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Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Telemedicine is increasingly used in rheumatology. While telemedicine guaranteed care of patients during the COVID-19 pandemic, it is now increasingly used to facilitate triage of patients, monitoring of disease activity, and patients' education. In addition, tele-visits as well as remote physio- and psychotherapy are replacing traditional face-to-face contacts between patients and their healthcare provider. While this may save resources in a world in which the gap between the demand and the provision of healthcare increases, there is also a danger of losing essential information, for example by non-verbal communication, that can only be retrieved during face-to-face contact in the office. In addition, it may be challenging to build a trusting relationship between patients and healthcare professionals by virtual means only. Globally acting companies that see market opportunities already amply offer 'simple' technical solutions for telemedicine. While such solutions may seem (economically) interesting at first glance, there is a risk of monopolization, leaving the most valuable parts of healthcare to a small number of profit-seeking companies. In this article, the opportunities and threats of telemedicine in rheumatology are debated. A possible way forward is to complement traditional face-to-face visits with information gained by telemedicine, in order to render these consultations more efficient rather than replacing personal contact by technology., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: The World Health Organization recognizes abortion as essential health care and has encouraged governments to ensure access to abortion services throughout the COVID-19 pandemic. However, the threat of infection combined with government responses to COVID-19 have impacted access to abortion services globally. This study explores access to abortion in Germany during the pandemic., Methods: This study used a mixed-methods design. An analysis of data collected by Women on Web (WoW) was carried out to assess women's reasons for choosing telemedicine abortion outside the formal health system in Germany during the pandemic. Descriptive statistics were generated for 2057 requests for telemedicine abortion received by WoW between March 2020-March 2021. Semi-structured interviews were conducted with eight healthcare professionals involved in the provision of abortion services to explore how they perceive of women's access to abortion services in Germany during the pandemic., Results: The quantitative analysis found that preferences and needs for privacy (47.3%), secrecy (44.4%) and comfort (43.9%) were the most common reasons for choosing telemedicine abortion. COVID-19 was another important reason (38.8%). The thematic analysis of the interviews was organized into two overarching themes: service provision, and axes of difference., Conclusions: The pandemic affected the provision of abortion services as well as the circumstances of women seeking abortion. The main barriers to access were financial constraints, privacy issues, and lack of abortion providers. Throughout the pandemic, accessing abortion services was more difficult for many women in Germany, especially women experiencing multiple and overlapping forms of discrimination., Competing Interests: Declaration of Competing Interest Coauthors HR and BT declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Coauthors RG and HA work for or are affiliated with WoW., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Chimamanda Ngozi Adichie showed how a single story is limited and thereby distorts the true nature of an issue. During this COVID-19 pandemic there have been, at least, three consecutive single stories-the 'lethal threat' story, followed by the 'economic threat' story, and finally the 'vaccine miracle' story. None of these single stories can convincingly and permanently capture the dynamics of the pandemic. This is because countries experienced different morbidity and mortality patterns, different socioeconomic disadvantage, age and vulnerability of population, timing and level of lockdown with economic variability, and, despite heavy promotion, vaccines were beset with a significant and variable degree of hesitancy. Lack of transparency, coherence and consistency of pandemic management-arising from holding on to single storylines-showed the global deficiency of public health policy and planning, an underfunding of (public) health and social services, and a growing distrust in governments' ability to manage crises effectively. Indeed, the global management has increased already large inequities, and little has been learnt to address the growing crises of more infectious and potentially more lethal virus mutations. Holding onto single stories prevents the necessary learnings to understand and manage the complexities of 'wicked' problems, whereas listening to the many stories provides insights and pathways to do so effectively as well as efficiently., (© 2021 John Wiley & Sons Ltd.)

Background: European countries are still searching to eliminate or contain the Covid-19 pandemic. A variety of approaches have achieved different levels of success in limiting the spread of the disease early and preventing avoidable deaths. Governmental policy responses may explain these differences and this study aims to describe evidence about the effectiveness of containment measures throughout the course of the pandemic in five European countries (France, Germany, Italy, Spain and the UK)., Methods: The research approach adopted consisted of three steps: 1) Build a Containment Index (C.I.) that considers nine parameters to make an assessment on the strength of measures; 2) Develop dynamic epidemiological models for forecasting purposes; 3) Predict case numbers by assuming containment measures remain constant for a period of 30 days., Results: Our analysis revealed that in the five European countries we compared, the use of different approaches definitively affected the effectiveness of containment measures for the Covid-19 pandemic., Conclusion: The evidence found in our research can be useful to inform policy makers' decisions when deciding to introduce or relax containment measures and their timing, both during the current pandemic or in addressing possible future health crises., (© 2022. The Author(s).)

The COVID-19 pandemic has spawned crises of violence, hunger and impoverishment. Maternal and Infant Health Canada (MIHCan) conducted this policy action study to explore how changes that have arisen during the COVID-19 pandemic may catalyze potential improvements in global women's health toward the creation of a more equitable post-pandemic world. In this mixed methods study, 280 experts in women's health responded to our survey and 65 subsequently participated in focus groups, including professionals from India, Egypt/Sudan, Canada and the United States/Mexico. From the results of this study, our recommendations include augmenting mental health through more open dialogue, valuing and compensating those working on the frontlines through living wages, paid sick leave and enhanced benefits and expanding digital technology that facilitates flexible work locations, thereby freeing time for improving the wellbeing of caregivers and families and offering telemedicine and telecounseling, which delivers greater access to care. We also recommend bridging the digital divide through the widespread provision of reliable and affordable internet services and digital literacy training. These policy recommendations for employers, governments and health authorities aim to improve mental and physical wellbeing and working conditions, while leveraging the potential of digital technology for healthcare provision for those who identify as women, knowing that others will benefit. MIHCan took action on the recommendation to improve mental health through open conversation by facilitating campaigns in all study regions. Despite the devastation of the pandemic on global women's health, implementing these changes could yield improvements for years to come.

As the unprecedented pandemic of COVID-19 became a major barrier during the past two years, many countries were using the "COVID pass" or COVID-19 vaccination certificates in attempts to facilitate effective international travel and domestic social activities. The difficulty remained in how the "COVID pass" from different countries and regions could be mutually recognised. This study surveys the current practice of COVID-19 vaccination certificates in 12 representative countries/regions around the world and provides a comprehensive mapping of the vaccination certificates in these countries/regions. The study compares and contrasts the vaccination certificates in both format and content, including their primary purposes, international accreditation, naming conventions, recipients' personal information, and the details on vaccines and vaccination. The findings are interpreted in light of implementation practices in each country/region and discussed in relation to their various functions, as well as legal, technical, and ethical considerations. Based on the analysis and discussion recommendations are made on the practice of vaccination certificates in attempts to facilitate effective international travel and domestic social activities., (Copyright © 2022. Published by Elsevier B.V.)

Background: During the first wave of the Covid-19 epidemic, a national lockdown was established in Norway, and inhabitants were asked to contact healthcare only if absolutely necessary. We investigated hospital admissions and mortality due to non-Covid-19 disease during the lockdown compared to previous years., Methods: We compared the number of emergency admissions and in-hospital fatality for diagnoses probably unaffected (acute myocardial infarction, acute abdominal conditions, cerebrovascular diseases) and affected by the lockdown (infections, injuries) in the South-Eastern Health Region of Norway during weeks 12-22, 2020, compared to the mean of the same period in the years 2017-2019. We also compared population mortality March-May 2020, to the mean of the same period in years 2017-2019., Results: A total of 280,043 emergency admissions were observed; 20,911 admissions probably unaffected, and 30,905 admissions probably affected by the lockdown. Admissions due to diagnoses probably unaffected was reduced by 12% (95% confidence interval (CI) 9-15%), compared to 2017-2019. Admissions for diagnoses probably affected was reduced by 30% (95% CI 28-32%). There was a 34% reduction in in-hospital fatality due to acute myocardial infarction (95% CI 4-56%), 19% due to infections (95% CI 1-33%), and no change for the other diagnoses, compared to 2017-2019. The risk of in-hospital mortality to total mortality was lower for acute myocardial infarction (relative risk 0.85, 95% CI 0.73-0.99) and injuries (relative risk 0.83, 95% CI 0.70-0.98)., Conclusions: Even though fewer patients were admitted to hospital, there was no increase in in-hospital fatality or population mortality, indicating that those who were most in need still received adequate care.

The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.

Background: In the time of a pandemic, it is typical for public health bodies to collaborate with epidemiologists to design health policies both at national and international levels for controlling the spread. A point largely overlooked in literature is the extent economic capability and public finance status can influence the policy responses of countries during a pandemic situation. This article fills this gap by considering 12 public health and 7 economic measures (i.e., policies) in 200 countries during the COVID-19 first wave, with countries grouped across income categories., Methods: We apply statistical analysis, inclusive of regression models, to assess the impact of economic capability and public finance status on policy responses. Multiple open-access datasets are used in this research, and information from the hybrid sources are cumulated as samples. In our analysis, we consider variables including population characteristics (population size, density) and economic and public finance status (GDR, current account balance, government surplus/deficit) further to policy responses across public health and economic measures. Additionally, we consider infection rates across countries and the institution of the measures relative to infection rate., Results: Results suggest that countries from all income groups have favoured public health measures like school closures and travel bans, and economic measures like influencing interest rates. However, strong economy countries have more adopted technological monitoring than low-income countries. Contrarily, low-income countries have preferred traditional measures like curfew and obligatory mask-wearing. GDP per capita was a statistically significant factor influencing the institution of both public health and economic measures. Government finance statuses like current account balance and surplus/deficit were also significant factors influencing economic measures., Conclusions: Overall, the research reveals that, further to biological characteristics, policymakers and epidemiologists can consider the economic and public finance contexts when suggesting health responses to a pandemic. This, in turn, calls for more international cooperation on economic terms further to public health terms., (© 2022. The Author(s).)

Background: China is generally regarded internationally as an "authoritarian" state. Traditional definitions have assigned many negative connotations surrounding the term of authoritarian. We realize that it might not be considered value-neutral in other countries. But authoritarian in the Chinese context emphasizes more on centralized decision making, collectivism, coordinating all activities of the nation, and public support, which is considered a value-neutral term. Therefore, it is adopted in this paper. We would like to clarify this. Authoritarian governance is considered an important mechanism for developing China's economy and solving social problems. The COVID-19 crisis is no exception. Most of the current research on crisis management and government crises focuses on advanced, democratic countries. However, the consequences of crisis management by authoritarian governments have not been fully appreciated. Although prior research has addressed authoritarian initiatives to manage crises in China, authoritarian interventions have rarely been theorized in public health emergencies. Methods: Based on a literature review and theoretical analysis, we use a descriptive and qualitative approach to assess public health policies and mechanisms from an authoritarian perspective in China. In light of the key events and intervention measures of China's government in response to COVID-19, the strategic practices of the Communist Party of China (CPC) to construct, embody, or set political goals through authoritarian intervention in public health crisis management are discussed. Results: China's government responded to the COVID-19 pandemic with a comprehensive authoritarian intervention, notably by establishing a top-down leadership mechanism, implementing a resolute lockdown, rapidly establishing square cabin hospitals, enhancing cooperation between different government departments, mobilizing a wide range of volunteer resources, enforcing the use of health codes, imposing mandatory quarantine on those returning from abroad, and implementing city-wide nucleic acid testing. These measures ensured that China was able to contain the outbreak quickly and reflect on the unique role of the Chinese authoritarian system in responding to public health crises. Conclusions: Our paper contributes to expanding the existing understanding of the relationship between crisis management and authoritarian system. China's response to COVID-19 exemplifies the unique strengths of authoritarian institutions in public health crisis management, which is a helpful and practical tool to further enhance the CPC's political legitimacy. As a socialist model of crisis management with Chinese characteristics, it may offer desirable experiences and lessons for other countries still ravaged by the epidemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gao and Zhang.)

In this article, the authors argue that the response to the COVID-19 pandemic is primarily focused exclusively on the virus, and would benefit from a broadening of perspective to a more systemic approach. After presenting, in a deliberately caricatural way, the opposition between the Pasteurian and holistic paradigms, they present some limitations of the Pasteurian approach, which is still dominant in the medical community. They put forward two explanations for the perpetuation of this dominance, relating to research methods and medical training. They then apply their analysis to the COVID-19 response strategy, arguing that the "neglect" of social determinants and of the role of co-morbidities - which play an essential role in the severity of the disease - constitutes a clear failure of public health. It is thus deprived of a whole range of prevention and health promotion tools, and even of early holistic care. They conclude by suggesting that the COVID-19 crisis reveals the limits of the Pasteurian model and calls for a paradigm shift, allowing for a more complex, systemic and coherent approach to COVID-19 - and all other health problems.

The coronavirus disease 2019 (COVID-19) pandemic has triggered an unprecedented number of policy responses around the world across multiple policy domains. While governments have combined containment and health policies with social policies (CHSPs) during the initial phase of the pandemic in various ways, the current literature offers little knowledge of the patterns of these combinations and their determinants and outcomes. This paper fills this gap by investigating CHSP combinations across ≥120 countries. We further examined whether the CHSP response was determined by political regimes or compensation hypotheses-serving the purposes of responding to pre-existing economic downturns, inequality or social unrest. We also investigated the associations between CHSP responses and mobility, virus infection and unemployment. Using policy data from the Oxford COVID-19 Government Response Tracker, results from sequence analysis indicated that governments' CHSP responses could be clustered into five categories: high social policies (SPs), middle SPs, containment and health (CH) leading SPs, low SPs and gradual high SPs. We used multinomial regression models to investigate determinants of CHSP responses. We found that CHSP responses did not differ by political regimes, and CHSP combinations were not driven by compensation hypotheses. Instead, gross domestic product per capita and government effectiveness were the key drivers for high levels of policy responses. We also found that low SP responses were associated with fewer mobility changes. Taken together, our findings suggest that lower-income countries required more support and resources in order for them to adopt necessary CH and SP responses., (© The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis. Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics. Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19. Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Irarrazaval, Norambuena, Montenegro, Toro-Devia, Vargas and Caqueo-Urízar.)

Background: To design better measures to contain the Covid-19 epidemics, it is relevant to know whether socioeconomic factors are associated with a higher risk of death by Covid-19. This work estimates the effects of individual socioeconomic characteristics on the risk of death by Covid-19., Methods: Logistic models were estimated to assess the effect of socioeconomic characteristics (income, race/ethnicity, schooling, occupation and economic activity) on the risk of death from Covid-19. For this purpose, Covid-19 individual death records in Rio de Janeiro state, Brazil were combined with the Annual Register of Social Information, which contains socioeconomic information about formal workers., Findings: Workers employed in establishments in the health and public safety sectors present a risk of dying 2.46 and 2.25 times higher than those employed in other activities. Non-white people, men, and those who work in the Metropolitan Region are also more likely to die from Covid-19. People with higher education are 44% less likely to die from the disease., Conclusions: Some population groups are more vulnerable to the Covid-19 pandemic and individual socioeconomic conditions play a relevant role in the probability of death by the disease. That should be considered in the design of prevention policies to be adopted., (© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed "one mask-protection") is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Johansson.)

The rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergency involved Italy as the first European country. Meanwhile, China was the only other country to experience the emergency scenario, implementing public health recommendations and raising concerns about the mental health of the population. The Italian National Institute of Health [Istituto Superiore di Sanità (ISS)] reviewed relevant scientific literature in mental health to evaluate the best clinical practices and established the collaboration with the WHO, World Psychiatry Association, and China to support the public health system in a phase of acute emergency. This process permitted the definition of organizational and practical-operational Italian guidelines for the protection of the well-being of healthcare workers. These guidelines have been extensively disseminated within the Italian territory for maximum stakeholder utilization., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Scattoni, Starace, de Girolamo and Xia.)

Objective: To assess and share learnings on the motivators and behavioural adherence across sex and age to evolving strategies in public policy to prevent the spread of SARS-CoV-2 at the end of a first COVID-19 wave and the beginning of a second COVID-19 wave in Australia. Design and Setting: A national longitudinal survey using a framework based on evidence-based behaviour change models. The survey was administered to a national sample representative across sex, age and location was undertaken at two time points: May 1st to 5th, 2020, and July 1st to 7th, 2020. Results: Overall 2,056 surveys were completed across the first and second rounds, with 63% (1,296/2,056) completing both. Age range was 18-99 years (median 53, IQR: 34-64). Suboptimal physical distancing and self-quarantining if unwell/diagnosed was reported in one in four respondents and not getting a test at onset of symptoms reported in one in three. Those non-adherent to all three behaviours (19%, 60/323), were mainly male, younger, lived in major cities and reported fewer concerns or motivators to change behaviour. Overall, government lockdown measures were considered very important by 81% (835/1,032) and appropriate by 75% (772/1,029). Conclusions: Prior to the suppression of a second COVID-19 wave, a significant minority of Australians reported suboptimal behavioural adherence to vital policy strategies to limit SARS-CoV-2 spread, mostly young adults and men. Successful wave 2 suppression required consistent communication from political and health leaders and supportive public health and economic strategies. Additional lockdown and punitive strategies were needed in Victoria and were generally well-supported and adhered to. To limit subsequent lockdown, this work reinforces the need for a mix of communication around saving lives of the vulnerable, and other strategies targeting high risk groups, facilitation of easy testing and minimisation of financial impacts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Enticott, Slifirski, Lavoie, Bacon, Teede and Boyle.)

The world stunned by a pandemic of such cataclysmic scale is reeling under the joint burden of health impact unleashed by the diseases and the strain on the economy. Glaring shortfalls and inconsistencies in strategies to combat the pandemic have surfaced worldwide irrespective of the country's economic and health care status. The responses have vacillated from mute to drastic. Gaps in health preparedness coupled with administrative tardiness, lack of co-ordination and foresight has heightened the impact of pandemic. Coordinated holistic approach with structured policies in place is the need of the hour. Surveillance and epidemiological models to predict the unpredictable and preempt the backlash will dictate our future successes and failures in this protracted fight against the pandemic. This article attempts to review the present status of health policy on COVID in general and with specific reference to India and their outcome thus far. We also propose a simple and practical framework on which a decisive, well-knit, reliable and acceptable policy can be framed., Competing Interests: The authors declare they have no conflicts of interest., (© 2020 The Authors. Published by Atlantis Press International B.V.)

Background: The gold standard for COVID-19 diagnosis is detection of viral RNA through PCR. Due to global limitations in testing capacity, effective prioritization of individuals for testing is essential., Methods: We devised a model estimating the probability of an individual to test positive for COVID-19 based on answers to 9 simple questions that have been associated with SARS-CoV-2 infection. Our model was devised from a subsample of a national symptom survey that was answered over 2 million times in Israel in its first 2 months and a targeted survey distributed to all residents of several cities in Israel. Overall, 43,752 adults were included, from which 498 self-reported as being COVID-19 positive., Findings: Our model was validated on a held-out set of individuals from Israel where it achieved an auROC of 0.737 (CI: 0.712-0.759) and auPR of 0.144 (CI: 0.119-0.177) and demonstrated its applicability outside of Israel in an independently collected symptom survey dataset from the US, UK, and Sweden. Our analyses revealed interactions between several symptoms and age, suggesting variation in the clinical manifestation of the disease in different age groups., Conclusions: Our tool can be used online and without exposure to suspected patients, thus suggesting worldwide utility in combating COVID-19 by better directing the limited testing resources through prioritization of individuals for testing, thereby increasing the rate at which positive individuals can be identified. Moreover, individuals at high risk for a positive test result can be isolated prior to testing., Funding: E.S. is supported by the Crown Human Genome Center, Larson Charitable Foundation New Scientist Fund, Else Kroener Fresenius Foundation, White Rose International Foundation, Ben B. and Joyce E. Eisenberg Foundation, Nissenbaum Family, Marcos Pinheiro de Andrade and Vanessa Buchheim, Lady Michelle Michels, and Aliza Moussaieff and grants funded by the Minerva foundation with funding from the Federal German Ministry for Education and Research and by the European Research Council and the Israel Science Foundation. H.R. is supported by the Israeli Council for Higher Education (CHE) via the Weizmann Data Science Research Center and by a research grant from Madame Olga Klein - Astrachan., Competing Interests: The study protocol was approved by the Weizmann Institute of Science review board (IRB). Informed consent was waived by the IRB, as all identifying details of the participants were removed before the computational analysis. Participants were made fully aware of the way in which the data will be stored, handled, and shared, which was provided to them and is in accordance with the privacy and data-protection policy of the Weizmann Institute of Science (https://www.weizmann.ac.il/pages/privacy-policy)., (© 2020 Elsevier Inc.)

Purpose: The United Nations (UN) has published a Policy Brief on the impact of the Coronavirus Disease 2019 (COVID-19) that identifies policies and responses to protect older adults. Our objective was to summarize actions, health policies and clinical guidelines adopted by six European countries (Belgium, France, Italy, Poland, Spain and United Kingdom) during the pandemic, and to assess the impact of national policies on reducing adverse effects of the COVID-19 pandemic in older populations., Methods: Reports by geriatricians on the measures and actions undertaken by governmental institutions in each country between March and July 2020, as well as the role of primary care during the pandemic, covered three areas: (a) general health strategies related to the pandemic; (b) impact of COVID-19 on health inequity; and (c) initiatives and challenges for the COVID-19 pandemic and beyond., Results: In the six countries, COVID-19 mortality in nursing homes ranged from 26 to 66%. Although all countries endorsed the World Health Organization general recommendations, the reports identified the lack of harmonized European guidelines and policies for nursing homes, with competencies transferred to national (or regional) governments. All countries restricted visits in nursing homes, but no specific action plans were provided. The role of primary care was limited by the centralization of the crisis in hospital settings., Conclusions: The older population has been greatly affected by COVID-19 and by the policies initiated to control its spread. The right to health and dignity are transgenerational; chronological age should not be the sole criterion in policy decisions.

Recent estimates by World Health Organization (WHO, Geneva, Switzerland) and United Nations International Children's Emergency Fund (UNICEF) show a significant decline in vaccinal coverage rates in both pediatric and adult populations. The interruption of vaccination services is reported in at least 68 countries, with the involvement of about 80 million children worldwide. The situation is alarming if we consider that already in the period preceding the pandemic, immunization programs slowed down in various areas of the world. For these reasons, there is the risk of overloading health systems, already under pressure from the pandemic emergency, by employing human and economic resources for the management of epidemic outbreaks from vaccine-preventable diseases. The restoration and integration of vaccination services, the immunization of susceptible individuals as well as the adoption of adequate monitoring and surveillance measures are the main activities adopted by different countries to address the current global health emergency.

Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The unexpected outbreak of the COVID-19 disease had significant and enormous repercussions on the healthcare systems, such as the need to reorganise healthcare organisations in order to concentrate resources needed to the care of COVID-19 patients and to respond in general to this health emergency. Due to these challenges, the care of several chronic conditions was in many cases discontinued and patients and healthcare professionals treating these conditions had to cope with this new scenario. This was the case of the world rare diseases (RDs) that had to face this global emergency despite the vulnerability of people with RDs and the well-known need for high expertise required to treat and manage them. The numerous lessons learned so far regarding health emergencies and RDs should represent the basis for the establishment of new healthcare policies and plans aimed at ensuring the preparedness of our health systems in providing appropriate care to people living with RDs in the case of eventual new emergencies. This paper aims at providing pragmatic considerations that might be useful in designing future actions to create or optimise existing organisational models for the care of RDs in case of future emergencies or any other situation that might threaten the provision of routine care. These policies and plans should benefit from the multi-stakeholder RDs networks (such as the European Reference Networks), that should join forces at European, national, and local levels to minimise the economic, organisational, and health-related impact and the negative effects of potential emergencies on the RDs community. In order to design and develop these policies and plans, a decalogue of points to consider were developed to ensure appropriate care for people living with RDs in the case of eventual future health emergencies.

The outbreak of the coronavirus disease (COVID-19) in December 2019 and its spread to 216 countries within the first eight months has created a huge strain on health systems across the world. Health care workers (HCWs) at the fore-front of combating the pandemic are largely at risk of infection with the number of infected HCWs increasing daily in many countries. Prior to the outbreak of COVID-19, focus of laws and policies have largely been on the responsibilities of HCWs with little or no attention paid to their rights and protection. The increased rate of infection among health workers and the inadequate conditions under which HCWs have carried out their life- saving responsibilities during the pandemic has created the need to change the narrative by focusing on policy formulation and implementation to ensure that HCWs rights are protected. We endorse the widespread use of the WHO recommendations on Coronavirus Disease (COVID-19) Outbreak: Rights, Roles and Responsibilities of Health workers, including key considerations for occupational safety and health.

Abstract: The article analyzes the fight against COVID-19 in three Latin American countries: Argentina, Brazil, and Mexico. A multiple case study was carried out in a comparative perspective, based on a bibliographic review, documentary analysis, and secondary data, considering characteristics of the countries and the health system, evolution of COVID-19, national governance, containment and mitigation measures, health systems response, constraints, positive aspects and limits of responses. The three countries had distinct health systems but were marked by insufficient funding and inequalities when hit by the pandemic and recorded high-COVID-19 mortality. Structural, institutional, and political factors influenced national responses. In Argentina, national leadership and intergovernmental political agreements favored the initial adoption of centralized control measures, which were not sustained. In Brazil, there were limits in national coordination and leadership related to the President’s denialism and federative, political, and expert conflicts, despite a universal health system with intergovernmental commissions and participatory councils, which were little used during the pandemic. In Mexico, structural difficulties were associated with the Federal Government’s initial reluctance to adopt restrictive measures, limits on testing, and relative slowness in immunization. In conclusion, facing health emergencies requires strengthening public health systems associated with federative, intersectoral, and civil society coordination mechanisms and effective global solidarity mechanisms.

This review provides a comprehensive summary of evidence to explore the role and value of differential diagnosis in the management of Acute Respiratory Infections (ARIs) through point-of-care (POC) rapid testing in a post-pandemic scenario, paying particular attention to coronavirus disease 2019 (COVID-19), influenza, and respiratory syncytial virus (RSV). The document builds on a review of literature and policies and a process of validation and feedback by a group of seven experts from Latin America (LATAM). Evidence was collected to understand scientific and policy perspectives on the differential diagnosis of ARIs and POC rapid testing, with a focus on seven countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru. The evidence indicates that POC rapid testing can serve to improve ARI case management, epidemiological surveillance, research and innovation, and evidence-based decision-making. With multiple types of rapid tests available for POC, decisions regarding which tests to use require the consideration of the testing purpose, available resources, and test characteristics regarding accuracy, accessibility, affordability, and results turnaround time. Based on the understanding of the current situation, this document provides a set of recommendations for the implementation of POC rapid testing in LATAM, supporting decision-making and guiding efforts by a broad range of stakeholders. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic affected an already critical state of the Italian National Healthcare System and of the Welfare State in general. The aim of this work is to describe how the challenge imposed by pandemic has been faced, and the possible directions that social and health policies could take in the country, also in light of the adoption of the National Recovery and Resilience Plan. Through the analysis of the deep-rooted contradictions in public policies and of the areas where the intervention is more urgent, the work underlines the structural factors which are leading to a progressive shift in the vision of health, from a perspective centred on the role of the State and the protection of the public interest, to one where the role of the private sector and the idea of individual interest are ever stronger, with a consequent change in the balance between economics, legal and political systems.

Abstract Background Increased workload and of the health workforce (HW) strained the capacity to maintain essential health services (EHS) during the Coronavirus Disease 2019 (COVID-19) pandemic, while putting them at increased risk of COVID-19 and other consequences to their health. The aim of this study was to assess the impact of COVID-19 on the health, wellbeing, and working conditions of nurses in Slovakia and to identify gaps in policies to be addressed to increase preparedness of the HW for future emergencies. Methods A nation-wide cross-sectional study was conducted among nurses during November–December 2021, referring to the period of January 2021 to November 2021. To assess the differences between impact on HW on various levels of care, respondents were grouped by type of facility: hospital-COVID-19 wards; Hospital–non-covid ward; Outpatient or ER; Other care facilities. Results 1170 nurses participated, about 1/3 of them tested positive for COVID-19 by November 2021, mostly developing mild disease. Almost 2/3 reported long-covid symptoms and about 13% reported that they do not plan to get vaccinated against COVID-19. The median of the score of the impact of workload on health was 2.8 (56% of the maximum 5), the median score of mental health-wellbeing was 1.9 (63% of a maximum of 3). The studied impacts in all domains were highest in nurses working in COVID-19 hospital wards. Significant disruptions of health care were reported, with relatively high use of telemedicine to mitigate them. Overall, about 70% of the respondents thought of leaving their job, mostly due to working stress or inadequate pay. Conclusions Our study showed that the COVID-19 pandemic poses a substantial burden on the health, wellbeing and working conditions of nurses in Slovakia and that a large proportion of nurses considered leaving their jobs because of work overload or low salaries. Human resource strategies should be adopted to attract, retain and continuously invest in HW development including in emergency preparedness and response. Such an approach may improve the resilience and preparedness of the health system in Slovakia for future emergencies.

Copyright of Journal of Economics, Business, Politics, & International Relations (JEBPIR) / Ekonomi Işletme Siyaset ve Uluslararsi Ilişkiler Dergisi (JEBPIR) is the property of Ekonomi Isletme Siyaset ve Uluslararsi Iliskiler Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Economics, Business, Politics, & International Relations (JEBPIR) / Ekonomi Işletme Siyaset ve Uluslararsi Ilişkiler Dergisi (JEBPIR) is the property of Ekonomi Isletme Siyaset ve Uluslararsi Iliskiler Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Increased workload and of the health workforce (HW) strained the capacity to maintain essential health services (EHS) during the Coronavirus Disease 2019 (COVID-19) pandemic, while putting them at increased risk of COVID-19 and other consequences to their health. The aim of this study was to assess the impact of COVID-19 on the health, wellbeing, and working conditions of nurses in Slovakia and to identify gaps in policies to be addressed to increase preparedness of the HW for future emergencies. Methods: A nation-wide cross-sectional study was conducted among nurses during November–December 2021, referring to the period of January 2021 to November 2021. To assess the differences between impact on HW on various levels of care, respondents were grouped by type of facility: hospital-COVID-19 wards; Hospital–non-covid ward; Outpatient or ER; Other care facilities. Results: 1170 nurses participated, about 1/3 of them tested positive for COVID-19 by November 2021, mostly developing mild disease. Almost 2/3 reported long-covid symptoms and about 13% reported that they do not plan to get vaccinated against COVID-19. The median of the score of the impact of workload on health was 2.8 (56% of the maximum 5), the median score of mental health-wellbeing was 1.9 (63% of a maximum of 3). The studied impacts in all domains were highest in nurses working in COVID-19 hospital wards. Significant disruptions of health care were reported, with relatively high use of telemedicine to mitigate them. Overall, about 70% of the respondents thought of leaving their job, mostly due to working stress or inadequate pay. Conclusions: Our study showed that the COVID-19 pandemic poses a substantial burden on the health, wellbeing and working conditions of nurses in Slovakia and that a large proportion of nurses considered leaving their jobs because of work overload or low salaries. Human resource strategies should be adopted to attract, retain and continuously invest in HW development including in emergency preparedness and response. Such an approach may improve the resilience and preparedness of the health system in Slovakia for future emergencies. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 coronavirus (COVID-19) pandemic is a major public health issue; it is the greatest challenge facing humanity in the 21st century, and a sharp increase in the prevalence of the disease has resulted in an increase in morbidity and mortality in many countries. The global health community, in an effort to reduce the spread of the virus, has been taking precautionary measures to address the crisis and alleviate the economic impact of the pandemic on healthcare services. Global information exchange is vital for health systems to meet these challenges. Health systems, even those in developed countries, appear to have been unprepared to meet this challenge, partly because of pre-existing problems. This study identifies some important features of health systems around the world, and the policies implemented by those responsible for addressing this global health crisis caused by SARSCoV-2. In addition, it highlights the government decisions and mechanisms that were implemented to strengthen and finance health systems, and to mitigate the cost of the pandemic. The response of health systems to the requirements created by the coronavirus pandemic shows adaptation to successive changes, allowing recovery and satisfaction of their needs for the protection of public health. [ABSTRACT FROM AUTHOR]

Highlights 1. Different Covid-19 containment measures were adopted comparing five European countries 2. The earlier the restrictions were assumed, the better the response was achieved 3. Targeted measures before lockdown improved the curves compared with no restrictions

There is a well-documented scholarly discourse on how the COVID-19 outbreak adversely affects the mental health of Chinese nationals. However, there is little evidence revealing how the public health crisis negatively influenced the mental health of rural-to-urban migrants in China. The relevant literature argues that rural-to-urban migrant workers and their dependents have been experiencing discrimination, exclusion, and stigmatization in the urban labor market and social space, thereby jeopardizing their mental health to a large extent. However, whether the COVID-19 outbreak and its associated consequences further compounded rural-to-urban migrant workers' mental health has rarely been discussed. Since 2010, the Chinese government has emphasized the importance of promoting positive mental health. Without identifying how COVID-19 specifically imposed mental health challenges on rural-to-urban migrant cohorts, Chinese policymakers cannot effectively and efficiently address the dilemmas faced by such vulnerable groups. The significant rural-to-urban migrant population (i.e. 291 million), alongside their disposition to encounter social and psychological challenges, prompts the urgency to develop this narrative essay to examine whether their mental health burdens worsened during the pandemic. The author also discusses remedies for the worsened mental issues faced by migrant cohorts, and recommends policies that local Chinese governments should adopt to mitigate the mental health burdens encountered by rural-to-urban migrants.

Objective We aimed to describe, from the perspective of rheumatologists in Europe, how the coronavirus disease 2019 (COVID-19) pandemic has impacted their management of people with RA and the continuing medical education of physicians. Methods Rheumatologists participating in the Adelphi RA Disease Specific ProgrammeTM in six European countries were contacted in August and September 2020 for a telephone survey. Rheumatologists were asked seven attitudinal questions on changes to patient management, prescription behaviour and continuing education owing to COVID-19. Results were summarized with descriptive statistics. Results The telephone survey was completed by 284 rheumatologists. The most commonly reported changes to patient management were increased utilization of video/telephone consultations (66.5% of respondents), fewer visits (58.5%) and limiting physical contact (58.1%). Furthermore, 67.9% of rheumatologists who indicated that prescribing behaviour had changed switched their patients to self-administered medication, and 60.7% reported not starting patients on targeted synthetic DMARDs, biologic originator DMARDs or biosimilar DMARDs. In total, 57.6% of rheumatologists believed that changes in management would persist. Rheumatologists reported that 38.0% of patients expressed concerns about how COVID-19 would impact treatment, including access to treatment and the risk of infection. The biggest impact on rheumatologist education was a switch to online training and conferences. Conclusion All countries saw changes in patient management and prescribing behaviour, including the rapid uptake of telemedicine. It is important that the international rheumatology community learns from these experiences to prepare better for future pandemics and to address ongoing rheumatologist shortages. [ABSTRACT FROM AUTHOR]

Abstract Background In the time of a pandemic, it is typical for public health bodies to collaborate with epidemiologists to design health policies both at national and international levels for controlling the spread. A point largely overlooked in literature is the extent economic capability and public finance status can influence the policy responses of countries during a pandemic situation. This article fills this gap by considering 12 public health and 7 economic measures (i.e., policies) in 200 countries during the COVID-19 first wave, with countries grouped across income categories. Methods We apply statistical analysis, inclusive of regression models, to assess the impact of economic capability and public finance status on policy responses. Multiple open-access datasets are used in this research, and information from the hybrid sources are cumulated as samples. In our analysis, we consider variables including population characteristics (population size, density) and economic and public finance status (GDR, current account balance, government surplus/deficit) further to policy responses across public health and economic measures. Additionally, we consider infection rates across countries and the institution of the measures relative to infection rate. Results Results suggest that countries from all income groups have favoured public health measures like school closures and travel bans, and economic measures like influencing interest rates. However, strong economy countries have more adopted technological monitoring than low-income countries. Contrarily, low-income countries have preferred traditional measures like curfew and obligatory mask-wearing. GDP per capita was a statistically significant factor influencing the institution of both public health and economic measures. Government finance statuses like current account balance and surplus/deficit were also significant factors influencing economic measures. Conclusions Overall, the research reveals that, further to biological characteristics, policymakers and epidemiologists can consider the economic and public finance contexts when suggesting health responses to a pandemic. This, in turn, calls for more international cooperation on economic terms further to public health terms.

Implementing the covid-19 health protocol in Indonesia is difficult due to governance concerns. The government of Indonesia developed real-time implementation tactics for the country's health protocol. This study aims to examine the function of government management in executing the covid-19 pandemic health protocol in the Wirosari District. This study will also explore how the local administration in Wirosari District, Grobogan Regency, assists with the covid-19 pandemic. The descriptive qualitative study approach collects district government data from government officials, the task force for dealing with the covid-19 epidemic, and the Wirosari District population. The outcomes demonstrated that the government's implementation of health guidelines in the Wirosari district was a successful strategy. This study contributes to the corpus of knowledge by highlighting the importance of government management. This study demonstrates that local government support is reflected in the policies outlined in regulations, while budgetary support for activities is not explicitly reflected in the budget for implementing activities in the district. However, the district administrator must supervise and control the implementation of the covid-19 pandemic health protocol. [ABSTRACT FROM AUTHOR]

In the past, epidemics such as AIDS, measles, SARS, H1N1 influenza, and tuberculosis caused the death of millions of people around the world. In response, intensive research is evolving to design efficient drugs and vaccines. However, studies warn that new pandemics such as Coronavirus (COVID-19), variants, and even deadly pandemics can emerge in the future. The existing epidemic confinement approaches rely on a large amount of available data to determine policies. Such dependencies could cause an irreversible effect before proper strategies are developed. Furthermore, the existing approaches follow a one-size-fits-all control technique, which might not be effective. To overcome this, in this work, we develop a game-theory-inspired approach that considers societal and economic impacts and formulates epidemic control as a non-zero-sum game. Further, the proposed approach considers the demographic information that provides a tailored solution to each demography. We explore different strategies, including masking, social distancing, contact tracing, quarantining, partial-, and full-lockdowns and their combinations, and present demography-aware optimal solutions to confine a pandemic with minimal history information and optimal impact on the economy. To facilitate scalability, we propose a novel graph learning approach, which learns from the previously obtained COVID-19 game outputs and mobility rates of one state (region) depending on the other to produce an optimal solution. Our optimal solution is strategized to restrict the mobility between states based on the impact they are causing on COVID-19 spread. We aim to control the COVID-19 spread by more than 50% and model a dynamic solution that can be applied to different strains of COVID-19. Real-world demographic conditions specific to each state are created, and an optimal strategic solution is obtained to reduce the infection rate in each state by more than 50%. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this research is to reveal the mental problems experienced by healthcare professionals during the Covid 19 Pandemic. It is also intended to provide inputs for health policies and human resource management. Methods: The research was carried out with the bibliometric analysis method. Within the scope of the research, 4043 articles published in the Web of Science Core Collection database between 2020 and 2021 were examined. Results: It was found that the articles examined within the scope of the research were published in 1329 sources (journals, books, etc.), the citation rate per article was 9.97, the number of articles with a single author was 200, and the ratio of articles with a single author to all articles was 0.049. In addition, as a result of the research, the most important effects of the Covid 19 Pandemic on the mental health of healthcare workers; anxiety, depression, stress, insomnia and burnout. Conclusions: In order to reduce or eliminate the negative mental problems experienced by health workers, providing expert support in certain matters such as increasing the psychological resilience of health workers, improving working conditions, improving communication with each other and managers, coping with stress, managing anxiety, etc. is required. In addition, carrying out activities that support morale and motivation will help reduce the negative effects experienced. Improving the mental health of health workers will have a positive effect on the health system and will ensure the correct implementation of human resources policies. [ABSTRACT FROM AUTHOR]

Migratory flows have a specific influence in the European and Portuguese demographic context. Societies' commitment to ensure fundamental rights of all citizens and migrants includes the promotion of health. This study aims to describe migrants' health policies and access to the health system in Portugal within the European framework. We carried out a mixed methods approach, analyzing health policies in European Union countries and public health key indicators from statistical secondary data collected from Eurostat and Migrant Integration Policy Index. This data was complemented with a survey applied to immigrants living in Portugal. Portugal is a European country known for its favorable immigrant integration policies and has developed access to the health care system. However, our study has shown that greater investment is needed to overcome limitations or social inequalities which inhibit migrants' access. Additionally, we sought to present a comparative analysis between Portugal and European Union countries, which can contribute to improve health systems within the current crisis. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lockdown and vaccination policies have been the major concern in the last year in order to contain the SARS-CoV-2 infection during the COVID-19 pandemic. In this paper, we present a model able to evaluate alternative lockdown policies and vaccination strategies. Our approach integrates and refines the multiscale model proposed by Bellomo et al., 2020, analyzing alternative network structures and bridging two perspectives to study complexity of living systems. Inside different matrices of contacts we explore the impact of closures of distinct nodes upon the overall contagion dynamics. Social distancing is shown to be more effective when targeting the reduction of contacts among and inside the most vulnerable nodes, namely hospitals/nursing homes. Moreover, our results suggest that school closures alone would not significantly affect the infection dynamics and the number of deaths in the population. Finally, we investigate a scenario with immunization in order to understand the effectiveness of targeted vaccination policies towards the most vulnerable individuals. Our model agrees with the current proposed vaccination strategy prioritizing the most vulnerable segment of the population to reduce severe cases and deaths. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)