COVID-19 pandemic in India: A Comparison of pandemic pattern in Selected States

COVID-19 Courtesy Stigma among Healthcare Providers in India: A Study of Stigma Management Communication and its Impact

In early 2020, the first wave of the COVID-19 pandemic hit India, generating one of the highest rates of infection and death in the world. Meanwhile, healthcare workers experienced stigma and discrimination due to their association with COVID-19 patients. This study analyzed healthcare workers' experience of courtesy stigma in India, the communication strategies they used to manage stigma, and the impact on their mental health. A cross-sectional survey of 150 healthcare workers in India showed that almost 50% experienced discrimination due to their association with COVID-19 patients. Using Confirmatory Factor Analysis and Structural Equation Modeling, this study found that experience of discrimination was associated with perceived courtesy stigma. Two stigma management strategies (reducing offensiveness and passive acceptance) mediated the relationship between perceived courtesy stigma and perceived stress and depression. Participants also reported engaging in stigma management strategies of bonding with other healthcare professionals and passive acceptance of the stigma more than reducing stigma and displaying/disclosing stigma. We conclude that perhaps due to depletion of cognitive and emotional resources, healthcare workers engaged more in social support (bonding) and passive stigma acceptance strategies to alleviate the stress associated with providing COVID-19 patient care. Practical and theoretical implications are further discussed.

Engagement of health workers and peer educators from the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram during the COVID-19 pandemic: Findings from a situational analysis

BACKGROUND

To understand the impact of COVID-19 on implementation of the peer education programme of the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK); repurposing of the RKSK health workers and Peer Educators (PEs) in COVID-19 response activities and effect on adolescents´ health and development issues.

METHODS

Virtual in-depth interviews were conducted with stakeholders (n = 31) (aged 15 to 54 years) engaged in the implementation of the RKSK and peer education programme at state, district, block, and village levels in Madhya Pradesh and Maharashtra (India). These interviews were thematically coded and analysed to address the research objectives.

RESULTS

Despite most peer education programme activities being stopped, delayed, or disrupted during the pandemic and subsequent lockdown, some communication networks previously established, helped facilitate public health communication regarding COVID-19 and RKSK, between health workers, PEs, and adolescents. There was repurposing of RKSK health workers and PEs' role towards COVID-19 response-related activities. PEs, with support from health workers, were involved in disseminating COVID-19 information, maintaining migrant and quarantine records, conducting household surveys for recording COVID-19 active cases and providing essential items (grocery, sanitary napkins, etc.) to communities and adolescents.

CONCLUSION

PEs with support from community health workers are able to play a crucial role in meeting the needs of the communities during a pandemic. There is a need to further engage, involve and build the skills of PEs to support the health system. PEs can be encouraged by granting more visibility and incorporating their role more formally by paying them within the public health system in India.

Visualizing the efficacy of vaccination in different Indian states: a comparative account with other countries

Efficacy of the vaccination program for COVID-19 pandemic caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome-CoronaVirus-2) was analyzed. The data for number of cases and vaccination, obtained from government websites from 1st January, 2020 to 10th October, 2021 for India, USA, United Kingdom, Italy, South Africa and states West Bengal, Delhi, Maharashtra, Kerala and Tamil Nadu. Modified Poisson prediction models were developed using SPSS to predict the number of cases with and without vaccination as predictor to catalogue the efficacy of vaccination. In the prediction model where vaccination was used as a predictor, the downward trend of predicted value matched with actual value, falling within the 95% confidence interval. However, individual peaks of waves were not observed clearly for the predicted values. Vaccination within the population was observed to be very critical in controlling the pandemic progression with all countries showing decrease in daily case counts as more people in the population got vaccinated. In India, owing to the huge population, more vaccination is needed for the predicted cases to fall lower.

Impact of Nonpharmacological Public Health Interventions on Epidemiological Parameters of COVID-19 Pandemic in India

Background Public health interventions are epidemiologically sound and cost-effective methods to control disease burden. Non-pharmacological public health interventions are the only mode to control diseases in the absence of medication. Objective To find the impact of public health interventions on the epidemiological indicators of disease progression. Methods This is a secondary data analysis done on COVID-19 data. The median doubling time and R0 were calculated for a rolling period of seven days. Interventions were scored from zero to three with an increasing level of stringency. Multivariate linear regression was performed to find the role of individual interventions on R0 and the median doubling time. Results The highest intervention score was reported in the lockdown phase, which gradually decreased to the lowest level of 22. The R0 values settled to a level of 1.25, and the median doubling time increased to 20 days at the end of the study. Public awareness and public health laws were found to be related to both R0 and the median doubling time in the pre-lockdown phase only. Conclusion The implementation of interventions at the ground level is one of the key factors in the success of public health interventions. Post implementation, poor effectiveness of many interventions is evident from the study. Further, studies related to the sequence of interventions are required to further analyze the poor effect of the interventions.

Comparisons between the Neighboring States of Amazonas and Pará in Brazil in the Second Wave of COVID-19 Outbreak and a Possible Role of Early Ambulatory Treatment

Brazil and many countries are now experiencing a second wave of the COVID-19 outbreak. The objective of this study is to compare results with statistical samples involving millions of people in the two largest neighboring states in Brazil, Amazonas and Pará, which in the first wave were similar but now show significant different results in combating COVID-19. During the first wave, in May 2020, the maximums of the 7-day average daily deaths per population of Amazonas and Pará were similar: 15.7 and 17.1 deaths per day per million people, respectively, which means a ratio 15.7/17.1 = 0.92 ≈ 1. Now, in the second wave of COVID-19 outbreak, Amazonas has entered a serious situation; meanwhile, Pará has presented a much smaller growth in the mortality. The accumulated mortality per population from 11 November 2020 to 15 March 2021 of Amazonas and Pará are 1645 and 296 deaths per million people, respectively. As 1645/296 = 5.55, Amazonas is presenting an accumulated mortality per population more than five times that of Pará. Future in-depth research can provide a grounded answer to explain this significant difference, nonetheless the explicit support of the Pará state government, after 21 May 2020, to early ambulatory treatment may have played some role on this result.