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  • Open access
  • 38 Reads
Coronavirus (COVID-19): What could be the environmental effects of disinfectant use in the pandemic?
Hakan Çelebi, Tolga Bahadır, İsmail Şimşek, Şevket Tulun

While the pressure of factors such as global warming and climate change, overpopulation growth, uncontrolled industrialization, and unplanned urbanization on environmental pollution is increasing, the relationship between humans and their environment has become more valuable than ever due to the new type of coronavirus (COVID-19) epidemic surrounding the world. The COVID-19 pandemic has led to the wide use of disinfectants (alcohol, soap, cologne, chlorinated compounds, antibacterial agents, etc.) to reduce the spread of the virus in homes and public spaces. In particular, more chemical compounds are used in public places than they should be in order to control the epidemic in many parts of the world. However, with this practice, human health, biological diversity and water resources can be adversely affected. Within the scope of COVID-19 measures, chemicals are directly mixed with rivers and seas through applications such as washing the streets and streets in cities with chemicals, spraying open and closed areas, along with the use of chemicals for personal cleaning at homes, from soil to groundwater, from sewage systems to treatment facilities, rainwater collection channels. In addition, due to the lethal, toxic, injurious and irritating properties of disinfectant chemicals used for cleaning and hygiene purposes, it has been determined that poisoning incidents due to disinfectants have increased during the COVID-19 process. According to the concept of "One Health", human health is linked to the environment and animal health. Therefore, the possible effects of chemicals used for cleaning and hygiene purposes should be evaluated in an integrated manner. This article explores the chemicals effective in neutralizing the virus and their possible environmental effects.

  • Open access
  • 23 Reads
Virus-Laden Particles and Particulate Matter (Air Pollutants) with Viruses Attached: Terminology Matters. How Rumors that Air Pollutants Spread SARS-CoV-2 Are Born

The causal role of air pollutants in COVID-19 transmission remains speculative, given ecologic biases and uncontrolled confounding. Furthermore, the definitions of essential concepts related to the relationship between air pollution and coronavirus are highly ambiguous, including the concepts “air pollution as a factor for health risk” and “SARS-CoV-2 spreads by particulate air pollution”, and the constituents of ”virus-laden particles”, “droplet nuclei”, “virus-bearing aerosols produced from human atomization”, and ”particulate matter (air pollutants) with viruses attached” remain controversial. This ambiguity has resulted in considerable misunderstandings between researchers. Unfortunately, premature and unsubstantiated claims that SARS-CoV-2 coagulates (creates clusters) with outdoor particulate matter (PM10) in the air and that SARS-CoV-2 can be transported by air pollutants became widely circulated in the media and have been cited by some studies as fact. Although the presence of the markers of SARS-CoV-2 (viral fragments of coronavirus) in environmental samples is an important finding, the media and researchers should be cautious regarding the claim that SARS-CoV-2 can create clusters with outdoor PM10 in the air and spread via particulate air pollution, as this statement is currently only a hypothesis that lacks direct or indirect supporting evidence. The issue of coagulation of virus-laden particles (respiratory droplets and droplets nuclei) with ultrafine particles (PM0.1) may have more important consequences for mitigating or intensify virus inactivation in urban air and needs to be studied.

  • Open access
  • 19 Reads
Impact of law against domestic violence (DV) on the reproductive health of abuse victims in India.
Vaishali Patil, Jeff Luck

Objectives: Assess the effect of law against DV on the prevalence of abuse and reproductive health.

Methods: I analyzed DV data from National Family Health Surveys (NFHS 3&4- 2005-06 and 2015-16) of India. The analytical sample was 69,438 NFHS3; n=66,013 NFHS4 of ever-married women aged 15-49 years. The main outcomes were unwanted pregnancy, termination of pregnancy, contraceptive use, age of first birth, and sexually transmitted infections in abuse victims and DV was the main independent variable. Covariates choice was guided by the socioecological model. I used the difference-in-difference model to compare the prevalence between the two surveys.

Results: The prevalence of DV was 39.8% in 2005-06 and 33.3% in 2015-16. In 2005 38.5% of victims were sterilized versus 1% having partner sterilized. In 2015 41% of victims were sterilized and only 0.29% had partners sterilized. There was no difference in the prevalence of victims experiencing STI between NFHS3 (16.5%) and NFHS4 (16.2%). About 29% did not want a pregnancy in 2005 versus 16.5% in 2015; 12.7% had terminated pregnancy in 2005 versus 13.7% in 2015; 66.4% had first birth before 20 years in 2005 versus 49% in 2015. The difference in female sterilization, male sterilization, unwanted pregnancy, and termination of pregnancy between two surveys was not significant. The probability of adolescent pregnancy increased by 3.8% points (p<0.001) and STIs decreased by 1% points (p<0.01) in 2015.

Conclusion: There was a mixed effect on reproductive health outcomes related to DV post-law. There is a need for stringent measures against DV to improve the sexual and reproductive health of women in India.

  • Open access
  • 15 Reads
Identification of vulnerable zone of surface water epidemiology using Remote Sensing and GIS techniques

The quality of urban surface water, access to clean and drinking water is a great challenge, resulting in water-borne diseases. In developing countries, they are not aware of the Geographical Information System (GIS) technology is still not utilized systematically. The aim of the study is to assess the surface water quality parameters and how they create health issues in the study area. This study reveals the surface water quality parameters by using principal component analysis (PCA) techniques with the help of Landsat 8 satellite imagery. Regular monitoring of environmental quality database produced by (GIS) can manage information from various sources such as point and nonpoint source, domestic, industrial, recreational activities, etc. and make spatial correlations with epidemiological data about time and space distribution of water-borne diseases. Medical GIS can easily detect the circulation and spread of disease across geographic regions to planning, policy, and water resource protection and avoid contamination. Remote sensing and GIS provides the highest quality mapping, data, and analysis of an ever-expanding scope has remained reliable. Using spatial analysis, it is probable to find the contaminating source. The study also has involved with the industrial and residential areas of Madurai urban region, to validate ground truth verification. The study will help to reveal the disease monitoring and surveillance systems, improving the distribution of health resources by predicting available health care accessibility and the source of pollution and it impacts on public health.

  • Open access
  • 37 Reads
Hello, Can You Hear Me? Orthopaedic Clinic Telephone Consultations in the COVID-19 Era- a Patient and Clinician Perspective
Anuhya Vusirikala, David Ensor, Ajay Asokan, Ravi Ray, Dimitrios Tsekes, J Edwin

BACKGROUND

The COVID-19 pandemic has resulted in seismic changes in healthcare delivery. As a result of this, hospital footfall required to be reduced due to increased risk of transmission of infection. To ensure patients can safely access healthcare, we introduced orthopaedic clinic telephone consultations in our busy district general hospital.

AIM

To investigate patients’ and clinicians’ perspective of telephone consultations during COVID-19, and whether this method of consultation could be a viable option in the post pandemic future.

METHODS

This is a single centre, prospective study conducted in a busy National Health Service (NHS) district general hospital. In May 2020, 100 non- consecutive adult patients were contacted by independent investigators within 48 hours of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire. The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term. Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.

RESULTS

93% of patients were overall satisfied with telephone consultations and 79% were willing to continue this method of consultation post- pandemic. Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment. 72% of clinicians reported overall satisfaction with this service and 80% agreed that telephone consultations should be used in the future. The majority found it less laborious in time and administration in comparison to face to face consultations.

Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.

CONCLUSION

Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic, achieving the aim of reducing hospital footfall. This method of consultation has resulted in immense clinician and patient satisfaction. Our findings suggest that this tool has benefits in post pandemic healthcare delivery. It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.

  • Open access
  • 19 Reads
Overcoming the Reluctance of Medical Professionals to Embrace Self-Directed Learning in Response to COVID-19

As a result of the 12 March 2020 lockdown of academic institutions in response to COVID-19, overnight, self-directed learning via online platforms became indispensable for all medical professionals. The curricula of medical professionals and research regarding adult learning recommend self-directed learning as the preferred method of learning. Yet medical professionals, especially medical students, have been reluctant to embrace self-directed learning for various reasons. Those who do adopt self-directed learning willingly have been found to have a passion for learning as well as a higher grade point average (GPA). One method for encouraging self-directed learning in medical professionals is the multi-disciplinary, on-line University of Toronto Health Narratives Research Group. The limitations regarding medical learning resulting from COVID-19 show no sign of abating. Therefore, medical professionals, especially medical students, would do well to participate in multi-disciplinary groups like the Health Narratives Research Group to encourage and enrich their ability to self-direct their learning. Furthermore, the curricula of medical programs should support their efforts to do so through providing opportunities to engage in such multi-disciplinary narrative research groups.

  • Open access
  • 21 Reads
Health and environment: a changing paradigm in the Covid 19 era

The Covid-19 pandemic has deeply impacted our relationship with the environment and the achievement of the sustainable development goals, sometimes in opposite ways. The SARS CoV2 origin has demonstrated the urgent need of adopting the “one health” approach in every future action involving health and environment, and its spread has highlighted the importance of research about the environmental determinants of its transmission. The increasing knowledge about the virus presence in different environmental matrices and conditions is showing the large diffusion of its RNA, even if its real viability is still undemonstrated. Moreover, some epidemiological findings suggest that environmental conditions can be associated with the virus spreading and related mortality.

The Covid-19 prevention is still entrusted to measures linked to the environment: use of masks, social distancing, hygiene and disinfection. On the other hand, some of these measures can increase the environmental pollution, as it occurs for wastes (gloves and masks) and generalized spreading of disinfectants: this can produce an apparent conflict of interest between the infective and the chemical risks. Therefore, the Covid-19 pandemic should change our way to consider the environmental risk assessment, focusing not only on chemicals but also on biological agents, both analyzed and compared with quantitative methods.

The efforts for the recovery from the socio-economic impact of the pandemic should also be focused on the environmental preservation and protection.

In conclusion, the pandemic give us the opportunity to rethink the health and environment binomial in a wider and more comprehensive perspective.

  • Open access
  • 21 Reads
USE OF FACE MASKS BY STUDENTS OF THE MEDICAL UNIVERSITY DURING COVID-2019 PANDEMIC
Oleg Mitrokhin, Ekaterina Shashina, Valentina Makarova

The coronavirus pandemic has posed a serious challenge to humanity. Most countries are entering a second wave of increased incidence. Currently, it is necessary to pay close attention to the measures of non-specific prevention of infection among the population, which include, first of all, the use of face masks.

The aim of our study was to assess the understanding of the importance of using face masks by students of the Sechenov Medical University.

The survey was used. 228 students participated in the survey. Three quarters of those surveyed consider wearing masks to be an adequate measure to combat Covid-2019. All respondents wear a mask inside the university. It is a mandatory requirement for all students and teaching staff. The majority of those surveyed believe that disposable medical masks protect from saliva and mucous secretions of carriers and covid-patients. Two of third of students know the rules and duration of the use of disposable masks. Breathing and vision difficulties were indicated as the main reasons for refusing to use of masks. The most popular type of masks were disposable medical masks. Skin reactions due to masks wearing were noted by 65% ​​of students. The most common manifestations were redness, dryness and itching of the skin. Despite of these symptoms, the majority of respondents continued to wear masks.

Conclusions. Medical students believe that wearing face masks during a pandemic is an adequate protective measure against Covid-2019. Their knowledge allows to properly select and use of personal protective equipment. Most of the respondents have civic responsibility and understand the importance of masks using not so much for personal protection as for protecting others and can actively promote their use among the population.

  • Open access
  • 23 Reads
COVID-19: a game-changer for higher education environment at Coimbra Health School

On March 4, in compliance with the Ministers' Offices determination, Coimbra Health School created the Emerging Infections Control Committee, aiming to fulfil the preparation of a contingency plan.

Several measures have been taken: hand rub formulation was produced and made available also a disinfecting footbath mat was placed at the entrances. Cleaning of the surfaces of frequent hand contact was reinforced and ventilation of all spaces was promoted. The negative pressure ventilation system in classrooms and offices has also been adapted. Simultaneously, cafeteria activities were cancelled and the use of employees biometric control. Suspension of the classroom activity was determined, on March 13, teleworking regime and closure of the campus (March 16). On March 18 the Government declared the emergency state. This ends on May 2, and academic activities were reactivated exclusively for the practical classes, with a previous serological testing campaign carried out for all the academic community involved. Exceptional measures were taken, namely the mandatory use of PPE, implementation of barrier methods in the classrooms and public attendance spots and the definition of circulation circuits. For the beginning of the academic year three scenarios have been outlined: first (50% of students, a minimum distance of 1 meter between students and 2 meters from the teacher); second (more restrictive, 30% of the students in the class, a minimum distance of 1.5 meters between students and 2 meters from the teacher) and third (lockdown). A hybrid-operating model was adopted, conditioned by the capacity of each space, combining face-to-face and on-line activities, assuming the simultaneousness and the alternation of students groups. The “mirror classes” were applied, with the definition of “bubble classes”, to prevent extended/break chains of contagion. The local health authority validates all measures.

Currently, in Portugal, the level of alert has been increased for a calamity state.

  • Open access
  • 72 Reads
Non-conformity to social distancing rules give rise to various COVID-19 clusters in Malaysia
Che Ghazali Norul Hajar, Sabreena Safuan, Nor Fazila Che Mat, Mohd Khairul Azhar Abdul Razab, Siddhartha Pati, Bryan Raveen Nelson, Hisham Atan Edinur

Coronavirus disease 19 (COVID-19) can be transmitted via contact with affected individuals and social distancing is widely practiced as a public preventive measure to contain the disease. Social distancing implementation includes maintaining at least one-meter gap from other people, avoiding mass gatherings and staying out of crowded places. To ensure successful implementation of social distancing, many countries including Malaysia have opted for Movement Control Order (MCO). Under MCO, mass assembly of cultural, religious, and social events are prohibited, education institutions, government, and public premises are closed and strict restrictions to leave and enter the country. Here, we provide several clusters of COVID-19 cases in Malaysia that emerged due to non-conformity to social distancing. Our report is thus providing informed decision to policy makers for designing a better pandemic response plan in the country.

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