The Incidence of Needlestick and Sharps Injuries Among Healthcare Workers in a Tertiary Care Hospital: A Cross-Sectional Study

Background Needlestick injuries (NSIs) and sharps injuries (SIs) remain significant hazards in most healthcare facilities that expose healthcare workers (HCWs) to blood-borne pathogens (e.g., HIV, hepatitis B, and hepatitis C). This study aims to review the incidence of NSIs and SIs in King Fahad Medical City (KFMC) and correlate this incidence with several parameters related to the event, including age, sex, length of work experience, type of injury, type of instrument causing the injury, type of activity during which the injury happened, nature of the job of the HCWs, and location within the hospital where the injury happened. Methodology This cross-sectional study involves all self-reported documents related to needlestick and sharp injuries among HCWs at King Fahad Medical City (KFMC) in Riyadh, Kingdom of Saudi Arabia, from January 2017 to December 2020. The data of 389 reports of needlestick and sharp injuries detailing incidence and site, shift, type, and instrument related to the incidents were reported to the infection control department for coding and analysis using the Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics, Armonk, NY, USA). Results Our data showed that NSIs/SIs could be caused by a wide range of objects used by healthcare workers, including needles, suture needles, scalpels, and sharp devices. Remarkably, the most common cause of NSIs was handling the sharp object (38.8%), followed by disposing of the sharp object (19.3%). Furthermore, nurses were found to be the highest at-risk category of HCWs experiencing NSIs (49.9%), while medical waste handlers (1.5%) and dentists (1.3%) were least likely to incur injuries. Conclusion This study sheds some light on the incidence rates of NCIs and SIs at KFMC and correlates these rates with several demographical, occupational, and experiential parameters related to these events.

Application of Public Health Precautionary Guidelines Before Contracting COVID-19: Lessons Learned from a Qualitative Descriptive Study

Background

The COVID-19 pandemic has affected the Saudi population despite early efforts taken by officials. This study aimed to describe the precautionary measures taken by patients prior to their diagnosis with COVID-19.

Methods

A qualitative descriptive design was employed to collect data from a convenience sample of 26 participants who had COVID-19 and recovered. Data was collected through conducting telephone interviews and was then transcribed and analyzed using inductive content analysis methods adapted from grounded theory.

Results

Data analysis yielded six categories of precautionary measures participants reported using to minimize their risk of contracting COVID-19: (1) wearing a mask, (2) staying at home and avoiding crowds, (3) washing hands and wearing gloves, (4) following social distancing, (5) using sanitizers, and (6) not interacting with anyone.

Conclusion

The discrepancy found between the participants' reported precautionary measures and their actual behavior, as well as the consistency and specificity with which they implemented some and not all measures raise concerns about existing public health messages. The study findings support the importance of well-structured and detailed communication when designing future public health campaigns and data-driven policies.

Workplace policies and quality of working life (QoWL) during the COVID-19 pandemic in Jordanian hospitals

BACKGROUND

Many healthcare organizations place a high value on quality of work-life (QoWL). The healthcare system's long-term sustainability and capability to offer high-quality services to patients depend on improving QoWL for their healthcare workers.

OBJECTIVE

The study aimed to explore the impact of Jordanian hospitals' workplace policies and measures in three main domains: (I) Infection prevention and control (IPC) measures, (II) Supply of personal protective equipment (PPE), and (III) COVID-19 precautionary measures on the QoWL among healthcare workers during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted from May to June 2021 through an online self-reported questionnaire (Google Form) targeting hospital healthcare professionals working at Jordanian hospitals (public, private, military, and university). The study used a valid work-related quality of life (WRQoL) scale to study the QoWL.

RESULTS

A total of 484 HCWs in Jordanian hospitals participated in the study with a mean age of (34.8 ± 8.28 years). 57.6% of the respondents were females. 66.1% were married, with 61.6% having children at home. An average QoWL among healthcare workers in Jordanian hospitals during the pandemic was observed. The study results also showed a significant positive correlation between workplace policies (IPC measures, supply of PPE, and COVID-19 preventive measures) and the WRQoL among healthcare workers.

CONCLUSION

Our findings highlighted the vital need for QoWL and psychological well-being support services for healthcare staff during pandemics. Improved IPC systems and other precautionary measures at the national and hospital management levels are required to help minimize the stress and fear that healthcare workers experience and lower the risk of COVID-19 and future pandemics.

A Precautionary Assessment of Systemic Projections and Promises From Sunlight Reflection and Carbon Removal Modeling

Climate change is a paradigmatic example of systemic risk. Recently, proposals for large-scale interventions-carbon dioxide removal (CDR) and solar radiation management (SRM)-have started to redefine climate governance strategies. We describe how evolving modeling practices are trending toward optimized and "best-case" projections-portraying deployment schemes that create both technically slanted and politically sanitized profiles of risk, as well as ideal objectives for CDR and SRM as mitigation-enhancing, time-buying mechanisms for carbon transitions or vulnerable populations. As promises, stylized and hopeful projections may selectively reinforce industry and political activities built around the inertia of the carbon economy. Some evidence suggests this is the emerging case for certain kinds of CDR, where the prospect of future carbon capture substitutes for present mitigation. Either of these implications are systemic: explorations of climatic futures may entrench certain carbon infrastructures. We point out efforts and recommendations to forestall this trend in the implementation of the Paris Agreement, by creating more stakeholder input and strengthening political realism in modeling and other assessments, as well as through policy guardrails.

COVID-19 Knowledge, Attitudes, and Preventive Measures of University Students in Bahrain

BACKGROUND

The severe, acute respiratory syndrome COVID-19 that was first reported in China in December 2019 quickly became a global pandemic that has resulted in over 100 million infections and more than 2 million deaths.

STUDY DESIGN

This study aimed to assess the awareness level of university students regarding the possibility of becoming infected with COVID-19. In order to achieve this objective, we assessed the students' knowledge, attitudes, and behaviors using an online survey questionnaire offered to a total of 300 students.

RESULTS

A positive response regarding awareness of COVID-19 symptoms was registered by more than 70% of the students, whereas 62% felt that wearing a mask did not give full protection against infection, approximately 30% agreed that antibiotics and antivirals did not treat COVID-19, and 62% agreed that vitamin C was helpful in treating common symptoms of COVID-19. Moreover, around 31% of the students believed that COVID-19 is a man-made virus. Students who had gotten infected with SARS-CoV-2 believed that wearing a mask gives full protection (p=0.018). In response to survey questions related to attitude, 80% of students cancelled and postponed meetings with friends, and 90% agreed that mask-wearing is the most precautionary measure used to prevent the infection. In addition, 82% avoided coughing in public, 82% avoided contact if they felt flu-like symptoms and 80% washed their hands far more often due to the pandemic. Interestingly, 76% carried hand sanitizer, 66.5% avoided shaking hands, and 42.7% were taking vitamin C supplements.

CONCLUSIONS

This study showed that the participants had a positive awareness of COVID-19 transmission, symptoms, and treatments misconceptions and mistaken beliefs related to treatments and the origin of the virus were also common and should be addressed. This study thus provides a baseline for a population-based surveillance program that could help local authorities to improve pandemic preparation plans, particularly with regard to governmental education and media campaigns.

A Robot-Mediated Activity Using the Nao Robot to Promote COVID-19 Precautionary Measures among Older Adults in Geriatric Facilities

Precautionary measures (e.g., social distancing, mask wearing, washing hands regularly) to limit the transmission of the Coronavirus 19 (COVID-19) have been put in place worldwide. However, a limited understanding of precautionary measures and low compliance with them has been observed in older adults with neurocognitive disorders, persons with intellectual disability, or mental illness. The objective of this study is to create and evaluate a robot-mediated activity to deliver information on COVID-19 precautionary measures in an accessible and engaging way using the humanoid robot Nao. An interactive scenario explaining and demonstrating COVID-19 precautionary measures is created using the verbal and non-verbal behaviours of the robot. The scenario (≈5 min) is presented to 124 users of a geriatric hospital, including the following: older patients (n = 45), accompanying persons (n = 39), and health professionals (n = 40). The data regarding perceived usefulness, acceptability, and accessibility are collected using a questionnaire. A video analysis of the participants' behaviour during the interaction with the robot is performed to examine the quality of engagement in the activity. The results show a good acceptance, satisfaction, and perceived usefulness of the robot-mediated activity. These findings suggest that robot-mediated interventions using humanoid robots can be an effective tool for the delivery of health promotion information.

Psycho-behavioural responses of the general population to COVID-19 after mass vaccination: a cross-sectional study

BACKGROUND

Previous studies have examined public psycho-behavioural responses in the early stages of the epidemic, little is known after mass vaccination has been implemented. This study aimed to investigate the public's behavioural (adoption of COVID-19 precautionary measures) and psychological (depression, anxiety and stress) responses to COVID-19 and their relationships after the launch of the territory-wide vaccination programme in Hong Kong.

METHODS

A cross-sectional survey study using anonymous online or face-to-face questionnaires was conducted between June 2021 and September 2021. A convenience sample of Hong Kong Chinese residents aged ⩾18 years were recruited online by referrals and from a university-run community vaccination centre.

RESULTS

A total of 1893 valid questionnaires were received. The results showed that Hong Kong residents have high levels of adoption of precautionary measures and low levels of depression, anxiety and stress after the mass vaccination. Hierarchical regression analysis identified that in the fully adjusted model, the adoption of precautionary measures was a consistent protective factor (β ranged -1.51 to -1.67, p < 0.001) for depression, anxiety and stress amid the COVID-19 pandemic.

CONCLUSIONS

This study offers new information on the public's psycho-behavioural responses to the pandemic, as well as insights into public health planning after introducing the mass vaccination.

Perception of the COVID-19 Pandemic Among Members of Saudi Society: Solidarity, Humility, and Connectivity

Background and purpose The magnitude of the coronavirus disease 2019 (COVID-19) pandemic on the healthcare system, economy, education, and social networking is dreadful, the least to say. Surprisingly, and unlike previous epidemics, the impact has been universal, and even top-ranking countries with solid economies were not immune. The purpose of this study is to develop a better understanding of the Saudi community's response and reaction to the preventative measures implemented by the government to combat the COVID-19 pandemic. Methodology A cross-sectional study using a self-administered online-based questionnaire was conducted among 920 participants from March 2020 to February 2021 among the Saudi community across the Kingdom. Results Among the studied participants, the majority (60%) are always committed to washing their hands according to the Ministry of Health (MoH) instructions, and 74% indicated that they were always compliant with the sneezing etiquette outlined by the MoH. Studied participants were affected through different influencers of life aspects. Moreover, 63% of them gained new skills and behaviors during the pandemic curfew. Additionally, many studied participants assumed that "life will not return to what it used to be" as a future perception. Conclusion In conclusion, the present findings proved the importance and power of the Saudi Vision (2030) represented by the National Transformation Program on enhancing the healthcare system, facilitating access to healthcare, and integrating technology among government parties addressed during the COVID-19 pandemic.

Evidence-based of conjunctival COVID-19 positivity: An Italian experience: Gemelli Against COVID Group

BACKGROUND

The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated.

METHODS

Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C-NF-), (2) NPs positive and Cs negative (NFs+Cs-), (3) NPs negative and Cs positive (NFs-Cs+), and (4) NPs and Cs both positive (NFs-Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP).

RESULTS

A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF-C- group (98%) and the lowest (90%) in the group NF+C+ (p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups (p = 0.019). Pulmonary impairment score increased from NFs-Cs- group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%).

CONCLUSIONS

In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity.

TRIAL REGISTRATION

Clinicaltrials.gov registration.

ETHICAL COMMITTEE AUTHORIZATION

ID number: 0013008/20.

Awareness and Practice of COVID-19 Precautionary Measures Among Healthcare Professionals in Saudi Arabia

Objective

Healthcare workers (HCWs) are the backbone of the healthcare system and a skilled and healthy workforce is vital during a health crisis, such as the present coronavirus disease 2019 (COVID-19) pandemic. Healthcare workers are at higher risk of exposure to and transmission of the severe acute respiratory coronavirus-2 (SARS-CoV-2). Hence, HCWs should possess good knowledge and attitudes toward COVID-19 to protect not only themselves but also their colleagues, families and the larger community. Thus, the current study aims to assess the knowledge and practice of protective measures by HCWs in Saudi Arabia during the first wave of the COVID-19 pandemic to identify awareness of the disease, potential trends and associated predictors.

Methods

A cross-sectional, web-based study was conducted among HCWs about knowledge related to COVID-19 and practice of protective measures, such as social distancing and use of personal protective equipment (PPE) during the pandemic. A Fisher exact test and one-way analysis of variance (ANOVA) were used to investigate the level of association among variables.

Results

A total of 674 HCWs were recruited in the study (51.8% male, 42.7% aged 28–37 years old and 52% specialists). The Saudi Ministry of Health (MoH) was the main source of knowledge for most of the HCWs (89%) followed by the WHO (44.5%) and social media (42.3%). Washing hands before touching the face was the most selected choice (97.9%) as a precautionary method to limit SARS-CoV2 transmission. Most of the HCWs (74.6%) scored low for staying at home while the majority (71.2%) showed a high practice of personal protective methods, with pharmacists and general physicians scoring the highest.

Conclusion

Saudi HCWs showed high knowledge and practice of protective measures for COVID-19. Good knowledge correlates with adoption of appropriate practices to prevent spread of infection. The current findings highlight the importance of interventions such as tailored education and training courses for those with low scores to improve overall knowledge and practice.

Knowledge, Perception, and Attitude on Conservative and Endodontic Practice on COVID Pandemic Situation: A Qualitative Research

AIM

The purpose of our study was to analyze the knowledge and attitude of conservative as well as endodontic practice among dental professionals during coronavirus pandemic situation.

METHODOLOGY

A cross-sectional study was conducted over a period of 3 months among 1256 dental surgeons, which included 400 MDS and 856 BDS dentists. Questionnaire assessed knowledge of the participants about COVID-19, risk assessment about the pandemic, preparedness of the participants, as well as specific precautions in cases which require conservative and endodontic treatment strategies against COVID-19.

RESULTS

It was observed that around 83% of the study participants felt that rubber dams are a useful tool to prevent cross-infections, even COVID-19. However, COVID-19 prevention techniques such as use of low-speed handpiece and chemicomechanical techniques were preferred by a smaller number of participants: 25% of participants by former, only 12% for the latter. To prevent aerosol splatter, use of high-volume suction was preferred by 49% of dental surgeons.

CONCLUSION

In our study, we concluded that dental surgeons, who come under high risk category; had good basic knowledge about COVID-19 disease process as well as transmission. However, it is imperative that these clinicians need to be extra cautious in handling cases during this pandemic time and limit the disease spread as well.

Depressive Symptomatology and Practice of Safety Measures among Undergraduate Students during COVID-19: Impact of Gender

The COVID-19 pandemic has greatly affected the personal and academic lives of undergraduates in Saudi Arabia. Although studies have suggested that COVID-19 increased the prevalence of psychological health problems among undergraduates, the associations between the risk of depression and safety practices and the influence of gender on these associations have not been studied in detail. A cross-sectional online survey was conducted among preparatory-year undergraduates in a large public university in Saudi Arabia during the outbreak. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression (CES-D) Scale, and the practice of eight precautionary behaviors was also assessed. Data analysis was performed using the chi-square test, multiple linear regression and Spearman's correlation coefficient. In total, 3044 undergraduates were surveyed. The mean age was 18.6 years (SD = 0.84), and 61.9% (n = 1883) of the participants were female. Overall, 47.7% of the participants reported having elevated depressive symptoms. Overall mean values of CES-D scores were higher among female undergraduates than that of male undergraduates (18.08 versus 15.56, p < 0.01). There were inverse and weak but significant relationships between the CES-D score and frequent cleaning of hands (male: r = -0.116, p < 0.01; female: r = -0.098, p < 0.01), wearing a mask when going out (male: r = -0.172, p < 0.01; female: r = -0.135, p < 0.01), keeping social distance (male: r = -0.117, p < 0.01; female: r = -0.147, p < 0.01), and covering the nose when sneezing (male: r = -0.202, p < 0.01; female: r = -0.115, p < 0.01). Regression analysis indicated that adherence to precautionary measures was a strong predictor of reduction of depressive symptoms in the target population. Male gender was also found to be an independent predictor of reduction of depressive symptoms. Depressive symptoms were highly prevalent in this target group, and female undergraduates seemed to be more vulnerable to developing such symptoms. Results also indicated that female undergraduates were more likely to implement the protective measures for COVID-19. The promotion of precautionary measures seems to be effective in reducing distress in this target population, but further research is needed to confirm our assertions.

Behavior Responses and Attitude of the Public to COVID-19 Pandemic During Movement Restrictions in Saudi Arabia

BACKGROUND

The behavior of the general public and the adoption of precautionary measures during a pandemic determine the fate of the country in the absence of any specific cure. This study aimed to determine the public attitude and behavior responses to the COVID-19 pandemic in Saudi Arabia during movement restrictions, and the predictors of behavioral responses.

METHODS

A community-based cross-sectional study of 2470 adult individuals in Saudi Arabia, 17-29 April 2020 was conducted via Survey Monkey, using an anonymous validated e-questionnaire. Data were collected on demographic characteristics, COVID-19-related attitudes, and behavioral responses in terms of; precautionary measures, preparedness, and self-quarantine activities, to be responded to by 4-point Likert scales. Multiple linear regression analyses were performed to identify the significant predictors of compliance with different behaviors. Significance was considered at p<0.05.

RESULTS

Participants reported positive attitudes towards governmental actions (95%), self-hygiene (93.2%), social distancing (97.1%) and choice of healthy food (89.6%), and negative attitudes towards the current worldwide situation of the pandemic (81.0%) and hearing someone tested positive (77.8%) or died from COVID-19 (83.7%). High rates of compliance to behavior were reported by only 55.8% of participants in terms of precautionary measures (71.3%), preparedness (38.4%), and self-quarantine activities (46.1%). After adjusting for all possible confounders, the total attitude score was a significant predictor of the total scores of precautionary measures (t=12.01, p<0.001), preparedness (t=9.29, p<0.001), self-quarantine activities (t=12.05, p<0.001), and overall behavior response (t=14.09, p<0.001). Other significant predictors of higher overall behavior response scores were female gender (t=7.22, p<0.001) and non-Saudi nationality (t=3.40, p<0.001).

CONCLUSION

This study provides baseline data on the behavioral response to the national COVID-19 pandemic in Saudi Arabia. The levels of compliance to behavior response and attitude to COVID-19 pandemic were less than satisfactory. Socio-demographics influence public behavior and protective health measures. COVID-19 awareness programs are recommended.

Considerations and Strategies for Restarting Elective Spine Surgery in the Midst of a Pandemic of COVID-19

The 2019 coronavirus disease (COVID-19) pandemic outbreak has rapidly spread to the globe, causing severe global socioeconomic disruption on an unprecedented scale. As the first wave of COVID-19 pandemic is now going to settle down, many medical organizations are in the process of reopening surgical services. This paper describes a few key factors that spine surgeons should consider prior to resuming elective spine services namely, local outbreak situations, availability of hospital resources, manpower and personal protective equipment (PPE). Spine surgeons should prioritize their operating list based on clinical indications and likely benefits from surgical intervention so as to make optimum use of hospital resources and operating room listings. International organizations have published on general principles and recommendations on how to restart elective surgery. However, with different regions at varying phases of the outbreak and unpredictable nature of the COVID-19 pandemic, a general set of practice guidelines may not be applicable. This paper also proposes, on top of peri-operative precautionary measures already in place, clearly-defined risk stratification algorithms for hospital visitors, as well as a disease-testing protocol for patients planned for elective surgery. It is of critical importance for surgeons to define key areas of concern and assimilate these principles into clearly-defined algorithms which can be applied to the field of spine surgery so as to help re-establish continuity of care for patients.

Knowledge, Attitude, and Precautionary Measures Towards COVID-19 Among Medical Visitors at the University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia

BACKGROUND

Novel coronavirus disease 2019 (COVID-19) is an emerging respiratory disease caused by severe acute respiratory syndrome coronavirus. It was designated a public health emergency of international concern on January 30, 2020. COVID-19 has no effective treatment; nonetheless, early recognition of the disease and applying prevention strategies will help to mitigate the virus propagation.

OBJECTIVE

This study aimed to assess the knowledge, attitude, and precautionary measures of medical center visitors at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from July 15 to August 15, 2020. A consecutive sampling technique was used to select the study participants. Data were collected by using a pre-tested structured, self-administered questionnaire. Data were analyzed using SPSS version 20. To explain the study variables, frequency tables, figures, and percentages were used. Bivariable and multivariable logistic regressions were used to see the association between independent and dependent variables.

RESULTS

The prevalence of poor knowledge, attitude, and precautionary measures was 42.2%, 39%, and 41.6%, respectively. Being female (AOR=2.79, 95% CI=1.752-4.44), divorced (AOR=0.29, 95% CI=0.09-0.88), and residing in a rural location (AOR=1.93, 95% CI=1.07-3.26) were significantly associated with poor knowledge. Being female (AOR=95%, CI=1.21-2.98), a farmer (AOR=4.13, 95% CI=1.60-10.63), residing in a rural location (AOR=2.53, 95% CI=1.31-4.88), poor knowledge (AOR=2.38, 95% CI=1.52-3.72), and negative attitude (AOR=3.25, 95% CI=2.07-5.09) were significantly associated with poor precautionary measures. Increasing income in one unit of Ethiopian birr (ETB) (AOR=0.26, 95% CI=0.031-0.051) was significantly associated with negative attitude.

CONCLUSION

The finding of this study showed that more than one-third of the participants had poor knowledge, attitude, and precautionary measures towards COVID-19 disease. A comprehensive health education program concerning knowledge, attitude, and precautionary measures toward COVID-19 ought to be strengthened.

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.

Knowledge, behavior and precautionary measures related to COVID-19 pandemic among the general public of Punjab province, Pakistan

INTRODUCTION

The world is facing a formidable challenge to prevent the COVID-19 global outbreak, and health care systems are under pressure globally. The governments alone cannot prevent the spread of this pandemic without creating a sensitive public opinion and cooperation. Therefore, this study analyzed the knowledge, behavior, and precautionary measures taken by the general public to protect themselves from COVID-19 pandemic.

METHODOLOGY

For this purpose, snowball sampling technique was used to collect data from 401 respondents through an online survey in the Punjab province of Pakistan. A Multivariate Probit Model was used to determine the factors affecting the choice of precautionary measures to avoid COVID-19 infection.

RESULTS

Majority of the respondents (58.1%) belonged to urban areas in this study. The urban respondents had higher knowledge about Coronavirus disease as compared to rural respondents. Similarly, the hygienic behavior of urban respondents was better than rural respondents. But unavailability of hygienic material (mask and hand sanitizer) was the main problem faced by the general public. Public transportation was considered the most risk-prone place to COVID-19 by the respondents. Majority of the respondents perceived medium to highest risk from COVID-19, and it was found one of the most influential factors affecting the adoption of precautionary measures along with knowledge of this pandemic.

CONCLUSIONS

Government needs to start a comprehensive awareness campaign on social media along with the mainstream media create awareness about the importance of social distancing, washing hands and wearing masks among the general public to enhance knowledge and improve the behavior of the general public about COVID-19.

Role of Precautionary Measures in Containing the Natural Course of Novel Coronavirus Disease

Background

The coronavirus disease (COVID-19) pandemic is spreading at an alarming rate. Several health authorities have implemented specific precautionary measures worldwide to combat the spread of the disease. The influence of these measures on tackling the spread of the disease remains to be elucidated. Therefore, this study aimed to assess the impact of precautionary measures to contain the COVID-19 outbreak.

Methods

Data for this study were gathered from publicly available data sources such as the Worldometer and World Health Organization websites. The expected number of new cases is calculated using a mathematical formula to assess the difference between the observed and expected number of cases, thus indicating the impact of precautionary measures on the spread of COVID-19.

Results

The preventive measures massively impacted the reduction of COVID-19 cases in Saudi Arabia from the expected number of 437,097 accumulated cases by May 4, 2020, to the observed number of 28,656 accumulated cases. Thus, the fatality rate is reduced from the expected 15,735 accumulated deaths by May 4 to 191 accumulated deaths.

Conclusion

Precautionary measures adopted by the Saudi Arabian health authorities were evidently effective in controlling the spread and further burden of COVID-19.

Public Trust and Compliance with the Precautionary Measures Against COVID-19 Employed by Authorities in Saudi Arabia

BACKGROUND

The newly emerged and highly infectious coronavirus disease (COVID-19), which first broke out in Wuhan, China, has invaded most countries around the globe. As both the daily positive cases and death toll increase, countries have taken aggressive action to halt its spread. Saudi Arabia recognized the danger early and implemented a series of urgent precautions. Thus, this study aims to evaluate public trust and compliance with the precautionary measures implemented by authorities to combat the COVID-19 outbreak.

METHODS

A cross-sectional study was conducted on a sample of the Saudi public using an electronic questionnaire during the COVID-19 outbreak. The data, which were collected using a validated public trust and compliance tool, were analyzed using the chi-square test, t test, and binary logistic regression.

FINDINGS

Of the 1232 participants, there were 655 (53.2%) males and 577 (46.8%) females with 34 ± 10 years as the mean and standard deviation of their age. Participants demonstrated a high level of trust and agreement (98.2%) with the implemented precautionary measures. A positive association between participants' age and their level of agreement with the government actions (r=-.082, P=0.004) was observed, with a significant difference between males (97.1±6.2) and females (98.0±4.7) (t=-2.7, P=0.006). Among the participants, 657 (53.3%) were considered to be practicing poor precautionary measures and 575 (46.7%) good precautionary measures. Males (OR=1.8 times, P<0.001) and those with a school education level (OR=1.7 times, P=0.002) were more likely to have poor precautionary practices compared to others. Married individuals (369, 49.0%; P=0.04) were more likely to comply with good practices.

CONCLUSION

A high level of trust was exhibited by the Saudi public in relation to the precautionary measures taken by authorities in Saudi Arabia. Gender, age, marital status, and educational level were found to be significant factors with regard to compliance with precautionary practices.

Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter

Effective management of the global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (also known as COVID-19), resulted in the implementation of severe restrictions in movement and enforcement of social distancing measures. This study aimed to understand and characterize the psychosocial effects of the COVID-19 pandemic in the general population and to identify risks and protective factors that predict changes in mental health status. In addition, the study investigated compliance with precautionary measures (PM) to halt the spread of the virus. The online anonymous survey collected information on sociodemographic data, compliance with PM, quality of life (QOL), and mental health via the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). A total of 1642 adult participants (71.6% women, 28.4% men) completed the survey in the European island country, Cyprus. A large percentage (48%) reported significant financial concerns and 66.7% significant changes in their QOL. About 41% reported symptoms associated with mild anxiety; 23.1% reported moderate-severe anxiety symptoms. Concerning depression, 48% reported mild and 9.2% moderate-severe depression symptoms. Women, younger age (18-29), student status, unemployment status, prior psychiatric history, and those reporting greater negative impact on their QOL, were at higher risk for increased anxiety and depression symptoms (p < 0.05). The youngest age group and males also reported lower levels of compliance with PM. Higher compliance with PM predicted lower depression scores (p < 0.001) but higher anxiety for measures related to personal hygiene. The results of this study provide important data on the effects of the COVID-19 outbreak on mental health and QOL and identify a variety of personal and social determinants that serve as risks and protective factors. Furthermore, it has implications for policy makers demonstrating the need for effective mental health programs and guidance for the implementation of PM as a public health strategy.

A Descriptive Study From Jordan

The recent coronavirus disease (COVID-19) pandemic is associated with increasing morbidity and mortality and has impacted the lives of the global populations. Human behavior and knowledge assessment during the crisis are critical in the overall efforts to contain the outbreak. To assess knowledge, attitude, perceptions, and precautionary measures toward COVID-19 among a sample of medical students in Jordan. This is a cross-sectional descriptive study conducted between the 16th and 19th of March 2020. Participants were students enrolled in different levels of study at the six medical schools in Jordan. An online questionnaire which was posted on online platforms was used. The questionnaire consisted of four main sections: socio-demographics, sources of information, knowledge attitudes, and precautionary measures regarding COVID-19. Medical students used mostly social media (83.4%) and online search engines (84.8%) as their preferred source of information on COVID-19 and relied less on medical search engines (64.1%). Most students believed that hand shaking (93.7%), kissing (94.7%), exposure to contaminated surfaces (97.4%), and droplet inhalation (91.0%) are the primary mode of transmission but were indecisive regarding airborne transmission with only 41.8% in support. Participants also reported that elderly with chronic illnesses are the most susceptible group for the coronavirus infection (95.0%). As a response to the COVID-19 pandemic more than 80.0% of study participants adopted social isolation strategies, regular hand washing, and enhanced personal hygiene measures as their first line of defense against the virus. In conclusion, Jordanian medical students showed expected level of knowledge about the COVID-19 virus and implemented proper strategies to prevent its spread.

A Descriptive Study From Jordan

The recent coronavirus disease (COVID-19) pandemic is associated with increasing morbidity and mortality and has impacted the lives of the global populations. Human behavior and knowledge assessment during the crisis are critical in the overall efforts to contain the outbreak. To assess knowledge, attitude, perceptions, and precautionary measures toward COVID-19 among a sample of medical students in Jordan. This is a cross-sectional descriptive study conducted between the 16th and 19th of March 2020. Participants were students enrolled in different levels of study at the six medical schools in Jordan. An online questionnaire which was posted on online platforms was used. The questionnaire consisted of four main sections: socio-demographics, sources of information, knowledge attitudes, and precautionary measures regarding COVID-19. Medical students used mostly social media (83.4%) and online search engines (84.8%) as their preferred source of information on COVID-19 and relied less on medical search engines (64.1%). Most students believed that hand shaking (93.7%), kissing (94.7%), exposure to contaminated surfaces (97.4%), and droplet inhalation (91.0%) are the primary mode of transmission but were indecisive regarding airborne transmission with only 41.8% in support. Participants also reported that elderly with chronic illnesses are the most susceptible group for the coronavirus infection (95.0%). As a response to the COVID-19 pandemic more than 80.0% of study participants adopted social isolation strategies, regular hand washing, and enhanced personal hygiene measures as their first line of defense against the virus. In conclusion, Jordanian medical students showed expected level of knowledge about the COVID-19 virus and implemented proper strategies to prevent its spread.

The Idea of Precaution: Ethical Requirements for the Regulation of New Biotechnologies in the Environmental Field

The rapid emergence of new biotechnologies for selectively altering genetic material-so-called genome editing-has sparked public controversy about how their development and application in the environmental fields are to be regulated. Since the use of these new technologies harbors not only considerable potential but also risks of serious damage whose occurrence is uncertain due to their application in complex environmental systems, many national and international legal authorities are currently adhering to policies of precaution. According to critics, however, precautionary measures and the legal principle of precaution on which they are based are unduly restrictive in the case of the new biotechnologies, hindering advancements in both research and various fields of application. At the same time, legal notions of precaution are highly ambiguous within and across different national and international formulations, thereby further complicating the controversy about their implications. This paper goes beyond the concept of precaution as found in environmental law by examining the ethical significance and the ethical justification of precautionary measures in the environmental field. In particular, it clarifies the criterion of potential damage, disambiguates different types of epistemic bases in precaution decisions, and considers the relevance and implications of different ethical risk theories as to their response to epistemic uncertainty and vagueness. The two main conclusions are that, first, irrespective of the ethical risk theory embraced, there is an ethical obligation to take precautionary measures whenever serious damage is possible and the probability of damage occurring epistemically uncertain or vague. Regarding the risk assessment, it is argued that the burden of proof lies not with those who fear the occurrence of serious environmental damage. Rather, it is up to those whose actions give rise to such fears to demonstrate that serious damage is extremely improbable or scientifically absurd. Second, the moral responsibility to determine precaution situations and to specify appropriate precautionary measures is attributed not only to state authorities but also to industrial players as well as research communities. Based on these two conclusions, recommendations are given as to how the precautionary principle should be incorporated in political and legal decision-making.

Communicating Earthquake Preparedness: The Influence of Induced Mood, Perceived Risk, and Gain or Loss Frames on Homeowners' Attitudes Toward General Precautionary Measures for Earthquakes

Despite global efforts to reduce seismic risk, actual preparedness levels remain universally low. Although earthquake-resistant building design is the most efficient way to decrease potential losses, its application is not a legal requirement across all earthquake-prone countries and even if, often not strictly enforced. Risk communication encouraging homeowners to take precautionary measures is therefore an important means to enhance a country's earthquake resilience. Our study illustrates that specific interactions of mood, perceived risk, and frame type significantly affect homeowners' attitudes toward general precautionary measures for earthquakes. The interdependencies of the variables mood, risk information, and frame type were tested in an experimental 2 × 2 × 2 design (N = 156). Only in combination and not on their own, these variables effectively influence attitudes toward general precautionary measures for earthquakes. The control variables gender, "trait anxiety" index, and alteration of perceived risk adjust the effect. Overall, the group with the strongest attitudes toward general precautionary actions for earthquakes are homeowners with induced negative mood who process high-risk information and gain-framed messages. However, the conditions comprising induced negative mood, low-risk information and loss-frame and induced positive mood, low-risk information and gain-framed messages both also significantly influence homeowners' attitudes toward general precautionary measures for earthquakes. These results mostly confirm previous findings in the field of health communication. For practitioners, our study emphasizes that carefully compiled communication measures are a powerful means to encourage precautionary attitudes among homeowners, especially for those with an elevated perceived risk.