MERS-CoV infection: Mind the public knowledge gap

Evaluation of community knowledge and attitude toward COVID-19: the case of Hawassa city, Sidama, Ethiopia

Background

Scientific information on the knowledge and attitude of the community toward the COVID-19 pandemic is a vital step for effective control measures. This study aimed to investigate the level of knowledge and attitude of Hawassa city residents toward COVID-19 and the interaction among knowledge and attitude toward COVID-19.

Methods

A community-based cross-sectional study with stratified random sampling was used from June 2020 to August 2020. Five hundred and eighty-seven residents were selected for the study, which aimed to evaluate their knowledge and attitude toward COVID-19 using a standardized structured questionnaire. Data were collected using face-to-face interviews that strictly follow the WHO and the Ministry of Health Ethiopia guidelines for COVID-19 prevention. Attitude and knowledge were categorized based on the mean score value. Descriptive statistics and two independent multiple logistic regressions were applied to identify the possible determinants of knowledge and attitude using SPSS version 20 set at 95% CIs with a value of p of <0.05 considered statistically significant.

Results

In total, 61.7% of the participants were knowledgeable about the virus and 65.9% had a positive attitude toward COVID-19. Educational level with the categories of second degree and above (AOR = 29.709, 95% CI = 1.239-712.55), first degree (AOR = 3.476, 95% CI = 3.278-22.02), certificate/diploma (AOR = 1.062-18.24, 95% CI = 1.062-18.24), and grade 12 completed (AOR = 1.903, 95% CI = 2.12-6.809); employment status of respondents who were self-employed (AOR = 9.545, 95% CI = 1.165-78.173) and employed respondents (AOR = 10.053, 95% CI = 1.783-56.673); reading interest with categories always (AOR = 34.45, 95% CI = 26.608-4462.226) and sometimes (AOR = 17.24, 95% CI = 17.213-1661.966); and habit of using social media with categories always (AOR = 38.708, 95% CI = 5.086-294.610) and sometimes (AOR = 3.432, 95% CI = 3.504-23.378) were the significant explanatory variables that were correlated with knowledge of the respondents.

Conclusion

Although the knowledge and attitude of respondents toward COVID-19 were positive, there is a need to use more effective strategies to improve their knowledge and attitude toward COVID-19, and increasing knowledge on preventive behaviors among the community was mandatory to attain better results. The educational level, use of social media, and reading habits of the respondents appear to play significant roles in determining their level of knowledge and attitude toward COVID-19.

COVID-19 pandemic fatigue among well-educated egyptian population: Cross-sectional study

Aim

The study explores the emergence of COVID-19 pandemic fatigue among well-educated Egyptians measured in terms of their level of adherence toward COVID-19 protective measures along 20 months since the beginning of the pandemic.

Setting and Design

A cross-sectional study was conducted in October 2021, using an online questionnaire for well-educated Egyptians in different governorates.

Results

A total of 888 participants completed the questionnaire, their mean age was 39 ± 7.2 years and 60% of them were females. There was a strong association between the presence of either behavioral risk factors or chronic conditions and % of infection. The main sources of COVID-19 information were social media, followed by the Egyptian Ministry of health and population and WHO websites. A pandemic fatigue was observed after nearly 7 to 10 months from the pandemic emergence. The participant's age, previous COVID-19 infection, and occupation status were significant predictors for adherence to COVID-19 protective measures. The participants claimed that difficulty in remaining at home, feeling uncomfortable with face masks, the high cost of protective supplies, absence of governmental enforcement, and forgetfulness are the most perceptive barriers hindering their adherence to COVID-19 protective measures. They suggested some strategies for better adherence and reduced pandemic fatigue that includes: the implementation of governmental enforcement measures, including penalties for nonwearing masks, educational health programs, and availability of free protective supplies at the workplace.

Conclusions

Pandemic fatigue was observed after 7 to 10 months from the pandemic emergence even though the high education level of the participants.

COVID-19 knowledge, attitudes, and practices among Iranian pregnant and postpartum women: A national study

BACKGROUND

To control the spread of COVID-19, Iran has adopted rigorous precautionary and preventive measures, particularly for vulnerable groups. Considering the effects of knowledge and attitudes about COVID-19 on adherence to preventive measures, we examined women's knowledge, attitudes, and practices (KAP) from pregnancy to 6 weeks postpartum about COVID-19 during this pandemic.

METHODS

In a cross-sectional study, 7363 women were recruited via an online questionnaire between June 23, 2021 and July 7, 2021. The questionnaire consisted of 27 questions, measuring KAP.

RESULTS

Most of the participants had a good understanding of COVID-19 (Mean: 7.30 out of 9, standard deviation [SD]: 1.27), but the knowledge of the disease's main symptoms and modes of transmission was at the lowest levels. The mean attitudes score was 31.47 out of 50 (SD: 7.70). The participants had good practices against COVID-19 with a mean score of 35.48 out of 40 (SD: 3.94). To reduce anxiety and fear during the pandemic, half of our participants strongly emphasized the role of family emotional support. Income status and educational levels were the most significant variables influencing KAP (p-value ≤0.001). A correlation was found between knowledge and practice scores (r = 0.205, p-value = 0.001).

CONCLUSION

Our findings may serve to formulate awareness-raising interventions and can be a guide to health policymakers and workers such as obstetricians, clinicians, and midwives for more effective educational communication emphasizing the COVID-19 symptoms and transmission modes and rendering appropriate counseling, particularly on the importance of emotional family support during the pandemic.

Knowledge Gaps, Cognition and Media Learning: Designing Tailored Messages to Address COVID-19 Communication Inequalities

Various health and crisis studies have demonstrated support for the existence of knowledge gaps-a hypothesis suggesting that information will reach those in the lower socioeconomic status last, worsening health disparities. At the point at which COVID-19 vaccines were becoming widely accessible, the present study surveyed 651 Black Americans to understand vaccine hesitancy, intentions, and media learning variations after exposure to different types of social media posts about the COVID-19 vaccine. Although exposure to any of the message conditions in our study resulted in a decrease in vaccine hesitancy, we found mixed support for the knowledge gap hypothesis. Results show that lack of knowledge because of socioeconomic status is not a key factor driving vaccine hesitancy among Black Americans. Instead, public communication (government) campaigns may consider focusing on strategies to target Black American communities by age to improve media learning, and consider increasing social control and communal message functions to increase cognitive processing of pro-vaccine messages, and over the longer term, influence COVID-19 vaccine hesitancy and uptake.

Lessons from SARS-CoV, MERS-CoV, and SARS-CoV-2 Infections: What We Know So Far

Within past decades, human infections with emerging and reemerging zoonotic viral pathogens have raised the eminent public health concern. Since November 2002, three highly pathogenic and major deadly human coronaviruses of the βετα-genera (β-hCoVs), namely, severe acute respiratory distress syndrome-coronavirus (SARS-CoV), middle east respiratory syndrome-coronavirus (MERS-CoV), and SARS-CoV-2, have been globally emerged and culminated in the occurrence of SARS epidemic, MERS outbreak, and coronavirus disease 19 (COVID-19) pandemic, respectively. The global emergence and spread of these three major deadly β-hCoVs have extremely dreadful impacts on human health and become an economic burden. Unfortunately, clear specific and highly efficient medical countermeasures for these three β-hCoVs and their underlying fatal illnesses remain under development. Although they belong to the same family and share many features and convergent evolution, these three deadly β-hCoVs have some important and obvious differences. By utilizing their lessons and gaining a deeper understanding of these β-hCoVs, we can identify areas of improvement and provide preparedness plans for fighting and controlling the future reemerging human infections that might arise from them or from other potential pathogenic hCoVs. Therefore, this review summarizes the state-of-the-art information and compares the similarities and dissimilarities between SARS-CoV, MERS-CoV, and SARS-CoV-2, in terms of their evolution trait, genome organization, host cell entry mechanisms, tissue infectivity tropisms, transmission routes and contagiousness, and the clinical characteristics, laboratory features, and immunological abnormalities of their related illnesses. It also provides an overview of the emerging SARS-CoV-2 variants. Additionally, it discusses the challenges of the most proposed treatment options for SARS-CoV-2 infections.

Consumption-Related Health Education Inequality in COVID-19: A Cross-Sectional Study in China

Background

The COVID-19 pandemic influences various aspects of society, especially for people with low socioeconomic status. Health education has been proven to be a critical strategy in preventing a pandemic. However, socioeconomic characteristics may limit health education among low socioeconomic status groups. This study explores consumption-related health education inequality and the factors that contribute to this, which are variable across China during COVID-19.

Methods

The 2020 China COVID-19 Survey is a cross-sectional study in China, based on an anonymous online survey from 7,715 samples in 85 cities. It employed machine-learning methods to assess household consumption and other contributing variates associated with health education during the pandemic. Concentration Index (CI) and Horizontal Index (HI) were used to measure consumption-related inequalities in health education, respectively. Moreover, Wagstaff decomposition analysis was employed to identify other contributing variables to health education inequality.

Results

The result indicates that participants with more education, better income, and positive consumption preferences undertake higher health education during COVID-19. The CI and HI of consumption-health education inequality are 0.0321 (P < 0.001) and 0.0416 (p < 0.001), respectively, which indicates that health education is concentrated in wealthy groups. We adapted Lasso regression to solve issues and omit variables. In terms of other socioeconomic characteristics, Annual Income was also a major contributor to health education inequalities, accounting for 27.1% (P < 0.001). The empirical results also suggests that education, health status, identification residence, and medical health insurance contribute to health education inequality.

Conclusions

The difference in Household consumption, annual income, rural and urban disparity, and private healthcare insurance are critical drivers of health education inequality. The government should pay more attention to promoting health education, and healthcare subside policy among vulnerable people. Significantly to improve awareness of undertaking health education with lower education, rural residential, to enhance confidence in economic recovery and life after COVID-19.

Public Opinion on European Health Policy, Lessons from the COVID-19 Pandemic

Often, global crises, such as the COVID-19 pandemic, bring to light crucial weaknesses in political, economic, social and health systems. First, there are governments who formulate and implement policies and, second, there are the citizens who support them, thus contributing a great deal to their success. Our paper investigates the European citizens’ opinion on health policy, focusing on their preference for European health policy during the coronavirus pandemic. The paper uses bibliometric analysis, descriptive statistics, and logistic regression to discuss the public opinion on health policy, the factors of influence, the change in perspectives between 2020 and 2021, and the socio-demographic profile of those favorable for the development of a European health policy in response to the coronavirus pandemic. Our findings show that citizens from southern and central European countries are more likely to prioritize the development of a European health policy, as compared to Nordic countries. Between 2020 and 2021, pro-European health policy citizens profile changes and becomes clearer, from pensioners to young working age males with medium education. In general, people prioritizing a European health policy value health as the most important issue at a national level are generally satisfied with the European Union and do not trust their national government.

Study on awareness of COVID-19 and compliance with social distancing during COVID-19 pandemic in Indonesia

Public compliance with social distancing policy is necessary to slow down the spread of coronavirus disease 2019 (COVID-19). One of the factors that contribute to compliance with social distancing policy is awareness of COVID-19. This study aimed to examine the relationship between awareness of COVID-19 and compliance with social distancing policy. The study used an online survey through Google Form to 404 respondents aged 18-63 years. The data were collected by using awareness on the COVID-19 scale and compliance with the social distancing scale. The data were analyzed using the Spearman correlation and Kruskal-Wallis, followed by Mann-Whitney U with Bonferroni correction. The awareness of COVID-19 was significantly and positively associated with compliance with social distancing order. Based on demographic variables found that the awareness was significantly higher in postgraduates. The awareness of COVID-19 was also significantly higher in working participants. The compliance with social distancing order was found higher in women. The study's primary result is that the awareness of COVID-19 positively correlates with public compliance on social distancing order. In particular, there is a need to provide means and interventions to raise public awareness of this challenging situation.

Unmasking emerging issues in solid waste management: Knowledge and self-reported practices on the discarded disposable masks during the COVID-19 pandemic in the Philippines

The COVID-19 global health crisis has resulted in the emergence of a new type of solid waste-inappropriately discarded disposable masks (DMs)-posing serious risks to the public health and to the environment. This study assessed the knowledge-("K") and self-reported practices-("P") of the general public in DM waste management. A researcher-developed instrument was utilized to gather data with a reliability coefficient index of 0.94. The survey was participated in by 13,116 online users. Pearson r and multiple linear regression were performed to test the relationship between the participants' demographic characteristics and their K and P. Results revealed that the participants obtained a weighted mean and standard deviation of 1.15±0.10, which shows that 11,597 or 88.41% are knowledgeable on solid waste disposal and management. The self-reported practices of the participants obtained weighted mean and standard deviation rating of 2.16±0.10, which is interpreted as "Always Practiced". This signifies that the participants adequately practiced the essentials in disposing DMs. Furthermore, there is a significant relationship between K and P with their demographic characteristics on disposing DMs like age, sex, level of education, annual income, and type of residence. The obtained Pearson r=-0.178 (p<.01) indicates that the level of knowledge of the participants is significantly related to the practices they apply in disposing used DMs. As a recommendation, campaigns and interventions on the proper disposal of DMs should be put forward and implemented, utilizing various social media resources and platforms that are conveniently accessible to the general public.

Determinants of restaurant consumers' intention to practice COVID-19 preventive behavior: an application of the theory of planned behavior

BACKGROUND/OBJECTIVES

The purpose of this study was to examine the effects of knowledge about coronavirus disease 2019 (COVID-19), attitude, subjective norm, and perceived behavioral control on behavioral intentions to practice COVID-19 preventive behaviors using the theory of planned behavior (TPB).

SUBJECTS/METHODS

A total of 519 restaurant customers' responses was collected in this study through an online self-administered questionnaire. Descriptive statistical analysis was performed on socio-demographic factors. One-way analysis of variance and t-test were conducted to determine differences in the constructs from the TPB according to age and sex. The hypotheses were tested using structural equation modeling (SEM).

RESULTS

SEM revealed the positive effect of knowledge about COVID-19 on attitude, subjective norm, and perceived behavioral control to prevent the spread of COVID-19 in restaurants. Attitude, subjective norm, behavior intention, and knowledge positively affected COVID-19 preventive behavior intentions in restaurants.

CONCLUSIONS

The results of this study confirmed that the TPB is helpful in elucidating the determinants of consumers' intention to practice COVID-19 preventive behavior in restaurants. These findings can help policy makers and professionals provide material for further public health interventions and inform them about awareness-raising, guidelines, and health education programs.

Knowledge and attitude toward coronavirus disease 19 pandemic among Saudi Arabia population: A cross-sectional study

BACKGROUND

Coronavirus disease 19 is a pandemic affecting millions worldwide. Since February 2020, new cases are reported in Saudi Arabia, and regulations have been imposed to control the spread of the disease and raise awareness. This study aimed to assess the knowledge and attitudes of the Kingdom's residents toward coronavirus disease 19 during the early stages of the pandemic.

METHOD

A cross-sectional study of 2071 participants who were recruited from various cities in Saudi Arabia. An online questionnaire was shared through social media, which contained questions about demographic data, general knowledge of coronavirus disease 19, and participants' attitudes.

RESULTS

The mean age of the study population was 34 ± 12.4 years. Most of the participants agreed that coronavirus disease 19 is a pandemic and is more serious than seasonal influenza. More than 90% believed that handwashing and social distancing are effective in preventing disease transmission. No significant results were observed when comparing the knowledge of high-risk participants and the normal population. More than half of the cohort were strictly compliant with curfew regulations, handwashing, and face mask. Around 80% of the population is following coronavirus disease 19 news and information through official authorities' press releases.

CONCLUSION

The Kingdom of Saudi Arabia residents showed decent knowledge of coronavirus disease 19. Nevertheless, some information needs emphasizing and proper education. Frequent communication between healthcare authorities and the public is highly recommended.

Education in Mathematics and the Spread of COVID-19

We investigate the effect of standardized mathematics scores for young adults on the number of COVID-19 cases in the USA. We find that a one-grade-level increase in test scores led to a decrease in COVID-19 cases 30, 60, and 90 days after the first case in each county. Our findings suggest that if states and localities implement policies that increase the level of education and comprehension of mathematics at the K-12 level, that people may be better prepared to find and interpret information in a future public health crisis.

The information-seeking behavior and levels of knowledge, precaution, and fear of college students in Iloilo, Philippines amidst the COVID-19 pandemic

COVID-19 pandemic is devastating the health, social, and economic well-being of citizens worldwide. The high rates of morbidity and mortality and the absence of vaccines cause fear among the people regardless of age, gender, or social status. People's fear is heightened by misinformation spread across all media types, especially on social media. Filipino college students are one of the top Internet users worldwide and are very active in social media. Hence they are very prone to misinformation. This paper aims to ascertain the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines, and determine the effects of their information-seeking behavior on the variables above. This paper is a cross-sectional survey that used a qualitative-quantitative method and snowball sampling technique. Data were gathered among 228 college students using an online survey instrument a few months after the pandemic began. College students were knowledgeable of the basic facts about the highly infectious COVID-19. However, the majority were inclined to believe the myths and misinformation regarding the pandemic. Television was the primary, most believable, and preferred source when seeking information. The Internet as a preferred source of information was significantly associated with a high level of knowledge. In contrast, the information sourced from interpersonal channels were found to make college students very cautious. The local presence of COVID-19 cases had caused college students to fear, likely exacerbated by the plethora of information about the pandemic, mostly from Facebook. This is the first study conducted on the effects of the information-seeking behavior on the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines.

Effect of telephone counselling on the knowledge, attitude and practices of contacts of confirmed COVID-19 cases in Egypt

Background

The coronavirus disease 2019 (COVID-19) is an emerging respiratory illness. The World Health Organization declared it a public health emergency of international concern on 30 January 2020 and called for collaborative efforts, such as contact tracing and promoting the public awareness about COVID-19, and recommended prevention and control measures.

Aim

The aim of this study was to assess the effect of telephone counselling on the knowledge, attitude and practices (KAPs) of contacts of COVID-19 confirmed cases towards COVID-19 epidemiology and infection prevention and control measures.

Setting

Ten areas in Sharkia Governorate, Egypt divided into six rural and four urban areas.

Methods

A non-randomised controlled trial was conducted in Sharkia Governorate, Egypt, from 26 March 2020 to 12 April 2020 on 208 contacts of confirmed COVID-19 cases, divided equally into two groups: an experiment group that was exposed to telephone counselling by the researchers and a control group that was exposed to routine surveillance by local health authority. A semi-structured questionnaire was used to assess the KAP of both groups towards COVID-19 before and after intervention.

Results

After intervention the percent of contacts who achieved good knowledge, positive attitudes and better practice scores in the experimental group was 91.3%, 57.8% and 71.2%, respectively, compared with 13.5%, 7.8% and 16.3%, respectively, in the control group. Male gender and working group were significantly associated with bad practice score. Furthermore, there was a statistically significant positive correlation between differences in knowledge, attitudes and practices of the experimental group before and after the intervention.

Conclusion

This study proved the effectiveness of telephone counselling in improving COVID-19-related KAP scores of contacts of confirmed COVID-19 cases.

Factors affecting the public's knowledge about COVID-19 vaccines and the influence of knowledge on their decision to get vaccinated

OBJECTIVE

An analysis was conducted to assess the factors affecting the public's knowledge about coronavirus disease (COVID-19) vaccines and the influence of that knowledge on their decision to get vaccinated.

STUDY DESIGN

Cross-sectional survey.

METHODS

An online, self-administered questionnaire was instrumentalized to assess the factors affecting the Jordanian public's knowledge about COVID-19 vaccines and the influence of that knowledge on their decision to get vaccinated. A multiple linear regression analysis was carried out to determine the variables that affected the participants' knowledge score regarding COVID-19 vaccines. The Mann-Whitney U test was used to evaluate the differences in knowledge scores among different groups. P < 0.05 was considered statistically significant.

RESULTS

Only 45.9% of the 468 participants reported being willing to receive the vaccine, and only 38.5% (n = 180) had registered on the Ministry of Health platform to get vaccinated. Moreover, very few of them (26/468, 5.6%) had received the vaccine. The participants showed inadequate knowledge, with a median knowledge score of 4 out of 8 (interquartile range = 4). The linear regression analysis showed that participants aged above 45 years, those with bachelor's or graduate degrees, and those with medical-related degrees had higher knowledge scores regarding COVID-19 vaccines than the others (P < 0.001). Participants who were willing to receive the vaccine, those who had registered to receive the vaccine, and those who had got vaccinated had higher knowledge scores than the others (P < 0.001 for all).

CONCLUSION

This cross-sectional analysis indicated that urgent education is needed to improve the public's knowledge and awareness about the COVID-19 vaccine to reduce the adverse impact of lack of knowledge on decision making for the COVID-19 vaccination.

Levels of fear and uncertainty regarding the spread of coronavirus disease (COVID-19) among university students

PURPOSE

This study aimed to assess the levels of fear and uncertainty regarding the spread of coronavirus disease 2019 among Jouf University students and to explore the factors influencing those fears and uncertainties.

DESIGN AND METHODS

This was a cross-sectional study of 416 undergraduate students who used an electronic questionnaire. Fear and intolerance of uncertainty scales were used to assess students' fear and uncertainty.

FINDINGS

Results indicated a positive correlation between fear and intolerance of uncertainty, and a negative correlation between the level of knowledge and fear. Gender, age, and type of college emerged as significant predictors of fear.

PRACTICE IMPLICATIONS

Developing strategies to respond positively to students' worries and fears and proactively help them to solve their problems and guide them in preparing a plan for the future.

Middle East Respiratory Syndrome (MERS) Virus-Pathophysiological Axis and the Current Treatment Strategies

Middle East respiratory syndrome (MERS) is a lethal respiratory disease with its first case reported back in 2012 (Jeddah, Saudi Arabia). It is a novel, single-stranded, positive-sense RNA beta coronavirus (MERS-CoV) that was isolated from a patient who died from a severe respiratory illness. Later, it was found that this patient was infected with MERS. MERS is endemic to countries in the Middle East regions, such as Saudi Arabia, Jordan, Qatar, Oman, Kuwait and the United Arab Emirates. It has been reported that the MERS virus originated from bats and dromedary camels, the natural hosts of MERS-CoV. The transmission of the virus to humans has been thought to be either direct or indirect. Few camel-to-human transmissions were reported earlier. However, the mode of transmission of how the virus affects humans remains unanswered. Moreover, outbreaks in either family-based or hospital-based settings were observed with high mortality rates, especially in individuals who did not receive proper management or those with underlying comorbidities, such as diabetes and renal failure. Since then, there have been numerous reports hypothesising complications in fatal cases of MERS. Over the years, various diagnostic methods, treatment strategies and preventive measures have been strategised in containing the MERS infection. Evidence from multiple sources implicated that no treatment options and vaccines have been developed in specific, for the direct management of MERS-CoV infection. Nevertheless, there are supportive measures outlined in response to symptom-related management. Health authorities should stress more on infection and prevention control measures, to ensure that MERS remains as a low-level threat to public health.

Public health awareness: knowledge, attitude and behaviors of the public on health risks during COVID-19 pandemic in sultanate of Oman

Purpose

This study aims to measure the level of public awareness about the threat of the emerging coronavirus (COVID-19) pandemic among the Omani population. It also aims to investigate the mediating effect of the Omanis’ attitudes and behaviors with underlying conditions of COVID-19.

Design/methodology/approach

A cross-sectional study was conducted to collect data via an online survey of Omani citizens and residents from various geographic areas in Oman, 305 responses were received. SPSS and partial least square-structural equation modeling were used for data analysis.

Findings

The study revealed that public awareness regarding the COVID-19 pandemic was significantly influenced by people’s perceived risk, information source and health-related knowledge. Further, preventive behavior during the disease spread has a significant direct and indirect impact on their awareness. However, an insignificant mediation effect of public attitude was found between the source of information and public awareness.

Research limitations/implications

This study is limited by the scarcity of related literature in the Omani context. It is recommended that future research complete an in-depth study of public awareness regarding COVID-19, using other constructs and/or other data collection techniques.

Practical implications

This research will provide governmental health authorities and policymakers with a guideline to establish more efficient pandemic containment strategies to control public behavior toward the COVID-19 pandemic and curb viral prevalence.

Social implications

This research will help in improving prevention measures against COVID-19 are recommended to be more educated through a more effective mechanism to raise public attitude regarding pandemic prevalence positively.

Originality/value

The originality of this research can be drawn from key findings that indicate that people overall gained knowledge about how to deal with the COVID-19 pandemic and the accuracy of information significantly impacts public awareness.

The interplay between the immune system and SARS-CoV-2 in COVID-19 patients

Millions of people across the globe have been affected by coronavirus disease 2019 (COVID-19), which began in Wuhan, China, and is caused by SARS-CoV-2. COVID-19 has a variety of clinical characteristics and triggers immune responses required for the elimination of the viral agent. Currently, no effective treatment options are available for targeting SARS-CoV-2 infection. Repurposing of drugs such as chloroquine, thalidomide, and leflunomide alongside convalescent plasma is being employed as a therapeutic strategy. Clinical studies have shown that both asymptomatic and symptomatic patients can have an extremely active immune response that is largely attributable to immune system modulations. This includes cytokine storm syndrome (CSS), which affects the adaptive immune system, leading to exhaustion of natural killer (NK) cells and thrombocytopenia in some cases. This review examines the interaction of SARS-CoV-2 with the host immune system and the potential for the development of appropriate immunotherapy for the treatment of COVID-19.

Public Response, Anxiety and Behaviour during the First Wave of COVID-19 Pandemic in Saudi Arabia

This study aims to investigate public response attitude, anxiety, practices and trust in the authorities' mitigation plan during the first wave of COVID-19 pandemic. A national cross sectional phone survey was conducted among Saudi residents aged 16 years and above. A total of 90,421 (45.2%) individuals participated in the study. Of those, the overall rate of COVID-19 correct knowledge was 82% (mean: 9.84); social media was the most reported source of knowledge. Younger age, low levels of education and foreign residents were associated with poor knowledge. Overall, 49.5% scored 5 or more on the GAD-7 test, indicating anxiety symptoms, 19.2% of them scored 10 and above, suggesting moderate to severe anxiety. Majority of participants (>78%) trusted and supported the interventions implemented by the government to control COVID-19. Social distancing practices among participants was as following, 72.5% stayed at home and avoid going out for nonessential business and 49.5% avoided attending social events and family gatherings. Trust in authorities, being anxious, worry and levels of knowledge about the disease, were the most common factors affecting adoption of the recommended practices. Continuous evaluation of public response about COVID-19, and the effectiveness of protective measures is essential to better inform policy-makers and identify ways of encouraging behaviour change among public during pandemic.

Awareness and perception of COVID-19 among the general population: A Middle Eastern survey

Due to the sudden emergence of the novel coronavirus as a worldwide pandemic, this study aimed to evaluate the awareness and practices of both the Jordanian and Iraqi populations during the early stages of the pandemic. A cross-sectional survey was conducted between the 19th and 22nd of March to assess the public's awareness toward COVID-19. Multiple scored domains were used to assess the differences between the two populations. Statistical analysis was conducted to reveal the influence of sociodemographic variables on these scores. A total of 3167 participants were recruited in the study, of which, 1599 (50.5%) were from Jordan and 1568 (49.5%) were from Iraq. More than half of the Jordanian (56.8%) and Iraqi participants (53.2%) showed average or adequate awareness about COVID-19. More than 60% of both populations relied on medical staff for COVID-19 related information. Social media was the second most common COVID-19 information source, as it was reported by 53.7% of Jordanian participants and 62.8% of Iraqi participants. More than 90% of both populations participated in precautionary measurements. Finally, about 20% of both populations failed to recognize droplet inhalation as a source of transmission. Despite the portrayed awareness levels, governmental involvement is warranted to increase the public's awareness and fill the gaps within their knowledge.

A snapshot of public knowledge of novel coronavirus disease 2019: a web-based national survey

Background

Although the number of existing cases of coronavirus disease 2019 (COVID-19) in China has been decreasing since late February 2020, the number of confirmed cases abroad is surging. Improving public knowledge of COVID-19 is critical to controlling the pandemic. This study aimed to determine China’s public knowledge of COVID-19 and the attitudes towards control measures.

Methods

A cross-sectional study was conducted over 48 h from 22:30 29 February 2020 to 22:30 2 March 2020 based on a self-administered web-based questionnaire. The survey was conducted on the WeChat network. Exponential non-discriminative snowball sampling was applied. The questionnaire was voluntarily completed by WeChat users. The questionnaire covered basic demographic information, public knowledge of the epidemiological and clinical characteristics of COVID-19, psychological state, and attitudes towards the overall control measures. The primary outcome was the China’s public knowledge of COVID-19 and the attitudes towards control measures and secondary outcome was the psychological state of the public during this pandemic.

Results

The study included 10,905 participants and 10,399 valid questionnaires were included for analysis. Participants with tertiary education, younger participants and healthcare workers had better overall knowledge than other participants (all P < 0.05). Approximately 91.9% of the participants believed in person-to-person transmission and 39.1% believed in animal-to-person transmission. No significant correlation between anxiety and the number of regional existing confirmed cases was found, while participants in Hubei were more anxious than those in other regions. In general, 74.1% of the participants acknowledged the effectiveness of the overall control measures, and the percentage of participants with agreement with the overall control measures was negatively correlated with the number of regional existing confirmed cases (r = − 0.492, P = 0.007).

Conclusions

In conclusion, the survey revealed that the Chinese public had overall good knowledge of COVID-19 except for those indeterminate knowledges. With dynamic changes in the global pandemic situation and more research, further studies should be conducted to explore changes in public knowledge and attitudes towards COVID-19 in the future. The media could be used in a strict and regular manner to publicize knowledge of such pandemics to halt their spread.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10495-4.

COVID-19 related knowledge and practice and barriers that hinder adherence to preventive measures among the Egyptian community. An epidemiological study in Upper Egypt

BACKGROUND

This study aims to assess COVID-19 related knowledge and practice among the Egyptians in Upper Egypt and to identify barriers that hinder adherence to these preventive measures.

DESIGN AND METHODS

We conducted a cross-sectional study using a structured questionnaire. Data was collected from 21 to 30 August 2020, via both online survey and personal interviews using a non-probability self-nominated sample.

RESULTS

A total of 731 participants completed the questionnaire. The mean age was 32.1± 2.1 and 64.3% were females. The main sources of knowledge were, Internet and Social Media followed by TV then family and friends. More than 96% of the respondents knew the origin, nature, the main symptoms, and the modes of transmission of COVID-19, however, 37.6% of them thought that COVID-19 patients must develop symptoms. 75.8% and 73.6% of the participants respectively covered their nose and mouth during sneezing and washed their hands regularly, 65.4% wore masks in crowded places, while only 31.1% and 30% of them respectively avoided touching their faces or shaking hands with friends. Knowledge and practice were positively correlated and both were linked to younger age and higher education and the female gender was also a predictor of better practice. The most common perceived barriers to adherence to preventive measures were feeling uncomfortable, forgetfulness then financial causes.

CONCLUSIONS

the study subjects were aware of COVID-19 and its preventive measures however adherence to some of these measures was not prevalent amongst them, indicating an urgent need of addressing and targeting barriers that hinder adherence to COVID-19 preventive measures in the future policies to prevent the spread of COVID-19 in Egypt.

COVID-19 related knowledge and practice and barriers that hinder adherence to preventive measures among the Egyptian community. An epidemiological study in Upper Egypt

Background: This study aims to assess COVID-19 related knowledge and practice among the Egyptians in Upper Egypt and to identify barriers that hinder adherence to these preventive measures. Design and methods: We conducted a cross-sectional study using a structured questionnaire. Data was collected from 21 to 30 August 2020, via both online survey and personal interviews using a non-probability self-nominated sample. Results: A total of 731 participants completed the questionnaire. The mean age was 32.1± 2.1 and 64.3% were females. The main sources of knowledge were, Internet and Social Media followed by TV then family and friends. More than 96% of the respondents knew the origin, nature, the main symptoms, and the modes of transmission of COVID-19, however, 37.6% of them thought that COVID-19 patients must develop symptoms. 75.8% and 73.6% of the participants respectively covered their nose and mouth during sneezing and washed their hands regularly, 65.4% wore masks in crowded places, while only 31.1% and 30% of them respectively avoided touching their faces or shaking hands with friends. Knowledge and practice were positively correlated and both were linked to younger age and higher education and the female gender was also a predictor of better practice. The most common perceived barriers to adherence to preventive measures were feeling uncomfortable, forgetfulness then financial causes. Conclusions: the study subjects were aware of COVID-19 and its preventive measures however adherence to some of these measures was not prevalent amongst them, indicating an urgent need of addressing and targeting barriers that hinder adherence to COVID-19 preventive measures in the future policies to prevent the spread of COVID-19 in Egypt.

Health literacy in the general population in the context of epidemic or pandemic coronavirus outbreak situations: Rapid scoping review

OBJECTIVE

The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks (SARS-CoV-1, MERS-CoV and SARS-CoV-2).

METHODS

We searched major databases and included publications of quantitative and qualitative studies in English and German on any type of research on the functional, critical and communicative domains of HL conducted in the context of the three outbreaks in the general population. We extracted and tabulated relevant data and narratively reported where and when the study was conducted, the design and method used, and how HL was measured.

RESULTS

72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic/epidemic HL instruments, or relate pandemic/epidemic or general HL to a pandemic/epidemic outcome, or any controlled intervention study. Type of assessment of the domains of HL varied widely.

CONCLUSION

Theory-driven observational studies and interventions, examining whether pandemic-related HL can be improved are needed.

PRACTICE IMPLICATIONS

The development and validation of instruments that measure pandemic-related HL is desirable.

Product of natural evolution (SARS, MERS, and SARS-CoV-2); deadly diseases, from SARS to SARS-CoV-2

SARS-CoV-2, the virus causing COVID-19, is a single-stranded RNA virus belonging to the order Nidovirales, family Coronaviridae, and subfamily Coronavirinae. SARS-CoV-2 entry to cellsis initiated by the binding of the viral spike protein (S) to its cellular receptor. The roles of S protein in receptor binding and membrane fusion makes it a prominent target for vaccine development. SARS-CoV-2 genome sequence analysis has shown that this virus belongs to the beta-coronavirus genus, which includes Bat SARS-like coronavirus, SARS-CoV and MERS-CoV. A vaccine should induce a balanced immune response to elicit protective immunity. In this review, we compare and contrast these three important CoV diseases and how they inform on vaccine development.

Risk Perception of COVID-19 Infection and Adherence to Preventive Measures among Adolescents and Young Adults

To explore factors influencing adolescents and young adults' (AYAs) risk perception of COVID-19 and adherence to public health measures, we conducted a cross-sectional online survey of AYAs (14-22 years old) from Quebec (Canada) recruited through school and community partners in April 2020 during the first wave of the COVID-19 pandemic. The study included 3037 participants (mean age = 17.7 years, 74.6% female). AYAs had higher mean (standard deviation (SD)) risk perception of COVID-19 for their relatives (8.2 (1.9)) than for themselves (5.6 (2.6)) (p < 0.001). Factors associated with higher risk perception included higher disease knowledge (adjusted odds ratio (aOR) 1.06, 95% CI 1.01-1.11), presence of chronic disease (aOR 2.31, 95%CI 1.82-2.93) and use of immunosuppressants (aOR 2.53, 95%CI 1.67-3.87). AYAs with a higher risk perception (aOR 1.06, 95%CI 1.02-1.10) those wishing to help flatten the disease curve (aOR 1.18, 95%CI 1.12-1.25) or to protect their family/friends (aOR 1.14, 95%CI 1.05-1.24) were more likely to engage in preventive behaviors. Self-perceived risk and desire to protect others were significantly associated with adherence to preventive measures among youth. These findings may help inform public health messaging to AYAs in the current and future pandemics.

Knowledge, attitudes, and practices toward COVID-19 among university students in Japan and associated factors: An online cross-sectional survey

The coronavirus disease (COVID-19) pandemic has greatly altered peoples’ daily lives, and it continues spreading as a crucial concern globally. Knowledge, attitudes, and practices (KAP) toward COVID-19 are related to individuals’ adherence to government measures. This study evaluated KAP toward COVID-19 among university students in Japan between May 22 and July 16, 2020, via an online questionnaire, and it further investigated the associated determining KAP factors. Among the eligible respondents (n = 362), 52.8% were female, 79.0% were undergraduate students, 32.9% were students whose major university subjects were biology-related, 35.4% were from the capital region, and 83.7% were Japanese. The overall KAP of university students in Japan was high. All respondents (100%) showed they possessed knowledge on avoiding enclosed spaces, crowded areas, and close situations. Most respondents showed a moderate or higher frequency of washing their hands or wearing masks (both at 96.4%). In addition, 68.5% of respondents showed a positive attitude toward early drug administration. In the logistic regressions, gender, major subjects, education level, nationality, residence, and psychological factors (private self-consciousness and extroversion) were associated with knowledge or attitudes toward COVD-19 (p < 0.05). In the logistic and multiple linear regressions, capital regions, high basic knowledge, high information acquisition, correct information explanations contributed positively to preventative action (p < 0.05). Non-capital regions, male gender, non-bio-backgrounds, high public self-consciousness, high advanced knowledge, incorrect information explanations, and high extroversion contributed negatively to self-restraint (p < 0.05). Moreover, self-restraint was decreasing over time. These findings clarify the Japanese university students’ KAP and the related factors in the early period of the COVID-19 pandemic, and they may help university managers, experts, and policymakers control the future spread of COVID-19 and other emerging infections.

Individuals' Self-Reactions Toward COVID-19 Pandemic in Relation to the Awareness of the Disease, and Psychological Hardiness in Saudi Arabia

The coronavirus (COVID-19) outbreak around the world has caused public health concerns and changes in peoples' behaviors and psychological distress. The pandemic impacts on human behavior, emotions, and cognition, leading to diverse reactions in relation to awareness of the disease. However, there is little understanding around the psychological impacts of the pandemic and strategies to overcome this impact. This study aimed to examine individuals' reactions toward the COVID-19 pandemic in relation to their psychological hardiness, their degree of awareness toward the pandemic, and precautionary measures taken. Individuals living in Saudi Arabia were invited to complete an online questionnaire which included demographic items, psychological responses to the pandemic, awareness of COVID-19, and measures of psychological hardiness. A total of 1272 individuals were recruited into the study, with the majority being female (85%). Results indicated that the average psychological responses to the COVID-19 pandemic in the study sample were 75.85%. This indicates that the sample generally has a high level of positive psychological responses to the COVID-19 pandemic. The awareness of COVID-19 among Saudi was 91.50%. This indicates a high level of awareness among the study sample.

Where we missed? Middle East Respiratory Syndrome (MERS-CoV) epidemiology in Saudi Arabia; 2012-2019

MERS-CoV first case was reported on 23rd November 2012 in Saudi Arabia, Since, then MERS has remained on World Health Organization (WHO) Blueprint list and declared pandemic. This study was conducted on MERS lab confirmed cases reported to Ministry of Health, Saudi Arabia and WHO for year 2012-2019. The epidemiology was investigated based on infection rate, death rate, case fatality rate, Gender, Age group, and Medical conditions (Comorbid and Symptomatic). The overall median age of infected male was 58 years and of female was 45 years. While average mortality age in male was 60 years and of female was 65 years which is greater than the global average of 50 years. The results also report that specially after age of 40 years in both men and women, chances of infection are more while comorbidities increase the infection rate. The men are more susceptible to infection than women. In case of asymptomatic distribution trend was vice versa with 69.4% women and 30.6% in men. Second, most infected age group was reduced by 20 years in case of men with 47.37% infection for age group of 20-39 years. This was also observed in age-group of 20-39 years for no comorbid cases (men (50%) & women (79%)). This explains MERS-CoV prevalence in Saudi Arabia, as young and healthy population were infected, and acted as carrier and on coming in contact with vulnerable population (Elderly, chronic and comorbid) transferred the infection. Hence, MERS-CoV outbreak kept on happening from time to time over past years. This finding might very well explain the exponential spread of Novel CoV-19 globally, as initial control measures required older people to stay indoors while younger generation brought infection from outside. Further studies are required for epidemiology analysis based on clusters, travel history and specific disease related mortality.

COVID-19 and Infection Control in Dental Clinics; Assessment of Public Knowledge, Attitudes and Practices in Several Regions of Saudi Arabia

Background:

The recent outbreak of the Corona Virus Disease (COVID-19) has affected millions of lives in different countries including the Kingdom of Saudi Arabia. Due to the characteristics of dental practice settings, there is a high risk of infection transmission between patients and dentists.

Objectives:

The aim of this study was to assess the level of public knowledge, attitude and practice regarding COVID-19 and infection control when visiting a dentist.

Methods:

In April 2020, a web-based cross-sectional survey was distributed randomly among the public through social media platforms. A validated anonymous questionnaire was used to assess knowledge about COVID-19 and participants’ attitudes toward extra measures to prevent the spread of infection.

Results:

Among the completed questionnaires (N=521), the mean age of the participants was 36.24 years, 68.3% were women, 87.5% held a university degree, and 81% were from the Makkah region. Most of the participants (99%) obtained a good knowledge score regarding COVID-19. Women were more likely than men to have more knowledge (p<0.05). Nearly all of the participants (99.6%) demonstrated good attitudes towards precautionary measures in dental clinics.

Spearman’s rho test showed a statistically significant correlation between age and attitude score, suggesting that attitude score increased with age (p<0.05). Overall, 73.3% reported that they would maintain good hygiene practices when visiting a dentist during this pandemic.

Conclusion:

Most Saudi residents with a high education level are knowledgeable about COVID-19, hold promising attitudes, and have appropriate practices towards precautionary measures needed while visiting a dental clinic during the virus outbreak.

Before and after case reporting: A comparison of the knowledge, attitude and practices of the Jordanian population towards COVID-19

Coronavirus disease- 2019 (COVID-19) is an emerging contagious infectious disease. It is pandemic and has affected more than 21 million people and resulted in more than 750,000 deaths worldwide (https://www.worldometers.info/coronavirus/#countries; 14/08/20). Our research group initiated a study to ascertain the knowledge, attitude and practices (KAP) of Jordanians toward COVID-19 prior to any initial case report in Jordan. This project was underway when the first Jordanian case was reported. We extended our study to identify how case reporting would alter public KAP towards COVID-19. This cross-sectional study randomly selected and recruited 2104 Jordanian adults. A four-section questionnaire was devised to address the sociodemographic characteristics of the subjects and their KAP toward COVID-19. The mean knowledge score for the study population was 15.9 ± 2.2 (out of the 20 knowledge questions), with 60.9% of the participants having good knowledge about COVID-19. Participants’ practices to prevent transmission of COVID-19 were adequate in more than 60% of participants. Most participants had positive attitudes regarding their role in preventing COVID-19 and many of the participants’ attitudes and practices changed to more appropriate ones after reporting the first case of COVID-19 in Jordan. The percentage of participants who trust the government in confronting COVID-19 increased significantly (p value < 0.001). However, one alarming and unexpected finding was that the prevention practice score of participants working in the medical field was similar to those from the general population. This may necessitate stricter training and guidelines for this group who will be in the frontline in combating the disease. Impact of this study: The data generated from this study shows that when cases of disease were reported, the public’s attitudes and practices improved in many aspects, and that confidence in the government to contain the disease was boosted. We believe that this study is important in allowing other, international governments to develop an understanding of public KAP during pandemic disease outbreaks.

The Knowledge and Attitude of the Community from the Aseer Region, Saudi Arabia, Toward COVID-19 and Their Precautionary Measures Against the Disease

BACKGROUND

Community adherence to current control measures is one of the vital factors that determines the success of controlling the spread of COVID-19. This adherence depends on the knowledge and attitude of a community toward COVID-19 and their precautionary measures against the disease.

OBJECTIVE

This study aims to evaluate the knowledge and attitude of the community from the Aseer Region, Saudi Arabia, toward COVID-19 and their precautionary measures against the disease.

METHODS

The descriptive cross-sectional study involved an online sample of participants from the Aseer Region, Saudi Arabia, who were recruited based on a nonprobability convenience sampling method from April to May 2020. The self-administered online questionnaire comprised four parts: the first included the demographic details of the participants; the second consisted of 11 closed-ended questions that assessed the participants' knowledge of COVID-19; the third contained six closed-ended questions that assessed the participants' overall attitude toward COVID-19; and the fourth comprised six closed-ended questions on the participants' precautionary measures against COVID-19. The data were analyzed using Statistisoftware SPSS 21.0.

RESULTS

Altogether, 740 participants completed the online questionnaire. The mean knowledge score concerning COVID-19 was 8.08 ± 1.765. Graduate participants scored significantly higher for all knowledge items than those from other educational levels. Furthermore, the main source of COVID-19 information was the Ministry of Health website 661 (89.3%). The mean attitude score regarding COVID-19 was 9.74 ± 1.935, whereas the mean precautionary measures score was 10.09 ± 1.91. University-educated participants scored significantly higher for all knowledge items than those from other educational levels. Female participants had significantly higher precautionary measures scores than male participants.

CONCLUSION

This study confirms that residents of the Aseer Region have high knowledge of, demonstrate a positive attitude toward, and use appropriate precautionary measures against COVID-19, which is associated with obtaining information about the virus from the Ministry of Health website.

COVID-19 and Severe Mental Illness: Impact on patients and its relation with their awareness about COVID-19

COVID-19 outbreak has promoted many public health measures in the general population. However, its impact on a vulnerable population with severe mental illness (SMI) is less addressed. Aim of this study was to determine the impact of COVID -19 to patients with SMI and identify its relation with their COVID-19 knowledge. A cross-sectional telephonic survey among 132 patients with SMI who were clinically stable before the COVID-19 pandemic was conducted. A 23 item interview proforma comprising of self-reported knowledge related to COVID-19 by patients and their illness and treatment status from their caregivers. Eleven patients were completely not aware of the ongoing COVID-19 pandemic. Three fourth of patients were not worried about getting COVID-19 and lacks adequate knowledge to identify symptoms. Two-third of patients lacked adequate knowledge of precautionary measures against COVID-19. One out of five patients lacked knowledge of the mode of transmission and stopped their psychiatric treatment. Thirty percent showed features of relapse of symptoms during this lockdown period. In multivariate regression analysis, patients from lower socioeconomic status, low literacy levels, with inadequate social support showed less knowledge related to COVID-19. Mental health services which target this vulnerable population during early disaster reduce the burden to the community.

Community's Knowledge of COVID-19 and Its Associated Factors in Mizan-Aman Town, Southwest Ethiopia, 2020

Background

Coronaviruses are a large group of viruses that are common throughout the community. They are associated with mortality, hospitalization, substantial extra costs and lower patient’s quality of life. Thus, this study aimed to assess the community’s knowledge of COVID-19 and associated factors in Mizan-Aman town, southwest Ethiopia.

Methods

Community-based cross-sectional study design was conducted among the community of Mizan-Aman from April 14 to May 14, 2020. A systematic sampling technique was used to collect data from selected households. Data were entered into Epi data version 4.0.2.101 and then exported to SPSS version 24.0 for analysis. To identify the predictors of knowledge of COVID-19, multiple backward logistic regression analysis was used. To show the accuracy of data analysis, 95% CI was used, and statistical significance was considered at p <0.05.

Results

From 423 sampled population, 393 (92.9%) of them responded to the questionnaire. Of these, 233 (59.3%) were male, 225 (57.3%) were 18–34 years old, and 250 (63.6%) were married. The overall correct rate of the knowledge questionnaire was 74.75%. More than 85% of respondents were well aware of the main clinical symptoms of COVID-19, its transmission by close contact, its prevention by not going to crowded places and isolation of infected persons. Male gender (AOR=3.74, CI: 1.87–7.49), age (35–54 years) (AOR=3.81, CI: 1.35–10.70), age ≥55 (AOR=2.97, CI: 1.16–7.62), lack of formal education (AOR=6.0, CI: 1.54–23.40), farmer (AOR=8.72, CI: 2.08–35.53), daily laborer (AOR=7.57, CI: 2.28–25.15), merchant (AOR=6.34, CI: 2.06–19.43), house wife (AOR=11.59, CI: 2.91–46.23) were significantly associated with poor knowledge, whereas single marital status was less likely associated with poor knowledge of COVID-19.

Conclusion

One-third of the study participants had poor knowledge regarding COVID-19. Male gender, age above thirty-five years, lack of formal education, being farmer, daily laborer, merchant and house wife were significantly associated with poor knowledge. Therefore, awareness creation should be given.

How Much Do Young Italians Know About COVID-19 and What Are Their Attitudes Toward SARS-CoV-2? Results of a Cross-Sectional Study

Objectives:

At the end of 2019, an outbreak of novel coronavirus pneumonia, called severe acute respiratory syndrome coronavirus 1 (SARS-CoV-2), was first identified in Wuhan, Hubei Province, China. It subsequently spread throughout China and elsewhere, becoming a global health emergency. In February 2020, the World Health Organization (WHO) designated the disease coronavirus disease 2019 (COVID-19). The objective of this study was to investigate the degree of knowledge of young Italians about COVID-19 and their current attitudes toward the SARS-CoV-2 and to determine if there were prejudices emerging toward Chinese.

Methods:

An online survey was conducted on February 3, 4, 5, 2020, with the collaboration of Italian website “Skuola.net”. Young people had the opportunity to participate by answering an ad hoc questionnaire created to investigate knowledge and attitudes about the new coronavirus, using a link published on the homepage.

Results:

A total of 5234 responses were received, of which 3262 were females and 1972 were males. Most of the participants showed generally moderate knowledge about COVID-19. Male students, middle school students, and those who do not attend school, should increase awareness of the disease; less than half of responders say that their attitudes toward the Chinese population has worsened in the last period.

Conclusions:

Global awareness of this emerging infection should be increased, due to its virulence, the significant risk of mortality, and the ability of the virus to spread very quickly within the community.

Transmission of SARS-CoV-2, Required Developments in Research and Associated Public Health Concerns

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly spreading across the world to cause thousands of mortalities each day. Poor responses from the authorities to the spread of infection, lack of effective measures for prevention, unavailability of promising treatment options, and sufficient diagnostic options have created an alarming for the world. The transmission routes from human to human of SARS-CoV-2 can be the direct transmission, droplet inhalation transmission, contact transmission, transmission through saliva, and transmission via fecal-oral routes. Due to the asymptomatic spread of SARS-CoV-2's, developing control and prevention measures is challenging. Implementing proper strategies addressing the infection control and clinical supplies, understanding the mechanism associated with pathogenesis, advancing in preventive measures and effective treatment and diagnostic options are necessary to control the ongoing pandemic. In this article, we briefly discuss the features, entry mechanism, infectiousness, and health consequences related to the COVID-19 outbreak.

Knowledge, Attitude and Practice Toward COVID-19 Among the Public in the Kingdom of Saudi Arabia: A Cross-Sectional Study

Background: Saudi Arabia has taken unprecedented and stringent preventive and precautionary measures against COVID-19 to control its spread, safeguard citizens and ensure their well-being. Public adherence to preventive measures is influenced by their knowledge and attitude toward COVID-19. This study investigated the knowledge, attitudes, and practices of the Saudi public, toward COVID-19, during the pandemic. Methods: This is a cross-sectional study, using data collected via an online self-reported questionnaire, from 3,388 participants. To assess the differences in mean scores, and identify factors associated with knowledge, attitudes, and practices toward COVID-19, the data were run through univariate and multivariable regression analyses, respectively. Results: The majority of the study participants were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 17.96 (SD = 2.24, range: 3-22), indicating a high level of knowledge. The mean score for attitude was 28.23 (SD = 2.76, range: 6-30), indicating optimistic attitudes. The mean score for practices was 4.34 (SD = 0.87, range: 0-5), indicating good practices. However, the results showed that men have less knowledge, less optimistic attitudes, and less good practice toward COVID-19, than women. We also found that older adults are likely to have better knowledge and practices, than younger people. Conclusions: Our finding suggests that targeted health education interventions should be directed to this particular vulnerable population, who may be at increased risk of contracting COVID-19. For example, COVID-19 knowledge may increase significantly if health education programs are specifically targeted at men.

Public health education for parents during the outbreak of COVID-19: a rapid review

Background

It is well-known that public health education plays a crucial role in the prevention and control of emerging infectious diseases, but how health providers should advise families and parents to obtain health education information is a challenging question. With coronavirus disease 2019 (COVID-19) spreading around the world, this rapid review aims to answer that question and thus to promote evidence-based decision making in health education policy and practice.

Methods

We systematically searched the literature on health education during COVID-19, severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) epidemics in Medline (via PubMed), Cochrane Library, EMBASE, Web of Science, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang Data from their inception until March 31, 2020. The potential bias of the studies was assessed by Joanna Briggs Institute Prevalence Critical Appraisal Tool.

Results

Of 1,067 papers found, 24 cross-sectional studies with a total of 35,967 participants were included in this review. The general public lacked good knowledge of SARS and MERS at the early stage of epidemics. Some people’s knowledge, attitude and practice (KAP) of COVID-19 had been improved, but the health behaviors of some special groups including children and their parents need to be strengthened. Negative emotions including fear and stigmatization occurred during the outbreaks. Reliable health information was needed to improve public awareness and mental health for infectious diseases. Health information from nonprofit, government and academic websites was more accurate than privately owned commercial websites and media websites.

Conclusions

For educating and cultivating children, parents should obtain information from the official websites of authorities such as the World Health Organization (WHO) and national Centers for Disease Control, or from other sources endorsed by these authorities, rather than from a general search of the internet or social media.

Emergence of a Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2: Biology and Therapeutic Options

The new decade of the 21^st century (2020) started with the emergence of a novel coronavirus known as SARS-CoV-2 that caused an epidemic of coronavirus disease (COVID-19) in Wuhan, China. It is the third highly pathogenic and transmissible coronavirus after severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in humans. The source of origin, transmission to humans, and mechanisms associated with the pathogenicity of SARS-CoV-2 are not yet clear, however, its resemblance to SARS-CoV and several other bat coronaviruses was recently confirmed through genome sequencing-related studies. The development of therapeutic strategies is necessary in order to prevent further epidemics and cure infections. In this review, we summarize current information about the emergence, origin, diversity, and epidemiology of three pathogenic coronaviruses with a specific focus on the current outbreak in Wuhan, China. Furthermore, we discuss the clinical features and potential therapeutic options that may be effective against SARS-CoV-2.

Main factors influencing recovery in MERS Co-V patients using machine learning

BACKGROUND

Middle East Respiratory Syndrome (MERS) is a major infectious disease which has affected the Middle Eastern countries, especially the Kingdom of Saudi Arabia (KSA) since 2012. The high mortality rate associated with this disease has been a major cause of concern. This paper aims at identifying the major factors influencing MERS recovery in KSA.

METHODS

The data used for analysis was collected from the Ministry of Health website, KSA. The important factors impelling the recovery are found using machine learning. Machine learning models such as support vector machine, conditional inference tree, naïve Bayes and J48 are modelled to identify the important factors. Univariate and multivariate logistic regression analysis is also carried out to identify the significant factors statistically.

RESULT

The main factors influencing MERS recovery rate are identified as age, pre-existing diseases, severity of disease and whether the patient is a healthcare worker or not. In spite of MERS being a zoonotic disease, contact with camels is not a major factor influencing recovery.

CONCLUSION

The methods used were able to determine the prime factors influencing MERS recovery. It can be comprehended that awareness about symptoms and seeking medical intervention at the onset of development of symptoms will make a long way in reducing the mortality rate.

Diagnostic delays in Middle East respiratory syndrome coronavirus patients and health systems

BACKGROUND

Although Middle East respiratory syndrome coronavirus (MERS-CoV) diagnostic delays remain a major challenge in health systems, the source of delays has not been recognized in the literature. The aim of this study is to quantify patient and health-system delays and to identify their associated factors.

METHODS

The study of 266 patients was based on public source data from the World Health Organization (WHO) (January 2, 2017-May 16, 2018). The diagnostic delays, patient delays, and health-system delays were calculated and modelled using a Poisson regression analysis.

RESULTS

In 266 MERS-CoV patients reported during the study period, the median diagnostic delays, patient delays, and health-system delays were 5 days (interquartile [IQR] range: 3-8 days), 4 days (IQR range: 2-7 days), and 2 days (IQR range: 1-2 days), respectively. Both patient delay (r = 0.894, P = 0.001) and health-system delay (r = 0.163, P = 0.025) were positively correlated with diagnostic delay. Older age was associated with longer health-system delay (adjusted relative ratios (aRR), 1.011; 95% confidence intervals (CI), 1.004-1.017). Diagnostic delay (aRR, 1.137; 95% CI, 1.006-1.285) and health-system delays (aRR, 1.217; 95% CI, 1.003-1.476) were significantly longer in patients who died.

CONCLUSION

Delays in MERS-CoV diagnosis exist and may be attributable to patient delay and health-system delay as both were significantly correlated with longer diagnosis delay. Early MERS-CoV diagnosis may require more sensitive risk assessment tools to reduce avoidable delays, specifically those related to patients and health system.

Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature

Middle East respiratory syndrome coronavirus (MERS-CoV) is capable of causing acute respiratory illness. Laboratory-confirmed MERS-CoV cases may be asymptomatic, have mild disease, or have a life-threatening infection with a high case fatality rate. There are three patterns of transmission: sporadic community cases from presumed non-human exposure, family clusters arising from contact with an infected family index case, and healthcare-acquired infections among patients and from patients to healthcare workers. Healthcare-acquired MERS infection has become a well-known characteristic of the disease and a leading means of spread. The main factors contributing to healthcare-associated outbreaks include delayed recognition, inadequate infection control measures, inadequate triaging and isolation of suspected MERS or other respiratory illness patients, crowding, and patients remaining in the emergency department for many days. A review of the literature suggests that effective control of hospital outbreaks was accomplished in most instances by the application of proper infection control procedures. Prompt recognition, isolation and management of suspected cases are key factors for prevention of the spread of MERS. Repeated assessments of infection control and monitoring of corrective measures contribute to changing the course of an outbreak. Limiting the number of contacts and hospital visits are also important factors to decrease the spread of infection.

Knowledge and Attitude of Dental Health Professionals about Middle East Respiratory Syndrome in Saudi Arabia

Aim and Objective

This study aims to evaluate the knowledge and attitude of practicing dental health professionals (DHPs) (dentist and dental auxiliaries) toward Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia.

Materials and Methods

A cross-sectional descriptive study was undertaken among practicing DHPs in Saudi Arabia. A total of 202 DHPs participated in this study. Knowledge and attitude were assessed using self-administered and pretested questionnaire. The questionnaire was administered online through Survey Monkey^® program by sending link to the registered E-mail. Descriptive statistics were performed on demographic data. Mean knowledge and mean attitude scores of DHPs were calculated. Mann-Whitney U-test and Kruskal-Wallis tests were used to disclose the differences between study variables. Chi-square tests and Spearman's correlation tests were applied to find the associations between the variables.

Results

The study participants showed mean knowledge score of 12.26 ± 2.27 (based on 17 knowledge questions) and attitude score of 8.63 ± 1.68 (based on 10 attitude questions). The spearman's test showed the positive correlation between knowledge and attitude of DHPs about MERS (r = 0.093, P = 0.188). Knowledge gaps were reflected in questions related to the duration of infectivity (47.5%), treatment of MERS (39.6%), reservoir of MERS-CoV (38.1%), availability of vaccination against MERS-CoV (25.2%), the likelihood of infection (24.3%), and the type of MERS-CoV (23.3%). DHPs showed a positive attitude toward adherence to universal precautions given by CDC and WHO (0.94 ± 0.25), active participation infection control program (0.94 ± 0.24), and use of gowns, gloves, mask, and goggles while dealing with MERS-CoV patients (0.97 ± 0.17). Male DHPs showed significantly higher knowledge and positive attitude toward MERS-CoV infection compared to females.

Conclusion

DHPs participated in this study showed good knowledge and positive attitude toward MERS. However, still few lacunae in the knowledge and attitudes toward MERS-CoV were found requiring extensive educational programs.