UNASSIGNED: The Indian Council of Medical Research (ICMR) played a crucial role in streamlining testing and diagnosis, formulating guidelines, and devising management strategies during the COVID-19 pandemic. Additionally, ICMR designed and developed a comprehensive data management tool for collecting testing data in a standardized format from all laboratories across the country. The current report is a retrospective analysis of the testing data generated by the ICMR. The study\'s main objectives are to understand the probability of a person testing negative based on their age after an initial positive test and to assess the varied impact and duration of the disease in people of different age groups and genders.
UNASSIGNED: Anonymized data on the testing for COVID were analyzed. The P-to-P is the longest time interval between two consecutive positive tests for a patient without any negative test in between the positives. P-to-Plast is the time between the first positive and last positive test, as opposed to P-to-P, here we are looking at the first and last positive tests that might or might not be consecutive. P-to-N intervals is the time between the first positive and first negative test of a patient.
UNASSIGNED: India conducted 170,914,170 tests during the study-period (until December 29, 2020). After excluding invalid test results and duplicates, there were 11,101,603 (6.5%) positive and 156,542,352 (93.5%) negative test-results performed upon 150,086,257 unique individuals. A negative-report following a positive-test was available in 12.69%. Nearly three-fourths of the cases (78.29%) belonged to the working-age group (18-60 years). The proportion of patients >50 years old has risen from 26.06 to 35.03%, with a steep rise beyond September 2020. Gender-ratio among the positives was 1.73:1 which was neutral in neonates < 7-days (age). The gender ratio was skewed in-favor-of males in the initial months with a reverse trend thereafter and with increasing age of patients. The mean P-to-P, P-to-Plast, and P-to-N durations were 12.7 + 4.3, 13.3 + 4.6, and 14.2 + 4.9 days for individuals with P-to-P duration of 1-4 weeks. The probability of testing negative was 82 & 85% at 14 & 21 days after the first-positive-test respectively with no gender bias.
UNASSIGNED: The current study has highlighted some vital aspects of COVID-19 epidemiology in India. This study will add to the current understanding of the virus in the absence of pre- existing information on the novel virus and the disease per se.

The COVID-19 pandemic brought changes in the pattern of care use. A significant increase in the volume of emergencies was expected. However, a significant decrease was observed worldwide.
An observational, analytical and cross-sectional study of all records of emergency episodes of patients aged 18 years or older admitted to the emergency services of the University of Porto Hospital Centre (2018-2022) were analysed.
During the pandemic, a significant reduction in emergency episode admissions (up to 40% during lockdowns), an increase in pre-emergency services, and discharges from Infectious Diseases and Internal Medicine was observed. The discharges from General Practice and General Practice and Family Medicine were residual.
The lower use and type of use of emergency services during the COVID-19 pandemic had a negative impact on the disease burden. This could be prevented in future pandemics through the development of strategies to promote confidence in the use of health resources and establishing contingency plans for virtual assistance.

The uncertainties surrounding the COVID-19 pandemic led to a surge in non-urgent emergency department (ED) attendance among people presenting with upper respiratory tract infection (URTI) symptoms. These non-urgent visits, often manageable in primary care, exacerbated ED overcrowding, which could compromise the quality of ED services. Understanding patients\' expectations and the reasons for these ED visits is imperative to mitigate the problem of ED overcrowding. Hence, we assessed the factors influencing patients\' expectations for diagnostic tests during their ED visits for uncomplicated URTI during different phases of the pandemic.
We conducted a cross-sectional study on adults with URTI symptoms seeking care at four public EDs in Singapore between March 2021 and March 2022. We segmented the study period into three COVID-19 pandemic phases-containment, transition, and mitigation. The outcome variables are whether patients expected (1) a COVID-19-specific diagnostic test, (2) a non-COVID-19-specific diagnostic test, (3) both COVID-19-specific and non-COVID-19-specific diagnostic tests, or (4) no diagnostic test. We built a multinomial regression model with backward stepwise selection and classified the findings according to Andersen\'s healthcare utilization model.
The mean age of participants was 34.5 (12.7) years. Factors (adjusted odds ratio [95% confidence interval]) influencing expectations for a COVID-19-specific diagnostic test in the ED include younger age {21-40 years: (2.98 [1.04-8.55])}, no prior clinical consultation (2.10 [1.13-3.89]), adherence to employer\'s health policy (3.70 [1.79-7.67]), perceived non-severity of illness (2.50 [1.39-4.55]), being worried about contracting COVID-19 (2.29 [1.11-4.69]), and during the transition phase of the pandemic (2.29 [1.15-4.56]). Being non-employed influenced the expectation for non-COVID-19-specific diagnostic tests (3.83 [1.26-11.66]). Factors influencing expectations for both COVID-19-specific and non-COVID-19-specific tests include younger age {21-40 years: (3.61 [1.26-10.38]); 41-60 years: (4.49 [1.43-14.13])}, adherence to employer\'s health policy (2.94 [1.41-6.14]), being worried about contracting COVID-19 (2.95 [1.45- 5.99]), and during the transition (2.03 [1.02-4.06]) and mitigation (2.02 [1.03-3.97]) phases of the pandemic.
Patients\' expectations for diagnostic tests during ED visits for uncomplicated URTI were dynamic across the COVID-19 pandemic phases. Expectations for COVID-19-specific diagnostic tests for ED visits for uncomplicated URTI were higher among younger individuals and those worried about contracting COVID-19 during the COVID-19 pandemic. Future studies are required to enhance public communications on the availability of diagnostic services in primary care and public education on self-management of emerging infectious diseases such as COVID-19.

There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist\'s experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.

Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses.
A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications.
Results indicate that the most frequently reported voice symptoms were \'voice tiredness\' and \'voiceless\'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic.
More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.

People incarcerated during the COVID-19 pandemic face higher vulnerability to infection due to structural and social factors in carceral settings. Additionally, due to the higher prevalence of chronic health conditions among carceral populations, they are also at risk for more severe COVID-19 disease. This study was designed to explore the experiences of people incarcerated in prisons and jails in Maryland during the height of the pandemic.
We conducted semi-structured phone interviews between January 2021 and April 2022 with ten individuals incarcerated in Maryland carceral facilities during the height of the U.S. COVID-19 pandemic and were subsequently released from prison or jail. We transcribed the interviews, coded them, and engaged in content analysis, an inductive analytical approach to developing themes and meaning from qualitative data.
Four themes emerged from participants\' descriptions of their experiences: (1) distress from fear, vulnerability, and lack of knowledge about COVID-19 and how to protect themselves, (2) shortcomings of prison and jail administrators and other personnel through lack of transparency and arbitrary and punitive enforcement of COVID-19 protocols, (3) lack of access to programming and communication with others, and (4) absence of preparation for release and access to usual re-entry services.
Participants responded that the prison and jails\' response during the COVID-19 pandemic was ill-prepared, inconsistent, and without appropriate measures to mitigate restrictions on liberty and prepare them for release. The lack of information sharing amplified their sense of fear and vulnerability unique to their incarceration status. Study findings have several institutional implications, such as requiring carceral facilities to establish public health preparedness procedures and making plans publicly available.

Being the second most populous country in the world, India presents valuable lessons for the world about dealing with the SARS-CoV-2 pandemic. From this perspective, we attempted a retrospective evaluation of India\'s SARS-CoV-2 genomic surveillance strategy and also gave some recommendations for undertaking effective genomic surveillance. The dynamics of the COVID-19 pandemic are continuously evolving, and there is a dire need to modulate the genomic surveillance strategy accordingly. The pandemic is now settling towards a low positivity rate scenario, so it is required to revise the practices and policies formulated for a high positivity rate scenario. The perspective also recommends adopting a decentralised approach for SARS-CoV-2 genomic surveillance with a focus on optimising the workflow of SARS-CoV-2 genomic surveillance to ensure early detection of emerging variants, especially in the low positivity rate scenario. The perspective emphasises a key observation that the SARS-CoV-2 genomic surveillance is an important mitigation effort during the pandemic, the guards of such mitigation efforts should not be lowered during the low positivity rate scenario. We attempt to highlight the limitations faced by the Indian healthcare administration during the SARS-CoV-2 genomic surveillance and, simultaneously, suggest policy interventions derived from our first-hand experience, which may be implementable in a vast, populated country like India.

UNASSIGNED: The COVID-19 pandemic and infection control measures caused changes to daily life for most people. Heavy alcohol consumption and physical inactivity are two important behavioral risk factors for noncommunicable diseases worldwide. The COVID-19 pandemic, with its social distancing measures, home office policies, isolation, and quarantine requirements may have an impact on these factors. This three-wave longitudinal study aims to investigate if psychological distress and worries related to health and economy were associated with levels and changes in alcohol consumption and physical activity during the two first years of the COVID-19 pandemic in Norway.
UNASSIGNED: We used data collected in April 2020, January 2021, and January 2022 from an online longitudinal population-based survey. Alcohol consumption and physical activity status were assessed at all three measuring points via the Alcohol Use Disorder Identification Test (AUDIT-C) and the International Physical Activity Questionnaire (IPAQ-SF). COVID-19-related worries, home office/study, occupational situation, age, gender, children below 18 years living at home, and psychological distress (measured with the Symptom Checklist (SCL-10)) were included as independent variables in the model. A mixed model regression was used and presented with coefficients with 95% confidence intervals (CI).
UNASSIGNED: Analysis of data from 25,708 participants demonstrates that participants with substantial symptoms of psychological distress more often reported higher alcohol consumption (1.86 units/week, CI 1.48-2.24) and lower levels of physical activity [-1,043 Metabolic Equivalents of Task (METs) per week, CI -1,257;-828] at baseline. Working/studying from home (0.37 units/week, CI 0.24-0.50) and being male (1.57 units/week, CI 1.45-1.69) were associated with higher alcohol consumption. Working/studying from home (-536 METs/week, CI -609;-463), and being older than 70 years (-503 METs/week, CI -650;-355) were related to lower levels of physical activity. The differences in activity levels between those with the highest and lowest levels of psychological distress reduced over time (239 METs/week, CI 67;412), and similarly the differences in alcohol intake reduced over time among those having and not having children < 18 years (0.10 units/week, CI 0.01-0.19).
UNASSIGNED: These findings highlight the substantial increases in risks related to inactivity and alcohol consumption among those with high levels of psychological distress symptoms, and particularly during the COVID-19 pandemic, and increase the understanding of factors associated with worries and health behavior.

UNASSIGNED: The COVID-19 pandemic entailed cutting off the usual access to hospitals, denying patients daily visits from their relatives and friends. The standard communication between medical staff and relatives also suffered, with a perceived negative impact on overall care. We developed an electronic communication solution to re-establish a proactive daily communication with patients\' families.
UNASSIGNED: The communication software allowed families to receive daily interprofessional (medical, nursing, and physiotherapy) updates by text message, on patients\' postoperative clinical state. Appreciation and performance of this communication was evaluated through a prospective randomised study. Two groups were compared (group D, 32 patients \"Digital\" receiving daily SMS, and group S, 16 patients \"Standard\" without SMS), assessing satisfaction through dedicated surveys under COVID-19 restrictions. Moreover, private outgoing vs. incoming communication flow between patients and their relatives (phone calls and text messages, for both groups) were analysed at different timeframes of the postoperative hospital stay.
UNASSIGNED: Mean age of the population was 66 ± 7 years for both groups. The digital communication service was successfully adopted in group D in all cases, sending overall 155 communications (4.84 per patient). Calls received from relatives were 13 in group D vs. 22 in group S (0.4 vs. 1.4 calls per patient, p = 0.002). Patients\' outgoing vs. incoming traffic flow was equal in the two groups for every timeframe (first two postoperative days vs. the rest), independently from digital communication. Comparing satisfaction of communication (from 1 to 7), level of information and understandability resulted in 6.7 in group D vs. 5.6 in group S (p = 0.004). Appreciation of digital communication was highest during the first three postoperative days.
UNASSIGNED: The restrictions caused by the COVID-19 pandemic generated simple and effective ideas on digital solutions for interprofessional communication. Offering this digital service, which complements rather than replace the classic communication, eased the need of the families to be informed and significantly enhanced the overall satisfaction regarding the healthcare service.
UNASSIGNED: The COVID-19 pandemic has interrupted access to hospital patients and cut off physical contact, denying patients, their families, and medical staff the necessary constant communication about the progress of their stay. It has become necessary, therefore, to compensate for the lack of \"physical\" face-to-face interaction by introducing innovative digital communication solutions. Our interprofessional project aims to assess the overall satisfaction and acceptance of digital communication service between the hospital and the families, updating on postoperative clinical condition of patients. Specifically, the introduction of a digital communication module attached to the electronic patient record allows relatives to be informed on a daily basis. The development of this module/software enabled families to receive daily, interprofessional and proactive digital updates, on their relative ones\' postoperative stay.

UNASSIGNED: Child attention skills are critical for supporting self-regulation abilities, especially during the first years of life. On the other hand, inattention symptoms in preschoolers have been associated with poor school readiness, literacy skills and academic achievement. Previous research has linked excessive screen time with increased inattention symptoms in early childhood. However, most research has only focused on TV exposure and did not investigate this association during the COVID-19 pandemic. This atypical context has increased screen time in children worldwide, including preschoolers. We hypothesize that higher levels of child screen media and parenting stress at age 3.5 will be associated with higher child inattention symptoms at age 4.5.
UNASSIGNED: This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers\' screen media use during the pandemic (N = 315, 2020). A follow-up with this sample was completed in 2021 (N = 264).
UNASSIGNED: Analyses using multiple linear regression, revealed a positive association between child screen time at age 3.5 and inattention symptoms at 4.5 years. Parental stress was also positively associated with child inattention symptoms. Associations were observed above individual (child age, inhibitory control, and sex) and family (parent education and family income) characteristics.
UNASSIGNED: These results confirmed our hypothesis and highlight that preschooler screen use and parenting stress may undermine attentional skills. Since attention is a crucial component for children development, behavior and academic outcomes, our study reinforces the importance for parents of adopting healthy media habits.