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IntroductionWastewater-based surveillance (WBS) is an emerging tool for monitoring the spread of infectious diseases, such as SARS-CoV-2, in community settings. Environmental factors, including water quality parameters and seasonal variations, may influence the prevalence of viral particles in wastewater. This study aims to explore the relationships between these factors and the incidence of SARS-CoV-2 across 28 monitoring sites, spanning different seasons and water strata.MethodsSamples were collected from 28 sites, accounting for seasonal and spatial (surface and intermediate water layers) variations. Key physicochemical parameters, heavy metals, and minerals were measured, and viral presence was detected using RT-qPCR. After data preprocessing, correlation analyses identified 19 relevant environmental parameters. Unsupervised learning algorithms, including K-means and K-medoid clustering, were employed to categorize the data into four distinct clusters, revealing patterns of viral positivity and environmental conditions.ResultsCluster analysis indicated that seasonal variations and water quality characteristics significantly influenced SARS-CoV-2 positivity rates. The four clusters demonstrated distinct associations between environmental factors and viral prevalence, with certain clusters correlating with higher viral loads in specific seasons. The clustering patterns varied across sample sites, reflecting the diverse environmental conditions and their influence on viral detection.DiscussionThe findings underscore the critical role of environmental factors, such as water quality and seasonality, in shaping the dynamics of SARS-CoV-2 prevalence in wastewater. These insights provide a deeper understanding of the complex interplay between environmental contexts and disease spread. By utilizing WBS and advanced data analysis techniques, this study offers a robust framework for future research aimed at enhancing public health surveillance and interventions.

Introduction: Wastewater-based surveillance (WBS) is an emerging tool for monitoring the spread of infectious diseases, such as SARS-CoV-2, in community settings. Environmental factors, including water quality parameters and seasonal variations, may influence the prevalence of viral particles in wastewater. This study aims to explore the relationships between these factors and the incidence of SARS-CoV-2 across 28 monitoring sites, spanning different seasons and water strata., Methods: Samples were collected from 28 sites, accounting for seasonal and spatial (surface and intermediate water layers) variations. Key physicochemical parameters, heavy metals, and minerals were measured, and viral presence was detected using RT-qPCR. After data preprocessing, correlation analyses identified 19 relevant environmental parameters. Unsupervised learning algorithms, including K-means and K-medoid clustering, were employed to categorize the data into four distinct clusters, revealing patterns of viral positivity and environmental conditions., Results: Cluster analysis indicated that seasonal variations and water quality characteristics significantly influenced SARS-CoV-2 positivity rates. The four clusters demonstrated distinct associations between environmental factors and viral prevalence, with certain clusters correlating with higher viral loads in specific seasons. The clustering patterns varied across sample sites, reflecting the diverse environmental conditions and their influence on viral detection., Discussion: The findings underscore the critical role of environmental factors, such as water quality and seasonality, in shaping the dynamics of SARS-CoV-2 prevalence in wastewater. These insights provide a deeper understanding of the complex interplay between environmental contexts and disease spread. By utilizing WBS and advanced data analysis techniques, this study offers a robust framework for future research aimed at enhancing public health surveillance and interventions., 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 © 2024 Gogoi, Singh, Koch, Kalyan, Boro, Devi, Mahanta and Bharali.)

Objectives: With the application of a systems thinking lens, we aimed to assess the national COVID-19 response across health systems components in Switzerland, Spain, Iran, and Pakistan.Methods: We conducted four case studies on the policy response of national health systems to the early phase of the COVID-19 pandemic. Selected countries include different health system typologies. We collected data prospectively for the period of January–July 2020 on 17 measures of the COVID-19 response recommended by the WHO that encompassed all health systems domains (governance, financing, health workforce, information, medicine and technology and service delivery). We further monitored contextual factors influencing their adoption or deployment.Results: The policies enacted coincided with a decrease in the COVID-19 transmission. However, there was inadequate communication and a perception that the measures were adverse to the economy, weakening political support for their continuation and leading to a rapid resurgence in transmission.Conclusion: Social pressure, religious beliefs, governance structure and level of administrative decentralization or global economic sanctions played a major role in how countries’ health systems could respond to the pandemic.

Objectives: To synthesize existing evidence on prevalence as well as clinical and socio-economic aspects of Long COVID.Methods: An umbrella review of reviews and a targeted evidence synthesis of their primary studies, including searches in four electronic databases, reference lists of included reviews, as well as related article lists of relevant publications.Results: Synthesis included 23 reviews and 102 primary studies. Prevalence estimates ranged from 7.5% to 41% in non-hospitalized adults, 2.3%–53% in mixed adult samples, 37.6% in hospitalized adults, and 2%–3.5% in primarily non-hospitalized children. Preliminary evidence suggests that female sex, age, comorbidities, the severity of acute disease, and obesity are associated with Long COVID. Almost 50% of primary studies reported some degree of Long COVID-related social and family-life impairment, long absence periods off work, adjusted workloads, and loss of employment.Conclusion: Long COVID will likely have a substantial public health impact. Current evidence is still heterogeneous and incomplete. To fully understand Long COVID, well-designed prospective studies with representative samples will be essential.

Objectives: To describe the prevalence and correlates of depressive symptoms, generalized anxiety disorder (GAD), and perceived negative mental health impact during the SARS-Cov-2 pandemic in Mexico City and evaluate their association with adherence to stay-at-home directives.Methods: Baseline data from a cohort study of 2,016 Mexico City government employees were analyzed using multivariable logistic regression models.Results: Among participants, 17.2% had clinically significant depressive symptoms, 21.6% had probable GAD, and 15.2% reported that the pandemic has had a major impact on their mental health. Factors including the presence of COVID-19 symptoms, self-isolation, and economic difficulties were associated with poor mental health. The presence of depressive symptoms and general anxiety were associated with non-adherence to public health directives, particularly among those who might have experienced these symptoms for the first time during the pandemic.Conclusion: Our study is one of the first to document the population mental health burden during the SARS-CoV-2 pandemic in Mexico and to provide evidence of the potential role of mental health in the adherence to public health measures.

Objectives: With the application of a systems thinking lens, we aimed to assess the national COVID-19 response across health systems components in Switzerland, Spain, Iran, and Pakistan. Methods: We conducted four case studies on the policy response of national health systems to the early phase of the COVID-19 pandemic. Selected countries include different health system typologies. We collected data prospectively for the period of January-July 2020 on 17 measures of the COVID-19 response recommended by the WHO that encompassed all health systems domains (governance, financing, health workforce, information, medicine and technology and service delivery). We further monitored contextual factors influencing their adoption or deployment. Results: The policies enacted coincided with a decrease in the COVID-19 transmission. However, there was inadequate communication and a perception that the measures were adverse to the economy, weakening political support for their continuation and leading to a rapid resurgence in transmission. Conclusion: Social pressure, religious beliefs, governance structure and level of administrative decentralization or global economic sanctions played a major role in how countries' health systems could respond to 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 © 2022 Tavakkoli, Karim, Fischer, Monzon Llamas, Raoofi, Zafar, Sant Fruchtman, de Savigny, Takian, Antillon and Cobos Muñoz.)

Objectives: To synthesize existing evidence on prevalence as well as clinical and socio-economic aspects of Long COVID. Methods: An umbrella review of reviews and a targeted evidence synthesis of their primary studies, including searches in four electronic databases, reference lists of included reviews, as well as related article lists of relevant publications. Results: Synthesis included 23 reviews and 102 primary studies. Prevalence estimates ranged from 7.5% to 41% in non-hospitalized adults, 2.3%–53% in mixed adult samples, 37.6% in hospitalized adults, and 2%–3.5% in primarily non-hospitalized children. Preliminary evidence suggests that female sex, age, comorbidities, the severity of acute disease, and obesity are associated with Long COVID. Almost 50% of primary studies reported some degree of Long COVID-related social and family-life impairment, long absence periods off work, adjusted workloads, and loss of employment. Conclusion: Long COVID will likely have a substantial public health impact. Current evidence is still heterogeneous and incomplete. To fully understand Long COVID, well-designed prospective studies with representative samples will be essential. [ABSTRACT FROM AUTHOR]

Objectives: To describe the prevalence and correlates of depressive symptoms, generalized anxiety disorder (GAD), and perceived negative mental health impact during the SARS-Cov-2 pandemic in Mexico City and evaluate their association with adherence to stay-at-home directives. Methods: Baseline data from a cohort study of 2,016 Mexico City government employees were analyzed using multivariable logistic regression models. Results: Among participants, 17.2% had clinically significant depressive symptoms, 21.6% had probable GAD, and 15.2% reported that the pandemic has had a major impact on their mental health. Factors including the presence of COVID-19 symptoms, self-isolation, and economic difficulties were associated with poor mental health. The presence of depressive symptoms and general anxiety were associated with non-adherence to public health directives, particularly among those who might have experienced these symptoms for the first time during the pandemic. Conclusion: Our study is one of the first to document the population mental health burden during the SARS-CoV-2 pandemic in Mexico and to provide evidence of the potential role of mental health in the adherence to public health measures., 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 Flores-Torres, Murchland, Espinosa-Tamez, Jaen, Brochier, Bautista-Arredondo, Lamadrid-Figueroa, Lajous and Koenen.)