Category: Covid-19

Throughout the COVID-19 pandemic, masking has been one of the key public health measures put in place to combat the disease. Since March 2020, billions of disposable surgical masks have been used around the world, raising the question: What happens to all those used masks?

As researchers in single use plastic and microplastic pollution, the onset of a global wave of plastic debris pollution became evident to us in the early days of the pandemic we could see the evidence even during lockdowns when exercise was limited to short daily walks in the neighbourhood. Masks and gloves were on the ground, fluttering in the wind and hanging on fencing.

As ecologists, we were also aware of where the debris would end up in nests, for example, or wrapped around the legs or in the stomachs of wildlife.

In Canada, a team of researchers led by conservation biologist Jennifer Provencher studied how plastic debris impacts wildlife. In a study conducted during a canal cleanup in The Netherlands, biologists at the Naturalis Biodiversity Center documented that Personal Protective Equipment (PPE) debris would interact with wildlife in the same way as other plastics.

Theres a cartoon circulating on the internet that goes like this: a rat comes home carrying bags of groceries to see two rats laying in bunk beds made from medical grade masks. The rat in the bottom bunk exclaims, Free hammocks, all over town. Its like a miracle!

We shared this cartoon with our colleagues at the beginning of the pandemic, while we were conducting surveys of PPE litter around Toronto streets and parking lots.

We found that within the area that we were surveying which covered an area of Toronto equivalent to about 45 football fields over 14,000 disposable masks, gloves or hand wipes accumulated by the end of the year. Thats a lot of rat hammocks.

We set out to understand the breadth of the harm that PPE is doing to wildlife. What we learned is just how many other people were equally concerned.

We conducted a global survey using social media accounts of wildlife interactions with PPE debris. The images are jarring: A hedgehog wrapped in a face mask, the earloops tangled in its quills. A tiny bat, with the earloops of two masks wrapped around its wing. A nest, full of ivory white eggs, insulated with downy feathers and a cloth mask.

Many of these animals are dead, but most were alive at the time of observation. Some were released from their plastic entanglement by the people who captured the photo.

In total, we found 114 cases of wildlife interactions with PPE debris as documented on social media by concerned people around the world. Most of the wildlife were birds (83 per cent), although mammals (11 per cent), fish (two per cent), invertebrates such as an octopus (four per cent) and sea turtles (one per cent) were also observed.

The majority of observations originated in the United States (29), England (16), Canada (13) and Australia (11), likely representing both the increase in access to mobile devices and our English-language search terms. Observations also came from 22 other countries, with representation from all continents except Antarctica.

With an estimated 129 billion face masks used monthly around the world, how do we, as ecologists and environmental researchers, tell a global population experiencing a global pandemic to use fewer masks? We dont.

N95 masks have been essential in reducing the transmission of COVID-19 and, although they are more environmentally harmful than cloth masks, the benefit to health is demonstrably superior.

So, what could we have done better? One thing we noted during our PPE litter surveys is the abundance of discarded masks and gloves in close proximity to public garbage bins.

We hypothesize that a lack of clear messaging from municipalities and provinces about safe ways to dispose of PPE, along with our reluctance to gather near sources of discarded PPE, may have contributed to this global pollution event.

These are lessons that can still be implemented as we continue to cycle through waves of this pandemic; the use of masks is not yet behind us. Our surveys continue as we track an accumulation of PPE debris that will likely find its way into more nests and tangled around the bodies of more animals.

The rise of single use plastic use due to COVID-19 may not have been avoidable. But the rise in plastic pollution could have been mitigated with some investment in public outreach and modifications to waste management infrastructure to allow for masks and other PPE to be disposed of and processed correctly with minimal leakage to the environment.

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The PPE used throughout the COVID-19 pandemic is getting tangled up in wildlife - The Conversation Indonesia

Introduction

The COVID-19 pandemic has formed a chief social and medical crisis, forcing the medical and healthcare communities to face unprecedented challenges and rethink how to provide quality healthcare while enforcing health promotion required for pandemic deterrence and optimal healthcare distribution of resources.

The literature on crisis detection, early cautions and the following activation of crisis administrations has a wealth of information. It also says nothing about the gradual erosion of administrative and healthcare capacity as budget limitations constrict and communal opposition to voluntary compliance grows. COVID-19 provides fertile ground for further investigation.1 Whether caused by natural catastrophes, conflicts, or disease outbreaks, crises disturb peoples lives, hurting their livelihoods, economies and social and personal well-being. The primary idea for developing robust post-crisis healing is to ensure that the situation does not return to normal after the recovery process, but rather improves.

Since World War II, COVID-19 has brought the world the longest era of prolonged crisis regimes. Addressing the pandemic will necessitate not only a biomedical approach, but also a larger social sciences approach to health and, most importantly, listening to and learning from existing diverse communities and health management system, flexibility and capacity to work across sectors and recognition of social justice while carrying out public health actions in various contexts. Researchers believe that, just as previous cultural, political and epidemiological transitions led to changes in public health, these turbulent times will result in stronger public health.1

Traditionally, anthropology, sociology and more lately, cultural studies, rather than medicine and public health, have been interested in culture. In general, the public health literature provides relatively little in the way of relevant interpretations of the culture idea. Instead, the concept of culture is often used blindly, relying on presumptions about culture and the cultural behaviors that are linked to health.2 A public health culture can be defined as a new collection of words and effects, signals and facts, that supersedes or modifies the traditional set.3 It is a social construct that provides meaning through which the world is portrayed, in this case as a pandemic requiring massive political participation rather than isolated cases left in the hands of professionals.4

Moreover, communities with stronger civic capital are thus more successful at acting collectively and producing essential utilities, necessitating less costly supervision.5 Also, in the absence of government initiatives and persuasion campaigns, a strong civic culture can elicit voluntary response action at an early stage in the event of a pandemic. Furthermore, because more civic communities are more law-abiding,6 they are more likely to follow required responsive action measures if they are implemented. As a result, the higher the civic capital pool, the greater the adherence to reactive action and the slower the pandemic expansion.7

Culture has been a fundamental form of adaptation during the history of humankind. Culture is a socially communicated arrangement of shared ideas, beliefs and/or behaviors that varies across organizations and individuals within those groups.8 Because socioeconomic position, gender, religion and moral values all influence how people feel, interpret and react to their surroundings, basic cultural interpretations are insufficient to comprehend a patients unique experience with well-being and sickness.9 Policymakers must understand how communities, as cultures of behavior, adjust to different and composite pressures to develop relevant and responsive health policies and programs.

Culture may not be considered as an official priority by authorities in times of crisis, but it is available as a resource to handle adverse events by individuals and groups. Public culture assets give communities a sense of self, history and social cohesion while also providing resources for economic development and restorative energy. Culture is more than just a pastime; it is essential to human existence.

Hence, culture may increase COVID-19 exposure, early identification and therapy. Handshaking or kissing is common cultural salutations between people, but they can help infections transmit. Although persuading patients to adopt or revise their customary cultural habits as a source of data control can be difficult, it is an important tool for reducing or changing the transmission of infection. The importance of culture in dealing with these situations is sometimes overlooked. The COVID-19 pandemic, on the other hand, demonstrates the necessity of relying on and employing culture to assist individuals in dealing with difficult situations. Many internet-based efforts centered on culture and tradition expressed peoples desire to band together and, as a result, strengthen societal resilience in the face of the pandemic.

In 2001, the United Nations Education, Scientific and Cultural Organization (UNESCO) defined culture as the set of distinctive spiritual, material, intellectual and emotional features of society or a social group [which] encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs.10 This concept emphasizes that culture is made up of overt beliefs and behaviors and is not confined to national, racial, ethnic, or religious identity as well as the delicate and unquestioned traditions that shape our perceptions of certainty, define what is ordinary and extraordinary, and provide meaning and direction to our lives.

Because culture encompasses more than what we explicitly acknowledge, recognizing that it necessitates the difficult effort of analyzing assumptions, questioning preconceived notions and recognizing how the importance of common group values can sharply diverge, for better or worse: for better when difference allows us to rethink our assumptions in a new way; for worse when difference causes conflicts and misunderstandings. Many public health professionals are aware of the dangers of failing to address the cultural contexts of their work. As a result, public health systems have been weakened in their ability to respond effectively to the health requirements of varied communities, sparking fresh interest in establishing a health and well-being approach that is culturally sensitive.2

Culture has become a normal part of epidemiological research, seemingly unchallenged next to traditional health risk behaviors such as food and physical activity. The concept that culture can be used to improve ones health has been expressed in a variety of ways, including incorporating cultural symbols and meanings into health promotion materials11,12 asserting that a society or culture may be conducive to better health behaviors and claiming that the process of reviewing and exploring ones cultural ancestors can help ones health.13 Hall and Neitz14 suggest that culture embraces (1) ideas, knowledge and recipes for doing things, (2) humanly fabricated tools and (3) the products of social action that may be drawn upon in the further conduct of social life.

On the other hand, most scientists and news commentators, appear to approve on one feature of this pandemic: that in the upshot of the COVID-19 pandemic, with its lockdown and movement limitations, this pandemic will be worse. It will be a long and slow process of recalibration to the new normal in human contact patterns around the world, as some commentators so eloquently stated it. Different cultures and societies will undoubtedly react differently to the issues they face. The area of community development theorists and practitioners is focused on the post-COVID-19 eras evolution (urban renewal) of our communities. We must take steps to protect ourselves from the pandemic and to participate actively in the repair of our community fabric and quality of life.15

Adding to the body of knowledge about the cultural settings of health and well-being. Policymakers use broad mortality and morbidity statistics to generate policy suggestions in traditional health impact evaluations, frequently without a good knowledge of the cultural settings that influence individual and societal behaviors. Though based on meticulously acquired statistical facts, the ensuing reports and policies may be out of touch with peoples interpreted experiences and expectations as well as what is practicable at the policy level. In response to this common misalignment of evidence, social requirement and health policy, measurements are primarily based on indices that, while they are beneficial in evaluating levels of perceived pleasure and contentment in a particular population, are missing the target when it comes to clarifying the shared meanings and values that support wellbeing.4

The huge number of actors involved; the complexity of the problem; and the time and space separation between the people generating and being affected by the problem are all features of a large-scale collective action problem.16 The COVID-19 pandemic has many characteristics of a large-scale collective action challenge. As a result of these qualities, stressors arise that operate against the possibility of collective action, such as anonymity (a large number of people and actors are involved, spread across the globe; lack of accountability and heterogeneity (the actors might be from different countries)).16

A variety of variables explain why different nations and governments have employed different COVID19-fighting measures. Policy advice will always be based on reservations and normative conceptions and scientific models may not be able to effectively forecast future political ramifications in this type of decision setting, even with accessible data.17 Well-functioning political institutions can build trust and social norms, which can enhance collaboration, and nations with high collective action capital have more policy options than only limits and militarism in their arsenal. This is critical when some behaviors are extremely difficult to control or monitor (e.g., washing hands). As a result, governments must respond to the needs of various segments of society in order to deal with the issue. Other potential explanatory variables, such as institutional capacity and cultural aspects must be considered in addition to demographic explanations.18 We give a convincing explanation for why certain governments are enforcing punitive policies based on the findings of collective action research. Such wealth enables a broader range of actions to combat pandemics.19

Cultural values,20 thinking patterns,21 regulatory focus,22 and other factors have all been utilized to operationalize common cultural meanings. There are considerable differences in coping mechanisms and indications of adaptive outcomes across cultures.23 Because cultural values imply desirable outcomes, they are worth pursuing.20

Peoples focus in a collectivist culture may extend beyond personal career growth concerns to issues affecting their workgroups, administrations, and social networks.23,24 National culture has also been demonstrated to influence coping strategy choices (eg, De Vaus et al).25 Because of the complexities of social identities and the various levels of cultural identification, there is a possibility of intergroup prejudice or even national conflict.23

Socioeconomic and other social factors influence the majority of health outcomes. Several studies have been conducted to investigate the impact of social factors on health. The substantial and extensively reported relationships between a variety of health variables and socioeconomic assets or social standing metrics, such as income, academic achievement, or occupational hierarchy rank, also support the health effects of social variables. This relationship regularly tracks a stepwise gradient pattern in both US and European data, with health increasing incrementally as social status rises.26 In times of crisis, make decisions as a group, management teams are required to make challenging decisions,27 and team decisions are particularly vulnerable to the effects of crises. This is because normal group functioning becomes maladaptive during crises, rendering standard therapies useless. Teams must successfully communicate and coordinate their efforts.28 Crises throw these routines off because they fundamentally alter how we collaborate and create new problems.

According to cultural variation research, tight cultures, such as Japan, and China, have severe social norms and deviant sanctions, whereas loose cultures, such as the United States, and Italy have weaker cultural standards and are more permissive.29 Tight nations are more likely to face substantial historical and ecological risks, such as natural disasters, population size and infection epidemics.29 When groups face collective risks, tight rules may help them coordinate to survive according to evolutionary theory.30

As a result of the spread of COVID-19, communities may become more strongly bonded. It may be more difficult to collaborate in the occasion of a pandemic in cultures that prioritize liberty over security. Communities may also negotiate social norms in order to strike a stability between freedom and restraint, or tightloose ambidexterity.31 The research suggests that in the fight against COVID-19, quite diverse measures may be required in different cultural situations.32

Culture and communications were predicted to be powerful forces in the twenty-first century, with the goal of improving population health and well-being. Furthermore, these forces would propel a quickly shifting and interconnected globe, with people and nations all over the world sharing common gains and hazards (eg, pandemics, climate change). In order to realize the potential of culture and technology, effective administration and information were to be a chief key in improving public health in this environment. Culture is critical for progress and it is crucial what may be learned from it, is understood and respected by the public, recognizing that there is no one-size culture fits all solution. Nonetheless, there may be some doubt and it is vital that the public understands that knowledge is always evolving and that new issues may arise.

In order to make better decisions in concealed profile circumstances, teams must normally take their time to gather and integrate available data. For example, arguing for several decision options (advocacy procedure).33 Similarly, true dissent (which can be difficult to extract in real teams) enhanced concealed profile decisions by raising the intensity of discussion in terms of spent talking time and information expansion.34 In addition, making hasty decisions in a crisis shows that the situation is changing.

During times of crisis, even management teams that share and integrate all information at the same time may have to alter their judgments in light of new information; effective decisions are not the end goal, but the beginning of a protracted implementation procedure. This is because catastrophes like the Coronavirus pandemic take time to unfold and so necessitate perseverance.

During the design, delivery, and evaluation phases, the cultural sensitivity technique strives to construct health interventions that take into account the target populations cultural traits, values, beliefs, experiences and conventions.35 The requirement for cultural competence in health communication stems from the belief that, in order to be most effective, health communication should adapt to a cultures unique characteristics.35,36 Being culturally sensitive entails tailoring communication solutions to the cultural characteristics that the health communicator values. The bigger aims of healthcare organizations and research institutions, which highlight that the means we interconnect about health to various people should be impacted by their cultures, reflect this emphasis on culture. People from more individualistic cultures may be more promotion or approach-oriented, making them more sensitive and susceptible to gain-framed communications that highlight positive results. People from more collectivistic cultures, on the other hand, may be more prevention or avoidance oriented, making them more sensitive and attentive to the negative effects highlighted in loss-framed communications.37

Health communication concepts become culturally responsive by isolating and incorporating specific cultural aspects into the primary ideas and claims of health communication. The goal is to identify common characteristics within the culture that may be used to define it and then design health communication apps that are suited to these characteristics. In models based on this strategy, certain cultural features are routinely identified and utilized to expect a variety of outcome variables. Health locus of control research, for example, seeks to predict the role of health locus of control in a variety of health outcomes.38

Certain cultural sensitivity health communication programs concentrate on hypothesizing and operationalizing the concept of cultural sensitivity, developing scales to test it and connecting it to outcome determinants. The prominence is once again on adjusting existing communication techniques, styles and messages to cultural characteristics. The goal of the culture-centered method is to identify gaps and/or silences in national public health scheme and practice in order to give a new way of thinking about and doing health communication.

Sensemaking is a social construction process that occurs when conflicting inputs disrupt peoples ongoing activities, and it entails the production of plausible meanings that legitimize what they are doing retrospective.39 The bracketing of environmental signals and the interpretation of those stimuli based on relevant frames is crucial to the creation of credible meanings. Integrating cues and frames to generate an account of what is going on, is thus the goal of sensemaking. It begins by looking at how people are reacting to the pandemic in their communities so that several contradicting responses have been received. What has occurred in the COVID-19 era is that bottom-up decision-making has been unrestricted in terms of macro strategies, as governments, medical specialists and public health authorities design policies and implement them without the participation of the general public. Citizens have generally been willing to hand over control of social contacts to the state, given evidence that harsh policies of social isolation and social distancing have been effective in slowing the spread of the virus.

Community development professionals must demonstrate their usefulness by providing strong scientific inputs based on strong scientific theory, one of the hallmarks of which is that it allows for some prediction of results,40 reducing the likelihood of unintended consequences. The Priority Index (P-Index), a basic requirements assessment technique, is one such hypothesis.41 The role of community development professionals is to (i) detect, (ii) tap into, and (iii) piggyback on the various types of flexibility that are apparent in communities, guiding them to a better quality of life as the lockdowns are lifted. The community needs prioritizing technique that has the proven capacity to aid as a nonstop social development effort to the multidisciplinary crews that organize the encouragement of societies out of the COVID-19 lockdown into the post-COVID-19 era as an information and tracking tool.15

The COVID-19 pandemic is a major global health emergency as the problem needs large-scale behavior change, the social and collective mind can be employed to assist in aligning human behavior with public health specialists recommendations. Here, we analyze evidence from various disease outbreak research, such as work on steering hazards and social and cultural implications on behavior.

This is especially important in the aftermath of COVID-19, which has forced communities all across the world to learn how to respond to and deal with a new disaster. The pandemic has highlighted a worldwide hazard, highlighting the need for international collaboration and integration to establish a sense of building back better that combines culture, in order to avoid them being swamped by other national concerns.42 The role of international organizations in connecting stakeholders is becoming increasingly vital in order to enable the widespread dissemination of shared information and best practices in order to build a collective resilient recovery from the pandemic.10

It specifically demands new well-being assessments that interpret for the properties of culturally interceded sickness and health experiences, acknowledging the importance of shared values for well-being. Understanding, recognizing, and aggressively supporting the behaviors that diverse and interconnected cultural practices can increase solidarity and resilience are all part of the process of developing these metrics. This will necessitate nothing less than a whole-of-control and whole-of-society strategy, one that builds on individual shared values to encourage new kinds of critical thinking, ordinary cooperation and long-term mutual cohesion both locally and worldwide.4

Digital contact tracing automates detecting on a scale and at a speed that would be impossible to achieve without the use of digital tools.43 It lessens the reliance on human memory, which is especially important in densely populated areas with mobile people. Digital contact-tracing apps have been developed for use in numerous countries during the COVID-19 pandemic; these apps rely on ideas and technologies that have never been used on this scale before and they are problematic in terms of privacy. It is critical to assess their accuracy and efficacy.

Assessing local differences in agility and contact behaviors could be crucial for forecasting the heterogeneity of transmission capacity between communities and areas when family size and age-stratified contact patterns varied. This background can help researchers understand the effectiveness of treatments to limit transmissions, such as handwashing,44 social distancing and school closures.45 Monitoring social-distancing techniques could be used to estimate healthcare system demands46 and it will be critical in determining when limits should be eased.

Informing the public in order to ensure community trust, operative performance of measures during a pandemic requires communal education and support, as well as an appropriate communications plan that integrates vigorous community engagement. Since the first reports of an atypical influenza-like sickness resistant to traditional treatment procedures surfaced in China,47 online data and social media have played a continuous and crucial role in public communication.48 Public health organizations and technology firms are speeding up their efforts to combat misinformation and favor reputable news sites.49

Furthermore, existing data-sharing efforts appear to be primarily focused on particular country adjustment and interoperability.50 While many of these concerns are not unique to global public health, given the self- or group-identifying qualities of data, there may be a particular urgency in this domain. To address these hazards, such as the misuse of public health data, a variety of actions will be needed, each tailored to the specific data typology and taking into account the motives and interests of data owners. It will also demand that countries and data owners agree to data-sharing rules and recognize data as a global public benefit.51

We believe the World Health Organization (WHO) could play an active role in managing data sharing efforts, forming partnerships and developing guidelines and standards, particularly for patient data, public health data and health systems data, given its capacity as the normative global health organization. There are numerous examples of similar projects already in progress. The World Health Organization (WHO) has adopted a number of data-sharing protocols.52 While these rules are not legally enforceable, they do provide guidance to member nations.53

However, knowledge management is complicated during a crisis because different networks use different tactics such as centralization and alternative organizational structures such as independence. A significant goal in dealing with COVID-19 was to develop health protocols, ensure their effectiveness and publicize the practice among healthcare professionals. The nature of the crisis, which in this case is a pandemic concern, fosters learning once again.

Communities have taken responsibility for their own well-being at the micro level while yielding control at the macro level. They accomplish this in variation of behaviors. Communities are engaged in spontaneous efforts to fortify social connectivity in projects that are congruent with community engagement. The use of social media to check-in on separated friends, the practice of leaving provisions at neighbors doors and joining balcony singing groups have all contributed to the preservation of social relationships and, as a result, communal solidarity.54 In order to preserve mainstreaming culture in catastrophe conditions, more efforts must be made to integrate global knowledge and approaches to their adaptation and implementation to local cases.

The impending COVID-19 pandemic is a unique time period marked by a slew of social, economic and health issues. In order to meet the aforementioned problems and establish reasonable expectations about the diseases future course, affected populations must have an acceptable level of COVID-19 related understanding. At the middle and lower levels of management, policymakers and senior leadership should try to instill a common feeling of duty among medical and non-medical personnel workers. Well-connected systems infused with a learning culture will aid in the development of successful interactions, coordinated activities and assessments that will help to enhance acceptable healthcare practices while correcting structures, processes and assumptions. Concisely, healthcare executives can foster a culture of continual learning.55

Yet, communities must establish pedagogical ways to learn and grasp the new science and technology in public health and education must develop leaders who can stay up. The development of learning expertise and the use of data collecting allows for the synthesizing of available data and the timely transmission of judgments. Data has become a more prominent focus of teaching and training in most schools of public health in recent years yet, the rate of change in such techniques often outpaces regular educational updates. Researchers believe that recent advances in technology and willingness, revolutionize healthcare diagnosis, assessment, and management, particularly during emergencies and pandemics.56

Collaboration through communal charity organizations, regional health agencies and health specialists can provide progressive expertise to these organizations as well as assist in the implementation of solutions to address community concerns. Practices can be employed and shared to improve outcomes using acquired knowledge from outsiders yet ingrained in the working systems. Learning public health culture was also favorably associated with empowerment, dialogue and a philosophy of lifelong learning. Employees at all levels participate in collaborative decision-making and accountability as part of the empowerment process. Logical reasoning and dialogues allow for critical thinking and the development of logical and acceptable answers to a variety of problems. Learning organization culture was also found to be highly linked to continuous learning.55 Behavioral competencies (such as creativity, exploration, and knowledge integration) ensure that resources are used effectively and that appropriate actions are taken.

However, few academics have looked at fear and uncertainty in the context of unpleasant outcomes, which may not considerate the genuine dread and doubt people felt during the experience. Any crisis provides an opportunity to learn, improve sympathy and expand flexibility while building a more secure and compassionate community. Taking lessons from a looming mega-crisis COVID-19 is the second global mega-crisis to strike modern nations in this century (following the financial crisis). Given the clear prospect of additional transboundary threats, it is critical to consider COVID-19 reactions and what we should learn from them.1 COVID-19 posed a significant challenge to the modern states crisis management capabilities. Until now, the pandemic had caused significant excess mortality in many countries, put enormous strain on health systems and had significant (and diverse) economic and societal repercussions. As a result, COVID-19 is classified as a mega-crisis.57 It also helps civilizations establish collective learning, which improves individual and organizational performance.

Contextual elements, such as culture, influence learning in general. Knowledge culture is defined as an organizations commitment to learning as a crucial component of its commercial success.58 Through collective knowledge and increased understanding among teams, collective learning among small teams may result in quality standards.59 In the context of healthcare settings, team followers may transform their knowledge into arrangements and then assess those activities against evidence-based practice and current recommendations.

Furthermore, the recommendations made are frequently erroneous because they overlook the distinctions between knowing (ie passive learning) and doing (ie active learning). The irony here is that one faulty system is being examined with the misguided aim of perfecting the other. Despite the widespread use of investigations, there is no evidence that they are a successful way of learning operational lessons from previous crises. As a result, we would support a review of the previous years events and we would also advocate for a review of how these investigations are conducted to ensure that they result in active rather than passive learning.60

COVID-19 and social capital possibilities as countries respond to COVID-19s numerous obstacles, as well as lessons learned from intervention and prevention studies linking enhanced social capital with improved health outcomes, greater community buy-in and the continuation of healthcare services to vulnerable populations suggest that social capital plays a critical role in ensuring a swift modification to todays neoliberal environment.

Preliminary research from the United States supports the role of social capital in the COVID-19 response, the rising rate of new COVID-19 cases has been demonstrated to be negatively connected to social capital at both the national and county levels.61 However, actively attempting to use or develop existing social networks in order to improve health results, each intervention groups social structure must be carefully examined.

Different components of socializing may respond to a public health intervention in different ways, so its critical for a social capital-based response to be able to recognize circumstances in which social capital building initiatives can effectively enhance the public health agenda, as well as accurately identify the subcategories of social capital. In this regard, a social capital-centric public health strategy to the COVID-19 response could be viewed as a paradigm for understanding how the social interactions between various groups of actors can be used to best successfully implement pandemic-related health policies.62

The aim of the study was to examine the factors influencing building effective public health culture. Having theoretical and practical implications, this study investigates the role of public health culture and some positive hints in the till-now continuing crisis of pandemic COVID-19. Besides, study findings guide policymakers to create rules and processes relying on experience of learning that develops a coherent workplace culture for a variety of communities sections to offer efficient and effective interventions and public health services.

In public health settings, the new knowledge-based learning should be deeply rooted and integrated into the fields daily operations. Empowerment, conversation and scrutiny, as well as a mindset of lifelong learning, were all found to be favorably associated with public health culture. Employees at all levels participate in collaborative decision-making and responsibility as part of the empowerment process. This approach increases policymakers incentive to learn new things so they can make effective choices. In healthcare, however, empowering partners to the point where they can participate in collective decision-making is the main hindrance.

Within the partners, a culture should be fostered where mechanisms infused with new knowledge are properly connected so that lessons can be disseminated across classifications to improve public health outcomes. Due to environmental and cultural differences, caution should be exercised when generalizing study findings in particular nations. Well-connected systems with a learning culture will aid in the development of successful interactions, coordinated activities, and insights that will promote acceptable public health behaviors while addressing protocols, methods, and assumptions.55

Culturally informed policies and practices begin with post-crisis assessments. Programs that are outlined and defined by post-crisis assessments are the beginning points and key vehicles for international support to post-crisis recovery. The goal is to prevent teams from overlooking culture in their first assessments, which could lead to missed opportunities or worse. A culturally informed analysis might use a variety of procedures, such as socioeconomic analyses, anthropological research, participatory engagement, and methods for identifying subordinate groups genuine perspectives and preferences.63 COVID-19 message for community engagement relies heavily on culture. Culture is defined as a collective sense of consciousness that shapes and influences perception, behavior and power, as well as how these are shared and conveyed.64

In general, public health is portrayed as action-oriented knowledge and competence at the disposal of decision-makers. The inputs to this knowledge and competence are regarded as natural facts that must simply be represented in statistics and the language of determinants and risk factors. The people who are expected to benefit from actions and decisions are thought to be part of a culture that needs to change for their own good. One method of reaching an understanding of what is happening on, and how a pandemic might transform ourselves and society in a post-pandemic era, is to frame a pandemic as deepening rift and hence as a learning process, in the context of fear (in the present case, the COVID-19 pandemic).65

Epidemiology is a social phenomenon. Health Determination of Society (HDOS) in COVID-19 eloquently illustrates how a health condition is profoundly affecting societies, a phenomenon that had hitherto gone unnoticed. The reactions of public health to community illness are also fundamental aspects; the kinds of organizations, rules of decision-making and conduct, and sets of values and principles might alter depending on the situation.66 The term reflective learning refers to instances in which people intentionally consider something and make an attempt to comprehend why things are the way they are. This includes drawing on relevant knowledge to figure out how to handle a problem and coming to conclusions that become part of a new reference frame.65

Because national culture can be initially conceived and operationalized in a variety of ways, future research should look for perspectives from other relevant ones, such as cultural differences in social views,67,68 or take an indigenous approach to gain a better understanding of the various aspects of cultural influence.69 Other aspects of a nation, such as economic, geopolitical and historical variables, play essential roles in molding individuals actions, and future studies should take this into account.70 As culture can be manifested at different levels, future research should adopt a multi-level approach to examine how culture interplay with each other in inducing entities coping and management strategies.

The pandemic has transformed how we give care, allowing us to re-evaluate conventional methods and improve the effectiveness of management techniques. Along with the sadness and significant obstacles, we have a unique influential effect on the public health society now and perhaps in the days ahead, as this pandemic continues to develop. If we are successful in learning from this pandemic and dealing with it, we should include some of the crisis principles and habits into our new inventive, creative, solidarity, empathetic, effective, equitable, healthy and stronger routine.

The author reported no conflicts of interest in this work.

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See more here:

Building the culture of public health post COVID-19 | RMHP - Dove Medical Press

If the sector is going to make meaningful progress in rebuilding its depleted workforce pool, federal government agencies need to begin unwinding many of the stringent Covid-19 related guidelines nursing homes have adhered to over the last two-plus years.

Until that occurs, the skilled nursing industry will likely remain stagnant, according to Carespring CEO Chis Chirumbolo.

A lot has changed since the start of the pandemic, Chirumbolo said, both in the large percentage of staff and resident vaccination levels, and the overall understanding of the coronavirus.

And for six months running, the rate of Covid-19 deaths among nursing home residents has been less than 1 per 1,000 residents, according to the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).

Still, nursing homes continue to be one of, if not the only, health care sector that continues to practice under these very challenging federal guidelines, he added.

I think thats step one And Im not talking about patient safety related stuff, how to manage infection, Im not talking about infection control criteria all those things are vitally important. But what we can stop is doing the things that really dont impact resident quality care and really hinders the health care delivery for our staff, he said during an episode of the Rethink podcast.

Chirumbolo specifically pointed to the active screening process that all health care employees have to undergo before entering a facility as well as contacting families if there is a new Covid case in the building even if that case has nothing to do with their respective family member as two Covid-related requirements that could be pulled back at this point in the pandemic.

Highlights of Robinsons podcast, edited for length and clarity, are below. Subscribe to Rethink via Apple Podcasts, Google Podcasts, or SoundCloud.

Yeah, I think its somewhat positive news.

I think what also is an optimistic approach is for all providers to understand that your voice matters. You have to stand up and make your voice heard, not just for this but into the future. During this rule. CMS received thousands of comments during the rulemaking process, many of which came from facilities, nurses, aides and other staff and I think globally that message from the frontlines matters.

I think it will help somewhat [for Carespring], but as we all know, our costs have exploded during the pandemic and patients on Medicare which is what this rule, the fee for service world talks about just makes up a portion of the patients we serve. The challenge is, I think, going forward is how do we rectify the several year, decades long issue in some states with a chronic underfunding of Medicaid. This population represents roughly about 60 to 70% of the SNF residents, so looking at that layered in with managed care as it comes into more facilities across the country, that component can be 70 to 80, 85% of the total population.

As were going forward, those segments either dont cover the costs or, in some cases, Medicaid grossly dont cover the cost. I have to give some states credit during the pandemic with added FMAP money, with that federal dollars thats helped some states push those dollars to facilities and so thats been a help. But I think its very much a reactive approach for, as I said, before decades long of underfunding.

I think I have no change in confidence. The federal government and CMS need to truly, truly listen to providers. You know this has been the long standing issue, from federal and state government, but it starts with the federal government because the state government follows the federal lead. So when you look at that, its time to innovate on all fronts, and so the regulatory and survey process today focuses mostly on compliance over quality of care, and this needs to be revamped as it distracts and often destroys the morale of our staff in SNFs.

As a result, whats happened because of the pandemic, its pushed good people out of the industry. Why work in a SNF, a skilled nursing facility, when you can practice in another health care sector, like a hospital or [other] health care field, and not have to deal with this overall practice, this punitive practice by the federal government?

We have to do everything we can to keep these great people in our industry along with developing these next generation leaders. We have to fix those issues by stripping back and simplifying some of the Covid regulations. Its not 2020 anymore, its 2022. We know so much more. The practices have changed so much more. In reality, were the only health care sector still practicing off of some of these CDC and CMS guidelines.

I think thats step one because until some of those things run wound, and Im not talking about patient safety related stuff, how to manage infection, Im not talking about infection control criteria all those things are vitally important. But what we can stop is doing the things that really dont impact resident quality care and really hinders the health care delivery for our staff.

Also on a national and state level, how do we develop more vocational nursing and STNA programs in high schools? How do we develop STNA programs so anybody who wants to become an STA can do it free of cost? Maybe you create a fund to do that. We have to get to the next generation of people And at the end of the day, until we develop a system between the federal government that listens and adapts and adjusts based upon actual feedback, frontline feedback. Were going to be stagnant.

The biggest cost is just were paying our staff more. Our focus has been to try to be agency free and I think weve globally done a really good job with that.

Early in 2020 we started paying our staff more right there because we knew there was a fear factor in 2020. We didnt know what we were dealing with, people were scared, we needed them to continue to help us take good care of the patients.

Then 2021, 2022 the global inflation has ballooned and its challenging in the sense that how do you forecast, predict and figure out how youre going to be able to afford paying your staff that much more, paying for your food, paying for all those supplies? Thats where again, going back to the advocacy approach, is trying to work back with the governments and making sure that we can keep getting reimbursed or getting an adjustment in reimbursement going forward and in helping tell the story.

So how do we manage it? We just manage it day by day. Weve got to make sure were meeting the patients expectations but also the challenging part layered it is weve limited some of the admissions weve taken in our buildings because we want to try to remain agency free. Thats a challenging decision to have to make in a position like me. Its a no brainer from a quality care standpoint, but the challenging part is theres patients out there who need to be taken care of, theres hospitals banging on facilitys doors, asking for help asking for to get the throughput through.

But also, when you want to invest and innovate, its hard to do that when, as an industry as a whole, youre only reimbursed at a stagnant fixed reimbursement rate.

Theres unfortunately a lot of facilities that are on the market because a lot of facilities are struggling and a lot of people just want to get out of the industry altogether. So taking over buildings that have that like mindedness makes it a lot easier going forward. The regional footprint is very much important. We do not really want to stretch out into multiple other states because thats where you lose control, in our minds, of the overall operations and the vision and the mission of the organization.

So when you look at a building do they have relatively good processes? And if they dont, thats still okay. Do they have [a] good physical plant to get [it] done the way you want to provide care or is it going to be something where the buildings 50 years old and needs to completely be rebuilt?

Is it within a general physical footprint so we can be there within an hour or two, or a couple of hours But I think at the end of the day, having the like mindedness and approach, going back to what I said before, and how they provide care, and doing the right thing at the right time, even if its more expensive We tend to try to find those opportunities.

So we created this role at each of the facilities, like a retention hiring coordinator. This persons role kind of melds a lot with the nursing department Our statistics show if we keep team members beyond that three to six-month mark, they generally stay longer term so how do we get them from hire date to that point, and help them problem solve, bring up issues when issues come up.

I think another thing I do a CEO talk every couple of weeks. So as we hire new team members, I virtually get on with all the new people at all the buildings and explain who we are, explain what were trying to do, be as transparent about the challenges, transparent about how were trying to manage the challenges but also trying to empower them on becoming the next generation of leaders We have to get people to see its not just a job, its a career. Its not just becoming a nurse aide, its becoming a nurse. Its not becoming just a nurse, its becoming a leader, a manager or director of nursing or into some other role and it doesnt have to be pigeonholed just for nursing. Since our buildings are regionally concentrated, those team members also have the ability to be promoted from sister building a to sister building b and be able to grow where some operators, some buildings might be just limited by their facility in their just one location.

Excerpt from:

Carespring CEO: The Time Has Come to Lessen Covid-19 Restrictions in Nursing Homes - Skilled Nursing News

The U.S. authorized the first major makeover of the Covid-19 vaccines this week in an effort to stem an expected tide of infections and hospitalizations this fall.

But it's unclear how much protection the new booster shots will provide. The Food and Drug Administration and the Centers for Disease Control and Prevention cleared the shots without any data from clinical trials that are testing the reformulated doses in humans.

The new boosters, authorized for people ages 12 and older, target the highly contagious and immune-evasive omicron BA.5 subvariant that has caused a wave of breakthrough infections over the summer. The shots also target the original strain of the virus that first emerged in Wuhan, China, in 2019.

The nation's top health officials acted with urgency this summer to ensure the new boosters would roll out in time for the fall. They are worried that the waning effectiveness of the old vaccines is creating an opening for omicron to cause another wave of hospitalizations this winter as people spend more time indoors where the airborne virus spreads more easily.

Deaths and hospitalizations have climbed since April among the elderly, the most vaccinated age group in America, as omicron has continued to mutate into more and more transmissible subvariants that dodge the protection of the original vaccines, according to Heather Scobie, a CDC epidemiologist.

Dr. Peter Marks, who heads the FDA office that reviews vaccines, said the new boosters aim to restore the high levels of protection that vaccines demonstrated in early 2021. But Marks acknowledged that the federal government's experts simply do not know yet whether the boosters will meet the high bar set by those doses.

"We don't know for a fact yet whether we will get to that same level, but that is the goal here. And that is what we believe the evidence that we've seen helps point to," Marks told reporters during a news conference after the FDA authorization Wednesday.

The FDA will conduct surveillance to see whether the boosters meet that goal, Marks said. When Pfizer's and Moderna's shots were authorized in December 2020, they provided more than 90% protection at preventing Covid.

Marks told reporters it will likely take at least another couple of months before human data on the BA.5 boosters is available to the public. But he said the FDA used basically the same process to authorize the new boosters that it has relied on for years to switch the virus strains in flu shots.

"We're pretty confident that what we have is very similar to the situation that we've done in the past with influenza changes where we don't do clinical studies for them in the United States," Marks said. "We know from the way the vaccine works, and from the data that we have, that we can predict how well the vaccine will be working."

The new boosters could prevent 2.4 million infections, 137,000 hospitalizations and 9,700 deaths if a new variant doesn't emerge, according to a projection by a team of scientists that forecasts the trajectory of the pandemic, called theCovid-19 Scenario Modeling Hub.

But that projection is based on optimistic assumptions about booster coverage and efficacy, according to the scientists. The model assumes that the shots will prove 80% effective at preventing illness and the public will broadly embrace the new boosters. There is no efficacy data on the new shots and it's unclear how strong public demand will be for them.

The CDC estimates that an early fall vaccination campaign with boosters could save the U.S. between $63 billion and $109 billion in medical costs by preventing hospitalizations and ICU admissions.

Pfizer and Moderna were originally developing new boosters to target the first version of omicron, BA.1, that caused the massive wave of infection and hospitalization last winter. But keeping up with the rapid evolution of the virus has proved challenging.

By the time the nation's top health leaders moved in earnest in April to get new boosters ready, more transmissible subvariants had already driven omicron BA.1 out of prevalence. In June, the FDA asked the vaccine makers to switch gears and target omicron BA.5 after it rose to dominance.

This decision did not leave enough time for Pfizer and Moderna to complete human clinical trials on the new boosters before a fall vaccine rollout.

As a consequence, the FDA and the CDC are relying on human data from the clinical trials of the BA.1 shots to understand how the BA.5 boosters might perform. They also relied on data from studies in which the BA.5 boosters were tested in mice.

The CDC's independent advisory committee backed the shots on Thursday in an overwhelming vote.

But several members of the panel also had reservations about the lack of human data.

"I really do struggle with a vaccine that has no clinical data that's reported for humans, for those that would be actually receiving the vaccine," said Dr. Oliver Brooks, a committee member and the chief medical officer at Watts HealthCare Corp. in Los Angeles.

Dr. Pablo Sanchez, the only CDC committee member who voted against the shots, called the decision to recommend the new boosters without human data premature.

"There's a lot of vaccine hesitancy already we need the human data," said Sanchez, a professor of pediatrics at Ohio State University.

Dr. Doran Fink, deputy head of the FDA's vaccine review division, told hesitant committee members that the new booster shots use the exact same manufacturing process as the old vaccines and contain the same total amount of mRNA, the code that instructs human cells to produce the proteins that provoke an immune response to defend against Covid.

Fink said the BA.1 and the BA.5 shots are similar enough to use data from the BA.1 human trials to get a good idea of how the new BA.5 boosters will perform.

Pfizer and Moderna presented data at the CDC meeting which showed that the BA.1 shots triggered a stronger immune response in humans than the old vaccines. The mouse studies from both companies on the BA.5 shots also showed a stronger immune response.

CDC Director Dr. Rochelle Walensky last week said waiting longer for human data from the BA.5 shots could mean the boosters become outdated if a new variant emerges.

"There's always a question here of being too slow versus too fast," Walensky told "Conversations on Health Care" in a radio interview. "One of the challenges is if we wait for those data to emerge in human data ... we will be using what I would consider to be a potentially outdated vaccine."

Moderna completed enrollment in its clinical trials last week and expects results by the end of the year. Pfizer's clinical trials are ongoing, though the company hasn't provided a time frame on when it will have data.

Brooks questioned why the FDA decided to go with a BA.5 vaccine when clinical data is available for the BA.1 shots that the vaccine makers were originally developing. Canada and the United Kingdom have authorized new booster shots that target omicron BA.1

Fink said the U.S. selected BA.5 based on the advice of the FDA's independent committee, data from South Africa that indicated natural infection from the subvariant provides broader protection than infection from BA.1, and the fact that BA.5 is dominant.

Though the committee members had some hesitation about proceeding without the human data, they agreed the new boosters should have a similar safety profile to the old vaccines because they use the same platform. The Covid vaccines have been administered to millions of people in the U.S. with mostly mild side effects.

The most common side effects from the human trials of the BA.1 shots was pain, redness, swelling at the injection site, fatigue, headaches, muscle pain, joint pain, chills, nausea, vomiting and fever, according to the FDA.

Dr. Sara Oliver, a CDC official, told the committee that the risk of myocarditis, inflammation of the heart muscle, after a BA.5 booster is unknown. But health officials anticipate it will be similar to the risk observed with the old vaccines.

Pfizer's and Moderna's vaccines have been associated with an elevated risk of myocarditis in young men and adolescent boys mostly after the second dose. But the risk of myocarditis is higher from Covid infection than vaccination, according to the CDC.

Dr. Grace Lee, the CDC committee chair, sought to reassure the public that there's a robust surveillance system to monitor safety, and that the panel will meet again if any new concerns emerge.

"I just want to make sure that the members of the public are aware that we're continuing to monitor closely," Lee said. "We have systems and teams that are continuing to monitor and to meet."

Read more:

New omicron boosters are now available, but it's unclear how effective they will be - CNBC

Updated COVID-19 booster shots are on their way! The FDA authorized new and improved booster shots from Moderna and Pfizer for emergency use. CDC recommended the boosters as well. Further review by Western States Scientific Review Group and Washington State Department of Health should be complete early next week. Doses should be available soon.

Got questions? Weve got answers.

Whats different about the updated boosters?

COVID-19 vaccines already provided strong protection against hospitalization and death. This bivalent vaccine offers more protection because it targets both the original COVID-19 strain AND the currently circulating BA.4 and BA.5 omicron variants. These vaccines are more like the annual flu vaccines that target different flu strains.

Who should get these booster doses?

Anyone 12 or older who got their initial series of vaccinations or latest booster dose at least 2 months ago.

The FDA authorized the:

Full authorization is not yet final. Eligibility could change.

I was scheduled to get a booster. Should I wait?

YES! You may have to wait a little longer. But this booster will provide better protection.

When can I get one?

The Western States Scientific Review Group and Washington State Department of Health will need to approve the new boosters before we will be able to give them locally.

That could happen as soon as next week, but we dont know for sure. Some age groups or immunocompromised people may be given priority for the short term. Check our social media or website for updates.

Will there be enough for everyone?

Eventually, yes. We expect Pierce County to get 9,000 doses of Pfizer and 3,000 doses of Moderna to start. Well work quickly to get those to providers and in our vaccine clinics as soon as possible.

I havent been vaccinated yet. Will I get this vaccine for my initial doses?

No. These doses are not for primary-series vaccination. They are boosters for people who got their primary-series vaccinations or latest booster dose at least 2 months ago.

And if you havent been vaccinated yet, you should. Find your dose at tpchd.org/vaxtothefuture.

Last week, we updated information on our vaccine dashboard. During the peak six months of the omicron wave, compared to those who completed their initial vaccine series, unvaccinated people in Pierce County were:

What about booster shots for kids under 12?

Everyone 5-11 years old can still receive the current Pfizer and Moderna boosters 5 months after their primary series of vaccine.

More here:

Your Reliable Source - Tacoma-Pierce County Health Department

COVID-19 viruses affecting the heart, conceptual 3D illustration. Heart complications associated ... [+] with COVID-19 coronavirus disease. The negative effect of SARS-CoV-2 virus on the human heart.

With new research on Long Covid emerging every day, it is becoming increasingly clear that Covid-19 infection impacts our health beyond the acute stage of the illness. A study demonstrates that infection with Covid-19 impacts the risk of cardiovascular events up to 12 months post-infection, regardless of age, race, sex, and other cardiovascular risk factors. This study emphasizes the recognition of and the need for more effective strategies to address the long term effects of Covid-19.

A group of researchers from the Clinical Epidemiology Center in Saint Louis, Missouri investigated the risk and excess burden of cardiovascular disease following the acute phase of Covid-19. In the study, over 150,000 veterans who had recovered from infection were compared with non-infected peers, in addition to a pre-pandemic control group. Xie and colleagues followed these three groups for twelve months and conducted a thorough analysis to estimate the risk and associated burden of cardiovascular outcomes.

Who and What Factors were Considered?

Xie and colleagues obtained information from databases managed by the United States Department of Veteran Affairs to construct their three cohorts. Of the 6,241,346 veterans who encountered the department of Veteran Affairs in 2019, 162,690 had a positive Covid-19 test between March 1st 2020 and January 15th 2021. 153,760 of such individuals were alive 30 days after their positive test date and selected into the Covid-19 test group. Researchers based the average date of the positive test for the cohort, T0, based on the distribution of the positive Covid-19 test dates.

5,960,737 veterans who encountered the department of Veteran Affairs in 2019 and were alive by March 1st, 2020; 5,806,977 of such individuals were not part of the Covid-19 group and were selected into the contemporary control group. Xie et al randomly chose the average enrollment date for the cohort, T0, which would allow for the participant distribution to be identical to the distribution of the Covid-19 group. In doing so, the contemporary control group and the Covid-19 cohort had similar follow-up times.

Xie et al selected individuals who encountered the department of Veteran Affairs in 2017 to be part of the pre-pandemic cohort. Of the 6,461,205 veterans, 6,150,594 of them were alive by March 1st 2018. 6,008,499 were not included in the Covid-19 cohort and were further chosen to be included in the pre-pandemic group. Researchers randomly selected the average enrollment date for the group, T0, which would allow for the participant distribution to be the same as the distribution of the Covid-19 group. This action similarly ensured that the historical control group and Covid-19 group had identical follow-up times.

The cardiovascular outcomes assessed were based on Xie and colleagues previous work regarding Long Covid. These outcomes include cerebrovascular disorders, dysrhythmia, inflammatory heart disease, ischemic heart disease, thrombotic disorders, and other cardiovascular diseases. Researchers conducted a follow-up for each cardiovascular outcome that the participant had no prior history with one year before their enrollment date. The follow up period began 30 days after the average enrollment date, T0, and ended by October 31st 2021.

Xie et al considered pre-defined and algorithmically selected variables to account for any baseline differences between the cohorts. Previous studies have shown that race, sex, body mass index, Area Deprivation index, smoking status, frequency of hospitalization, and use of long term care can influence risk and associated burden of cardiovascular outcomes. Xie and colleagues identified

cancer, chronic kidney disease, diabetes, and several other comorbidities as variables to also consider. In addition, they adopted an algorithm that determined the top 100 variables with the highest risk relative to the cardiovascular outcome and cohort. The program factored the diagnoses, medications, and lab abnormalities common in at least 100 members of the cohort. Researchers tested each cardiovascular outcome within each cohort independently so the algorithm could be applied.

Recovered from Infection Vs. Never Infected Vs. Pre-Pandemic: What Happened?

In the study, Xie et al estimated the risk, burden, and excess burden up to 12 months post infection of cardiovascular outcomes through inverse probability weighting, a common method used to estimate the probability of exposure observed for a particular person and using the value as a weighting factor in further analyses.

In this case, researchers calculated a propensity score, which describes the chance of being selected to the target population, for individuals who had no prior history (up to one year before enrollment) for each specific cardiovascular outcome. These scores estimated the probability of being a veteran who encountered the department of Veteran Affairs in 2019 based on the pre-defined and algorithmically selected variables; they were then used to calculate the inverse probability weight of being part of the sample who interacted with the department in 2019. Additionally, researchers applied the weight scores in hazard ratio models for each cardiovascular outcome. These models estimated the risk of each cardiovascular complication caused by Covid-19, using death as the other, competing risk.

Among the pre-specified cardiovascular outcomes, those who recovered from the acute phase of infection had higher risk of all pre-specified cardiovascular outcomes in comparison to those who were not infected. The composite scores for each group of cardiovascular outcome were above one, indicating increased risk: cerebrovascular disorders scored 1.530.16 , dysrhythmias scored 1.69 0.11, inflammatory heart disease scored 2.02 0.53, ischemic heart disease scored 1.66 0.28, thromboembolic disorder scored 2.39 0.24, and other cardiovascular disorders scored 1.72 0.14 . In particular, veterans who survived the first 30 days following a positive test result exhibited higher risk of myocarditis (5.38 3.79), cardiac arrest (2.45 0.81), cardiogenic shock (2.43 1.30), and pulmonary embolism (2.93 0.42).

Xie et al estimated the associated burden of cardiovascular outcomes caused by Covid-19 per 1,000 people at twelve months based on the differences between the estimated rate of Covid-caused cardiovascular outcomes caused in the Covid-19 cohort and the contemporary control cohort. They found similarly high and excess burdens with all cardiovascular outcomes. The associated excess burden for heart failure (11.61 2.78) and atrial fibrillation (10.74 2.3) were especially high.

Taking care setting into consideration, risks and associated burdens persisted among those who were not hospitalized for infection, which gradually increased with severity of infection. Participants who were not hospitalized, representing the majority of the US general population, had higher risk and excess burden for cardiovascular disease than those who were not infected by Covid-19. Those who were hospitalized for infection had higher risk and associated burdens than those who did not, and those who were admitted to intensive care had the highest risk of cardiovascular disease and excess burden.

Relative to the pre-pandemic control group, participants who recovered from Covid-19 infection had higher risk and excess burden of any pre-specified cardiovascular disease per 1,000 individuals in one year. The results of each assessment were consistent to what was found when comparing the covid-19 cohort with the contemporary control group.

A few studies suggested a potential association of some Covid vaccines and a very rare risk of heart or pericardium inflammation; Xie et al conducted two analyses to diminish any potential impact vaccine exposure may have had on cardiovascular outcomes. In their first test, researchers excluded participants who received their first dose of a Covid-19 vaccine. In the second assessment, they considered vaccination status as a time-sensitive covariate. In both analyses, Covid-19 was associated with higher risk of both heart and pericardium inflammation. This set of findings reinforces the importance of getting vaccinated.

Xie and colleagues validated their analytical approach by testing variables with expected outcomes. They tested the association between Covid-19 and the signature risk of fatigue; Covid-19 increased the risk of experiencing fatigue, as expected. Researchers tested the association between receiving a flu shot on even-numbered versus odd-numbered calendar days and the pre-specified cardiovascular outcomes. Following the same analytical approach and resources as the study, they found no significant association between the even versus odd-numbered calendar day of the influenza shot and pre-specified cardiovascular outcomes.

The cardiovascular disease risk associated with Covid-19 infection further highlights how we need a coordinated global response strategy to urgently address the challenges of dealing with the long-term health effects of Covid-19. Physicians should also be adjusting their screening questions to include past infection with Covid-19 and assess for all Long Covid symptoms including cardiovascular. Early identification, diagnosis, and treatment of heart disease are essential to lessen the risk of adverse health impacts.

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Covid-19 Infection Increases Risk And Excess Burden Of Cardiovascular Disease - Forbes

With updated COVID-19 boosters being recommended to provide increased protection against the circulating omicron variant, a new paper by University of Hawaii at Mnoa and Waianae Coast Comprehensive Health Center (WCCHC) researchers is shedding light on who is getting booster shots in Hawaii, and how trust and consumption of different information sources affect that decision.

The paper, Dynamics of Trust and Consumption of COVID-19 Information Implicate a Mechanism for COVID-19 Vaccine and Booster Uptake, was published August 31, in Vaccines.

Results of the study show individuals vaccinated within two months of eligibility tended to have more years of schooling, with greater trust in and consumption of official sources of COVID-19 information, in comparison to those who waited three to six months, or those who remained unvaccinated at six months post-eligibility. Most or 70% of those individuals who were vaccinated within two months of eligibility took the booster shot, compared to only 30.5% of those who waited three to six months, with the latter group gaining trust and consumption of official information after four months.

This study shows that social factors, including education and individual-level degree of trust in sources of COVID-19 information, played a large part in whether someone decided to get a booster shot, said Ruben Juarez, an economics professor in UH Mnoas College of Social Sciences and HMSA Endowed Professor of Health Economics at UHERO. COVID-19 booster hesitancy remains an issue in our community, and understanding what contributes to this has significant implications to ongoing public health responses as we enter a new phase in the pandemic.

Working in collaboration with the Pacific Alliance Against COVID-19, UH researchers surveyed almost 1,600 Hawaii adults enrolled in the groups COVID-19 testing program. Study participants completed standardized surveys from January to February 2021 on demographics, vaccination status and trust in sources of COVID-19 information during the delta wave. Of those, about 800 individuals or 50.3% completed a follow-up survey from January to February 2022 during the omicron wave.

Results from our study reinforces the need to nurture trust and promote health literacy in our community, which our model predicts will improve vaccine uptake, including boosters. This is especially important given new COVID-19 vaccines recently announced by the FDA that target the Omicron variant that is currently circulating in our population, said Alika Maunakea, John A. Burns School of Medicine (JABSOM) associate professor.

Added May Okihiro, JABSOM associate professor and pediatrician at WCCHC, This data provides critical information for the Department of Health and our community of health centers to act on the development of effective strategies that include vaccination to help us emerge out of this pandemic.

In addition to Juarez, Maunakea and Okihiro, other co-authors include:

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Which people are most likely to get vaccinated for COVID-19? | University of Hawaii System News - University of Hawaii

Science, Competing Values, and Trade-offs in Public Health The Example of Covid-19 and Masking | NEJM  nejm.org

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Science, Competing Values, and Trade-offs in Public Health The Example of Covid-19 and Masking | NEJM - nejm.org

Flags at the Washington Monument commemorate Americans who died from COVID-19. In 2021, life expectancy in the U.S. fell for the second year in a row. Spencer Platt/Getty Images hide caption

Flags at the Washington Monument commemorate Americans who died from COVID-19. In 2021, life expectancy in the U.S. fell for the second year in a row.

Life expectancy in the U.S. fell in 2021, for the second year in a row. It was the first time life expectancy dropped two years in a row in 100 years.

In 2019, someone born in the U.S. had a life expectancy of 79 years. In 202o, because of the pandemic, that dropped to 77 years. In 2021 life-span dropped again to 76.1 years. And for some Americans, life expectancy is even lower, according to a provisional analysis from the Centers for Disease Control and Prevention.

"The results of this study are very disturbing," says Dr. Steven Woolf, a professor of population health and health equity at Virginia Commonwealth University. "This shows that U.S. life expectancy in 2021 was even lower than in 2020," he says.

Other high-income countries have seen a rebound in life expectancy, which Woolf says makes the U.S. results "all the more tragic."

One of the most dramatic drops in life expectancy in 2021 was among American Indian and Alaska Native people.

Between 2019 and 2021, the life expectancy for this population fell by 6.6 years, to 65.2.

"That's horrific," Woolf says. "The losses in the Native American population have been terrible during the COVID-19 pandemic. And it reflects a lot of barriers that tribal communities face in getting access to care," he says.

Life expectancy for this community is now the same as it was for the whole population in the 1940s, says Elizabeth Aria of the CDC's National Center for Health Statistics who was the lead author of the report.

"To see the decline over the two-year period for this population was 6.6 years was jarring," Aria says.

Despite a high vaccine uptake in this community, American Indians are 2.2 times more likely to die from COVID-19 and 3.2 times more likely to be hospitalized for the virus, says Chandos Culleen, director of federal relations for the National Council of Urban Indian Health. When you see these numbers "it breaks your heart," he says.

White Americans also saw a larger decrease in life expectancy in 2021 than Black and Hispanic Americans. This was the reverse of what happened in 2020 when Hispanic Americans saw a 4 year decline and Black Americans saw a 3 year drop. Life expectancy for white Americans declined by a year in 2021 to 76.4. Black Americans saw a 0.7 year decline to 70.8 years, Hispanic Americans saw a 0.2 year decline to 77.7 years. Asian Americans saw a 0.1 year decline to 83.5 years.

Woolf says the greater drop in life expectancy for white Americans could reflect attitudes in some parts of the country to vaccines and pandemic control measures. The U.S. health care system is fragmented he points out public health is determined by the states, which means there were 50 different pandemic response plans. The states which were more relaxed about COVID restrictions and have lower vaccination rates saw higher excess deaths during the delta and omicron surges than states which had more aggressive vaccination campaigns, masking and other mitigation requirements.

Death rates from COVID-19 in counties that went heavily for Donald Trump saw higher death rates than counties that favored President Biden, according to an NPR analysis.

Injuries, heart disease, chronic liver disease and cirrhosis and suicide also contributed to the life expectancy decline. Increases in unintentional injuries in 2021 were largely driven by drug overdose deaths which increased during the pandemic.

"To have this second year crash basically wiping out the meager gains made during this century is really pretty shocking," says John Haaga, a retired division director of the National Institute on Aging.

The U.S. has been lagging for years in making improvements in things like heart disease the country's number one killer and the life expectancy gap between the U.S. and other countries has been growing for decades, Haaga says.

"A lot of much poorer countries do much better than us in life expectancy," he says. "It's not genetics, it's that we have been falling behind for 50 years."

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Life expectancy in the U.S. continues to drop, driven by COVID-19 - NPR

Contact:Cleo Garcia(210) 722-7944, cleo.garcia@sanantonio.gov

SAN ANTONIO (September 1, 2022) Better access to mental health services will be coming to San Antonio through a $26 million Mental Health Plan. The services and plan are funded from the Citys American Rescue Plan Act (ARPA) State and Local Fiscal Recovery Funds (SLFRF).

People of all ages have gone through a long period of disruption through the COVID-19 pandemic. Through public input meetings, provider and stakeholder feedback sessions and input from school districts as well as faith leaders, there was a clear consensus that investments in mental health were needed across the community, said City Manager Erik Walsh. We are grateful to the community for their support in developing this plan and to the City Councils Public Safety Committee for their tireless efforts in the development of the plan.

This effort aligns with the SA Forward plan which identified the Citys health priorities and augments mental health initiatives that contribute to healthier and safer communities, said Metro Health Director Claude A. Jacob. We are ready to get to work to provide these critical resources in order to support residents during these uncertain times.The implementation plan will drive the San Antonio Metropolitan Health Districts mental health initiatives over the next two years. The $26 million will be utilized over two years and divides the available funds into four strategic areas:

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City of San Antonio to invest $26 million in COVID-19 relief funds to Provide Access to Mental Health Care for the Community - City of San Antonio