https://doi.org/10.11606/s1518-8787.2020054002481 (J.E. Rod, Oscar OviedoTrespalacios, Javier Cortes-Ramirez. Queensland University of Technology (QUT). School
of Public Health and Social Work. Brisbane, Queensland, Australia
“The World Health Organization has emphasized that one of the most important
questions to address regarding the covid-19 pandemic is to understand risk factors for
disease severity. We conducted a brief review that synthesizes the available evidence and
provides a judgment on the consistency of the association between risk factors and a
composite end-point of severe-fatal covid-19.”
(Organization WH. Coronavirus disease 2019 (COVID-19): situation report.
https://www.who.int/ publications/m/item/weekly-update-on-covid-19-16- october-2020.)
2020
Viral, environmental and host factors play roles in virus infection and disease. The
virus has high transmissibility and is rapidly transmitted to people through close contact
and droplets from coughing, sneezing and talking loudly, as well as through contact with
contaminated objects. As crowding is an environmental risk factor for contamination, its
transmission is high among patients and staff in hospital and also in elderly-care centers.
It is more common in the elderly, in men, and subjects with diabetes mellitus, hypertension,
cardiovascular disease, and malignancy.
COVID-19, Risk, Fear, and Fall-out
Lenore Manderson
&
Susan Levine 2019
“Culture” was always included in popular discourse and media accounts of Ebola.
This is not so for coronavirus disease 2019, named COVID-19 to disassociate the disease
from Wuhan, China, where viral infection was first identified. COVID-19 appears to be
outside of culture. Yet the institution of quarantine practices, lockdowns, and border
controls, and the insistence on adherence to hygiene practices (handwashing) highlight how
human practices and behaviors are implicated, and foreshadow a global humanitarian crisis
as community transmission takes hold in global south communities. Here, manifold risks
are tied to the poverty of infrastructures and resources (Satterthwaite et al. 2019). Consider
the potential rapid spread of the virus with co-sleeping in cramped living quarters, poor
ventilation, poor or absent hygiene and sanitation, water shortages and broken taps, and
the lack of capacity for householders but also institutions (including local health centers) to
provide soap and hand sanitizers. Consider the impact on community health workers, and
the challenges that they face, in trying to manage pneumonia in older villagers when
transport and district level services are miles away. Or consider the wildfire spread if (when)
COVID-19 takes hold in informal settlements and slums in South Africa, Kenya, and Nigeria,
cities like Rio de Janeiro and Mexico City, and cramped refugee camps in east Africa, Turkey,
Jordan, Bangladesh, and Pakistan. In such settings, COVID-19 will capitalize on structural
violence (Farmer 2006) and vulnerability (Quesada et al. 2011), in which context people are
at high risk of infection, vilification, and social exclusion.
(Seraphim kotoulas) 2021Department of Respiratory Medicine, G Papanikolaou Hospital,
Aristotle University of Thessaloniki, 55236 Thessaloniki, Greece
The greatest challenge vaccines face is that of acceptance from the general
population. Healthcare professionals’ (HCPs) recommendations have significant influence
on general public vaccination behavior. The aim of this study was to assess the willingness
of HCPs to get vaccinated against COVID-19, two weeks before initiation of vaccinations.
COVID-19: Facts, Cultural Considerations, and Risk of Stigmatization
Debra Pettit Bruns, PhD, MSN, MSPH, Nina Vanessa Kraguljac, MD, Thomas R. Bruns, MSHF
The University of Alabama, Tuscaloosa, AL, USA April 21, 2020
Data on COVID-19 supports targeted social distancing could be an effective way
to reduce morbidity and mortality, but could inadvertently increase stigma for affected
populations. As health care providers we must be aware of the facts of COVID-19,
cultural implications, and potential for stigmatization of populations affected by COVID2019. It is important to consider the real economic impact related to lost
workdays due to quarantine and social isolation efforts as well as travel restrictions that
may negatively impact access to care and ability to pay for care. Efforts geared towards
general education about the disease and the rationale for quarantine and public health
information provided to the general public can reduce stigmatization.
Countries who are successful at aggressive screening, early identification, patient
isolation, contact tracing, quarantine, and infection control methods should also
address the risk of stigmatization among populations and the negative effects which
could occur. The cases of COVID-19 will continue to rise and the virus will be
sustainable for future infections. Timely and appropriate public health interventions
addressing cultural impact and risk for stigmatization along with proper screening,
treatment, and follow up for affected individuals and close contacts can reduce the
number of infections, serious illness, and deaths.
/Understanding COVID-19 vaccine efficacy
MARC LIPSITCH AND NATALIE E. DEAN
SCIENCE • 21 Oct 2020
The elderly and people with comorbidities are at greatest risk of severe coronavirus
disease 2019 (COVID-19). A safe and effective vaccine could help to protect these groups in
two distinct ways: direct protection, where high-risk groups are vaccinated to prevent
disease, and indirect protection, where those in contact with high-risk individuals are
vaccinated to reduce transmission. Influenza vaccine campaigns initially targeted the
elderly, in an effort at direct protection, but more recently have focused on the general
population, in part to enhance indirect protection. Because influenza vaccines induce
weaker, shorter-lived immune responses in the elderly than in young adults, increasing
indirect protection may be a more effective strategy. It is unknown whether the same is true
for COVID-19 vaccines.
For COVID-19, age-structured mathematical models with realistic contact patterns
are being used to explore different vaccination plans (1, 2), with the recognition that vaccine
doses may be limited at first and so should be deployed strategically.
Key limitation of observational studies is confounding. There may be many
differences between individuals who do and do not get vaccinated, which may create noncausal correlations between vaccine status and outcomes. Although such biases can
threaten any observational study of vaccine effectiveness, there are some approaches to
detect such biases and reduce their magnitude (7, 8).
The clearest evidence of indirect protection is from a vaccine that prevents infection
entirely, thereby reducing transmission. These data will be generated in efficacy trials that
include infection as a secondary endpoint. This endpoint is measured by a specialized assay
to distinguish an infection-induced response from a vaccine-induced antibody response. A
vaccine can provide indirect protection even if it does not fully prevent infection (see the
figure). Vaccines that reduce disease severity can also reduce infectiousness by reducing
viral shedding and/or symptoms that increase viral spread (e.g., coughing and sneezing). A
worst-case scenario is a vaccine that reduces disease while permitting viral shedding; this
could fail to reduce transmission or conceivably even increase transmission if it suppressed
symptoms.
Associated Press-University of Chicago National Opinion Research Center. (2020). Expectations for a COVID19 Vaccine. https://apnorc.org/projects/expectations-for-a-covid-19-vaccine/ [Google Scholar];
Long-term control of the COVID-19 pandemic hinges in part on the development and uptake of a
preventive vaccine. Among various efforts to address vaccine hesitancy and foster vaccine confidence,
evidence-based communication strategies are critical. There are opportunities to consider the role of emotion
in communication efforts. In this commentary, we highlight several ways negative as well as positive emotions
may be considered and leveraged. Examples include attending to negative emotions such as fear and anxiety,
raising awareness of emotional manipulations by anti-vaccine disinformation efforts, and activating positive
emotions such as altruism and hope as part of vaccine education endeavors.
Although COVID-19 preventive behaviors such as mask wearing and social distancing have been shown
to be effective in curbing the spread of the virus (World Health Organization, 2020), long-term control of the
COVID-19 pandemic will hinge on the development and uptake of a preventive vaccine
This trend is concerning from a public health standpoint given that herd immunity is paramount to
slowing the pandemic’s spread. However, hesitancy to vaccinate against COVID-19 is also understandable given
the novelty of the disease, the unusually rapid speed of vaccine development, some groups’ mistrust in science
and health experts (Funk et al., 2020; Kaiser Family Foundation, 2020 (KFF); Tyson et al., 2020), and the
documented concerns by some over the politicization of the vaccine as well as its safety and efficacy standards
(Kaiser Family Foundation, 2020; The City University of New York School of Public Health, 2020; Tyson et
al., 2020). In order to effectively address vaccine hesitancy and foster vaccine confidence, evidence-based
health communication strategies are necessary. One important aspect of communication is the consideration
of the role of emotion (e.g., fear, anger, and happiness) (see a definition and a comprehensive discussion in
Ferrer & Ellis, 2019) in anticipation of COVID-19 vaccine rollout. Attention to emotion can complement other
major aspects of vaccine dissemination and education, such as building trust and credibility of health agencies
and scientific experts, conveying the safety as well as stringent standards enforced in vaccine development
process, and facilitating equitable dissemination of vaccine information across the US.
Emotions, health behavior, and COVID-19
Emotional engagement has played a central role in the research and practice of health behavior
change (Perugini & Bagozzi, 2001), and emotional appeals have been effectively used in health message design
for behavior change (Dillard & Nabi, 2006; Lang & Yegiyan, 2008) The relationship between emotions and
health behaviors, however, is complex. For example, a message intending to activate one type of emotion may
instead activate other emotions (e.g., guilt messages evoking shame) that increase health risk behaviors or
decrease willingness to perform preventive behaviors (Duhachek et al., 2012; Eppright et al., 2002). These
complexities may be accentuated during the pandemic, as the emotionally charged nature of COVID-19,
coupled with anti-vaccination rhetoric may cause confusion, nervousness, apathy, and other emotions
affecting vaccine decisions. Furthermore, given the novelty and science’s evolving understanding of the virus,
expedited vaccine development process, and the broader political discord, concerns over the safety and
efficacy of future vaccines against COVID-19 have been exacerbated, including worries about compromised
safety standards for vaccine approvals (Associated Press-University of Chicago National Opinion Research
Center, 2020; Kaiser Family Foundation, 2020; U.S. Department of Health and Human Services, 2020). This
complex context helps to explain key drivers of vaccine hesitancy. Fears over vaccine safety, side effects, and
the rapid development of the vaccine have been cited as barriers to vaccination (Associated Press-University
of Chicago National Opinion Research Center, 2020; Fisher et al., 2020). Given that emotions are found to
influence vaccine risk perceptions and intentions more strongly than statistical information (Betsch et
al., 2011), future COVID-19 vaccine education efforts must move beyond presenting factual information to
address emotions surrounding COVID-19. Below we highlight possible approaches to leverage emotions in
COVID-19 vaccine communication efforts.
The widespread anxiety, loss, and psychological fatigue caused by the pandemic have impacted health
behaviors and vaccination intentions (Jungmann & Witthöft, 2020; Lwin et al., 2020; Morgul et al., 2020; Qiu
et al., 2020). Assuming the upcoming availability of a COVID-19 vaccine that passes stringent safety standards
and demonstrates efficacy, vaccine education efforts must still acknowledge and manage pervasive negative
emotions, while also considering the different emotional predispositions of the specific intended audiences.
Sofia Tomacruz
Health officials urged the public to continue masking, practicing physical distancing,
and overseeing good ventilation, especially as the campaign season for the May 2022 polls
is now in full swing.
The DOH likewise appealed to those not yet vaccinated to get their COVID-19 shots.
Officials on the government’s pandemic task force are eyeing to downgrade quarantine
classifications to Alert Level 1 – where no restrictions on capacity will be observed –
sometime in March, though this would only be done under the condition that “high”
vaccination rates were met. – Rappler.com
DOH (2022)” -Health Undersecretary Maria Rosario Vergeire said around 3.5
million were vaccinated during the third wave of the government’s “Bayanihan
Bakunahan” from February 10 to 11, falling short of their goal to vaccinate 5 million
individuals.
During a Laging Handa public briefing on Saturday, February 19, Vergeire
mentioned challenges including the capacity of healthcare workers to attend to both the
Bayanihan Bakunahan and the children’s vaccination.
“75% of Pinoys say vaccine a must for COVID” jocelyn montemayor (2021) Malaya business insight
SEVENTY-FIVE percent of Filipinos believe that everyone should be vaccinated against the
coronavirus disease (COVID-19), but only 43 percent are actually willing to be inoculated, the June 7
to 16 Ulat sa Bayan survey of Pulse Asia showed.
The survey, which involved 2,400 adult respondents with a ± 2 percent margin of error, also
showed that 96 percent of Filipinos are concerned that they or a member of their family might contract
COVID-19, up from 94 percent in February this year, while two percent cannot say if they are worried
or not.
Pulse said 75 percent of the respondents believe that members of their community should get
vaccinated against the deadly virus while eight percent said there is no need to be vaccinated. Sixteen
percent were ambivalent whether the community should be vaccinated or not.
Presidential spokesman Harry Roque welcomed the results of the survey, saying: “We are happy
because vaccine is the solution to this pandemic and this is the way for us to return to our normal
lives.”
Majority of the social-economic class ABC (50 percent) are also willing to get vaccinated,
followed by those from class D (42 percent) and class E (38 percent).
The main reason for those who willing to be vaccinated now is that their relatives, friends or
acquaintances have been vaccinated and are safe (35 percent), followed by those who had been
assured by their doctors or healthcare providers that the vaccines are safe (33 percent), and those
who learned the efficacy of vaccines from government official or medical experts (13 percent).
Other reasons for those willing to be vaccinated is that they saw government officials get
vaccinated (8 percent), vaccination is a requirement for employment (7 percent), and they have been
assured the vaccines are safe.
Pulse said the reasons for those who refused to be vaccinated include: they are not sure about
the safety of the vaccine (69 percent); vaccines may not be effective (12 percent); vaccines are not
needed to combat COVID -19 (11 percent); it might not be free (2 percent), and it might be expensive
(0.4 percent).