Background: COVID-19 disease has a wide range of persisting and new onset clinical manifestations even long after the acute phase. This study was conducted to identify the persisting and new onset symptomatology of post-COVID-19 syndrome patients from clinics in urban and peri-urban Kozhikode, South India, as well as to grade their functional limitation; assess the determinants and predictors. Material and Methods: A cross-sectional study was conducted among 938 subjects attending the post-COVID clinics. Symptom profile, functional assessment, and limitation grading were done using the Post-COVID-19 Functional Status (PCFS) scale. Statistical analyses were done using the SPSS ver.20. Results: Mean age was 41.50 ± 16.90 years. Fever, anosmia, dysgeusia, headache, and myalgia were the common acute COVID-19 symptoms (505,54%; 433,46.3%; 420,44.9%; 323,34.4%; 252,26.9%, respectively). Post-COVID-19, common persisting symptoms were myalgia (167,17.8%), fatigue (149,15.9%), dyspnea (113,12%), and headache (85,9.1%); the common new onset symptoms were shortness of breath and fatigue (228,24.3% and 220,23.4%, respectively). A total of 91 cases (9.7%) had post-COVID sleep disturbances; 16 (1.7%) had symptoms of anxiety and depressive thoughts. PCFS grading showed that 552 (63.8%) had negligible limitations (Grade I). Only one person had Grade IV limitation. Significant association (p < 0.05) was found between functional impairment grading by PCFS and age, gender, locality, type of family, duration of hospitalization, duration of unemployment following illness, source of infection, diabetes mellitus, and hypertension. Male gender, married status, CAD, and smoking had significant higher risks; urban locality and hospitalization decreased the risk. Conclusions: SARS-CoV-2 cases have persistent and new onset symptoms and some degree of functional impairment post-COVID. Significant association was identified for various sociodemographic and clinical variables with the PCFS functional impairment grading.
A BSTRACT Introduction: The coronavirus disease 2019 (COVID-19) pandemic has seen multiple surges globally since its emergence in 2019. The second wave of the pandemic was generally more aggressive than the first, with more cases and deaths. This study compares the epidemiological features of the first and second COVID-19 waves in Kozhikode district of Kerala and identifies the factors associated with this change. Methods: A comparative cross-sectional study was conducted in Kozhikode district. A total of 132,089 cases from each wave were selected for the study using a consecutive sampling method. Data were collected from the District COVID-19 line list using a semistructured proforma and analyzed using Statistical Package for Social Sciences (SPSS) ver. 18. Results: The second wave had a higher proportion of symptomatic cases (17.3%; 20.1%), cases with severe symptoms (0.3%; 0.6%), intensive care unit (ICU) admissions (11.2%; 17.9%), and case fatality rate (0.69%; 0.72%). Significant difference was noted in the age, gender, locality, source of infection, comorbidity profile, symptom, and the pattern of admission in various healthcare settings between the first and second wave. Among the deceased, gender, duration between onset of symptoms and death, comorbidity status, and cause of death were significantly different in both waves. Conclusion: The presence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant, as well as changes in human behavior and threat perception as the pandemic progressed, resulted in significant differences in various epidemiological features of the pandemic in both waves, indicating the need for continued vigilance during each COVID-19 wave.
Introduction: The Fort McMurray Alberta wildfire was one of Canada's largest natural disasters in history, burning 589,995 hectares of land until being controlled on July 5, 2016. In responding to the fire, Alberta Health Services (AHS) prompted a province-wide coordinated response. Through a combination of pre-emptive strategies and responsive activities, the AHS response has been considered a success. Underlying the successful response is the collective experiences and contextual knowledge of AHS staff members acquired from past events. While the frequency and severity of risks associated with extreme weather and climate change are increasing worldwide, there is a persistent knowledge gap in the evidence-base informing public health emergency preparedness. It is imperative that lessons learned from past events inform future preparedness activities. Learning lessons is a systematic implementation process that can be used to inform future responses and best practices that are transferable to similar situations. Aim: To describe strategies employed and challenges encountered during recovery after the Alberta wildfires. Methods: A single-case study approach was employed to understand the AHS method to "learning lessons," and the process involved in translating lessons into actionable goals. Semistructured interviews with senior leaders (n=11) were conducted and internal documents were obtained. Results: The analysis revealed a strategic learning process, including debriefs, staff surveys, interviews, and member validity checking. The implementation process used to translate the lessons identified included a project management framework, evaluation techniques, and the utilization of tacit and explicit knowledge. Key challenges for implementation involve clarification of processes, leadership commitment, resource and time constraints, staff turn-over, and measuring outcomes. Discussion: Translating the lessons from the Alberta wildfires is crucial for enhancing preparedness, and exploratory research in this area can contribute to building a program of research in evaluation during disaster recovery.
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