Core policies disparity response to COVID-19 among BRICS countries

The Intersections of COVID-19 Global Health Governance and Population Health Priorities: Equity-Related Lessons Learned From Canada and Selected G20 Countries

Background: COVID-19-related global health governance (GHG) processes and public health measures taken influenced population health priorities worldwide. We investigated the intersection between COVID-19-related GHG and how it redefined population health priorities in Canada and other G20 countries. We analysed a Canada-related multilevel qualitative study and a scoping review of selected G20 countries. Findings show the importance of linking equity considerations to funding and accountability when responding to COVID-19. Nationalism and limited coordination among governance actors contributed to fragmented COVID-19 public health responses. COVID-19-related consequences were not systematically negative, but when they were, they affected more population groups living and working in conditions of vulnerability and marginalisation. Policy options and recommendations: Six policy options are proposed addressing upstream determinants of health, such as providing sufficient funding for equitable and accountable global and public health outcomes and implementing gender-focused policies to reduce COVID-19 response-related inequities and negative consequences downstream. Specific programmatic (e.g., assessing the needs of the community early) and research recommendations are also suggested to redress identified gaps. Conclusion: Despite the consequences of the COVID-19 pandemic, programmatic and research opportunities along with concrete policy options must be mobilised and implemented without further delay. We collectively share the duty to act upon global health justice.

Depression Symptoms Amongst Older Brazilian and Chinese Women Submitted to Different Social Distancing Measures Rigidness During COVID-19 Outbreak

BACKGROUND

It is plausible that depression symptoms and disrupting sleep quality were differently affected according to the rigidity of social distancing during the COVID-19 outbreak.

OBJECTIVE

To describe and compare depression symptoms and sleep quality amongst older Brazilian and Chinese women who were submitted to different social distancing measures (less rigid (Brazil) versus more rigid (China)).

METHODS

This observational cross-sectional study assessed urban older women who underwent home confinement with less (Brazil; n=1015) or more (China; n=644) rigidity. Socio-demographic correlates, general health information, depression symptoms [Geriatric Depression Scale (GDS- 15)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were assessed through interviews.

RESULTS

1659 older women (66.74 ± 5.48 years old; 38.8% Chinese; 61.2% Brazilian) were included for analysis. 22% of Brazilians and 19.6% of Chinese women presented depression symptoms. The frequency of bad sleepers was 56.4% and 37.7% amongst Brazilian and Chinese older women, respectively. After adjusting for socio-demographic variables, general health status, and PSQI global score, Chinese women had a significantly higher score of depression symptoms (3.88 ± 0.13) compared to the Brazilians (3.26 ± 0.10; p < 0.001).

CONCLUSION

The frequency of poor sleep quality was very high regardless of the country. After adjusting for confounders and sleep quality, older Chinese women had a significantly superior score of depression symptoms exacerbating psychological distress by confinement rigidness.

COVID-19-related global health governance and population health priorities for health equity in G20 countries: a scoping review

Since the declaration of the COVID-19 pandemic, the promotion of health equity including the health of various population sub-groups has been compromised, human rights jeopardised, and social inequities further exacerbated. Citizens worldwide, including in the Group of 20 (G20) countries, were affected by both global health governance (GHG) processes and decisions and public health measures taken by governments to respond to COVID-19. While it is critical to swiftly respond to COVID-19, little is known about how and to what extent the GHG is affecting population health priorities for health equity in global economies such as the G20 countries. This scoping review synthesised and identified knowledge gaps on how the COVID-19-related GHG is affecting population health priorities for policy, programme, and research in G20 countries. We followed the five-stage scoping review methodology promoted by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews guidelines. We searched four bibliographic databases for references conducted in G20 countries and regions and published in English and French, between January 2020 and April 2023. Out of 4,625 references and after two phases of screening, 14 studies met the inclusion criteria. G20 countries included in the review were Australia, Brazil, Canada, China, France, India, Italy, Japan, Russia, South Africa, the United Kingdom, the United States of America, and the European Union. We found insufficient collaboration and coordination and misalignment among governance actors at multiple levels. In most cases, equity considerations were not prioritised while unequal consequences of COVID-19 public health measures on population groups were widely reported. COVID-19-related population health priorities mainly focused on upstream and midstream determinants of health. Our scoping review showed the stark inequities of COVID-19 public health outcomes, coupled with a prevalent lack of coherent collaboration and coordination among governance actors. Moreover, governance as an object of empirical study is still emerging when examining its intersection with global health and population health policy, programme, and research. An urgent shift is required to effectively act upon structural health determinants that include transformative and comprehensive policies for prevention, equity, resilience, and sustainable health.

The impact of containment policy and mobility on COVID-19 cases through structural equation model in Chile, Singapore, South Korea and Israel

Objectives

The study aims to understand the impact of containment policy and mobility on COVID-19 cases in Chile, Singapore, South Korea and Israel. To provide experience in epidemic prevention and control.

Methods

Structural equation modeling (SEM) of containment policies, mobility, and COVID-19 cases were used to test and analyze the proposed hypotheses.

Results

Chile, Israel and Singapore adopted containment strategies, focusing on closure measures. South Korea adopted a mitigation strategy with fewer closure measures, focusing on vaccination and severe case management. There was a significant negative relationship among containment policies, mobility, and COVID-19 cases.

Conclusion

To control the COVID-19 and slow down the increase of COVID-19 cases, countries can increase the stringency of containment policies when COVID-19 epidemic is more severe. Thus, countries can take measures from the following three aspects: strengthen the risk monitoring, and keep abreast of the COVID-19 risk; adjust closure measures in time and reduce mobility; and strengthen public education on COVID-19 prevention to motivate citizen to consciously adhere to preventive measures.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

COVID-19 vaccination and governance in the case of low, middle and high-income countries

BACKGROUND

Global crises, regardless of the place where they started to spread or of the factors that triggered them, require a comprehensive approach, primarily based on good communication, cooperation and mutual support. No individual and no institution should remain indifferent to crises but, on the contrary, be fully aware that any involvement in curbing them matters. Although humanity can be affected by various types of crises, in this paper we refer to the one related to COVID-19 pandemic. There are certain reasons that come to justify our choice: first of all, being a shock with a strong impact on people, its analysis should be performed from several angles; this may bring to light an image with its disparate propagation and measures to counteract it both in developed countries, and especially in those with a shortage of resources. Secondly, in the context of the emergence of vaccines against COVID-19, it is helpful to have an overview of COVID-19 through the lens of the relationship between the vaccination process and the elements that characterize governance, with a differentiated dashboard by country categories worldwide: low, middle and high-income countries. Our study is far from capturing the complexity arising from such social problem, but rather aims to outline the defining role of governance when it comes to providing firm reactions to the COVID-19 crisis.

METHODS

Given that our sample consists of a large number of countries, namely 170, first, examined all together, and then, split into three groups (high, middle and low-income), it is challenging to address governance in association with COVID-19 vaccination, in order to see how much they interact and how each of the six aggregate governance indicators of the World Bank (Worldwide Governance Indicators) is reflected in this process. Even if they do not oscillate strongly over relatively short periods of time, reporting on health issues requires a sequential inventory, considering closer time intervals, so as to be able to act promptly. Thus, to better distinguish how the COVID-19 vaccination process evolved in low, middle and high-income countries, but also how it was imprinted by governance, we present the situation quarterly (March, June, September and December), in 2021, the year when the immunization campaigns were the most intense at the global level. Regarding the applied methods, we mention both OLS regressions with robust estimators and a panel model, used to investigate the determinants of COVID-19 vaccination, some of them describing the good governance, as well as other dimensions.

RESULTS

The findings point out that the influence of governance on COVID-19 vaccination differs depending on whether a country belongs to high, middle or low-income typology: the strongest determinism of governance on vaccination is encountered in high-income countries, and the weakest in low-income ones; in some cases, governance does not matter significantly. However, exploring the three groups of states included in the research, it is observed that the most relevant factors in this relationship are government effectiveness, regulatory quality and control of corruption.

CONCLUSIONS

Besides the order of importance of governance indicators on COVID-19 vaccination, our study indicates that, overall, governance positively shapes the vaccination rate at the level of the chosen sample. In normative terms, these findings can be translated particularly by the fact that they can serve as information to raise awareness on the relevance of the existence of an institutional framework that allows the formulation of strategies according to the patterns of each country, especially since the actionable tools depend on the available resources. As a general conclusion, public policies should be designed in such a way as to strengthen trust in vaccination regulations and in governments, to reduce the multifaceted negative effects of this health crisis and to hope for its total end.

Longitudinal Association of Changes in Parental Correlates With Screen Time in Chinese Preschoolers

BACKGROUND

This study aimed to explore the relationship between the changes in parent-related factors and preschoolers exceeding screen time (ST) recommendations.

METHODS

A longitudinal analysis using 2-year follow-up data from 4 kindergartens (n = 409) was conducted in Zhejiang, China, from 2019 to 2021. Multivariate logistic regression models were used to determine the potential parental modifiable predictors.

RESULTS

The significant associations of baseline ST, change in screen accessibility, and the interaction of preschooler ST with maternal ST change with preschooler follow-up ST were observed. For preschool-aged children with baseline ST ≤ 1 hour per day, the follow-up of preschoolers with ST > 1 hour per day increased significantly when parental clarity of their ST rules decreased or remained low. For preschool children with baseline ST > 1 hour per day, follow-up ST increased significantly when their father kept ST >2 hours per day, when the screen accessibility became or remained easy, or when parental awareness of the ST decreased.

CONCLUSIONS

Changes in parental correlates played an important role in preschooler ST based on 2-year longitudinal data. Early interventions should focus on improving the clarity of parental rules and perceptions, as well as on reducing parental ST and accessibility of home screens.

Mental health issues in parents of children with autism spectrum disorder: A multi-time-point study related to COVID-19 pandemic

Given the unpredictability and challenges brought about by the 2019 novel coronavirus (COVID-19) pandemic, this study aimed to investigate the impact trend of the prolonged pandemic on the mental health of parents of children with autism spectrum disorder (ASD). The 8112 participants included parents of children with ASD and parents of typically developing (TD) children at two sites (Heilongjiang and Fujian province, China). The parents completed a set of self-report questionnaires covering demographic characteristics, influences related to COVID-19, COVID-19 concerns and perceived behaviors, as well as the Connor-Davidson resilience scale (CD-RISC), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) by means of an online survey platform. Data were collected by three cross-sectional surveys carried out in April 2020 (Time 1), October 2020 (Time 2), and October 2021 (Time 3). The results of quantitative and qualitative comparisons showed that: (i) parents of children with ASD had lower levels of resilience, and more symptoms of anxiety and depression than parents of TD children at each time point (all P < 0.05); and (ii) there were significant time-cumulative changes in resilience, anxiety, and depression among all participants (all P < 0.05). The logistic regression analyzes after adjusting for demographic characteristics revealed that the following factors were significantly associated with poor resilience and a higher rate of anxiety and depression in parents of children with ASD: time-point, the effect of COVID-19 on children's emotions and parents' emotions, changes in relationships, changes in physical exercise, changes in daily diet during the COVID-19 pandemic, and COVID-19-related psychological distress. In conclusions, the parents did not report improvements in resilience, anxiety, or depression symptoms from Time 1 to Time 2 or 3, indicating that cumulative mental health issues increased when, surprisingly, the COVID-19 restrictions were eased. The psychological harm resulting from the COVID-19 pandemic is far-reaching, especially among parents of children with ASD.

Intention to maintain and willingness to stop: Applying a dual-process model to understanding the maintenance of COVID-19 preventive behaviors

Preventive behaviors have played an essential role in coping with COVID-19 and may continue to exerting a crucial impact on pandemic control in the future. This study aimed to evaluate the effectiveness of social-cognitive factors on maintenance of COVID-19 preventive behaviors based on a dual-process model, which encompasses a reasoned path via the intention to maintain and a social reaction path via the willingness to stop. We collected a probability sample of 472 community-dwelling adults. Social-cognitive factors, behavioral tendencies, and preventive behaviors of COVID-19 were measured. The results supported that the dual-process framework could account for individual differences in preventive behaviors. Self-efficacy and response cost significantly explained the intention to maintain preventive behaviors, while favorability of risk image and subjective norm significantly explained the willingness to stop preventive behaviors. Our findings proposed strategies for promoting individuals' maintenance of preventive behaviors during a pandemic. The development of prevention policies may focus on two paths: strengthening the intended path by enhancing self-efficacy and decreasing response cost of preventive behaviors and monitoring and improving social influences, such as risk prototype and subjective norm, which can reduce the willingness to stop preventive behaviors.

Acceptance and willingness to pay under the different COVID-19 vaccines: A contingent valuation method

Background

The COVID-19 vaccine is recognized as a novel tool in the battle against COVID-19. Recently, there were several types of vaccines that have a different effectiveness and safety profile. Understanding the vaccine acceptance and willingness to pay (WTP) are essential to develop a strategic plan to increase the rate of COVID-19 vaccination uptake.

Objectives

To assess the acceptance and WTP for a COVID-19 Vaccine in Thailand using the contingent valuation method (CVM). Additionally, to identify the factors that affect the acceptance and the amount of WTP for a COVID-19 Vaccine.

Methods

We conducted a cross-sectional survey using a payment card approach with open-ended questions during September 2021. Three hypothetical COVID-19 vaccines (Vaccines A, B, and C) in two scenarios were employed. Data were collected from 752 people. Multivariate logistic regression was performed to assess the predictors of vaccine acceptance. Multiple linear regression was used to analyze factors associated with the maximum amount WTP for a vaccine.

Results

Of 742 respondents, the highest acceptance was vaccine C (70.71%), followed by B (17.72%) and A (11.57%). Similarly, 53.87%, 41.44%, and 36.21% of the respondents expressed WTP for vaccine C, B and A, respectively. The maximum amount WTP for vaccine C was US$46, followed by B (US$35) and A (US$32). Factors affecting acceptance included monthly salary, region of residence, education, perceived risk of COVID-19 infection, knowledge and attitude about the COVID-19 vaccine. In addition, monthly salary, region of residence, education and knowledge on COVID-19 vaccine were related to maximum amount WTP.

Conclusion

Acceptance and WTP depends on vaccine characteristics. Educational campaigns should be implemented to improve people's awareness, knowledge, and attitude towards COVID-19 vaccines to increase the vaccines' acceptance. To increase the rate of vaccination, the Thai government needs to allow freedom of choice on vaccines, while considering effectiveness and safety issues.

Strategies comparison in response to the two waves of COVID-19 in the United States and India

BACKGROUND

This study aimed to compare the prevention and control strategies adopted by the United States and India in the COVID-19 outbreak and analyze the effectiveness of their strategies, in order to provide empirical experience for the prevention and control of the epidemic.

METHODS

This study extracted official data on COVID-19 from various official websites, summarized the policies in place in the United States and India, and evaluated the effectiveness of their policies.

RESULTS

The United States has adopted a series of mitigation strategies to control the two waves of epidemic, including strengthening virus detection, calling on the people to wear masks and so on. As of May 30, 2021, although the daily new cases there decreased to some extent, the effect was not ideal. The US's daily new cases ranked fourth and the cumulative number of confirmed cases ranked first in the world. India has adopted containment strategies in the initial stage of the outbreak, making the epidemic relatively stable. In the later stage, India has turned to adopt mitigation strategies. In addition, many factors including the lack of medical resources and premature relaxation measures led to the rapid deterioration of the epidemic situation. As of May 30, 2021, although the daily new cases in India has a downward trend, it ranked first in the world, and the cumulative number of confirmed cases ranked second.

CONCLUSION

There are differences between the epidemic prevention strategies adopted by the United States and India, especially India's containment strategies which helped it better control the epidemic in the early stage. However, the epidemic in the two countries is still severe. With the advent of virus mutants and the absence of immune barriers, it is meaningful that the two countries continue to take non-pharmacotherapy intervention measures and accelerate vaccination, according to specific national conditions adopt containment strategies that can control the epidemic more quickly when necessary, and pay attention to the risk of epidemic rebound caused by premature relaxation of epidemic prevention policies.