Characterising the impact of COVID-19 environment on mental health, gender affirming services and socioeconomic loss in a global sample of transgender and non-binary people: a structural equation modelling.

BACKGROUND: We characterised the impact of COVID-19 on the socioeconomic conditions, access to gender affirmation services and mental health outcomes in a sample of global transgender (trans) and non-binary populations. METHODS: Between 16 April 2020 and 3 August 2020, we conducted a cross-sectional survey with a global sample of trans and non-binary people (n=849) through an online social networking app. We conducted structural equational modelling procedures to determine direct, indirect and overall effects between poor mental health (ie, depression and anxiety) and latent variables across socioecological levels: social (ie, reduction in gender affirming services, socioeconomic loss impact) and environmental factors (ie, COVID-19 pandemic environment). RESULTS: Anxiety (45.82%) and depression (50.88%) in this sample were prevalent and directly linked to COVID-19 pandemic environment. Adjusted for gender identity, age, migrant status, region, education and level of socioeconomic status, our final model showed significant positive associations between relationships of (1) COVID-19 pandemic environment and socioeconomic loss impact (ß=0.62, p<0.001), (2) socioeconomic loss impact and reduction in gender affirming services (ß=0.24, p<0.05) and (3) reduction in gender affirming services and poor mental health (ß=0.19, p<0.05). Moreover, socioeconomic loss impact and reduction in gender affirming services were found to be partial mediators in this model. CONCLUSION: The study results supported the importance of bolstering access to gender affirming services and strengthening socioeconomic opportunities and programmatic support to buffer the impact of COVID-19 pandemic environment on poor mental health among trans and non-binary communities globally.

Predicting SARS-CoV-2 Infection Trend Using Technical Analysis Indicators.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) pandemic is a global health emergency caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to evaluate whether technical analysis (TA) indicators, commonly used in the financial market to spot security price trend reversals, might be proficiently used also to anticipate a possible increase of SARS-Cov-2 spread. METHODS: Analysis was performed on datasets from Italy, Iran, and Brazil. TA indicators tested were: (1) the combined use of a faster (3-d) and a slower (20-d) simple moving averages (SMA), (2) the moving average converge/divergence (MACD), and (3) the divergence in the direction of the number of new daily cases trend and the corresponding MACD histogram. RESULTS: We found that the use of both fast/slow SMAs and MACD provided a reliable signal of trend inversion of SARS-Cov-2 spread. Results were consistent for all the 3 countries considered. The trend reversals signaled by the indicators were always followed by a sustained trend persistence until a new signal of reversal appeared. CONCLUSIONS: TA indicators tested here proved to be reliable tools to identify in the short mid-term a subsequent change of direction of viral spread trend either downward, upward, or sideward.

Daños colaterales de la pandemia por COVID-19: ¿consecuencias inevitables? / Collateral damage from the COVID-19 pandemic: inevitable consequences?

Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)

This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)

COVID-19 y África: sobreviviendo entre la espada y la pared / COVID-19 and Africa: Surviving between a rock and a hard place

Con más de 575.000 muertes y cerca de 13,3 millones de casos a nivel global, la pandemia por COVID-19ha causado un terrible impacto en apenas medio año de evolución desde que por primera vez fuesen detectados casos en China. Conscientes de las dificultades planteadas en entornos con sistemas de salud robustos, donde la mortalidad ha sido significativa, y la transmisión difícilmente controlable, había una lógica preocupación por ver cómo el virus podría afectar a los países africanos, donde sus frágiles sistemas de salud auguraban un impacto aún mayor. Este «tsunami» anunciado, de potenciales consecuencias devastadoras, parece, sin embargo, no haber llegado todavía, y los países africanos, donde ya se ha evidenciado una creciente transmisión, no están viendo el impacto en la salud de sus habitantes que muchos habían predicho. En este artículo repasamos la situación actual de la pandemia en el continente africano, intentando entender los determinantes de su lenta progresión

With over 575,000 deaths and about 13.3 million cases globally, the COVID-19 pandemic has had a terrible impact globally during the 6 months since cases were first detected in China. Conscious of the many challenges presented in settings with abundance of resources and with robust health systems, where mortality has been significant and transmission difficult to control, there was a logical concern to see how the virus could impact African countries, and their fragile and weak health systems. Such an anticipated "tsunami", with potentially devastating consequences, seems however to not have yet arrived, and African countries, albeit witnessing an increasing degree of autochthonous transmission, seem to this day relatively unaffected by the pandemic. In this article we review the current situation of the pandemic in the African continent, trying to understand the determinants of its slow progress

Renda básica para salvar vidas

O tema foi debatido, na quarta (3/06), em live com a presença do vereador de São Paulo, Eduardo Suplicy, e da conselheira nacional de Saúde Michele Seixas O debate sobre distribuição de renda tem se amplificado em todo o mundo com a crise imposta pela pandemia do Novo Coronavírus (Covid-19). No Brasil, um auxílio emergencial de R$ 600 reais começou a ser pago em três parcelas para garantir o mínimo para sobrevivência de alguns segmentos sociais. No entanto, essa medida tem se mostrado insuficiente. O desemprego, a redução da renda dos trabalhadores(as) e desigualdade social têm evidenciado a necessidade de uma renda permanente e universal. Sobre isso, o Conselho Nacional de Saúde (CNS) promoveu, na quarta (3/06), uma live com a participação do vereador de São Paulo, Eduardo Suplicy, e da conselheira nacional de Saúde, representante da Articulação Brasileira de Lésbicas (ABL), Michele Seixas. A atividade foi conduzida pela também conselheira nacional de Saúde, representante da União Brasileira de Mulheres (UBM) e integrante da Mesa Diretora do CNS, Vanja dos Santos. Na abertura do debate ela destacou os impactos da pandemia para a população mais vulnerável e questionou: “o que foi destinado é suficiente?” Segundo a Caixa Econômica Federal, 59 milhões de brasileiros foram considerados elegíveis para receber o suporte público. São trabalhadores(as) informais, microempreendedores(as) individuais (MEI), autônomos(as) e desempregados(as) de famílias em situação de vulnerabilidade. No entanto, há muitos relatos sobre dificuldades no cadastramento, demora no pagamento e recusa sem possibilidade de recurso. O auxílio tem validade de três meses, mas os efeitos da crise devem ser sentidos por mais tempo. “E depois de três meses, como fica? O que se faz? […] Há gente em análise até hoje, aglomerações em fila de banco”, questiona Michele Seixas. A conselheira ressalta ainda que o aumento de famílias em vulnerabilidade social está cada vez maior. “Desde 2016, o Brasil vem passando por um declínio social absurdo. É dever do governo garantir à população meios de sobrevivência”.

[Essay on Pandementia: when the characters and microbes of science fiction jump off the screen and invade the planet]. / Ensayo sobre la pandemencia: cuando los personajes y microbios de la ciencia ficción salen de la película.

This essay intends to carry out an ethical and philosophical reflection on the effects of the emergency contingencies of the COVID-19 pandemic. With a focus on Brazil, it seeks to understand, critique, and attribute meaning to references to the pandemic, in particularly dramatic moments brought about by the synergy produced between the serious disease affecting the country and the world and a government that stands out for its remarkable unwillingness and inability to deal with this calamity. This text was written during the Brazilian "quarantine," which lasted from mid-March to late April, 2020. During this period, we were bombarded by facts that never ceased to haunt us, and lived each day under the terrible dominion of the pandemic. Therefore, this text was written in the midst of a social context marked by control efforts, with great attention directed at the health of those affected, despite the complex political framework and serious economic difficulties facing the country.

Este ensayo crítico acerca de las declaraciones sobre la técnica y la vida en el planeta COVID-19 propone una reflexión ético-filosófica de los efectos de la pandemia. Trata de entender, atribuir significados y criticar las referencias a la pandemia, especialmente en Brasil, en momentos especialmente dramáticos, debido a la sinergia entre la grave enfermedad que afecta al país y al planeta, y un gobierno que se destaca por su gigantesca incapacidad para hacer frente a la calamidad. Este texto fue escrito en el periodo de "cuarentena" brasileña, desde mediados de marzo hasta fines de abril de 2020. Es un momento en el que los hechos nos golpean y no dejan de atormentarnos, y se vive a diario bajo el terrible dominio de esta pandemia. Así, este texto se caracteriza por estar elaborado en medio de un contexto social marcado por los esfuerzos de control y atención de la salud de los afectados, a pesar del complejo marco político actual y de las profundas dificultades económicas del país.

Impact of COVID-19-Related Stress and Lockdown on Mental Health Among People Living With HIV in Argentina.

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.

Dangerous Pathogens as a Potential Problem for Public Health.

Pathogens are various organisms, such as viruses, bacteria, fungi, and protozoa, which can cause severe illnesses to their hosts. Throughout history, pathogens have accompanied human populations and caused various epidemics. One of the most significant outbreaks was the Black Death, which occurred in the 14th century and caused the death of one-third of Europe's population. Pathogens have also been studied for their use as biological warfare agents by the former Soviet Union, Japan, and the USA. Among bacteria and viruses, there are high priority agents that have a significant impact on public health. Bacillus anthracis, Francisella tularensis, Yersinia pestis, Variola virus, Filoviruses (Ebola, Marburg), Arenoviruses (Lassa), and influenza viruses are included in this group of agents. Outbreaks and infections caused by them might result in social disruption and panic, which is why special operations are needed for public health preparedness. Antibiotic-resistant bacteria that significantly impede treatment and recovery of patients are also valid threats. Furthermore, recent events related to the massive spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are an example of how virus-induced diseases cannot be ignored. The impact of outbreaks, such as SARS-CoV-2, have had far-reaching consequences beyond public health. The economic losses due to lockdowns are difficult to estimate, but it would take years to restore countries to pre-outbreak status. For countries affected by the 2019 coronavirus disease (COVID-19), their health systems have been overwhelmed, resulting in an increase in the mortality rate caused by diseases or injuries. Furthermore, outbreaks, such as SARS-CoV-2, will induce serious, wide-ranging (and possibly long-lasting) psychological problems among, not only health workers, but ordinary citizens (this is due to isolation, quarantine, etc.). The aim of this paper is to present the most dangerous pathogens, as well as general characterizations, mechanisms of action, and treatments.

Living with Coronavirus (COVID-19): a brief report.

The world will never be the same after the current COVID-19 pandemic. We may have to live with the coronavirus for a long time. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in a major burden on the global health system and economy. This report describes the current COVID-19 landscape and its socioeconomic implications. Despite the concerns for second waves of infection, gradual lifting of lockdown restrictions has occurred worldwide to relieve economic pressures and likely contributes towards possibly surging of outbreak although region wise variation exists due to several other biological factors, such as testing capacity and basic healthcare facilities among susceptible population within that region. Different prediction models have been put forth to forecast the spread of the current outbreak. However, it is challenging to perceive the precise changes happening in the real world as every time dynamics differ same as other epidemics cannot possibly be exactly superimposed to COVID-19. Currently, to decrypt the conundrum for effective antiviral drug against SARS-CoV-2 is in full swing. Due to high rate of mortality and it expeditiously spread is it decisive to understand the biological properties, clinical characteristics, epidemiology, evolution, pathogenesis for vaccine development and pathogenicity studies against the viral curb. Instant diagnostic and adequate therapeutics serve as a major intervention for the management of pandemic containment. Our study aims to analyze the impact of current measures and to suggest appropriate administrative strategic planning rather than to make somewhat authentic prediction in relation to the current scenario. Our predictive analysis study should be helpful against prevention, cure and control of the current outbreak of COVID-19 till the availability of cure or vaccine.

COVID-19 pandemic and antiretrovirals (ARV) availability in Nigeria: recommendations to prevent shortages.

HIV/AIDS is an infectious disease that has claimed the lives of millions of people worldwide. Currently, there is no vaccine that has been developed in a bid to fight this deadly infection, however, antiretrovirals (ARVs), which are drugs used in the treatment of HIV infection are routinely prescribed to infected persons. They act via several mechanisms of action to reduce the severity of infection and rate of infectivity of the virus by decreasing the viral load while increasing CD4 counts. COVID-19 pandemic has resulted in unprecedented events affecting almost all areas of humans' life including availability of medicines and other consumables. This paper analyses the availability of ARVs during COVID-19 era and offered recommendations to be adopted in order to prevent shortages.

Addressing budget reduction and reallocation on health-related resources during COVID-19 pandemic in malaria-endemic countries.

The global COVID-19 pandemic has been affecting the maintenance of various disease control programmes, including malaria. In some malaria-endemic countries, funding and personnel reallocations were executed from malaria control programmes to support COVID-19 response efforts, resulting mainly in interruptions of disease control activities and reduced capabilities of health system. While it is principal to drive national budget rearrangements during the pandemic, the long-standing malaria control programmes should not be left behind in order to sustain the achievements from the previous years. With different levels of intensity, many countries have been struggling to improve the health system resilience and to mitigate the unavoidable stagnation of malaria control programmes. Current opinion emphasized the impacts of budget reprioritization on malaria-related resources during COVID-19 pandemic in malaria endemic countries in Africa and Southeast Asia, and feasible attempts that can be taken to lessen these impacts.