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The COVID-19 pandemic posed substantial challenges to healthcare systems globally and severely disrupted essential health services, including routine immunization programs. In India, these disruptions were exacerbated due to the sudden emergence of the pandemic and lockdown measures, leading to mass migrations and a shortage of healthcare workers. Caregivers' concerns about routine immunization sessions further compounded the problem, resulting in a sharp increase in zero-dose children. This review paper examines India's strategies for conducting one of the world's largest COVID-19 vaccination programs while effectively restoring and perpetuating its Universal Immunization Program (UIP). The UIP played a pivotal role in sustaining immunization services during the pandemic, ultimately improving immunization coverage compared to pre-pandemic levels. India's accomplishments in this regard are highlighted through key performance indicators, the reach of immunization services, a reduction in zero-dose children, and antigen-wise coverage. The paper also discusses the successful integration of COVID-19 vaccination within the UIP framework, underscoring the significance of existing infrastructure, technology, and capacity building. India's dedication to concurrently managing routine immunization and COVID-19 vaccination showcases the adaptability and resilience of its healthcare system. India's journey serves as a global example of efficient mass immunization during challenging times, emphasizing the importance of political will, healthcare infrastructure investment, skilled healthcare workforces, and comprehensive vaccination programs. In a world grappling with the dual challenge of COVID-19 and routine immunization, India's experience provides a roadmap for strengthening healthcare systems and promoting public health as the critical agenda in challenging times. [ABSTRACT FROM AUTHOR]

Corona virus disease, COVID-19, has emerged as a pandemic covering the entire world, almost every country is effected by COVID-19. Numbers of infected people across the world are increasing at an exponential rate. Such large number of patients put extra ordinary demand of health care facilities. Although every country is putting tremendous efforts in frontline to fight with this pandemic but shortage of medical facilities, especially for densely populated countries like India, it becomes a serious challenge. The fear of pandemic has arrested everyone in homes due to which various sectors are affected badly. Pandemic situations are badly deteriorating the hospitality and tourism business. Smart healthcare tourism is the new prominence application of IoT based healthcare tourism. This paper presents an IoT based health monitoring framework, which may be helpful for medical tourists as well as the hotel management to monitor the health of guests and staff. The framework will detect and check the various vital signs of body and then report to the admin about health status of persons. The paper focuses on use of Internet of Things technology involving wearable sensors for monitoring the health status, detecting the disease and providing online health services for medical tourism sector. [ABSTRACT FROM AUTHOR]

COVID -19 is causing plenty of deaths in India as well as globally and many of them are health care workers (HCWs). As per data given by IMA 744 MBBS doctors have been died due to Covid - 19 till 4 February 20213. As this disease transmitted between person to person by respiratory droplets hence mask hygiene is very important effective preventive measure for HCWs. In market due to high demand, much different type of masks is available with different specifications. Some of them are from Indian origin and many of them are procured from foreign. Many of them are not effective to safeguard health care workers against COVID 19 infection2. Hence this paper will discuss different country specific standards of masks in relation to SARS COV-2 as well as home based disinfection method of masks. In market many masks are available and most of them are sub-standard and making falsely claim of N95. Most of them are not able to protect Health Care Workers from the infection of SARS COV-2. Hence in this paper will examine different countries specific standard of mask with respect to size of SARS COV-2. US standard N95 masks will give desire level of protection against SARS COV-2. Conclusion: NIOSH certified N95 or N99 or N100 mask should be given priority over other counties N95 equivalent masks. Chinese masks GB2626-2006 are least recommended among all other countries N95 equivalent masks6. [ABSTRACT FROM AUTHOR]

The rapid spread of the novel corona virus disease (COVID-19) has disrupted the traditional clinical services all over the world. Hospitals and healthcare centers have taken extreme care to minimize the risk of exposure to the virus by restricting the visitors and relatives of the patients. The dramatic changes happened in the healthcare norms have made it hard for the deaf patients to communicate and receive appropriate care. This paper reports a work on automatic sign language recognition that can mitigate the communication barrier between the deaf patients and the healthcare workers in India. Since hand gestures are the most expressive components of a sign language vocabulary, a novel dataset of dynamic hand gestures for the Indian sign language (ISL) words commonly used for emergency communication by deaf COVID-19 positive patients is proposed. A hybrid model of deep convolutional long short-term memory network has been utilized for the recognition of the proposed hand gestures and achieved an average accuracy of 83.36%. The model performance has been further validated on an alternative ISL dataset as well as a benchmarking hand gesture dataset and obtained average accuracies of 97 % and 99.34 ± 0.66 % , respectively. [ABSTRACT FROM AUTHOR]

BACKGROUND: The worldwide lockdown and social isolation measures during COVID management are likely to have a negative impact on emotional wellbeing. While the psychological impact on health care workers or the general adult population are being studied, not much data is available about the psychological impact on adolescent population (and none from India so far), an already sensitive and vulnerable developmental age. This study tried to bridge that gap. AIM: This pilot study was planned to assess the emotional wellbeing of adolescents during these socially distant times causing school closures. METHOD: 60 Indian adolescents enrolled from 9th to 12th standards of a few private schools with medium of instruction as English, participated in web based assessments where standardized tests were used to assess different components of emotional wellbeing: Positive affect, Negative affect, Difficulty in emotion regulation, and Life satisfaction. The measures used for these were Positive And Negative Affect Scale (PANAS), Difficulties in Emotion Regulation Scale (DERS), and Satisfaction With Life Scale (SWLS). RESULTS: The adolescents were found to be experiencing high negative affect and low positive affect. Also, mild to severe difficulties with emotion regulation were found in 23.33 percent of the sample, and low satisfaction with life in 30 percent of the sample. Gender differences weren’t found in all study variables. While satisfaction with life was found to be modestly negatively associated with difficulty in emotion regulation, both these variables were found to be strongly associated with relative presence of positive affect over negative affect, with nil to low correlations with absolute values of both kinds of affects, revealing thought provoking insights about this differential. The results have been discussed in the context of restrictions on wellbeing promoting activities, and other factors associated with the lockdown. CONCLUSION: Relevant recommendations for caregivers and mental health practitioners in contact with adolescents have been offered in the paper, which may help buffer the impact of the lockdown, and help enhance adolescents’ emotional wellbeing while they cope with a new albeit temporary norm of being, and communicating. For mental health practitioners and psychotherapists especially, the case for more tele mental health services, mental health apps, web based group interventions becomes stronger than ever. Therapeutic focus could be on introducing more experiences and opportunities in their lives which allow for an increase in positive affect, irrespective of the level of negative affect experienced by them. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to examine the impact of big data management on green service production (GSP) and environmental performance (ENPr) while considering green HRM practices (GHRM) in healthcare emergencies. Design/methodology/approach: The authors collected primary data from major healthcare organizations in India by surveying healthcare professionals. The data analysis through structural equation modelling (PLS-SEM) reveals several significant relationships to extricate the underlying dynamics. Findings: Grounded in the theories of service production and natural resource-based view (NRBV), this study conceptualizes GSP with its three dimensions of green procurement (GP), green service design (GSD) and green service practices (GSPr). The study conducted in India's healthcare sector with a sample size limited to healthcare professionals serving in COVID-19 identifies the positive and significant impact of big data management on GSP and ENPr that organizations seek to deploy in such emergencies. The findings of the study explain the moderating effects of GHRM on GSP-ENPr relationships. Research limitations/implications: The study was conducted in the healthcare sector in India, and its sample size was limited to healthcare professionals serving in COVID-19. The practical ramifications for healthcare administrators and policymakers are suggested, and future avenues of research are discussed. Originality/value: This paper develops a holistic model of big data analytics, GP, GSD, GSPr, GHRM and ENPr. This study is a first step in investigating how big data management contributes to ENPr in an emergency and establishing the facets of GSP as a missing link in this relationship, which is currently void in the literature. This study contributes to the theory and fills the knowledge gap in this area. [ABSTRACT FROM AUTHOR]

Rapidly growing rate of infection among health workers during the current COVID-19 pandemic, is posing a serious challenge to global health systems. Lately, India is also witnessing an intensifying COVID-19 disease burden and its impact on health workers. This paper aims to discuss the challenges to health worker protection in India and the possible ways forward. Given the inadequate and unequally distributed healthcare workforce, it is highly essential for the country to strategize prompt measures for ensuring occupational health and safety of its health workers. Information for this paper were gathered by searching PubMed and Google Scholar databases using "COVID-19", "Infection Control", "Health worker", "India" as search keywords in different combinations. In addition, websites of Government of India, relevant UN agencies and leading news agencies were also searched manually for related reports and publications. India must take timely measures in rapid manufacturing and procurement of essential personal protective equipment (PPE) to ensure adequate stockpiling to meet the rising demands. Comprehensive and repeated training with sharply focussed content including usage of PPE kits as well as active surveillance of adherence to recommended protocol are critical in protecting health workers especially the primary care physicians and frontline health staff from the deadly COVID-19 infection. The provision of psychological and financial support for health workers and their families is absolutely critical in building trust and dedicated work efforts by the health workforce for a continuous fight against the deadly disease. [ABSTRACT FROM AUTHOR]

The prevalence and severity of Covid 2019 has brought to light new vulnerabilities of Health Care Workers (HCWs) in their working conditions, social protection, and occupational safety and mental health. In view of this, our paper aimed to provide comprehensive analysis of psychological stress, socio-economic impact, government intervention, interpersonal relations, work-life balance, and coping strategies of HCWs during the pandemic time in India. Based on data collected physically from 606 HCWs working in seven hospitals located in Delhi-NCR using structured questionnaires, six latent variables were constructed. T-test and ANOVA technique along with Post-hoc analysis was used to make comparisons and identify groups across which significant differences existed. Further, a two-group discriminant analysis was performed to find the variables that best discriminated between HCWs from private or public hospitals and medically or not-medically trained. Lastly, chi-squared (χ²) test was performed to examine the statistical association between coping strategies and few demographic characteristics. The results revealed that females and medically-trained HCWs were more psychologically stressed than their counterparts. Work-life-balance and interpersonal relations were found to be more disturbed among the medically-trained HCWs. Government regulations favourably affected the non-medically trained and HCWs with children and elderlies. Additionally, the impact of interpersonal relationships and work-life-balance was found to be adverse on permanent HCWs. Discriminant analysis showed that interpersonal relationships, followed by government intervention, work-life balance and socio-economic impact were the most important predictors between medically and non-medically trained HCWs. However, none of these factors discriminated between HCWs from private or public hospitals. Further, the preference patterns of coping strategies suggested that HCWs worked with an optimistic state of mind and adopted positive techniques. To make the healthcare system more resilient, it is strongly suggested that the government should play a key role during the times of pandemic, especially-encompassing females and financially stressed categories of HCWs. [ABSTRACT FROM AUTHOR]

The World Health Organization declared COVID-19 as a pandemic on 11 March, 2020, followed by an unprecedented global increase of the disease in recent times. Healthcare workers, including Nursing Professionals (NP), are more likely to experience psychological distress during the pandemic. The purpose of the study is to examine the stress, depression, and anxiety experienced by the nursing professionals in India, who provide care to COVID positive patients. A cross-sectional, web-based survey collected demographic data and mental health measurements from 187 NPs from 29 April, 2020 to 15 May, 2020. Eligibility criterion was NPs' treating COVID positive patients during the pandemic period. A total of 103 (55.08%) participants were screened positive for depression, 105 (56.14%) for anxiety, and 80 (42.78%) for stress. In addition, 24 (12.83%) participants experienced comorbid conditions, suffering from extremely severe or severe forms of stress-anxiety-depression levels. Participants reported high rates of depression, anxiety, and stress especially frontline NPs directly engaged in providing services for patients with COVID-19. The paper recommends counseling, mentorship, Cognitive Behavioral Therapy, and specialty trainings focused on patient care, as possible interventions for managing the psychological wellness of NPs during these testing times. [ABSTRACT FROM AUTHOR]

Lifestyle is a set of characteristics consisting of daily routine, diet, fun activities, work and family of individuals. A review of previous research revealed that many studies were conducted to analyze the lifestyles of respondents using attitudes, opinions and interests with an objective to understand their buying behavior. A general clustering of respondents based on their lifestyles, in the context of COVID-19, would be useful for stakeholders like marketers, health care professionals and Government officials. Hence this paper attempts to group respondents based on their lifestyles. The study had a sample of 275 respondents from Tamilnadu, South India. A set of 32 questions based on the Activities, Interests and Opinions (AIO) model were used. Factor analysis, to arrive at meaningful aspects to group the respondents yielded 6 factors, based on which the respondents were grouped. Their demographic constitution was also examined. The study showed the existence of six distinct clusters in the context of COVID-19. This grouping has important implications for Government, Marketers and Healthcare officials to direct their communication, products and services, specific to those clusters. A review of literature showed a dearth of studies on lifestyle conducted during a pandemic in the Indian context. This study addresses the lacuna and would serve as a prototype that can be replicated on larger samples across countries to understand the impact of a pandemic on lifestyles of people. The study also threw light on the perspectives people have about them, their work and life. [ABSTRACT FROM AUTHOR]

The release of the Telepsychiatry Operational Guidelines 2020 in India, during the COVID-19 pandemic, is a relief for both clinicians and patients. These guidelines embark on initiating and executing naive and recently started telepsychiatry services in India. The document is aligned with other ethical regulations, policies, laws and the 2020 Telemedicine Practice Guidelines in India. This paper discusses a few points about the broader applicability of the guideline for the benefit of humankind in the prevailing healthcare crisis. The guidelines may be extrapolated in policy-making for telepsychiatry services in other low- and middle-income countries sharing a similar socioeconomic, cultural and political milieu. [ABSTRACT FROM AUTHOR]

Telemedicine and related e-health facilities facilitate care from a distance through electronic information systems. COVID-19 pandemic is establishing telemedicine in the health care delivery system of countries. Telehealth is contributing significantly in health care delivery during the COVID-19 crisis. For mild-to-moderate symptoms of COVID-19 or any illness, telehealth services might represent a better, efficient way to receive initial care and perform triaging. Telemedicine also has a significant role in screening for COVID-19 symptoms and delivering routine needs and follow-up care. The large-scale adoption of telemedicine in public health care delivery is still not visible in low- and middle-income countries like India. Adoption by patients and healthcare professionals is limited and their concerns need to be addressed to ensure its utilization in future of the care continuum. In the current paper, we aim to review recent measures of Telemedicine adopted during the course of pandemic and its impact on public health in lower-middle income countries like India. [ABSTRACT FROM AUTHOR]

India's first case of novel coronavirus (COVID-2019) detected on January 30, 2020, in the State of Kerala, and the government switched to alert mode. As the number of confirmed COVID-19 positive cases discerned an increase, the government clamped Epidemic Diseases Act, 1897 on March 11, 2020, by mandating the norm of social distancing and the voluntary public curfew in the country. The nation-wide Lockdowns-I (March 25, 2020, to April 14 2020), II (April 15, 2020, to May 3 2020), and III (May 4, 2020, to May 17, 2020) justified on the ground of Sections 6, 10, 38 and 72 of the Disaster Management Act, 2005. During the lockdown period, the protection of medical and paramedical forces has been a central concern in controlling novel COVID-19 pandemic in India. Therefore, the State also invoked quarantine disobedience under sections 188, 269, 270, 271 of Indian Penal Code, 1860 on command and control theory but unable to control the riotous situation working against medical care personnel. Realizing this exigency, the President under Article 123 of the Constitution of India, 1950 promulgated the Epidemic Diseases (Amendment) Ordinance, 2020. To deal with the miscreants effectively, the Ordinance declares 'act of violence' cognizable and non-bailable with high deterrent value. The paper contextualizes the Epidemic Diseases (Amendment) Ordinance, 2020 in controlling horrendous Epidemic-Pandemic Syndrome of COVID-19 in India in historical and contemporary perspective. [ABSTRACT FROM AUTHOR]

Background: COVID-19 caused by the SARS-COV-2; a novel corona virus is a highly contagious respiratory disease. Objective: The Corona Virus disease 2019 (COVID-19) caused by the SARS-COV-2,a novel corona virus known as severe acute respiratory syndrome is highly contagious respiratory disease, transmitted by respiratory route. There is no specific treatment for COVID-19 and there is a constant need for updating knowledge since the related facts are evolving on day-to-day basis. Knowledge, Attitude, and practice (KAP) study was conducted among the medical students of a tertiary care hospital to assess their Knowledge, Attitude and practices regarding COVID-19. As we never know how the novel virus may change its behaviour and pose a great public health problem to all in society where even the medical students may be one of the primary doctor and are provider. Methods: A total no of 258 medical students from 3rd and 4th semester batch of SCB Medical College & Hospital were included in the study. They were provided with the predesigned questionnaire and their responses were collected by online survey keeping in view the COVID situation and minimizing the risk of viral transmission by paper being exchanging hands. Results: Out of the 258 students 58% were from the 3rd semester and 42% from 4th semester, from them 99.22% do not have any previous training in COVID-19. Out of the 59.3% males and 40.7% females. 100% of students knew COVID-19 is a viral infection and transmitted by close contact with the infected person. About 96% knew that only patients with co morbid conditions progress to severe forms. Majority (96%) used mass media, Internet to update their knowledge 93% believed infected person should not donate blood while 88.7% were of the opinion the vaccination should not be given to pregnant ladies, Lactating mothers and children under 18 years of age. Majority (98%,) showed a positive response towards stringent lockdown, 94% gave the opinion that HCW should be immunized first with COVID Vaccination. Only 80% gave an optimistic response towards beneficial role of convalescent plasma therapy for managing moderately severe cases. Majority of medical students observed COVID appropriate behaviour that is to use masks (88%), sanitizer (94%) and observed social distancing (100%) supporting that the students showed expected levels of KAP regarding COVID-19. Conclusion: The results of our study showed good, expected levels of knowledge regarding various aspects of COVID-19. As it is a novel virus and new concept are emerging every day, there is need to educate the Health care workers and students by regular training programmes, seminars and webinars in order to fight with this dreadful illness. [ABSTRACT FROM AUTHOR]

Background: The pandemic coronavirus disease 2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a worldwide abrupt and significant rise in admissions for pneumonia with multiorgan diseases. Aims and Objective: To determine the positive prevalence of SARS-CoV-2 antibodies in healthcare professionals over 6 months. In addition, to make a subgroup analysis and estimate the age, gender, and workforce-based prevalence of SARS-CoV-2. Materials and Methods: An observational cross-sectional study was conducted on 200 healthcare professionals during 6 months. After taking proper informed consent, the study was started. We included subjects aged ≥18 years in this study. Not receiving any other vaccine during the study, suspected or confirmed immunosuppressive condition, imaging confirmed COVID-19 or recent blood transfusions were excluded from the study. Results: Most patients were 26-30 years old. Out of 200 patients, 116 (58%) were males, and 84 (42%) were females. The total positivity of the titers amounts was 57%. In addition, the males had higher mean titers than the females, with 24.186 versus 13.304. Of the 116 males, 68 were positive (58.6%), and of the 84 females, 46 were positive (54.7%). The age-wise positivity of the titers was high among the 26-30 years of age group, of which, in the 53 people, 33 were seropositive, which is 62.2% of this age group and lowest in the 51-55 years age group, of which in the 23 participants 9 were positive (39.31%), and 14 were negative (60.85%). Conclusion: We concluded that male doctors and adults had a greater seroprevalence of SARS-CoV-2 infection, suggesting that they are more susceptible to contracting COVID-19 through patient contact or surgical procedures. [ABSTRACT FROM AUTHOR]

The sudden occurrence of COVID-19 has made the world into big trouble. It is known that COVID-19 is a highly contagious and deadly virus. People initially infected have no symptoms, while some people are showing no symptoms. In this pandemic the government has showed a strong interest in a smartphone contact monitoring software that can assist in automating of discovering all recent contacts of newly discovered sick people. In this article, we are proposing our app covid suraksha yantra. We have used React for the frontend framework and node js for backend framework. We have given certain 5 quizzes about covid-19 compared to other recently developed apps. Comparative analysis of various application developed for Covid-19 has been studied and a clear overview of these application has been presented in this article and finally we have introduced a blockchain framework known as Covid-19 Suraksha Yantra for medical supply. In this website we also provide the details of slots available for Covid vaccine with proper address, availability, duration, fee Type. We will also provide tracking of medicine across India with the help of blockchain technology. [ABSTRACT FROM AUTHOR]

COVID-19 led to a multitude of psychosocial issues contributing to a mental health crisis with repercussions that continue to persist. While it was indiscriminate as everyone was impacted, certain populations were more vulnerable to detrimental outcomes. The aim of this narrative review was to identify these groups, and investigate the intersection of gender inequalities for the same across the globe, but especially in India. A systematic literature search was undertaken in electronic databases, including PubMed, Google Scholar, Elsevier, Scopus, and PsycINFO. Findings revealed that COVID-19 patients, healthcare workers, other frontline workers, caregivers, bereaving families, students, and the homeless and migrant workers showed significant psychological distress due to numerous psychosocial challenges. Further, the intersection of gender was found for all the groups, except nonhealthcare frontline workers, suggesting that gender acted as a risk factor as women exhibited more severe outcomes with respect to their mental health. The gender disparity in mental health consequences can be attributed to pandemic-related stressors that disproportionately affected women, compounded further by their economic disadvantages, such as increased economic vulnerability, the unequal burden of childcare and caregiving, concerns surrounding reproductive health, gender-based violence, and body dissatisfaction. Further investigations with a focus on qualitative narratives and long-term assessment of mental health outcomes will be beneficial. The way forward is to develop effective coping strategies and address the mental health concerns of frontline workers and caregivers, along with a research imperative of better crisis management, improved work environment, and training, keeping the intersections of gender in mind. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and resulting lockdown have compounded existing inequalities in India. As a second wave of infections hit, there were shortages of medicines, vaccines, oxygen cylinders and hospital beds, and healthcare professionals were overworked and under-resourced. However, in the midst of these stories of systemic inadequacy, there are rich and powerful stories of collective care and resistance. People stepped in to create alternative forms of community care and mutual aid. This paper describes three stories of community response in the context of systemic collapse. There have been countless other such stories of action and resistance throughout the course of the crisis period as well as in the co llective history of the country. [ABSTRACT FROM AUTHOR]

Background: Despite significant advancements in healthcare technology, digital health solutions – especially those for serious mental illnesses – continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particularly in the field of mental health. This paper details results from Phase 1 of a two-part study that seeks to engage people with schizophrenia, their family members, and clinicians in co-designing a digital mental health platform for use across different cultures and contexts in the United States and India. Methods: Each site interviewed a mix of clinicians, patients, and their family members in focus groups (n = 20) of two to six participants. Open-ended questions and discussions inquired about their own smartphone use and, after a demonstration of the mindLAMP platform, specific feedback on the app's utility, design, and functionality. Results: Our results based on thematic analysis indicate three common themes: increased use and interest in technology during coronavirus disease 2019 (COVID-19), concerns over how data are used and shared, and a desire for concurrent human interaction to support app engagement. Conclusion: People with schizophrenia, their family members, and clinicians are open to integrating technology into treatment to better understand their condition and help inform treatment. However, app engagement is dependent on technology that is complementary – not substitutive – of therapeutic care from a clinician. [ABSTRACT FROM AUTHOR]

Background: Lockdown represents a remarkably effective strategy of social distancing to break the chain of transmission of COVID-19. This state of lockdown led to a significant influence on physical and mental wellbeing of people. The present study was conducted to assess the impact of COVID-19 pandemic on anxiety level of general public and find out the associated factors. Methods: The present web based cross-sectional study was carried out among 450 participants in India in the month of May 2020. Data collection was done using online Google form. A semi-structured questionnaire was used. Generalized Anxiety Disorder Scale-7 (GAD-7) Scale was used to assess anxiety symptoms among the participants. Descriptive Statistics and Chi-square test were done using SPSS version 21. Results: Age of the participants ranged between 18 to 71 years. Nearly one-third of the participants were health care professionals. Symptoms of mild anxiety was reported by 17.1% of participants, while 20.2% reported moderate anxiety. Anxiety was found to be significantly more among female gender, health care professional and among the study participants who were going to work daily. Conclusion: Covid-19 pandemic has increased the anxiety level among general public. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic caused a huge impact on the healthcare system worldwide. With a spectrum of outcome ranging from mild symptoms to mortality, the experiences of patients admitted in isolation wards have not been documented. Objective: To explore the experience of COVID-19 patients during hospitalization during the early phase of pandemic. Materials and Methods: A qualitative study using in-depth interviews was conducted among 30 COVID positive patients admitted in COVID wards of a private medical college in Coimbatore, South India between May and June 2020. Qualitative data analysis was done using the seven steps of Colaizzi's descriptive phenomenological method. Results: The experiences of COVID-19 patients during their hospitalization were categorized into three themes. Firstly, their initial reaction to being diagnosed positive for COVID-19. Secondly, experience during hospitalization with regards to their mental health, treatment providers, caregivers (family and relatives) and other COVID patients admitted in the same ward. Lastly, perceived change in their quality of life after discharge. Conclusion: The study highlights that the psychological experiences of COVID-19 patients admitted to the hospital were heterogeneous. Therefore, primary care physicians should provide individualized psychological interventions based on the needs. Since many expressed fear on diagnosis and stigma of the disease, hence policy makers and health care providers should plan intervention for control and treatment without causing stigma to patients and their families. [ABSTRACT FROM AUTHOR]

Up until now, countries have adopted a 'isolate-test-treat-trace' strategy to contain the COVID-19 pandemic. The next critical intervention in the fight against COVID-19 will be effective delivery of safe and efficacious vaccines. Various countries such as the USA, the UK, Canada, Israel, etc., have started administering vaccines to priority population groups. India is gearing up its critical components of the vaccine delivery system to effectively deliver vaccines across the country and has prioritized certain population groups to whom the vaccine will be administered. Considering India's ambitious target to vaccinate close to 300 million people in the first phase of the vaccination drive with limited initial supply (which will be ramped up gradually), it is critical for stakeholders at all the levels – national, state and district – to understand the estimated need for vaccines across geographies based on the vulnerable population and disease epidemiology with the objective of preventing maximum number of future infections from the disease. This paper aims to describe a comprehensive geo-prioritization framework based on existing prevalence of COVID-19, high-risk co-morbidities, and demographic analysis to identify states/districts that could be most in need of the COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background: Despite an increase in institutional births and a fall in maternal mortality, the satisfaction of women with their birthing experience in public health institutions is low. Birth Companion (BC) is an important part of the Labour Room Quality Improvement Initiative introduced by the Government of India in 2017. Despite mandates, its implementation has been unsatisfactory. Little is known about the perception of healthcare providers about BC. Methods: We conducted a facility-based, cross-sectional quantitative study with doctors and nurses in a tertiary care hospital in Delhi, India to gauge their awareness, perception and knowledge about BC. Following universal total population sampling, the participants were administered a questionnaire, which was completed by 96 of 115 serving doctors (response rate of 83%), and 55 of 105 serving nurses (response rate of 52%). Results: Most (93%) healthcare providers were aware of the concept of BC, WHO's recommendation (83%) and Government's instructions (68%) on BC during labour. A woman's mother was the BC of choice (70%) closely followed by her husband (69%). Ninety-five percent of providers agreed that the presence of a BC during labour will be beneficial, in providing emotional support, boosting the woman's confidence, providing comfort measures, helping in the early initiation of breastfeeding, reducing post-partum depression, humanizing labour, reducing the need for analgesia and increasing chances of spontaneous vaginal births. Yet, support for the introduction of BC in their hospital was low due to institutional barriers like overcrowding, lack of privacy, hospital policy, risk of infection; privacy issues and costs. Conclusions: Widespread adoption of the concept of BC would require, besides directives, a buy-in by the providers, and action on their suggestions. These include greater funding for hospitals, creating physical partitions to ensure privacy, sensitization and training of health providers and BC, incentivizing hospitals and birthing women, formulation of guidelines on BC, standards setting and a change in institutional culture. [ABSTRACT FROM AUTHOR]

India's nearly 1-million strong band of quasi-volunteer accredited social health activists (ASHAs) have been key actors in government efforts to control COVID-19. Utilizing a nationalist rhetoric of war, ASHAs were swiftly mobilized by the government in March 2020 as 'COVID warriors' engaged in tracking illness, disseminating information, and caring for quarantined individuals. The speed at which ASHAs were mobilized into mentally and physically grueling labor was all the more stunning given these minimally paid community health workers have long been seen to have low morale given their precarious, informalized work arrangements. Building on work examining the spatialities of global health governance alongside literature on geographic contingency, this paper explores the ways that nationalist COVID-19 war rhetoric promulgated from Delhi worked as a technology of health governance to propel ASHAs into certain forms of action, yet also opened up spaces of potentiality for them to reimagine their relationship to both the state and the communities they serve. In particular, in our analysis of in-depth telephone interviews with ASHA workers in the state of Himachal Pradesh, we find that their hailing as COVID warriors inspired patriotic calls to duty and legitimized their (long over-looked) roles as critical governance actors, yet also was subject to resistance and reworking due to a combination of institutional histories, local politics, as well as happenstantial everyday encounters of ASHA work. The precarious employment of ASHAs – in terms of basic remuneration as well as the great on-the-job risks that they have faced – underscores both the fragile nature of India's health governance system as well as possible political movements for its renewal. We conclude by calling for geographers to give greater attention to community health care workers as a key window into understanding the uneven ways in which health systems are made manifest on the ground, and their ability to respond to citizens' healthcare needs – both in the COVID-19 pandemic and beyond. [ABSTRACT FROM AUTHOR]

Across India, there have been multiple studies conducted to address the issues of the mental health of healthcare workers during the COVID-19 pandemic. The present study estimated the pooled prevalence of psychological morbidity among healthcare workers during the early phase of the COVID 19 pandemic in India. We searched the following electronic bibliographic databases: PubMed, ScienceDirect, Wiley online library, and Google scholar for studies conducted from the onset of the COVID 19 pandemic until 25 September 2021. The methodological quality of each study was scored and outcome measures with uniform cut off scores as per various screening measurements were evaluated. According to the current meta analysis, the pooled estimates of depression, anxiety, stress, and insomnia among Indian healthcare workers during the COVID 19 pandemic are 20.1% (95% CI: 15.6 to 24.6%; n = 21 studies), 25.0% (95% CI: 18.4 to 31.6%; n = 20 studies), 36% (95% CI: 23.7 to 48.2%; n = 22 studies) and 18.9% (95% CI: 9.9 to 28.0%; n = 6 studies) respectively. In subgroup analyses, low quality studies based on the JBI checklist (Score < 3/9) and studies using DASS 21 showed a higher pooled prevalence of depression and anxiety. About 20–36% of the healthcare workers in India reported having depression, anxiety, and stress during the early phase of the COVID 19 pandemic. The present study provides a comprehensive review of the overall burden of mental health problems among healthcare workers during the COVID 19 pandemic in India necessitating appropriate intervention strategies to protect these frontline groups before the memory of the pandemic crisis starts to fade. [ABSTRACT FROM AUTHOR]

Background: The unprecedented onset of coronavirus disease 2019 (COVID-19) had a huge impact on health-care facilities, leading to different psychosocial challenges among health-care workers (HCWs) during this pandemic. Aim: This study aimed to explore the impact of COVID-19 on the work, family, and personal life of HCWs engaged in COVID-19 duties during the first wave in India and gain insights on the coping strategies. Materials and Methods: The findings from 12 qualitative in-depth interviews were analyzed and presented in this article. This study is a part of a mix-method design study conducted at two hospitals and one community site in Mumbai, Maharashtra. The present qualitative sample was drawn conveniently from the randomly selected quantitative sample chosen from the three sites. Results: This study highlights that in the early stage of the COVID-19 pandemic, HCWs experienced transition in work life, burnout, disruption in family life, negative emotions such as fear, and experiences of stigma. The findings also reveal that while institutional workers faced discrimination and stigma outside their workplace, noninstitutional workers faced discrimination at multiple sites during traveling and at in their residential places and additionally faced harassment while working in the community. The findings also suggest that despite numerous challenges faced by HCWs, they were driven by a sense of responsibility and displayed resilience. Conclusion: Considering the HCWs as the backbone of the health-care system, it is crucial to boost and maintain the mental well-being of HCWs by providing timely and tailored interventions to sustain their resilience and build better responses to future pandemic. [ABSTRACT FROM AUTHOR]

Health economics has long been neglected as a subset of the larger discipline of Economics and Finance. However, this could not be further from the truth. There is a large body of researchers and professionals alike that are of the consensus that extensive studying and working upon Healthcare Economics can help us avert the situation that arose in the wake of the recent COVID-19 pandemic. Applying the core principles of Health Economics to a situation like that would help avert bad outcomes. In this article, the authors begin by defining and establishing the concepts of Health Economics and then building on them. We further explain the concepts in light of the Indian Economy and Healthcare Sector and how it has seen unprecedented growth in the last decade. Furthermore, we touch on the various diseases that put the most strain on the healthcare infrastructure and what we can do to make the situation better. We also shed light on how the COVID-19 pandemic affected the Health Economics in the Indian setting and go on to elaborate how India managed to tackle it. Finally, we elaborate on what steps we can take, as researchers and healthcare professionals, to make it easier for the common man to get access to better and more economical healthcare. We determine the importance and effectiveness of data collection and processing and also how to make better research attempts to study, evaluate and process that said data. The onus falls on the academic and the healthcare professional to ensure that the true meaning of Health Economics is not reduced to a mere numbers game, but is something which is truly subjective and for the benefit of the masses. [ABSTRACT FROM AUTHOR]

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Background: Data for COVID-19 incidence and the source of infection among health care workers (HCWs) in Indian population are limited. The main objective of the study was to assess the incidence of COVID-19 infection and identify the source of infection among the HCWs in a tertiary teaching hospital. Methods: A prospective cohort study was conducted among the 2134 HCWs recruited by purposive sampling from a tertiary teaching hospital from May to August 2020 (4-month period--123 days). Over the 4-month period, all the HCWs who had symptoms or those were close contacts of COVID positive patients were traced and tested using validated COVID diagnostic test (reverse transcription-polymerase chain reaction [RT-PCR] test). A semi-structured questionnaire was used to interview each positive HCW to identify the source of exposure of the infection. Results: Incidence proportion was 9.3% among HCWs and was two times higher among males compared to females. Hazard ratio was found to be higher among males and HCWs working in the non-COVID areas. Test positivity rate was found to highest (around 57.8%) among those aged less than 30 years. The most common source of infection was infected HCW colleagues (40.9%) followed by exposure to patients in non-COVID areas (27.3%). Only 5.1% of total infection was found in HCWs who had worked in COVID zones. Conclusions: People working in non-COVID areas, those using shared workplace, dining halls, and staff hostels, must follow strict COVID protocols by using appropriate Personal Protective Equipment (PPE) and following social distancing measures. [ABSTRACT FROM AUTHOR]

Purpose: Due to the rapid surge in the number of COVID-19 cases in India, the health-care supply chain (HCSC) disruptions and uncertainties have increased manifold posing severe challenges to health-care facilities and significantly hampering the functioning of the health industry. This study aims to propose a hierarchical structural model of enablers of HCSC in the COVID-19 outbreak and identifies inter-relationships among them in the health-care market. Design/methodology/approach: Enablers of emergency HCSC have been identified through extensive literature review and experts' opinions. Subsequently, total interpretive structural modeling (TISM) and cross-impact matrix-multiplication (MICMAC) analysis have been implemented to determine the hierarchical inter-relationships among enablers and classify them according to their contribution to the overall system. Findings: The research has identified and validated 15 enablers of the emergency supply chain in health-care businesses. The study resulted in a seven-level hierarchical structural model based on enabler's driving and dependence powers. Further, the application of MICMAC analysis resulted in the classification of enablers into four groups, namely, autonomous, dependent, linkage and independent group. Research limitations/implications: This study would help health professionals, policymakers and academia to implement the theoretical model constructed to alleviate the effect of COVID-19 by improving the HCSC performances in pandemic situations. This study has social and economic implications in terms of cost-effective and efficient delivery of care services in health emergencies. Originality/value: The proposed theoretical model constructed is a new effort addressing the issues of HCSC in the COVID-19 crisis. Procedural implementation of TISM and MICMAC analysis in this study would help researchers to grasp concepts in a very lucid manner. The present study is one of the very few studies analyzing enablers in pandemic situations by implementing the TISM approach. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has resulted in dramatic challenges to healthcare systems worldwide. There has been an increased awareness to protect frontline workers from COVID-19 exposure and its consequences. To assess the prevalence of healthcare professionals in India during the COVID-19, a cross-sectional web-based survey was conducted with healthcare professionals from medical colleges and hospitals from different states across the country. The study comprised 772 healthcare professionals aged ≥18 years. The main outcome measures studied were anxiety, depression, and stress. Among the healthcare professionals, 37.17%, 33.68%, and 23.7% were reported to have anxiety, depression, and stress respectively. The physicians, female, aged population, and professionals sleeping less than 7 hours are more prone to psychological problems. The results of this study predict the high levels of anxiety, depression, and stress among healthcare professionals in different states of India. Increased COVID-19 cases, high pressure, workload, and lack of training are the main reasons for the psychological problems in healthcare professionals. Proper strategies must be followed in healthcare settings to reduce the burden of stress. [ABSTRACT FROM AUTHOR]

Objectives: Ground-glass opacity (GGO)—a hazy, gray appearing density on computed tomography (CT) of lungs—is one of the hallmark features of SARS-CoV-2 in COVID-19 patients. This AI-driven study is focused on segmentation, morphology, and distribution patterns of GGOs. Method: We use an AI-driven unsupervised machine learning approach called PointNet++ to detect and quantify GGOs in CT scans of COVID-19 patients and to assess the severity of the disease. We have conducted our study on the "MosMedData", which contains CT lung scans of 1110 patients with or without COVID-19 infections. We quantify the morphologies of GGOs using Minkowski tensors and compute the abnormality score of individual regions of segmented lung and GGOs. Results: PointNet++ detects GGOs with the highest evaluation accuracy (98%), average class accuracy (95%), and intersection over union (92%) using only a fraction of 3D data. On average, the shapes of GGOs in the COVID-19 datasets deviate from sphericity by 15% and anisotropies in GGOs are dominated by dipole and hexapole components. These anisotropies may help to quantitatively delineate GGOs of COVID-19 from other lung diseases. Conclusion: The PointNet++ and the Minkowski tensor based morphological approach together with abnormality analysis will provide radiologists and clinicians with a valuable set of tools when interpreting CT lung scans of COVID-19 patients. Implementation would be particularly useful in countries severely devastated by COVID-19 such as India, where the number of cases has outstripped available resources creating delays or even breakdowns in patient care. This AI-driven approach synthesizes both the unique GGO distribution pattern and severity of the disease to allow for more efficient diagnosis, triaging and conservation of limited resources. [ABSTRACT FROM AUTHOR]

Introduction COVID-19 has been one of the worst pandemics faced by the human civilization, and otorhinolaryngological manifestations are commonly seen in this disease. Objective The present study was done to profile the ear, nose, and throat (ENT) manifestations in patients diagnosed with COVID-19. An attempt has also been made to assess whether there was any difference between the symptoms of different strains of COVID-19. A brief review of the current knowledge of the transmission of the disease and its treatment has also been done. Methods A cross-sectional, record-based study was conducted in a COVID hospital of India between May and July 2020. Descriptive statistics were used and appropriate parametric/nonparametric tests were applied to assess the association between various variables. Results Out of 250 patients, 80 cases were asymptomatic and 170 were symptomatic. Most of the symptomatic patients had sore throat and nasal congestion. Conclusion Knowledge of the ENTmanifestations of COVID-19 is essential for its early identification and to devise appropriate prevention protocols for the benefit of health care workers (HCWs) and of the general population. [ABSTRACT FROM AUTHOR]

Background: The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation. Objective: This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases. Methods: This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts Results: During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non-COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003). Conclusions: Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19--related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings. [ABSTRACT FROM AUTHOR]

Introduction: The hallmark of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection is high infectivity, pre symptomatic transmission and asymptomatic prevalence which could result in high cumulative numbers of infections, hospitalisations, and deaths. Kerala was the first state to confirm community transmission in July 2020. Healthcare Workers (HCWs) being in the forefront in the war against COVID-19 are more prone to acquire the infection and could possibly be asymptomatic sources for cluster formation. Knowing the development of immunity as shown by the presence of anti COV-2 antibodies in the population contributes to the epidemiological understanding of the disease. Aim: To determine the pattern of seropositivity of SARS-CoV-2 among the HCWs at Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India, six months after revoking the lockdown. Materials and Methods: This cross-sectional study was carried out among 423 HCWs of the medical college from September 5th to December 15th, 2020. Multistage sampling was done with the hospital block as the first stage and departments as the second stage. Blood sample was collected and Anti SARS COV-2 IgG antibody testing which targets the Spike Protein 1 (SP1) was done using the vitros chemiluminescence platform (Orthoclinical diagnostics, USA). For the summary of demographic characteristics, continuous variables were summarised as mean values and Standard Deviation (SD) while categorical variables were summarised as proportions. The X2 test was used for comparing the epidemiological features between positive and negative cases. Chi-square for trend analysis was done for exploring the relationship of the degree of severity with test positivity. All analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 25.0. Results: Jubilee Mission Medical College has 2785 working staff at the time of study. A total of 423 staff consented and their samples were tested. Thirty seven staff members tested positive for COVID-19 antibody, yielding an overall prevalence of 8.75% (95% CI, 6.23-11.86). A 86.5% (32/37) of them were having a history of COVID-19 Antigen/Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) Positivity. A statistically significant linear trend (p-value=0.00001) was observed, between seropositivity and the degree of severity of COVID-19. Among the various factors which increase the risk of seroconversion, history of undergoing quarantine (p-value <0.001), contact with a confirmed case (p-value=0.002), contact with a caregiver for COVID-19 (p-value=0.001) and history of upper respiratory symptoms (p-value=0.001), were found to be significantly associated with positive serology. Conclusion: The pattern of seropositivity across the different category of HCWs observed in the present study showed a higher prevalence among nurses. Being an educational institution, it was obligatory to train all the elements of care delivery to the future generation of HCWs. Acquiring experience from a small but relevant sample was expected to facilitate larger community study envisaged in peripheral areas Jubilee Mission Hospital served. [ABSTRACT FROM AUTHOR]

Healthcare Sector Is One Of The Significant Sectors That Played Major Role In Coiv-19 Pandemic Situation In Indian. Healthcare Sector In India Is Experiencing Many Challenges Due To The Lock Down And Curfews At Many Places Of India. The Research Study Was Commenced Only Among Women Employees Of Jan Aushadhi Store Chennai City. The Study Conclusions Arrived On The Basis Of Data Received From Women Employees At Jan Aushadhi Store. To Collect The Data From The Women In Jan Aushadhi Store A Questionnaire Was Prepared. The Study Findings Clear That Women Employee Working In Jan Aushadhi Store Play A Crucial Role To Complete Their Day To Day Activity In Both Work And House. Apart From The Two Women Working In Jan Aushadhi Store Have Multifaceted Role To Manage Society, Friends And Etc. The Study Findings Clear That There Is A Need For Jan Aushadhi Store Management To Focus On Aspects Life Awards And Rewards For The Welfare Of Jan Aushadhi Store Women Employees. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 is a global pandemic, and to deal with the unexpected, enormous burden on healthcare system, liver transplantation (LT) services have been suspended in many centers. Development of robust and successful protocols in preventing the disease among the recipients, donors and healthcare workers would help in re‐starting the LT programs. We adapted a protocol at our center, which is predominantly a living donor liver transplant center based in north India, and continued the service as the pandemic unfolded and peaked in India with good results and shared the experience of the same. Between March 24 and June 7, 2020, during the government‐enforced public curfew—"lockdown"—7 children received LT. The protocols of infection control were drafted in our team by local customization of published guidelines. The number of pediatric LT done during the lockdown period in 2020 was similar to that done in corresponding pre‐COVID period in 2019. The outcomes were of 100% survival, and none of recipients developed COVID. One potential donor was asymptomatic positive for COVID, responded well to conservative treatment, and was later accepted as a donor. LT program during the COVID pandemic can successfully function after putting in place standard protocols for infection control. These can be implemented with minimal extra involvement of healthcare infrastructure, hence without diversion of resources from COVID management. In conclusion, pediatric liver transplantation services can be continued amid COVID‐19 pandemic after establishing a properly observed protocol with minimum additional resources. [ABSTRACT FROM AUTHOR]

The COVID-19 crisis, with its rapid spread and devastating effects on world economics, also had a crippling effect on health care systems that were already overburdened especially in a developing country like India which is in the midst of a second COVID-19 wave. Dentists particularly are among the most-at risk group of healthcare professionals. Their use of equipment like a dental drill, dental scaler etc., release aerosols that could be contaminated by the microbial flora from the infected patient's oral cavity, thus, putting the dentist at risk. In such a setting, it would be prudent to use prophylactic measures. The six-decadeold Chlorhexidine (CHX) mouthwash with low toxicity and good broad-spectrum activity against bacteria, fungi and enveloped viruses could prove useful just before a dental procedure. The few completed studies of Chlorhexidine use in SARS-CoV-2 patients to reduce viral load show promising results. Hence, Chlorhexidine could be beneficial as a prophylactic measure for both asymptomatic and symptomatic SARS-CoV-2 patients due to its ability to target and reduce the viral load so that they do not contribute in further spreading of the virus. Moreover, CHX could be used on a regular basis to improve oral hygiene. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) which causes severe viral pneumonia rapidly leading to acute respiratory distress syndrome (ARDS). Pregnant women are considered more vulnerable to severe viral respiratory infections owing to the physiological changes in pregnancy. In COVID-19, patient can present with a variety of symptoms of which dyspnoea is one that is also commonly seen in the late stages of pregnancy. The clinical presentation as well as response to therapy is highly variable, and since no conclusive proven treatment is available yet, prevention and symptomatic treatment remains the mainstay of management. Thus, we report a case series of four SARS-CoV-2-positive obstetric patients who presented with severe ARDS in a tertiary care hospital, posing diagnostic and therapeutic challenges to the clinician, and were managed with a holistic multidisciplinary stepwise approach. Through this, an effort has been made to sensitize the attending obstetrician on diverse presentation of COVID-19 disease and to emphasize the importance of prevention, early pick up, and timely optimal management of pneumonia in pregnant females with COVID-19. The clinical presentation of respiratory illness due to SARS-CoV-2 in pregnancy can be mistaken for exaggerated physiological changes of pregnancy leading to delay in seeking medical care. During the current pandemic, high suspicion for COVID-19 should be kept. If found symptomatic, immediate care should be sought in a designated facility and managed accordingly preferably with a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: COVID‑19 ongoing pandemic has proved beyond doubt that all countries in the world from high income to low‑ and middle‑income countries were unprepared with under‑diagnosed and underreported losses of precious human lives on already overstretched healthcare delivery infrastructure. Thus, the urgent need of the hour is to understand and identify the operational issues and challenges encountered in the sample collection process and also at the testing labs in order to respond at the earliest. This early and effective response will help not only to address the identified issues in the whole chain of sample collecting to test result communication but also it will help to improve the functioning of the entire system involved in this process. Objectives: The present study was undertaken to identify the issues faced during various steps involved in laboratory testing as part of the COVID‑19 control activities in selected remote districts of North East and East India. Further, perceived adequacy of human resources, equipment, diagnostic kits, and other essential consumables including PPEs vis‑a‑vis the load of samples received from the catchment areas of the testing laboratories were also explored. Methods: The study was a qualitative research using in‑depth interview method to collect and collate the data from the chain of personnel involved in sample collection, storage, transportation, and testing by recorded telephonic interview by state‑level collaborators as per the study protocol. The respondents were recruited from randomly selected sites of remote districts for sample collection, storage, transportation, and dedicated testing labs in six states of North East and Eastern India. The study findings were analyzed by two‑dimensional scaling and hierarchical cluster analysis to get the collective picture involving transcription, preliminary data scrutiny, content analysis, and interpretation of the verbal IDI; classified and summarized by triangulation; free listing and pile sorting of suggestions. Results: The entire laboratory testing related human resources has been working on war‑footing round‑the‑clock to fulfil the expectation of the stakeholders and maintaining high quality despite the ever‑increasing load of sample testing in both the public and private sectors. The findings indicated that the healthcare workers from all levels of laboratory diagnosis have taken it as a challenge to control the pandemic even with limitations of logistics to capacity building. Positive suggestions to improve laboratory services were to increase human resources, infrastructure, IT with the robust mechanism of monitoring and supervision. Conclusions: Upgradation of laboratory capacities and expertise in public health has become one of the points of concern to contain the COVID‑19 pandemic of the new millennium. [ABSTRACT FROM AUTHOR]

Background: Risks to healthcare workers have escalated during the pandemic and they are likely to experience a greater level of stress. This cross-sectional study investigated mental distress among healthcare workers during the early phase of Coronavirus disease-2019 (COVID-19) outbreak in India. Method: 140 healthcare workers of a tertiary care hospital in India were assessed for perceived stress and insomnia. A factor analysis with principal component method reduced these questions to four components which were categorized as insomnia, stress-related anxiety, stress-related irritability, and stress-related hopelessness. Further statistical analyses were done on these factor scores to identify the predictors and investigate the differences between the different categories of healthcare workers. Result: Doctors had the highest level of anxiety among the healthcare workers. Both doctors and nurses perceived a greater level of irritability than the other HCWs. Compared to doctors and nurses, other HCWs were more likely to experience insomnia. Lower age, higher education, female gender, and urban habitat were associated with greater perception of anxiety. Older age, being quarantined, and single marital status were the significant predictors of irritability. Female gender, single marital-status, and higher number of medical ailments contributed to perceived hopelessness. Quarantine significantly predicted insomnia. Conclusion: Different categories of healthcare workers are experiencing varied mental health problems owing to their heterogeneous socio-demographic backgrounds. Tailored and personalized care, as well as policies, might help in alleviating their problems. Further research is warranted to explore the psychological distress and remedies among these frontline workers during and after the ongoing pandemic crisis. [ABSTRACT FROM AUTHOR]

Background: Covid19 pandemic has resulted in drastic changes in human lives across the globe in the form of lockdown and an uncertain future. Information regarding the COVID-19-related anxiety and well-being among the public in India is very limited, especially from the state of West Bengal. We conducted this e-survey among the general population of West Bengal to assess the anxiety levels and the well-being status during lockdown. This information would be helpful to guide family physicians to screen patients for anxiety from the primary care level. Aims: The main aim of this questionnaire based study was to assess the levels of anxiety and well-being status among the public including the frontline workers in West Bengal, India. Materials and Methods: A prospective study was conducted with a validated e-questionnaire after Institutional Ethics committee approval, from 18th April, 2020 to 3rd May, 2020. The questionnaire had 12 questions which included the Generalized Anxiety disorder (GAD)-7 scale and the WHO-5 scale (5 question-items) to assess the well-being of the participants. The survey link was distributed through the social networking sites of WhatsApp, LinkedIn, Facebook and Twitter and e-mails within West Bengal. Microsoft Excel (version 2016) was used to analyse the data. Results: A total of 355 responses were received 15.49% responders were observed to have anxiety and 37.74% participants had low well-being scores. Majority of healthcare workers (89.47%) were seen to have anxiety and a significant (52.03%) had a low well-being status. Conclusions: We report the presence of anxiety and low well-being among the general population of West Bengal. It is important to understand the current psychological status of the public for the family physicians as many would visit them with vague symptoms. There is a dire need to screen all patients including front line workers visiting primary care physicians for mental health to ensure better clinical outcome. [ABSTRACT FROM AUTHOR]

Introduction: With 5.3 million people living with dementia in India and the pandemic wreaking havoc, dementia care has faced unique challenges during the outbreak, with reduced healthcare access, travel restriction, long-term lockdown and fear of hospitalization. We explored the experiences and barriers faced by the physicians involved in dementia care during the lockdown period. Methods: A qualitative approach was used with purposive sampling. After an initial pilot, 148 physicians were included in the study. They were virtually interviewed in-depth based on a pre-designed semi-structured questionnaire, in areas related to tele-consultations, attributes related to dementia care, challenges faced and way forward. Interviews were recorded, transcribed and thematically analyzed using Nvivo-10 software. Triangulation, peer debriefing and respondent validation were used to ensure rigor. Results: The overarching categories that emerged were "Tele-medicine as the future of dementia care in India," "people living with dementia being uniquely susceptible to the pandemic with a triple burden of: age, ageism and lack of autonomy " and "markedly reduced healthcare access in this population with significant mental health burden of caregivers." The experiences of the physicians were categorized into their challenges during the lockdown period and perceptions related to specific facets of dementia care during the crisis. The general physicians expressed special "unmet needs" of dementia-specific training and specialist collaboration. Most of the participants perceived ambiguity related to the newly released telepsychiatry guidelines. Conclusion: Resource constraints and pandemic burden are currently high. This study looks at the "voices" of those actively providing dementia care during the ongoing crisis and to the best of our knowledge, is the first one from India to do so. Concurring with their experiences, PwD and their families are exposed to multiple vulnerabilities during COVID-19, need tailored care, especially at the primary healthcare level which includes general physicians. These relevant "voices" are discussed in light of the new tele-psychiatry guidelines and further optimization of dementia care in an aging India. [ABSTRACT FROM AUTHOR]

The World is going through a tough situation and that is a pandemic caused by the Novel Corona virus which originated in the Wuhan Province of China in December 2019. During this tough and critical situation, the only saviors of humanity are our health care professionals, who restore the faith and trust in humanity and ensure the safety of each individual suffering from this COVID-19 disease. The cherry on the cake is the additional health support provided by the staff of Emergency Medical Services who help the health care workers in treating the patients in hospital, by giving the pre-requisite or the initial treatment during this emergency situation. So to tackle this pandemic, it is important to meet up to the increasing demand of Emergency Medical Services so that the situation remains under control and there is a decrease in mortality. The fragile and fragmented healthcare system of India needs to be upgraded and emphasis needs to be put on developing the Emergency Medical Services so as to strengthen the healthcare system as a whole and to make living better. [ABSTRACT FROM AUTHOR]

The ongoing global pandemic of the coronavirus disease 2019 (COVID-19) has placed a severe strain on the management of chronic conditions like diabetes. Optimal glycemic control is always important, but more so in the existing environment of COVID-19. In this context, timely insulinization to achieve optimal glycemic control assumes major significance. However, given the challenges associated with the pandemic like restrictions of movement and access to healthcare resources, a simple and easy way to initiate and optimize insulin therapy in people with uncontrolled diabetes is required. With this premise, a group of clinical experts comprising diabetologists and endocrinologists from India discussed the challenges and potential solutions for insulin initiation, titration, and optimization in type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic and how basal insulin can be a good option in this situation owing to its unique set of advantages like lower risk of hypoglycemia, ease of training, need for less monitoring, better adherence, flexibility of using oral antidiabetic drugs, and improved quality of life compared to other insulin regimens. The panel agreed that the existing challenges should not be a reason to delay insulin initiation in people with uncontrolled T2DM and provided recommendations, which included potential solutions for initiating insulin in the absence or restriction of in-person consultations; the dose of insulin at initiation; the type of insulin preferred for simplified regimen and best practices for optimal titration to achieve glycemic targets during the pandemic. Practical and easily implementable tips for patients and involvement of stakeholders (caregivers and healthcare providers) to facilitate insulin acceptance were also outlined by the expert panel. Simplified and convenient insulin regimens like basal insulin analogues are advised during and following the pandemic in order to achieve glycemic control in people with uncontrolled T2DM. [ABSTRACT FROM AUTHOR]

Due to the pandemic of COVID-19, lockdown has been implemented in different countries. In the past many lockdowns took place for different reasons. Also, different pandemics took place across the globe resulting in the death of millions. To prevent the spread of the pandemic, lockdown has been implemented. Due to the pandemic and the lockdown the education sector, health sector, economy and the public have been affected both positively and negatively. A search strategy was executed in which literature from specific websites were only considered. Reports from different organizations like CDC and WHO tells us about the symptoms, incubation period and types of coronaviruses. In India there were in total 4 phases of lockdowns implemented with guidelines given by the government. The economy was gravely affected. The stock market fell to the lowest in history. The race for the formation of a vaccine for Coronavirus has started. With three vaccines that have been given emergency authorization, Pfizer, Moderna, and AstraZeneca, there are more vaccines, including Covaxin, produced by the Bharat Biotech and ICMR, which have reached the clinical stage. The Government of India has taken various steps to control the spread of the COVID-19. Although different steps were taken by the government to keep the transmission of the infection, the underprivileged are still gravely affected due to the lockdown. And lack of knowledge and sanitation among them has caused an increase in cases. In this review article we highlight the epidemiology, socio-economic impact and strategies to combat COVID-19 pandemic in India. [ABSTRACT FROM AUTHOR]