0.97), P=0.031; Nirmatrelvir-Ritonavir: OR=0.47 (0.24-0.93), P=0.030). ICERs for death averted for Molnupiravir stood at USD493,345.09 in outpatient settings and USD2,629.08 in inpatient settings. In outpatient settings, Nirmatrelvir-ritonavir cost USD331,105.27 to avert one death, but saved USD5,502.53 to avert one death in comparison with standard care.

INTERPRETATION

In high-risk patients in Hong Kong with mild-to-moderate COVID-19, Molnupiravir and Nirmatrelvir-Ritonavir prescriptions were associated with reduced all-cause mortality and significant cost savings.

FUNDING

Centre for Health Systems & Policy Research is funded by The Tung's Foundation; and The Laboratory of Data Discovery for Health Limited(D24H) is funded the AIR@InnoHK platform administered by the Innovation and Technology Commission of Hong Kong. Funders did not have any role in study design, data collection, data analysis, interpretation and writing of this manuscript.

Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Implications for the Future

The introduction of effective vaccines in December 2020 marked a significant step forward in the global response to COVID-19. Given concerns with access, acceptability, and hesitancy across Africa, there is a need to describe the current status of vaccine uptake in the continent. An exploratory study was undertaken to investigate these aspects, current challenges, and lessons learnt across Africa to provide future direction. Senior personnel across 14 African countries completed a self-administered questionnaire, with a descriptive analysis of the data. Vaccine roll-out commenced in March 2021 in most countries. COVID-19 vaccination coverage varied from low in Cameroon and Tanzania and up to 39.85% full coverage in Botswana at the end of 2021; that is, all doses advocated by initial protocols versus the total population, with rates increasing to 58.4% in Botswana by the end of June 2022. The greatest increase in people being fully vaccinated was observed in Uganda (20.4% increase), Botswana (18.5% increase), and Zambia (17.9% increase). Most vaccines were obtained through WHO-COVAX agreements. Initially, vaccination was prioritised for healthcare workers (HCWs), the elderly, adults with co-morbidities, and other at-risk groups, with countries now commencing vaccination among children and administering booster doses. Challenges included irregular supply and considerable hesitancy arising from misinformation fuelled by social media activities. Overall, there was fair to reasonable access to vaccination across countries, enhanced by government initiatives. Vaccine hesitancy must be addressed with context-specific interventions, including proactive programmes among HCWs, medical journalists, and the public.

Differences in Immunoglobulin G Glycosylation Between Influenza and COVID-19 Patients

The essential role of immunoglobulin G (IgG) in immune system regulation and combatting infectious diseases cannot be fully recognized without an understanding of the changes in its N-glycans attached to the asparagine 297 of the Fc domain that occur under such circumstances. These glycans impact the antibody stability, half-life, secretion, immunogenicity, and effector functions. Therefore, in this study, we analyzed and compared the total IgG glycome-at the level of individual glycan structures and derived glycosylation traits (sialylation, galactosylation, fucosylation, and bisecting N-acetylglucosamine (GlcNAc))-of 64 patients with influenza, 77 patients with coronavirus disease 2019 (COVID-19), and 56 healthy controls. Our study revealed a significant decrease in IgG galactosylation, sialylation, and bisecting GlcNAc (where the latter shows the most significant decrease) in deceased COVID-19 patients, whereas IgG fucosylation was increased. On the other hand, IgG galactosylation remained stable in influenza patients and COVID-19 survivors. IgG glycosylation in influenza patients was more time-dependent: In the first seven days of the disease, sialylation increased and fucosylation and bisecting GlcNAc decreased; in the next 21 days, sialylation decreased and fucosylation increased (while bisecting GlcNAc remained stable). The similarity of IgG glycosylation changes in COVID-19 survivors and influenza patients may be the consequence of an adequate immune response to enveloped viruses, while the observed changes in deceased COVID-19 patients may indicate its deviation.

The Impact of the COVID-19 Pandemic on Inpatient Admissions for Psychotic and Affective Disorders: The Experience of a Large Psychiatric Teaching Hospital in Romania

The COVID-19 pandemic resulted in a global sanitary crisis and, in addition, elicited serious mental health consequences. The utilization of psychiatric hospital-based services acts as an indicator of public mental health. Therefore, this research sought to investigate differences in the numbers and characteristics of inpatient admissions for psychotic and affective disorders at the largest Romanian psychiatric hospital between the period of lockdown (16 March−15 May 2020) and another three corresponding periods: the same year in the pre-lockdown period (16 January−15 March 2020), the immediate post-lockdown period (16 May−15 July 2020), and two years later (16 March−15 May 2022). A retrospective analysis was performed. The study included a total of 6604 patients. Inpatient admissions decreased during lockdown in comparison with the pre-lockdown period and immediate post-lockdown period for psychotic disorders (p < 0.001 and p < 0.001, respectively) and affective disorders (p < 0.001 and p < 0.001, respectively). For both psychotic and affective disorders, a decrease in the age of the patients admitted during lockdown, as compared with the pre-lockdown period (p < 0.05 and p < 0.001, respectively), was observed. The length of the hospital stay for affective disorders was higher immediately post-lockdown in comparison with the lockdown period (p < 0.001). Collectively, the present findings provide a glimpse of the immediate and long-term consequences of the COVID-19 pandemic and lockdown measures on patients’ access to mental healthcare in the form of hospitalization, and these findings could provide the basis for the development of a different approach to times of crisis.

COVID-19 related policies: The role of environmental concern in understanding citizens' preferences

COVID-19 has led to an unprecedented health and economic crisis worldwide. Many governments of the world have accelerated an adoption of public policies to address this crisis; however, a trade-off between the economy and public health exists. Previous studies in this area have mainly focused on the impact of COVID-19 on human life and the environment. This work adds to the literature by analyzing how individual environmental concern can affect citizens' preferences for public policies that deal with COVID-19. A data set of 26,131 participants from 26 countries was used to test the research model. Results indicate that environmental concern is positively associated with a preference for long-term oriented altruistic policies, and it shapes the relationship between economic and health problems at the country level on our dependent variable. Specifically, as the level of environmental concern increases, the negative effect of COVID-19's economic problems on the preference for long-term altruistic policies is diminished. In turn, in the case of health problems, the impact on the preference for long-term altruistic policies increases as environmental concern increases. Also, both individual-level and country-level characteristics affect citizens' preferences for policies related to the COVID-19 pandemic.

Effectiveness of environmental surveillance of SARS-CoV-2 as an early warning system during the first year of the COVID-19 pandemic: a systematic review

Since infected persons shed SARS-CoV-2 in faeces before symptoms appear, environmental surveillance (ES) may serve as an early warning system (EWS) for COVID-19 and new variants of concern. The ES of SARS-CoV-2 has been widely reviewed; however, its effectiveness as an EWS for SARS-CoV-2 in terms of timeliness, sensitivity and specificity has not been systematically assessed. We conducted a systematic review to identify and synthesise evidence on the ES of SARS-CoV-2 as an EWS to evaluate the added value for public health. Of 1,014 studies identified, we considered 29 for a qualitative synthesis of the timeliness of ES as an EWS for COVID-19, while six studies were assessed for the ability to detect new variants and two for both aims. The synthesis indicates ES may serve as an EWS of 1-2 weeks. ES could complement clinical surveillance for SARS-CoV-2; however, its cost-benefit value for public health decisions needs to be assessed based on the stage of the pandemic and resources available. Studies focusing methodological knowledge gaps as well as how to use and interpret ES signals for public health actions are needed, as is the sharing of knowledge within countries/areas with long experience of such surveillance.

Gingival recessions caused by Herpes Simplex Virus in a patient with COVID ‐19 infection

Herpes Simplex Virus type 1 (HSV‐1) is a very common infection often localized in the mucocutaneous junction of the lip. Rarely, it could be detected also in periodontal tissues, associated with an elevated risk of periodontal disease progression and gingival recessions. Recently, HSV‐1 and numerous co‐infections have been reported in literature associated with the Coronavirus and subsequent COVID‐19 disease. This report illustrates a case of HSV‐1 in a patient with Covid‐19 infection, showing the presence of ulcers and vesicles on the gingival margin of maxillary teeth associated with soreness and pain. The histology highlighted the presence of intraepithelial cell ballooning, confirming the diagnosis of HSV‐1 infection.

Locating temporary waste treatment facilities in the cities to handle the explosive growth of HCWs during pandemics: A novel Grey-AHP-OCRA hybrid approach

The COVID-19 outbreak has not only put the community health at stake but, also the environmental health. Usually, the healthcare wastes (HCWs) are composed of 15-20% of the infectious wastes and the rest of the non-infectious wastes. But, during any communicable health outbreak like COVID-19, the whole HCWs coming from the infected people become contagious. During the COVID-19 outbreak, the infectious waste is not only limited to the hospitals' premises, but also comes from the households, where COVID19 infected people are under home quarantine. Hence, keeping in mind the explosive growth in generation rates of infectious HCWs, the present study targets to expand the treatment and disposal capacity by installing temporary healthcare waste treatment facilities (HCWTFs). The study identifies ten criteria from the literature review and in consultation with the field experts, to evaluate the potential candidates for setting up temporary HCWTF during the health outbreaks. The study proposes a hybrid methodology based on grey analytical hierarchy process (G-AHP) and grey operational competitiveness rating analysis (grey-OCRA) for prioritizing the evaluation criteria and selecting the optimal temporary HCWTF location by considering the experts' inputs, respectively. The stakeholders consider the 'proximity to the inhabitation', 'infrastructure availability', and 'transportation distance' are the most important criteria for selecting the temporary HCWTF location. The proposed methodology is applied to select the temporary HCWTF location in Sundargarh District, Odisha, India. The study identifies the four locations by using geographical information system (GIS) tools and sequences them as per the preferences given by the stakeholders on various identified criteria. The study may be useful for the administration to set up the temporary facilities to quickly dispose of the extra HCWs during the pandemics. However, the future studies can be targeted to coordinate the collection, storage and transportation activities with the temporary HCWTFs.

Favorable outcome of SARS-CoV-2 infection in pediatric hematology oncology patients during the second and third pandemic waves in Italy: a multicenter analysis from the Infectious Diseases Working Group of the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP)

COVID-19 has a mild clinical course with low mortality rate in general pediatric population, while variable outcomes have been described in children with cancer. Infectious diseases working party of the AIEOP collected data on the clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric oncology/hematology patients from April 2020 to May 2021, including the second and the third waves of the pandemic in Italy. Factors potentially associated with moderate, severe, or critical COVID-19 were analyzed. Of the 153 SARS-Cov2 infections recorded, 100 were asymptomatic and 53 symptomatic. The course of COVID-19 was mild in 41, moderate in 2, severe in 5, and critical in 5 children. A total of 40.5% of patients were hospitalized, ten requiring oxygen support and 5 admitted to the intensive care unit. Antibiotics and steroids were the most used therapies. No patient died due to SARS-CoV-2 infection. Infections occurring early (< 60 days) after the diagnosis of the underlying disease or after SCT were associated to moderate, severe, and critical disease compared to infections occurring late (> 60 days) or during maintenance therapy. In the patients on active chemotherapy, 59% withdrew the treatment for a median of 15 days. SARS-CoV-2 presented a favorable outcome in children with cancer in Italy during the pandemic. Modification of therapy represents a major concern in this population. Our findings suggest considering regular chemotherapy continuation, particularly in patients on maintenance therapy or infected late after the diagnosis.

Socioeconomic status and COVID‐19‐related cases and fatalities in the world: A cross‐sectional ecological study

Background and Aims

The COVID‐19 pandemic poses an extraordinary threat to global public health. We designed an ecological study to explore the association between socioeconomic factors and the COVID‐19 outcomes in 184 countries, using the geographic map and multilevel regression models.

Methods

We conducted a cross‐sectional ecological study in 184 countries. We performed regression analysis to assess the association of various socioeconomic variables with COVID‐19 outcomes in 184 countries, using ordinary least squares and multilevel modeling analysis. We performed two‐level analyses with countries at Level 1 and geographical regions at Level 2 in multilevel modeling analysis, using the same set of predictor variables used in ordinary least squares.

Results

There was a significant relationship between COVID‐19 cases rate (Log) per 100,000 inhabitants‐day at risk with human development index (HDI), percentage of the urban population, unemployment, and cardiovascular disease prevalence. The results displayed that the variances are varied between Level 1 (country level) and Level 2 (World Health Organization [WHO] regions), meaning that the geographic distribution represented a proportion of the changes in the COVID‐19 outcomes.

Conclusion

The study suggests that in addition to the socioeconomic status affects the COVID‐19 outcomes, countries' geographical location makes a part of changes in outcomes of diseases. Therefore, health policy‐makers could overcome morbidity and mortality in COVID‐19 by controlling the socioeconomics factors.

Hospital sewage treatment facilities witness the fighting against the COVID-19 pandemic

Real-time evaluation of the fighting activities during a sudden unknown disaster like the COVID-19 pandemic is a critical challenge for control. This study demonstrates that the temporal variations of effluents from hospital sewage treatment facilities can be used as an effective indicator for such evaluation. Taking a typical infection-suffering city in China as an example, we found that there was an obvious decrease in effluent ammonia and COD concentrations in line with the start of city lockdown, and its temporal variations well indicated the major events happened during the pandemic control. Notably, the lagging period between the change point of effluent residual chlorine and the change points of COD and ammonia concentration coincided with a period in which there was a deficiency in local medical resources. In addition, the diurnal behavior of effluents from designated hospitals has varied significantly at different stages of the pandemic development. The effluent ammonia peaks shifted from daytime to nighttime after the outbreak of the COVID-19 pandemic, suggesting a high workload of the designated hospitals in fighting the rapidly emerging pandemic. This work well demonstrates the necessary for data integration at the wastewater-medical service nexus and highlights an unusual role of the effluents from hospital sewage treatment facilities in revealing the status of fighting the pandemic, which helps to control the pandemic.

An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

Physical activity trajectory in the first 10 months of the COVID-19 pandemic in Southern Brazil: a follow-up study

Background

A continuous tracking of the PA level during the COVID-19 pandemic is important to understand how people’s behaviour has varied along time. The aim of this study was to evaluate the physical activity (PA) trajectory over the first 10 months of the COVID-19 pandemic in the south of Brazil.

Methods

Data from three timepoints of the PAMPA Cohort were used, as follows: (1) pre-COVID-19 (retrospective); (2) Jun/Jul 2020; (3) Dec 2020/Jan 2021. Self-reported PA practice, frequency, duration, as well as place where activities were performed (at or out of home) were assessed.

Results

A reduction in any (from 68.7 to 47.7%), sufficient (from 41.5 to 22.1%) and out of home PA (from 59.4 to 30.1%) was observed from the first (pre-COVID-19) to the second (Jun/Jul 2020) timepoint, followed by an increase in the third timepoint (Dec 2020/Jan 2021) (60.1%, 37.9%, and 54.3% for any, sufficient, and out of home PA, respectively). The PA trajectory was similar, regardless of sex, educational level or income. Only any (p = 0.0007) and sufficient (p = 0.0012) PA showed significant interaction with time by sex. Female participants were less likely to engage in any (OR 0.45 95% CI 0.26; 0.77) and sufficient PA (OR 0.40 95% CI 0.24; 0.66).

Conclusion

During the first 10 months of COVID-19 pandemic there was a marked fluctuation on PA pattern in adults from southern Brazil. An ongoing tracking of PA behaviour during COVID-19 pandemic is important to understand how this behaviour varies. Public policies should focus on increasing PA in a higher standard than pre-COVID levels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00450-0.

Virucidal Activity of Different Mouthwashes against the Salivary Load of SARS-CoV-2: A Narrative Review

The saliva of COVID-19-confirmed patients presents a high viral load of the virus. Aerosols generated during medical and dental procedures can transport the virus and are a possible causative agent of cross-infection. Since the onset of the pandemic, numerous investigations have been attempting to mitigate the risk of transmission by reducing the viral load in saliva using preprocedural mouthwashes. This study aims to review the most up-to-date in vitro and in vivo studies investigating the efficacy of different mouthwashes on reducing the salivary viral load of SARS-CoV-2, giving particular attention to the most recent randomized control trials published.

Do environmental pollutants carrier to COVID-19 pandemic? A cross-sectional analysis

The coronavirus disease (COVID-19) is a highly transmitted disease that spreads all over the globe in a short period. Environmental pollutants are considered one of the carriers to spread the COVID-19 pandemic through health damages. Carbon emissions, PM2.5 emissions, nitrous oxide emissions, GHG, and other GHG emissions are mainly judged separately in the earlier studies in different economic settings. The study hypothesizes that environmental pollutants adversely affect healthcare outcomes, likely to infected people by contagious diseases, including coronavirus cases. The subject matter is vital to analyze the preventive healthcare theory by using different environmental pollutants on the COVID-19 factors: total infected cases, total death cases, and case fatality ratio, in a large cross-section of 119 countries. The study employed the generalized least square (GLS) method for robust inferences. The results show that GHG and CO2 emissions are critical factors likely to increase total coronavirus cases and death rates. On the other hand, nitrous oxide, carbon, and transport emissions increase the case fatality ratio through healthcare damages. The study concludes that stringent environmental policies and improving healthcare infrastructure can control coronavirus cases across countries.

The emergence of severe acute respiratory syndrome-coronavirus 2 epidemic and pandemic

In the history of travel and tourism, a microscopic creature wrote a dark note, which interrupted the fast pace of globalization. In December 2019, in the seafood market of Wuhan city of China, a severe viral pneumonia-like infection was initiated, and which was new to the world and resulted in the emergence of a global health emergency. Thousands of passengers traveled through the city without knowing that one travel can change not only their lives but the future of the world. When WHO declared the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) outbreak as a global emergency, still no one thought of the conversion of the epidemic in the worst pandemic of the ongoing decade. Initially, the spread of SARS-CoV-2 infection over a wide area with a lot of patients at the same time declared it as a global epidemic, but the rapid escalation of the infection at more comprehensive geographical locations with a significant portion of the infected population soon turned the epidemic into the pandemic. The imported cases soon spread to their native places and turn the disease pandemic. While many countries are imposing partial or complete lockdown for the safety of travelers and civilians, the vacant human-made spaces and tourist architectures are asking that where the lacunae were, which has put the globe in such a devastating phase. The emergence of SARS-CoV-2 created a colossal health crisis for the entire world. From a provincial health concern to a global meltdown, the impact of SARS-CoV-2 has undeniably impacted the world medically, socially, financially, and psychologically. The footprints of SARS-CoV-2 are impactfully imprinted on the decade that will require a lot of time for global recovery.

Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020

BACKGROUND

The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo.

METHODS

A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male).

RESULTS

The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52-0.80]) or insufficiently active [aPR: 0.39 (0.18-0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35-0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40-0.79)].

CONCLUSIONS

A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

Comparison of Different Waves during the COVID-19 Pandemic: Retrospective Descriptive Study in Thailand

Background

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. An outbreak is called an epidemic when there is a sudden increase in cases. Many countries have experienced a two-wave pattern in the reported cases of COVID-19. The spread of COVID-19 in Thailand was a cluster event distributed over multiple locations. This study aims to compare the characteristics of different waves during the COVID-19 pandemic in Thailand.

Methods

A retrospective cohort study was conducted from January 2020 to May 2021 (17 months) to determine the number of COVID-19 screenings and confirmed cases and deaths as well as sociodemographic characteristics such as gender, age, nationality, and source population at risk factors. The categorical data were compared using a chi-square test.

Results

Three waves of the COVID-19 pandemic occurred within 17 months in Thailand, and the number of cases increased by over 100,000 due to source population at risk factors such as close contact with a previously confirmed patient, community risk, cluster communities, and active and community surveillance. The chi-square test revealed significant differences between the three waves (p < 0.01).

Conclusion

Significant differences between pandemic phases or waves may be due to weak social distancing policies and the lack of public health interventions. A COVID-19 vaccination plan is needed for people at risk of suffering severe symptoms and the general population in outbreak areas to increase immunity.

Selection of healthcare waste disposal firms using a multi-method approach

The aim of this study is to propose a hybrid multi criteria decision making model with a linear programming (LP) model to tackle the issue of safe disposal of hazardous and infectious healthcare waste. For this, ten criteria in this study have been identified from literature and field surveys which are modelled using Decision making trial and evaluation (DEMATEL) and Analytic network process (ANP) methods to select the best disposal firm i.e. single sourcing for a hospital. We found that Experience of the firm, Technology for disposal, and Waste collection infrastructure acts as the most vital criteria in selecting a healthcare waste disposal firm for single sourcing. Furthermore, to optimize the total value of disposal and mitigating the risk involved in disposing waste through single sourcing; the LP model considering constraints such as waste lose constraint and waste processing constraint etc. Is solved for multiple sourcing using Lingo 18.0. The solution to LP results into allocation of 500, 500, and 1000 (kg/day) disposables to healthcare waste disposal firms D1, D2 and D3, respectively. The multi-method approach proposed in this study helps the hospital management in selecting economically, socially, and environmentally sustainable healthcare waste disposal firm.

From outbreak of COVID-19 to launching of vaccination drive: invigorating single-use plastics, mitigation strategies, and way forward

The unforeseen outbreak of the COVID-19 epidemic has significantly stipulated the use of plastics to minimize the exposure and spread of the novel coronavirus. With the onset of the vaccination drive, the issue draws even more attention due to additional demand for vaccine packaging, transport, disposable syringes, and other allied devices scaling up to many million tonnes of plastic. Plastic materials in personal protective equipment (PPE), disposable pharmaceutical devices, and packaging for e-commerce facilities are perceived to be a lifesaver for the frontline healthcare personnel and the general public amidst recurring waves of the pandemic. However, the same material poses a threat as an evil environmental polluter when attributed to its indiscriminate and improper littering as well as mismanagement. The review not only highlights the environmental consequences due to the excessive use of disposable plastics amidst COVID-19 but also recommends mixed approaches to its management by adopting the combined and step-by-step methodology of adequate segregation, sterilization, sanitization activities, technological intervention, and process optimization measures. The overview finally concludes with some crucial way-forward measures and recommendations like the development of bioplastics and focusing on biodegradable/bio-compostable material alternatives to holistically deal with future pandemics.

From Muscles to Wires: Report of Two Cases and Literature Review on COVID-19 Vaccination and Cardiac Conduction Disturbance

Since the end of 2020, several vaccines have become available as part of the global efforts to contain the adverse health outcomes of the coronavirus disease 2019 (COVID-19) pandemic. Although research has confirmed their safety on large scales, several post-marketing reports have revealed some rare cardiovascular side effects. Towards the end of the first half of 2021, multiple reports indicate possible links between COVID-19 vaccines (both mRNA-based vaccine and vector-based vaccines) and myopericarditis. Nevertheless, cardiac conduction disease in this context has only rarely been reported. In this report, we present two cases of probable vaccination-induced cardiac conduction disturbances along with a thorough literature review. In addition, we discuss probable pathophysiological mechanisms and insights into the suggested areas for future research. To our knowledge, these are the first published cases to result in permanent pacemaker implantation.

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.

Application of Internet of Things and Naive Bayes in Public Health Environmental Management of Government Institutions in China

As the builder and maintainer of the city appearance and environment, the city appearance and environmental service industry provides urban residents with a beautiful, livable, and comfortable living environment and is also responsible for providing city appearance and environmental public health services for the economic and social functions carried by the global cities task. Based on this problem, this study has carried out the work of government agencies' public health environmental management and influencing factors based on the Internet of Things and edge computing. This study analyzes the influencing factors of public health environmental management of government agencies based on traditional research and conducts data analysis through the Naive Bayes algorithm. On this basis, the study combines the Internet of Things technology to construct system architecture for public health environmental management. The proposed management system is used to manage government agencies, which meets security, privacy and efficiency, and data security requirements. Experimental results prove that after algorithm optimization and architecture design, the evaluation level of the public health environment is significantly improved.

Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis

There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11-0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36-0.52) and aphthous lesions 0.10 (95% CI 0.01-0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.

Plastic Pollution by COVID-19 Pandemic: An Urge for Sustainable Approaches to Protect the Environment

COVID-19 pandemic has created a prolonged impact globally and destructed the life all over the world. The necessary use of personal protective equipments, masks, gloves and other plastic products has to some extent reduced transmission of virus. However, the impact of plastic waste generated worldwide due to the pandemic has affected the environment globally. The coronavirus disease (COVID-19) has destructed and altered every part of life and environment globally. Potential impacts on the environment are seen due to the transmission of virus as well as a slowdown in economic activities as lockdown prevails. Increased biomedical waste, improper usage and disposal of surgical masks, disinfectants, gloves, and increasing plastics wastes from domestic households continuously endangers environment. Not only it has an impact on environment, but also deteriorates human health in the future. Global environmental sustainability is necessitated to overcome the plastic pollution problem and facilitate strategies to recycle and reuse plastics products. This review highlights the influence of COVID-19 on wastes generated by plastic products along with environmental challenges and repercussions. Also, measures to combat the plastic pollution problem have to be implemented for future protection and safety of the environment.

Secondary transmission of SARS-CoV-2 through wastewater: Concerns and tactics for treatment to effectively control the pandemic

The SARS-CoV-2 virus has spread globally and has severely impacted public health and the economy. Hand hygiene, social distancing, and the usage of personal protective equipment are considered the most vital tools in controlling the primary transmission of the virus. Converging evidence indicated the presence of SARS-CoV-2 in wastewater and its persistence over several days, which may create secondary transmission of the virus via waterborne and wastewater pathways. Although, researchers have started focusing on this mode of virus transmission, limited knowledge and societal unawareness of the transmission through wastewater may lead to significant increases in the number of positive cases. To emphasize the severe issue of virus transmission through wastewater and create societal awareness, we present a state of the art critical review on transmission of SARS-CoV-2 in wastewater and the potential remedial strategies to effectively control the viral spread and safeguard society. For low-income countries with high population densities, it is suggested to identify the virus in large scale municipal wastewater plants before following up with one-to-one testing for effective control of the secondary transmission. Ultrafiltration is an effective method for wastewater treatment and usually more than 4 logs of virus removal are achieved while safeguarding good protein permeability. Decentralized wastewater treatment facilities using solar-assisted disinfestation methods are most economical and can be effectively used in hospitals, isolation wards, and medical centers for reducing the risk of transmission from high local concentration sites, especially in tropical countries with abundant solar energy. Disinfection with chlorine, sodium hypochlorite, benzalkonium chloride, and peracetic acid have shown potential in terms of virucidal properties. Biological wastewater treatment using micro-algae will be highly effective in removal of virus and can be incorporated into membrane bio-reaction to achieve excellent virus removal rate. Though promising results have been shown by initial research for inactivation of SARS-CoV-2 in wastewater using physical, chemical and biological based treatment methods, there is a pressing need for extensive investigation of COVID-19 specific disinfectants with appropriate concentrations, their environmental implications, and regular monitoring of transmission. Effective wastewater treatment methods with high virus removal capacity and low treatment costs should be selected to control the virus spread and safeguard society from this deadly virus.

Recent breakthroughs of antibacterial and antiviral protective polymeric materials during COVID-19 pandemic and after pandemic: Coating, packaging, and textile applications

The global epidemic owing to COVID-19 has generated awareness to ensuring best practices for avoiding the microorganism spread. Indeed, because of the increase in infections caused by bacteria and viruses such as SARS-CoV-2, the global demand for antimicrobial materials is growing. New technologies by using polymeric systems are of great interest. Virus transmission by contaminated surfaces leads to the spread of infectious diseases, so antimicrobial coatings are significant in this regard. Moreover, antimicrobial food packaging is beneficial to prevent the spread of microorganisms during food processing and transportation. Furthermore, antimicrobial textiles show an effective role. We aim to provide a review of prepared antimicrobial polymeric materials for use in coating, food packaging, and textile during the COVID-19 pandemic and after pandemic.

Surveillance of Wastewater for Early Epidemic Prediction (SWEEP): Environmental and health security perspectives in the post COVID-19 Anthropocene

The present work summarizes the major research findings related to wastewater-based epidemiology (WBE) study of COVID-19 and puts forward a conceptual framework, termed as "Surveillance of Wastewater for Early Epidemic Prediction (SWEEP)" for implementation of WBE. SWEEP framework is likely to tackle few practical issues related to WBE and simultaneously proposes refinements to the approach for better outcome and efficiency to save precious lives around the globe. It is observed that the present pandemic offers an opportunity for SWEEP to get included in routine urban water management to put the humankind at front to stop such pandemic in future or at least be prepared to fight against it. With global collaboration, SWEEP can be fine-tuned to meet diverse needs, making the present and future generations resilient to future viral outbreaks. Recent WBE studies conducted to check for the presence of SARS-CoV-2 in wastewater revealed that raw sewage samples tested positive to PCR-based assays while the treated samples showed absence of viral titers. Moreover, the lockdown had a positive impact on decreasing the viral loading in sewage. The proposed SWEEP protocol has an advantage over testifying individuals for predicting the stage of pandemic.

Assessment of Health Infrastructure in Tackling COVID-19: A Case Study of European and American Scenario

The COVID-19 coronavirus pandemic is an unparalleled threat intoday's quickly developing climate, and we face it as a global community. Like climate change, it is challenging our resilience from environmental health, social security, and government, to knowledge exchange and economic policy in all sectors of the economy and all fields of growth. So much as climate change, everybody's coming together would require the initiative. Throughout Europe and America, several organizations have mobilized to ensure that the neediest are not left behind, encouraging emergencies and disruptions avoidance and preparedness. The coronavirus outbreak has highlighted the growing community's strengths and vulnerabilities that it has influenced, and has provided us with the ability to benefit from each other's accomplishments and shortcomings. The comparison graph has also been shown in this paper displaying European and American scenarios. The globe might feel smaller amid disaster states and global travel bans, but it is a period when teamwork and looking outward were never more relevant.