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57 Research products, page 1 of 6

  • COVID-19
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  • Frontiers in Public Health
  • COVID-19

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  • Open Access English
    Authors: 
    Allie Slemon; Corey McAuliffe; Trevor Goodyear; Trevor Goodyear; Liza McGuinness; Elizabeth Shaffer; Emily K. Jenkins;
    Publisher: Frontiers Media S.A.

    Background: The COVID-19 pandemic is having considerable impacts on population-level mental health, with research illustrating an increased prevalence in suicidal thoughts due to pandemic stressors. While the drivers of suicidal thoughts amid the pandemic are poorly understood, qualitative research holds great potential for expanding upon projections from pre-pandemic work and nuancing emerging epidemiological data. Despite calls for qualitative inquiry, there is a paucity of qualitative research examining experiences of suicidality related to COVID-19. The use of publicly available data from social media offers timely and pertinent information into ongoing pandemic-related mental health, including individual experiences of suicidal thoughts.Objective: To examine how Reddit users within the r/COVID19_support community describe their experiences of suicidal thoughts amid the COVID-19 pandemic.Methods: This study draws on online posts from within r/COVID19_support that describe users' suicidal thoughts during and related to the COVID-19 pandemic. Data were collected from creation of this subreddit on February 12, 2020 until December 31, 2020. A qualitative thematic analysis was conducted to generate themes reflecting users' experiences of suicidal thoughts.Results: A total of 83 posts from 57 users were included in the analysis. Posts described a range of users' lived and living experiences of suicidal thoughts related to the pandemic, including deterioration in mental health and complex emotions associated with suicidal thinking. Reddit users situated their experiences of suicidal thoughts within various pandemic stressors: social isolation, employment and finances, virus exposure and COVID-19 illness, uncertain timeline of the pandemic, news and social media, pre-existing mental health conditions, and lack of access to mental health resources. Some users described individual coping strategies and supports used in attempt to manage suicidal thoughts, however these were recognized as insufficient for addressing the multilevel stressors of the pandemic.Conclusions: Multiple and intersecting stressors have contributed to individuals' experiences of suicidal thoughts amid the COVID-19 pandemic, requiring thoughtful and complex public health responses. While ongoing challenges exist with self-disclosure of mental health challenges on social media, Reddit and other online platforms may offer a space for users to share suicidal thoughts and discuss potential coping strategies.

  • Open Access
    Authors: 
    Madelaine Gierc; Negin A. Riazi; Matthew James Fagan; Katie M. Di Sebastiano; Mahabhir Kandola; Carly S. Priebe; Katie A. Weatherson; Kelly Wunderlich; Guy Faulkner;
    Publisher: Frontiers Media SA
    Project: CIHR

    Background: In addition to its physical health benefits, physical activity is increasingly recognized as a means to support mental health. Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental well-being, reduced likelihood of developing mental illness, and improved symptom management. Despite these benefits, most people fail to achieve minimum recommended levels of MVPA. Population levels of physical activity have further declined since the onset of the COVID-19 pandemic and implementation of public health measures (e.g., shelter-in-place protocols). The potential impact of this decline on mental heath outcomes warrants ongoing investigation.Purpose: To investigate associations between changes in MVPA and mental health (depressive symptoms, anxiety symptoms, and life satisfaction) in adults impacted by the COVID-19 pandemic.Method: Research followed a cross-sectional design. English-speaking adults were invited to complete an online questionnaire. MVPA was assessed retrospectively (before COVID-19) and currently (during COVID-19) with the International Physical Activity Questionnaire. Mental health was assessed with the Patient Health Questionnaire, 9-Item (PHQ-9), the Generalized Anxiety Disorder, 7-Item (GAD-7), and the Satisfaction with Life Scale (SWLS). Regression was used to assess relationships between MVPA and mental health. ANOVA with follow-up tests examined whether participants who differed in mental health status (e.g., no symptoms vs. severe symptoms) differed in their change in MVPA. T-tests were used to examine differences in mental health symptomatology between participants who were sufficiently (i.e., achieving MVPA guidelines of ≥ 150 min/week) vs. insufficiently active.Results: Prior to COVID-19, 68.2% of participants were classified as being sufficiently active, vs. 60.6% during COVID-19. The majority of participants reported experiencing some level of depressive symptoms (62.0%) or anxiety symptoms (53.7%). After controlling for covariates, changes in MVPA accounted for significant variability in the PHQ-9 (7.7%), GAD-7 (2.5%), and SWLS (1.5 %). Participants with clinically significant mental health symptomatology reported greater declines in MVPA than those who reported no symptoms. Conversely, participants who were sufficiently active during COVID-19 reported significantly lower depression and anxiety, and higher life satisfaction.Conclusion: Participants who experienced the greatest declines in MVPA reported relatively greater psychological distress and lower life satisfaction. While preliminary, these findings suggest the importance of maintaining and promoting physical activity during a period of pandemic.

  • Open Access English
    Authors: 
    Ollier, Joseph; Neff, Simon; Dworschak, Christine; Sejdiji, Arber; Santhanam, Prabhakaran; Keller, Roman; Xiao, Grace; Asisof, Alina; Rüegger, Dominik; Bérubé, Caterina; +35 more
    Publisher: Frontiers Media
    Countries: Switzerland, United Kingdom

    Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention. Methods: Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep and diet and nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time, such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS and Android devices in English, European Spanish and Latin American Spanish with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons 4.0 license CC BY-NC-SA (intervention logic and content), allowing future collaborations; such as cultural adaptions, integration of new sensor-related features or the development of new topics. Discussion: Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations. Frontiers in Public Health, 9 (1543) ISSN:2296-2565

  • Open Access English
    Authors: 
    Schmidt-Petri, Christoph; Schröder, Carsten; Okubo, Toshihiro; Graeber, Daniel; Rieger, Thomas;
    Publisher: Freie Universität Berlin
    Country: Germany

    BackgroundAccording to a recent paper by Gelfand et al., COVID-19 infection and case mortality rates are closely connected to the strength of social norms: “Tighter” cultures that abide by strict social norms are more successful in combating the pandemic than “looser” cultures that are more permissive. However, countries with similar levels of cultural tightness exhibit big differences in mortality rates. We are investigating potential explanations for this fact. Using data from Germany and Japan—two “tight” countries with very different infection and mortality rates—we examined how differences in socio-demographic and other determinants explain differences in individual preventive attitudes and behaviors.MethodsWe compared preventive attitudes and behaviors in 2020 based on real-time representative survey data and used logit regression models to study how individual attitudes and behaviors are shaped by four sets of covariates: individual socio-demographics, health, personality, and regional-level controls. Employing Blinder-Oaxaca regression techniques, we quantified the extent to which differences in averages of the covariates between Japan and Germany explain the differences in the observed preventive attitudes and behaviors.ResultsIn Germany and Japan, similar proportions of the population supported mandatory vaccination, avoided travel, and avoided people with symptoms of a cold. In Germany, however, a significantly higher proportion washed their hands frequently and avoided crowds, physical contact, public transport, peak-hour shopping, and contact with the elderly. In Japan, a significantly higher proportion were willing to be vaccinated. We also show that attitudes and behaviors varied significantly more with covariates in Germany than in Japan. Differences in averages of the covariates contribute little to explaining the observed differences in preventive attitudes and behaviors between the two countries.ConclusionConsistent with tightness-looseness theory, the populations of Japan and Germany responded similarly to the pandemic. The observed differences in infection and fatality rates therefore cannot be explained by differences in behavior. The major difference in attitudes is the willingness to be vaccinated, which was much higher in Japan. Furthermore, the Japanese population behaved more uniformly across social groups than the German population. This difference in the degree of homogeneity has important implications for the effectiveness of policy measures during the pandemic.

  • Open Access
    Authors: 
    Kathleen M. Vogel; Amanda J. Ozin; Jonathan E. Suk;
    Publisher: Frontiers Media SA

    In September 2011, scientists announced new experimental findings that would not only threaten the conduct and publication of influenza research, but would have significant policy and intelligence implications. The findings presented a modified variant of the H5N1 avian influenza virus (hereafter referred to as the H5N1 virus) that was transmissible via aerosol between ferrets (1, 2). These results suggested a worrisome possibility: the existence of a new airborne and highly lethal H5N1 virus that could cause a deadly global pandemic. In response, a series of international discussions on the nature of dual-use life science arose (3). More proposed “gain-of-function (GOF)” research on the flu, and other respiratory viruses such as severe acquired respiratory syndrome (SARS) and middle east coronavirus (MERS-CoV), has led to this work being labeled as having “potential pandemic potential (PPP).” Scientists and other interested parties are increasingly asked to more clearly state the risks and benefits of this kind of research and whether new regulations and oversight mechanisms are needed. More recently, controversies such as reported accidents and lax controls over dangerous pathogens in high profile research labs have once again raised the issue of accounting and safeguards of dangerous pathogens, with new calls for greater transparency of the oversight of these materials (4, 5). The emerging field of synthetic biology is also raising concerns about its current and future impact on human health and the environment, and its potential for bioterrorism by do-it-yourself biologists. With the Ebola outbreaks happening as we began to work this editorial, we have encountered additional (but fairly speculative!) discussion about the threat of bioterrorism during naturally occurring outbreaks and how this risk could be dealt with by the health security agenda. Regardless of where one finds oneself on the topic, it seems clear that advances in the life sciences are creating new ethical, safety, regulatory, and security challenges. To what extent such research should be conducted, published, and governed? Who should have a say in these outcomes? What viable alternatives exist? Since 2001, there have a variety of national and global initiatives to increase biosecurity, while not unduly inhibiting responsible scientific innovation. Various countries are continuing to develop or revamp their biosecurity regimes. The traditional “bottom up” approach of scientist self-governance for biosecurity is increasingly in question, but controversial changes to the National Science Advisory Board for Biosecurity in the United States indicate that top-down approaches are also not a panacea. This special issue was devoted to contributions that explored this matrix of issues from a variety of case study and international perspectives. This issue was a challenge to manage because of the rapidly evolving nature of developments in the field even from when we first issued the call for papers in December 2013. Emblematic of the topic itself, this made it difficult to draw a line on what to include in the issue as new submissions were entered and new controversies arose. The debate and discussion over the dual-use implications of emerging infectious diseases and the life sciences continues and will continue in the foreseeable future. We thank the authors of this special issue for an excellent set of papers to starting framing and prioritizing the national and international dialog on these timely issues. The articles in this issue ultimately clustered around five central themes: (1) dual-use as a unique kind of policy problem; (2) involving diverse stakeholders in dual-use discussions; (3) instituting a culture of responsibility among scientists; (4) producing more evidence-based risk-benefit analyses of dual-use research; and (5) developing greater oversight, control, and standardization of dual-use procedures. For the first theme, Rappert (6) noted that dual-use has been a largely “non-problem” – a curious phenomenon. Rappert (6) notes that although much concern has been cited with the misuse of the life sciences since September 11, there have been very few research identified as “of concern.” Moreover, Jefferson and colleagues (7) find that there has been a lot of mythmaking around synthetic biology that has been used to mobilize support, resources, and action for focusing policy attention on this field. Koblentz (8), however, finds that dual-use is an inherently “wicked problem” that makes it resistant to long-lasting solutions. In contrast, Murdock and Koepsell (9) argue that dual-use research is a classical principal-agent problem and that this kind of asymmetry between governments and scientists, creates the tensions that we see in regulation. Connecting to the second theme, Suk et al. (10) argue that the public health sector could be brought in more to dual-use discussion to help guide policy decisions and promote actions along all phases of the research cycle. To date, the authors find that public health perspectives have been an underutilized resource in dual-use/biosecurity discussions. Kosal (11) argues more dramatically that improving public health could serve as a powerful active deterrent to those who might wish to launch a bioterrorist attack. Laboratory biosafety and biosecurity are closely intertwined concepts, both dependent on compliance with appropriate regulations, laws, and oversight mechanisms. In both, there is no such thing as “zero risk.” As concerns biosafety, it is important to note that safety consists not simply of the design of laboratories, but also crucially in the trained people that work there, the implementation of regulations, and the use of robust risk-based approaches to mitigate adverse events. In the third theme cutting cross the papers, Jacobsen et al. (12) and Sijnesael et al. (13) argue that we need to internally cultivate responsibility within specific organizations that handle dangerous pathogens, as well as the larger life science community. These authors also argue that we need a more diverse set of stakeholders in discussions about dual-use issues and in the development and implementation of new oversight and assessment measures. Further, Jacobsen et al. (12) as well as Klotz and Sylvester (14) both argue that we need more quantitative and qualitative risk-benefit analyses for assessing research with dual-use potential. In the area of governance, Smith and Scott (15), as well as Lev and Samimian-Darash (16), Ehrlich (17), and Jacobsen et al. (12) all advocate for the need for new oversight and governance structures for research and funding of dual-use science. In sum, what we see from these papers and continuing media coverage is that the debate of dual-use is growing, gaining more public, expert, and policy attention. But as the papers in this issue suggest, these debates need to happen at higher policy levels. Moreover, there is the need for more inculcation of scientific responsibility and norms at the local, national, and global level. Countries need to continue to work on improving their biosecurity efforts and develop some key indicators to not only show that they are committed to biosecurity and biosafety, but they are implementing, monitoring, and assessing key aspects at the local and national level. This needs to include not only academic and government research institutions, but also those in the private sector. Within this context, the underlying objective should be, ultimately, to improve and not threaten public health, but exactly how to do this is remains an outstanding and elusive question. Finally, we need more review and accounting both nationally and globally about what biosecurity measures are in place, what gaps still exist, and how to remedy these shortcomings.

  • Open Access English
    Authors: 
    Jean-Denis Courcol; Cédric F. Invernizzi; Zachary Landry; Mikhaél Minisini; Dieter A. Baumgartner; Sebastian Bonhoeffer; Barbara Chabriw; Estelle Emilie Clerc; Michael Daniels; Pavlo Getta; +15 more
    Publisher: Frontiers Media S.A.
    Country: Switzerland
    Project: EC | Microsyndia (886198), EC | BactoBubble (798411), EC | NeuroFreezing (844326)

    Frontiers in Public Health, 9 ISSN:2296-2565

  • Open Access English
    Authors: 
    John Elvis Hagan; John Elvis Hagan; Bright Opoku Ahinkorah; Abdul-Aziz Seidu; Abdul-Aziz Seidu; Edward Kwabena Ameyaw; Thomas Schack;
    Publisher: Frontiers Research Foundation
    Countries: Australia, Germany

    Given that COVID-19 (SARS-CoV-2) has crept into Africa, a major public health crisis or threat continues to linger on the continent. Many local governments and various stakeholders have stepped up efforts for early detection and management of COVID-19. This mini review highlights the current trend in Africa, history and general epidemiological information on the virus. Current ongoing efforts (e.g., improving testing capacity) and some effective ways (e.g., intensified surveillance, quick detection, contact tracing, isolation measures [e.g., quarantine], and social distancing) of preventing and managing COVID-19 in Africa are described. The review concludes by emphasizing the need for public health infrastructure development (e.g., laboratories, infectious disease centers, regional hospitals) and human capacity building for combating COVID-19 and potential future outbreaks. Additionally, regular public health educational campaigns are urgently required. Future epidemiological studies to ascertain case fatality and mortality trends across the continent for policy directions are necessary.

  • Open Access
    Authors: 
    Lucy O. Keatts; Martin Robards; Sarah H. Olson; Karsten Hueffer; Stephen J. Insley; Stephen J. Insley; Damien O. Joly; Susan Kutz; David S. Lee; Cheryl-Lesley B. Chetkiewicz; +13 more
    Publisher: Frontiers Media SA

    The COVID-19 pandemic has re-focused attention on mechanisms that lead to zoonotic disease spillover and spread. Commercial wildlife trade, and associated markets, are recognized mechanisms for zoonotic disease emergence, resulting in a growing global conversation around reducing human disease risks from spillover associated with hunting, trade, and consumption of wild animals. These discussions are especially relevant to people who rely on harvesting wildlife to meet nutritional, and cultural needs, including those in Arctic and boreal regions. Global policies around wildlife use and trade can impact food sovereignty and security, especially of Indigenous Peoples. We reviewed known zoonotic pathogens and current risks of transmission from wildlife (including fish) to humans in North American Arctic and boreal biomes, and evaluated the epidemic and pandemic potential of these zoonoses. We discuss future concerns, and consider monitoring and mitigation measures in these changing socio-ecological systems. While multiple zoonotic pathogens circulate in these systems, risks to humans are mostly limited to individual illness or local community outbreaks. These regions are relatively remote, subject to very cold temperatures, have relatively low wildlife, domestic animal, and pathogen diversity, and in many cases low density, including of humans. Hence, favorable conditions for emergence of novel diseases or major amplification of a spillover event are currently not present. The greatest risk to northern communities from pathogens of pandemic potential is via introduction with humans visiting from other areas. However, Arctic and boreal ecosystems are undergoing rapid changes through climate warming, habitat encroachment, and development; all of which can change host and pathogen relationships, thereby affecting the probability of the emergence of new (and re-emergence of old) zoonoses. Indigenous leadership and engagement in disease monitoring, prevention and response, is vital from the outset, and would increase the success of such efforts, as well as ensure the protection of Indigenous rights as outlined in the United Nations Declaration on the Rights of Indigenous Peoples. Partnering with northern communities and including Indigenous Knowledge Systems would improve the timeliness, and likelihood, of detecting emerging zoonotic risks, and contextualize risk assessments to the unique human-wildlife relationships present in northern biomes.

  • Open Access English
    Authors: 
    Kazem Rahmani; Rasoul Shavaleh; Mahtab Forouhi; Hamideh Feiz Disfani; Mostafa Kamandi; Rozita Khatamian Oskooi; Molood Foogerdi; Moslem Soltani; Maryam Rahchamani; Mohammad Mohaddespour; +1 more
    Country: Netherlands

    BackgroundVaccination, one of the most important and effective ways of preventing infectious diseases, has recently been used to control the COVID-19 pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19.MethodsA systematic search was performed independently in Scopus, PubMed via Medline, ProQuest, and Google Scholar electronic databases as well as preprint servers using the keywords under study. We used random-effect models and the heterogeneity of the studies was assessed using I2 and χ2 statistics. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting based on the type of outcome.ResultsA total of 54 studies were included in this meta-analysis. The PVE against SARS-COV 2 infection were 71% [odds ratio (OR) = 0.29, 95% confidence intervals (CI): 0.23–0.36] in the first dose and 87% (OR = 0.13, 95% CI: 0.08–0.21) in the second dose. The PVE for preventing hospitalization due to COVID-19 infection was 73% (OR = 0.27, 95% CI: 0.18–0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07–0.17) in the second dose. With regard to the type of vaccine, mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness in preventing infection. Regarding the COVID-19-related mortality, PVE was 68% (HR = 0.32, 95% CI: 0.23–0.45) in the first dose and 92% (HR = 0.08, 95% CI: 0.02–0.29) in the second dose.ConclusionThe results of this meta-analysis indicated that vaccination against COVID-19 with BNT162b2 mRNA, mRNA-1273, and ChAdOx1, and also their combination, was associated with a favorable effectiveness against SARS-CoV2 incidence rate, hospitalization, and mortality rate in the first and second doses in different populations. We suggest that to prevent the severe form of the disease in the future, and, in particular, in the coming epidemic picks, vaccination could be the best strategy to prevent the severe form of the disease.Systematic review registrationPROSPERO International Prospective Register of Systematic Reviews: http://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42021289937].

  • Open Access English
    Authors: 
    Sara Monteiro Pires; Grant M. A. Wyper; Annelene Wengler; José L. Peñalvo; Romana Haneef; Declan Moran; Sarah Cuschieri; Hernan G. Redondo; Robby De Pauw; Scott A. McDonald; +6 more
    Countries: Belgium, Denmark, Malta, Netherlands

    Objectives: Quantifying the combined impact of morbidity and mortality is a key enabler to assessing the impact of COVID-19 across countries and within countries relative to other diseases, regions, or demographics. Differences in methods, data sources, and definitions of mortality due to COVID-19 may hamper comparisons. We describe efforts to support countries in estimating the national-level burden of COVID-19 using disability-adjusted life years. Methods: The European Burden of Disease Network developed a consensus methodology, as well as a range of capacity-building activities to support burden of COVID-19 studies. These activities have supported 11 national studies so far, with study periods between January 2020 and December 2021. Results: National studies dealt with various data gaps and different assumptions were made to face knowledge gaps. Still, they delivered broadly comparable results that allow for interpretation of consistencies, as well as differences in the quantified direct health impact of the pandemic. Discussion: Harmonized efforts and methodologies have allowed for comparable estimates and communication of results. Future studies should evaluate the impact of interventions, and unravel the indirect health impact of the COVID-19 crisis. peer-reviewed