To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The virus responsible for the coronavirus-19 pandemic is predominantly spread by droplet and contact routes of transmission. Many airway management interventions, particularly when applying positive pressure to the airway, generate aerosol particles which pose a further risk of airborne viral transmission. The fundamental principles of airway management in the setting of a respiratory epidemic are not changed but it is essential to maximise safety for both the patient and all staff involved in caring for them. The airway manager should fully understand and apply principles of infection prevention and control, including understanding and matching personal protective equipment (PPE) to the prevailing mode of viral transmission. Airway management should be meticulously planned, safe for the patient and staff, be undertaken by skilled operators using reliable, well-practised techniques and should aim to achieve high first-attempt success rates so that securing the airway is timely and swift.
The COVID-19 pandemic has created an unprecedented global crisis, necessitating drastic changes to living conditions, social life, personal freedom and economic activity. No study has yet examined the presence of psychiatric symptoms in the UK population under similar conditions.
We investigated the prevalence of COVID-19-related anxiety, generalised anxiety, depression and trauma symptoms in the UK population during an early phase of the pandemic, and estimated associations with variables likely to influence these symptoms.
Between 23 and 28 March 2020, a quota sample of 2025 UK adults aged 18 years and older, stratified by age, gender and household income, was recruited by online survey company Qualtrics. Participants completed standardised measures of depression, generalised anxiety and trauma symptoms relating to the pandemic. Bivariate and multivariate associations were calculated for demographic and health-related variables.
Higher levels of anxiety, depression and trauma symptoms were reported compared with previous population studies, but not dramatically so. Anxiety or depression and trauma symptoms were predicted by young age, presence of children in the home, and high estimates of personal risk. Anxiety and depression were also predicted by low income, loss of income and pre-existing health conditions in self and others. Specific anxiety about COVID-19 was greater in older participants.
This study showed a modest increase in the prevalence of mental health problems in the early stages of the pandemic, and these problems were predicted by several specific COVID-related variables. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses.
The COVID-19 pandemic presents an opportunity to refocus scholarly attention on the politics of crisis. Crises that abruptly upend political and economic relations are important and increasing in frequency. However, the division of international relations into international political economy (IPE) and international security has contributed to the relative neglect of non-militarized crises like pandemics. Crises are defined by threat, uncertainty, and time pressure: understanding them requires a careful examination of how these variables affect political and economic outcomes. Drawing on often disparate literatures on finance, energy and climate change, natural disasters, pandemics, and violent conflict, I propose a broad research program around the politics of crisis, focusing on puzzles related to causes, responses, and transformations.
Healthcare systems all over the world are stretched out and being reconfigured to deal with COVID 19 pandemic. Some countries have flattened the curve, some are still fighting to survive it and others are embracing the second wave. Globally, there is an urgent need to increase the resilience, capacity and capability of healthcare systems to deal with the current crisis and improve upon the future responses. The epidemiological burden of COVID 19 has led to rapid exhaustion of local response resources and massive disruption to the delivery of care in many countries. Healthcare networking and liaison are essential component in disaster management and public health emergencies. It aims to provide logistical support between hospitals; financial support through local or regional governmental & nongovernmental agencies for response; manpower & mechanism for coordination and to implement policies, procedures and technologies in the event of such crisis.
This brief report describes how four independent private hospitals in northern India had adopted the principles of healthcare networking, pooled their resources, and scaled up one of the partner hospitals as Dedicated COVID 19 Hospital (DCH) to treat moderate to severe category of COVID 19 patients. It brings out the importance of a unique coalition between private and public healthcare system.
This study was conducted to assess the feasibility of extended use of N95 mask in our hospital during COVID-19 pandemic. We also studied the utilization pattern, user satisfaction and issues faced during extended use of the mask.
A cross sectional study in large tertiary care teaching hospital in North India among Health Care Provider from 1stApril to 31stMay 2020. A list was prepared from the Institute register and required sample of participants was taken using random sampling. The data collected from the physical forms was transferred to excel sheets.
A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer ‘cup-shaped N95 mask with respirator’. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each.
It was concluded that the extended use of N95 masks was acceptable with more than 96% of the participants using these masks.
This article examines the possible use of ‘virtual’ Eucharists in the Anglican Church of Australia in a time of a global pandemic such as exists in the world in 2020 with the spread of coronavirus or COVID-19. The changing nature of modern communication is considered in the context of the possibility of the use of a ‘virtual’ Eucharist, where a priest in one place with a set of bread and wine, consecrates the bread and wine, while at the same time a person in their own home consumes another set of bread and wine with the assumption that second set of bread and wine is also consecrated. Suggestions for and discussion of the use of a ‘virtual’ Eucharist in two dioceses of the Anglican Church of Australia are discussed with a consideration of published material by episcopal leaders. Biblical, theological and constitutional perspectives are then considered in relation to a ‘virtual’ Eucharist before the recommendation is made that ‘virtual’ Eucharists are not considered as appropriate at any time, including during a global COVID-19 pandemic, in the Anglican Church of Australia. Several alternatives to a ‘virtual’ Eucharist are considered which would allow people to obtain spiritual nourishment by other means.
When children are exposed to serious life adversities, Ed Zigler believed that developmental scientists must expediently strive to illuminate the most critical directions for beneficial interventions. In this paper, we present a new study on risk and resilience on adolescents during COVID-19, bookended – in introductory and concluding discussions – by descriptions of programmatic work anchored in lessons learned from Zigler. The new study was conducted during the first two months of the pandemic, using a mixed-methods approach with a sample of over 2,000 students across five high schools. Overall, rates of clinically significant symptoms were generally lower as compared to norms documented in 2019. Multivariate regressions showed that the most robust, unique associations with teens’ distress were with feelings of stress around parents and support received from them. Open ended responses to three questions highlighted concerns about schoolwork and college, but equally, emphasized worries about families’ well-being, and positive outreach from school adults. The findings have recurred across subsequent school assessments, and strongly resonate with contemporary perspectives on resilience in science and policy. If serious distress is to be averted among youth under high stress, interventions must attend not just to the children's mental health but that of salient caregiving adults at home and school. The article concludes with some specific recommendations for community-based initiatives to address mental health through continued uncertainties of the pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
Shortages of personal protective equipment during the COVID-19 pandemic has led to the extended use or re-use of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.
To synthesise current guidance and systematic review evidence on extended use, re-use, or reprocessing of single-use surgical masks or filtering facepiece respirators.
World Health Organization, European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. Medline, Pubmed, Epistemonikos, Cochrane Database and preprint servers for systematic reviews.
Two reviewers conducted screening and data extraction. Quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesised.
Six guidance documents were identified. Levels of detail and consistency across documents varied. Four high-quality systematic reviews were included: three focused on reprocessing (decontamination) of N95 respirators, one on reprocessing of surgical masks. Vaporised hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.
There is limited evidence on the impact of extended use and re-use of surgical masks and respirators and gaps and inconsistencies exist in current guidance. Where extended use or re-use is being practiced, healthcare organisations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
Strengthening health systems and maintaining essential service delivery during health emergencies response is critical for early detection and diagnosis, prompt treatment, and effective control of pandemics, including the novel coronavirus disease (COVID-19). Health information systems (HIS) developed during recent Ebola outbreaks in West Africa and the Democratic Republic of the Congo (DRC) provided opportunities to collect, analyze, and distribute data to inform both day-to-day and long-term policy decisions on outbreak preparedness. As COVID-19 continues to sweep across the globe, HIS and related technological advancements remain vital for effective and sustained data sharing, contact tracing, mapping and monitoring, community risk sensitization and engagement, preventive education, and timely preparedness and response activities. In reviewing literature of how HIS could have further supported mitigation of these Ebola outbreaks and the ongoing COVID-19 pandemic, three key areas were identified: governance and coordination, health systems infrastructure and resources, and community engagement. In this concept paper, we outline scalable HIS lessons from recent Ebola outbreaks and early COVID-19 responses along these three domains, synthesizing recommendations to offer clear, evidence-based approaches on how to leverage HIS to strengthen the current pandemic response and foster community health systems resilience moving forward.
The time of widespread outbreaks of infectious diseases can lead to elevated stress and mental health problems among all persons affected, and in particular those sub-groups of the population that are at an increased risk of mental health problems. One such vulnerable group constitutes university students. The aim of this study is to assess stress, depression, anxiety, and suicidality among different groups of university students (medical, psychology, and other).
Using a repeated cross-sectional study design, we collected survey data among a large sample of 7228 university students from Poland (mean age = 22.78, s.d. = 4.40; 81% female). Data were collected in five waves, during the first 2 months of the COVID-19 pandemic in Europe (March and April 2020).
The results demonstrate a significant increase in depression levels as the pandemic was progressing. We also found that female students scored significantly higher than male students on depression, anxiety, and stress. Psychology students recorded the lowest scores on depression and anxiety. Young adult students (aged 18–24 years) had more symptoms of depression, anxiety, and suicidality than adult students (⩾25 years).
These results provide insights into stress and mental health among university students during the early stages of the COVID-19 pandemic. Findings can be used for a more effective identification of students who may struggle during next stages of the pandemic and future crises.
The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented traumatic event influencing the healthcare, economic, and social welfare systems worldwide. In order to slow the infection rates, lockdown has been implemented almost everywhere. Italy, one of the countries most severely affected, entered the “lockdown” on March 8, 2020.
The COvid Mental hEalth Trial (COMET) network includes 10 Italian university sites and the National Institute of Health. The whole study has three different phases. The first phase includes an online survey conducted between March and May 2020 in the Italian population. Recruitment took place through email invitation letters, social media, mailing lists of universities, national medical associations, and associations of stakeholders (e.g., associations of users/carers). In order to evaluate the impact of lockdown on depressive, anxiety and stress symptoms, multivariate linear regression models were performed, weighted for the propensity score.
The final sample consisted of 20,720 participants. Among them, 12.4% of respondents (N = 2,555) reported severe or extremely severe levels of depressive symptoms, 17.6% (N = 3,627) of anxiety symptoms and 41.6% (N = 8,619) reported to feel at least moderately stressed by the situation at the DASS-21.
According to the multivariate regression models, the depressive, anxiety and stress symptoms significantly worsened from the week April 9–15 to the week April 30 to May 4 (p < 0.0001). Moreover, female respondents and people with pre-existing mental health problems were at higher risk of developing severe depression and anxiety symptoms (p < 0.0001).
Although physical isolation and lockdown represent essential public health measures for containing the spread of the COVID-19 pandemic, they are a serious threat for mental health and well-being of the general population. As an integral part of COVID-19 response, mental health needs should be addressed.
As a result of the coronavirus-19 disease (COVID-19) pandemic, Australia adopted emergency measures on 22 March 2020. This study reports the effect of the COVID-19 lockdown on appetite and overeating in Australian adults during the first month of emergency measures.
This study reports analysis of data from the population-based, self-completed survey. The main outcome measure was an item from the Patient Health Questionnaire 9 asking: ‘Over the past 2 weeks, how often have you been bothered by poor appetite or overeating?’. Data on sociodemographic factors, symptoms of anxiety and depression, and the impact of COVID-19 and lockdown were also collected. Multivariable logistic regression was used to examine associations with poor appetite or overeating.
An anonymous online survey available from 3 April to 2 May 2020.
A total of 13 829 Australian residents aged 18 years or over.
The weighted prevalence of being bothered by poor appetite or overeating in the past 2 weeks was 53·6 %, with 11·6 % (95 % CI 10·6, 12·6) of the cohort reporting poor appetite or overeating nearly every day. High levels of anxiety, concern about contracting COVID-19, being in lockdown with children and reporting a severe impact of the lockdown were associated with increased odds of poor appetite or overeating.
Given the widespread prevalence of being bothered by poor appetite or overeating, universal public health interventions to address emotion-focused or situational eating during periods of lockdown may be appropriate.
This study presents the main motivation to investigate the COVID-19 pandemic, a major threat to the whole world from the day when it first emerged in China city of Wuhan. Predictions on the number of cases of COVID-19 are crucial in order to prevent and control the outbreak. In this research study, an artificial neural network with rectifying linear unit-based technique is implemented to predict the number of deaths, recovered and confirmed cases of COVID-19 in Pakistan by using previous data of 137 days of COVID-19 cases from the day 25 February 2020 when the first two cases were confirmed, until 10 July 2020. The collected data were divided into training and test data which were used to test the efficiency of the proposed technique. Furthermore, future predictions have been made by the proposed technique for the next 7 days while training the model on whole available data.
The current coronavirus (SARS-CoV-2) pandemic has resulted in severe shortages of personal protective equipment, including respiratory protective equipment such as N95 respirators. This has led some government agencies to suggest the use of cloth face coverings (CFC) by healthcare providers and the general public as a last resort when standard respiratory protective equipment is unavailable. Although such coverings have been in use for over a century and have found widespread usage during some previous pandemics, research data is relatively scant for the protective value of this measure. This article, a literature review, explores the development of CFC and reviews available scientific research regarding the efficacy of this intervention as a preventive measure in the spread of airborne infectious diseases.
Analysis of the post-COVID world tends to gravitate to one of two poles. For some, the pandemic is a crisis that will reshuffle the decks, producing a fundamental reordering of global politics. For others, the basic principles of the international order are likely to remain much the same, driven largely by the emerging bipolar system between the US and China. We find both narratives dissatisfying, as the former overinterprets the causal role of the pandemic itself, while the latter underappreciates the critical ways in which global politics have been transformed beyond the state-centered system of the Cold War. We argue instead that the pandemic exposes underlying trends already at work and forces scholars to open the aperture on how we study globalization. Most centrally, we contend that globalization needs to be seen not just as a distributional game of winners and losers but rather a more profoundly transformational game that reshapes identities, redefines channels of power and authority, and generates new sites for contentious politics. We draw on emerging work to sketch out a theoretical frame for thinking about the politics of globalization, and assess some of the key policy arenas where COVID-19 is accelerating the transformative effects of globalization. In so doing, we suggest a roadmap to a post-pandemic research agenda for studying global markets that more fully captures these transformations and their implications for world politics.
The response to COVID-19 demonstrates an inclusive and dispersed form of global health security that is less reliant on the UN Security Council or the World Health Organization (WHO). While WHO remains central to fighting the pandemic, the dispersed global health security addressing the crisis is inclusive of the wider UN system, civil society, and epistemic communities in global health. As part of the special issue on “The United Nations at Seventy-Five: Looking Back to Look Forward,” this essay argues that instead of facing crisis or criticism like WHO, this inclusive and dispersed form of global health security provides mechanisms of resilience and support to the UN at the height of global political tensions surrounding COVID-19.