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Student run free clinics (SRFCs) fill a void in healthcare access for many communities and have been subject to unprecedented shifts in care delivery brought about by the coronavirus disease 2019 (COVID-19) pandemic. Our single-center institution serving uninsured patients in central Missouri switched from in-person visits to strictly telehealth visits with the onset of the pandemic. This study investigated the impact of the pandemic and the switch to telehealth on the clinic return rates by ethnicity, race, gender, rurality, and age. The pandemic led to a 47.4% reduction in the number of monthly patient encounters. Of the established SRFC population (N = 309), only 87 patients (28.2%) returned for a telehealth visit during the COVID-19 pandemic. Older patients (≥ 45 years old) were more likely to return (OR 1.71, 95% CI 1.02–2.85) for care via telehealth after the onset of the pandemic than younger patients (

We sought to evaluate the religious coping styles of adolescents during the coronavirus disease 2019 (COVID-19) pandemic and its restrictions. The study was conducted online during the 2020 academic year among students in three randomly selected high schools in a city center located in Eastern Turkey. The students studying in the chosen high schools who agreed to participate were included in the study (n = 514). We found that most adolescents were anxious, had been affected in terms of health and life satisfaction, and felt sad due to isolation. Almost all subjects attached importance to their religious beliefs. The adolescents' mean Religious Coping Scale score was 2.23 ± 0.50, their mean Positive Religious Coping subscale score was 2.91 ± 0.73, and their mean Negative Religious Coping subscale score was 1.54 ± 0.52. Specifically, male adolescents of ages 15-17 whose incomes were less than their expenditures and who lived in a broken family had the highest level of negative religious coping. In light of these findings, adolescents can be supported by teaching them to develop positive religious coping styles during the COVID-19 pandemic.

The COVID-19 pandemic is an inherently stressful situation, which may lead to adverse psychosocial outcomes in various populations. Yet, individuals may not be affected equally by stressors posed by the pandemic and those with pre-existing mental disorders could be particularly vulnerable. To test this hypothesis, we assessed the psychological response to the pandemic in a case–control design. We used an age-, sex- and employment status-matched case–control sample (n = 216) of psychiatric inpatients, recruited from the LMU Psychiatry Biobank Munich study and non-clinical individuals from the general population. Participants completed validated self-report measures on stress, anxiety, depression, paranoia, rumination, loneliness, well-being, resilience, and a newly developed index of stressors associated with the COVID-19 pandemic. Multiple linear regression analyses were conducted to assess the effects of group, COVID-19-specific stressors, and their interaction on the different psychosocial outcomes. While psychiatric inpatients reported larger mental health difficulties overall, the impact of COVID-19-specific stressors was lower in patients and not associated with worse psychological functioning compared to non-clinical individuals. In contrast, depressive symptoms, rumination, loneliness, and well-being were more strongly associated with COVID-19-specific stressors in non-clinical individuals and similar to the severity of inpatients for those who experienced the greatest COVID-19-specific stressor impact Contrary to expectations, the psychological response to the pandemic may not be worse in psychiatric inpatients compared to non-clinical individuals. Yet, individuals from the general population, who were hit hardest by the pandemic, should be monitored and may be in need of mental health prevention and treatment efforts. Supplementary Information The online version contains supplementary material available at 10.1007/s00406-021-01291-7.

Background The 2019 coronavirus disease (COVID‐19) pandemic is a public health emergency that represents a challenge to psychological health. This study aimed to assess the psychological conditions among university students in Saudi Arabia during the COVID‐19 pandemic. Methods During the period between the 4th and 18th of June 2020, the students of Umm AlQura University in Saudi Arabia were invited to complete an online survey. The survey assessed their sociodemographic characteristics, educational disciplines, and manifestations of psychological health problems including depression, anxiety, and stress as determined by the Arabic version of the Depression Anxiety Stress Scale‐21 (DASS‐21). Results The study included 936 university students (56.4% women and 43.6% men). Of them, 41.1% had depressive symptoms (31.7% mild to moderate and 9.4% severe to very severe), 26.9% had anxiety symptoms (15.8% mild to moderate and 11.1% severe to very severe), and 22.4% had stress symptoms (15.2% mild to moderate and 7.2% severe to very severe). Students who reported having a friend or relative infected with or died of COVID‐19, watching or reading news about the pandemic ≥2 hours/day, and not getting emotional support from family, university, and society were more likely to show psychological problems. Conclusion Symptoms of depression, anxiety, and stress were common among Saudi university students during the COVID‐19 pandemic. Psychological counselling and support should be provided to university students in Saudi Arabia.

The emergence of SARS-CoV-2 in the end of 2019, an aetiologic agent responsible for the 1SARS plunged the world into an unprecedented sanitary crisis. Papers on COVID-19 have been fast-tracked since then.2–5 Accelerated time from submission to publication6–8 and qualitative changes in peer review,9 associated with empirical evidence that duplicate and implausible clinical trials have been carried out during the pandemic,10–12 could perhaps imply lower quality of peer review in COVID-19 research. Accumulating empirical evidence has also been indicating the pandemic era output to be less reliable than its prepandemic counterpart.2 10–14 A systematic review to evaluate the methodological quality of COVID-19 peer-reviewed clinical studies compared with historical controls found methodological quality scores to be lower in COVID-19 articles across all study designs.12 Meanwhile, data sharing practices remained largely unchanged during the first year of the pandemic.13 14 With no mandates of data sharing in place for COVID-19 studies, the reproducibility of these data on COVID-19 is yet to be independently verified as well.2 However, more efficiency in scientific publication did manifest in accelerated publication,6–8 journals tearing down their paywalls for their COVID-19 output,14 an increased usage of life and medical sciences preprint servers to increase speed and transparency,15 not to mention the intense international collaboration that resulted in the development of multiple high-efficacy vaccines within the first year of the pandemic.16 On the other hand, some pratices that reduce the reliability of clinical trials may have gained some traction during 2020, such as executing underpowered studies with small samples, multiplicity of trials testing ideas with low prior probability of being true, forgoing blinding to test interventions10 11 14 17–20 and incomplete reporting of findings, which was already an issue before the pandemic.12 21 To …

The current study aimed to investigate the impact of the COVID-19 pandemic on the mental health of people with OCD and the degree of family accommodation (FA) by live-in family members across phases of the lockdown measures imposed by the Belgian government. Forty-nine OCD patients and 26 live-in family members participated in the study. We assessed OCD symptom severity and FA of the live-in family members, as well as depressive symptoms, anxiety and stress levels and COVID-19 related psychological distress of patients and family members at four different timepoints: one month after the start of the lockdown (T1), during the gradual relaxation (T2), between the two waves (T3) and during the second wave (T4). Results showed that although COVID-19 related stress increased and decreased in accordance with the waxing and waning pattern of the pandemic, OCD symptoms showed an initial slight increase followed by a decrease at T3 and again at T4. Changes in family members’ accommodation of symptoms followed the same course as the OCD symptoms. Furthermore, OCD symptoms correlated with depressive symptoms, anxiety and stress levels and COVID-19 related distress at all timepoints. It is important to involve family members in the treatment of OCD even during a pandemic. Clinicians should also pay attention to symptoms of depression, anxiety and stress during OCD treatment. Further research is necessary to entangle the causal relationship between OCD symptoms, FA and symptoms of depression, anxiety and stress.

Background The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. Objective This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. Methods A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. Results The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=−0.71, P Conclusions It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.

The paper revises the ample empirical and theoretical literature on sustainable organizational growth and strategic leadership relating to the critical aspects of the ongoing pandemic, including poverty, social responsibility, public health, and organizational and managerial innovation. Drawing from available COVID-19, management, and sustainable leadership publications released from 2020 to 2021, this paper considers influential studies exploring core business concepts, principles, philosophies, and activities for accelerating, stimulating, and nurturing social and corporate sustainability. The study analyzed the characteristics and interrelation of 133 articles through bibliometric and literature systemization techniques. We shed light on the significant influence COVID-19 has had on financial, operational, and psychological solvency and organizational health to elucidate expectations and implications for businesses worldwide concerning the long-term financial and functional impact of COVID-19. An overview of the relevant studies on the individual, organizational, and external factors relating to novel disease’s relation to sustainability are provided. We emphasize the need for digital transformation following the COVID-19 upheaval and throughout the upcoming years. Some of the generally employed techniques in response to adversity entail portfolio diversification, service delivery innovation, product redesigning, new market development, partnering with competitors and/or complementary service providers, synergizing with other stakeholders, and open innovation.

COVID-19 has had a severe impact on human health, as well as in social and economic terms, with implications for the management and governance of the water and sanitation sector. These implications are evident in Latin America and the Caribbean due to existing challenges the region faces in accessing water and sanitation services. In spite of significant advances, around 65 million people in the LAC region currently lack appropriate access to water and soap to wash their hands—one of the most basic measures to prevent the spread of disease. Furthermore, social and economic vulnerabilities have exacerbated the effects of the pandemic in the region, particularly among those living in poverty. The COVID-19 pandemic thus requires the mobilization of frameworks such as the human rights to water and sanitation, specifically considering the region’s realities. This paper provides a review of some of the challenges currently faced in the region and advances a series of recommendations for enhancing access to water, sanitation and hygiene. The importance of effective governance, management and communication strategies in the water provisioning sector is highlighted in the context of the pandemic, and the role of science and research for adequate decision making is emphasized.

China has adopted a variety of digital technologies to effectively combat the unprecedented COVID-19 pandemic. The massive utilisation of digital technologies, however, to a great extent, magnifies the age-related digital divide. This paper aims to examine the impacts of the age-related digital divide on older adults in the context of the COVID-19 pandemic. Cases of three age-related digital divide scenarios, including older people taking public transportation, seeking medical care, as well as conducting digital transactions, are collected from Chinese official news outlets. The results indicate that the COVID-19 pandemic accelerates the pace of digital technology utilisation but exacerbates the age-related digital divide. Such an age-related digital divide has largely excluded older adults from both the real society and the virtual society. Older adults’ personal attitudes and motivations, as well as education and income, governmental policies, and family and social supports, are all major contributors to the severe impacts of the age-related digital divide on old adults during the pandemic. More measures should be adopted to bridge the age-related digital divide and build a senior-friendly e-society.

The coronavirus became a phenomenon in 2020, which is making an unwanted but wide space for the study of various scientific disciplines. The COVID-19 pandemic situation which has reached almost the whole civilized world by its consequences thus offers a unique possibility to analyze the graphic space and the human activities inside it. The aim of this study is to predict and identify the potential rate of threat on the example of COVID-19 in Slovakia through an established model. This model consisted of an assessment of the partial phenomena of exposure, vulnerability, and overall risk. The statistical data used to evaluate these phenomena concerned individual cities in Slovakia. These represent the smallest administrative unit. Indirect methods based on the point method were applied in the paper. The spreading and transfer of the disease was influenced much more by the exposure presented by traffic availability, especially, but also the concentration of inhabitants in the selected locations (shops, cemeteries, and others). In the results, our modeling confirmed the regions with the highest intensity, especially in the districts (Bratislava, Košice, Prešov, and Nitra). The selection of the data and method used in this study together with the results reached and presented may serve as an appropriate tool for the support of decision-making of other measures for the future.

Summary Considering the global number of confirmed COVID-19 cases and deaths, it is not strange that COVID-19 disease is a reminiscent of concepts such as death and affliction with a serious disease. Furthermore, it might remind people of issues such as the reason(s) for occurrence of deplorable events in the universe, the meaning of life, individuals’ duties toward themselves and others, the relationship between the nature and human beings, and individuals’ relationship with a higher being (in case there is a belief in a higher being), i.e. the subjects spirituality deals with. The constructive or destructive role of each of religious and non-religious spiritual systems at the time of crises are observed more clearly than ever. The present paper addresses roles which spiritual systems might play in facing the COVID-19 disease crisis, considering different areas of spiritual well-being and the possibility that spiritual systems might be affected by perceived challenges during a pandemic. Because of the problems interfering with overcoming COVID-19 pandemic and the risk of next waves of its epidemics and pandemics, it is necessary for health policy-makers to use all available capacities and capabilities to counteract the disease, including using both internal motivations (such as spiritual beliefs which prohibit hurting oneself and others and which emphasize performing social responsibilities) and external ones (e.g. regulations) to cope with it. It makes sense for public health officials in different countries to use more actively the potential of those spiritual systems that support COVID-19 public health recommendations, as a culturally based intervention and policy. Lay summary COVID-19 disease might remind people of issues such as the reason(s) for occurrence of deplorable events in the universe, the meaning of life, individuals’ duties toward themselves and others, the relationship between the nature and human beings, and individuals’ relationship with a higher being as an omnipotent (in case there is a belief in a higher being). These are the subjects which spirituality deals with. Some spiritual packages (or say spiritual systems), religious or non-religious, might respond appropriately to our questions about the above topics and help us to get through the disasters such as COVID-19 disease with the least complications and some might not. Given what health officials and scientists have said regarding COVID-19 pandemic, it is important to adhere to those spiritual systems which could help us: - Do our best in order to prevent endangerment of our life and that of other people. - Lead, despite all the bitter facts, a meaningful life during the pandemic. - When afflicted with the disease, cope with it well and also cope with the possibility of death. - Learn the lesson ‘every good thing you wish for yourself, wish it for others too, and every evil thing you do not like for yourself, do not like it for others either’.

Background: The pace at which the present pandemic and future public health crises involving viral infections are eradicated heavily depends on the availability and routine implementation of vaccines. This process is further affected by a willingness to vaccinate, embedded in the phenomenon of vaccine hesitancy. The World Health Organization has listed vaccine hesitancy among the greatest threats to global health, calling for research to identify the factors associated with this phenomenon. Methods: The present cross-sectional study seeks to investigate the psychological, contextual, and sociodemographic factors associated with vaccination hesitancy in a large sample of the adult population. 4,571 Norwegian adults were recruited through an online survey between January 23 to February 2, 2021. Subgroup analyzes and multiple logistic regression was utilized to identify the covariates of vaccine hesitancy. Results: Several subgroups hesitant toward vaccination were identified, including males, rural residents, and parents with children below 18 years of age. No differences were found between natives and non-natives, across education or age groups. Individuals preferring unmonitored media platforms (e.g., information from peers, social media, online forums, and blogs) more frequently reported hesitance toward vaccination than those relying on information obtainment from source-verified platforms. Perceived risk of vaccination, belief in the superiority of natural immunity, fear concerning significant others being infected by the virus, and trust in health officials’ dissemination of vaccine-related information were identified as key variables related to vaccine hesitancy. Conclusion: Given the heterogeneous range of variables associated with vaccine hesitancy, additional strategies to eradicate vaccination fears are called for aside from campaigns targeting the spread of false information. Responding to affective reactions in addition to involving other community leaders besides government and health officials present promising approaches that may aid in combating vaccination hesitation. This paper is a collaborative effort by the COPE (Complexity in treatment Outcome, Psychopathology and Epidemiology) Research Team. The authors are employed by the University of Oslo, University of Bergen, and Modum Bad Psychiatric Hospital.