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    Good Health Indicators are Not Enough: Lessons from COVID-19 in Peru.
    (National Institutes of Health, 2020-12-01)
    Peru received international acclaim for being one of the first countries to implement a comprehensive package of measures to control the spread of the COVID-19 pandemic. The government imposed a general lockdown, combined with social protection measures--mainly cash transfers and the distribution of food parcels. This was an attempt to mitigate the impact of the lockdown, in a country where 70% of the population works in the informal sector. Yet despite this, the transmission rate remained high, and as of early June Peru's COVID-19 mortality rates were amongst the highest worldwide. The pandemic has shed a stark light on Peru's failure to guarantee the right to health and the limits of the tools used to assess the health system's performance. Over the past two decades Peru has been praised for introducing a series of reforms aimed at achieving Universal Health Coverage (UHC), primarily through the expansion of health insurance across low-income groups. Nevertheless, reforms have failed to overcome the historical fragmentation of the system, where access to services is determined by income, gender, and geographical location.
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    Belief in a COVID-19 Conspiracy Theory as a Predictor of Mental Health and Well-Being of Health Care Workers in Ecuador: Cross-Sectional Survey Study (Preprint)
    (JMIR Publications, 2020-05-28)
    BACKGROUND During the coronavirus disease (COVID-19) pandemic, social media platforms have become active sites for the dissemination of conspiracy theories that provide alternative explanations of the cause of the pandemic, such as secret plots by powerful and malicious groups. However, the association of individuals’ beliefs in conspiracy theories about COVID-19 with mental health and well-being issues has not been investigated. This association creates an assessable channel to identify and provide assistance to people with mental health and well-being issues during the pandemic. OBJECTIVE Our aim was to provide the first evidence that belief in conspiracy theories regarding the COVID-19 pandemic is a predictor of the mental health and well-being of health care workers. METHODS We conducted a survey of 252 health care workers in Ecuador from April 10 to May 2, 2020. We analyzed the data regarding distress and anxiety caseness with logistic regression and the data regarding life and job satisfaction with linear regression. RESULTS Among the 252 sampled health care workers in Ecuador, 61 (24.2%) believed that the virus was developed intentionally in a lab; 82 (32.5%) experienced psychological distress, and 71 (28.2%) had anxiety disorder. Compared to health care workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to report psychological distress and anxiety disorder and to have lower levels of job satisfaction and life satisfaction. CONCLUSIONS This paper identifies belief in COVID-19 conspiracy theories as an important predictor of distress, anxiety, and job and life satisfaction among health care workers. This finding will enable mental health services to better target and provide help to mentally vulnerable health care workers during the ongoing COVID-19 pandemic.
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    Succumbing to the COVID-19 Pandemic – Healthcare Workers not Satisfied and Intend to Leave Their Jobs (Preprint)
    (JMIR Publications, 2020-06-27)
    BACKGROUND Healthcare workers are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. It is paramount for healthcare workers to feel satisfied with their jobs and lives during a pandemic. OBJECTIVE This study aims to examine the predictors of job satisfaction, life satisfaction, and turnover intention of healthcare workers during the COVID-19 pandemic. METHODS Between 10 to 30 April, 2020, 240 healthcare workers in Bolivia completed a cross-sectional online survey, which assessed their job satisfaction, life satisfaction, and turnover intention in the ongoing COVID-19 pandemic. RESULTS The results revealed that their number of office days predicted job satisfaction, life satisfaction, and turnover intention, but the relationships varied by their age. For example, healthcare workers’ office days negatively predicted job satisfaction for the young (e.g. at 25 years old: b=-0.21; 95% CI: -0.36 to -0.60) but positively predicted job satisfaction for the old (e.g. at 65 years old: b=0.25; 95% CI: 0.06 to 0.44). CONCLUSIONS These findings provide evidence to enable healthcare organizations to identify staff concerned about job satisfaction, life satisfaction, and turnover intention to enable early actions so that these staff can remain motivated to fight the prolonged COVID-19 pandemic.
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    Personas mayores en los medios digitales peruanos durante la pandemia por COVID-19
    (LA Referencia, 2020-09-30)
    This article analyzes the treatment that was given to the elderly by the digital media in the context of COVID 19 in Peru during the first weeks of the mandatory social isolation measure. Documentary research and exploratory methodology were used, as well as, analytic frameworks of framing theory and ageism to analyse a group of 99 journalistic notes. The findings showed that the media treatment of older adults during the COVID-19 pandemic has reproduced ageist stereotypes. They were represented as a homogeneous group which is associated to economic dependence, vulnerability, as well as, lacking of agency and decision-making power.
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    Modelling death rates due to COVID-19: A Bayesian approach
    (Cornell University, 2020-04-06)
    Objective: To estimate the number of deaths in Peru due to COVID-19. Design: With a priori information obtained from the daily number of deaths due to CODIV-19 in China and data from the Peruvian authorities, we constructed a predictive Bayesian non-linear model for the number of deaths in Peru. Exposure: COVID-19. Outcome: Number of deaths. Results: Assuming an intervention level similar to the one implemented in China, the total number of deaths in Peru is expected to be 612 (95%CI: 604.3 - 833.7) persons. Sixty four days after the first reported death, the 99% of expected deaths will be observed. The inflexion point in the number of deaths is estimated to be around day 26 (95%CI: 25.1 - 26.8) after the first reported death. Conclusion: These estimates can help authorities to monitor the epidemic and implement strategies in order to manage the COVID-19 pandemic.
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    The distress of Iranian adults during the Covid-19 pandemic – More distressed than the Chinese and with different predictors
    (Cold Spring Harbor Laboratory, 2020-04-07)
    Summary Early papers on the mental health of the public during the Covid-19 pandemic surveyed participants from China. Outside of China, Iran has emerged as one of the most affected countries with a high death count and rate. The paper presents the first empirical evidence from Iranian adults during the Covid-19 pandemic on their level of distress and its predictors. On March 25–28, 2020, a dire time for Covid-19 in Iran, we surveyed 1058 adults from all 30 provinces in Iran using the Covid-19 Peritraumatic Distress Index (CPDI). The distress level of Iranian adults (mean: 34.54; s.d.: 14.92) was significantly higher (mean difference: 10.9; t =22.7; p <0.0001; 95% CI : 10.0 to 11.8) than that of Chinese adults (mean: 23.65; s.d.: 5.45) as reported in a prior study with the same measure of Covid-19 Peritraumatic Distress Index (CPDI). We also found the predictors of distress in Iran vary from those in China. Our findings that the predictors of distress in Iran vary from those in China suggest the need to study the predictors of mental health in individual countries during the Covid-19 pandemic to effectively identify and screen for those more susceptible to mental health issues. Funding None
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    The Mental Health of Healthcare Staff during the COVID-19 Pandemic: It Depends on How Much They Work and Their Age
    (Cold Spring Harbor Laboratory, 2020-08-21)
    ABSTRACT Background Healthcare staff are the forefront of fight against COVID-19 and they are under enormous pressure due to the fast growth in the number and severity of infected cases. This creates their mental issues such as distress, depression and anxiety. Exploring healthcare staff’s mental health during the pandemic contributes to improving their persistence in the growing challenges created by COVID-19 and enabling effective management of their mental health. Methods An online survey of 280 healthcare staff in all the 31 provinces of Iran was conducted during April 5–20, 2020. The survey assessed staff’s distress, depression and anxiety in the COVID-19 pandemic. Results Nearly a third of healthcare staff suffered from distress, depression and anxiety. Females and more educated healthcare staff were more likely to experience distress. Compared to personnel who did not have COVID-19, those who were unsure whether they had COVID-19 were more likely to experience distress and depression. The number of COVID-19 cases among the staff’s colleagues or friends positively predicted their anxiety. Compared to radio technologists, doctors were less likely to experience distress and anxiety. Technicians and obstetrics experienced less anxiety. Analysis the interaction between weekly working days and age of the staff indicated the chance of experiencing distress and depression varied greatly by working days among younger but not older healthcare staff. Conclusion The predictors of mental health issues assists healthcare organizations to identify healthcare staff with mental health issues in sever crises such as the COVID-19 pandemic. Our research highlight the need to identify more working characteristics as predictors for healthcare staff at different ages. Funding This work was supported by Tsinghua University-INDITEX Sustainable Development Fund (No. TISD201904).
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    Succumbing to the COVID-19 Pandemic – Healthcare Workers not Satisfied and Intend to Leave Their Jobs
    (Cold Spring Harbor Laboratory, 2020-05-24)
    Abstract Background Healthcare workers are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. It is paramount for healthcare workers to feel satisfied with their jobs and lives during a pandemic. Methods Between 10 to 30 April, 2020, 240 healthcare workers in Bolivia completed a cross-sectional online survey, which assessed their job satisfaction, life satisfaction, and turnover intention in the ongoing COVID-19 pandemic. Results The results revealed that their number of office days predicted job satisfaction, life satisfaction, and turnover intention, but the relationships varied by their age. For example, healthcare workers’ office days negatively predicted job satisfaction for the young (e.g. at 25 years old: b=-0.21; 95% CI: −0.36 to −0.60) but positively predicted job satisfaction for the old (e.g. at 65 years old: b=0.25; 95% CI: 0.06 to 0.44). Conclusions These findings provide evidence to enable healthcare organizations to identify staff concerned about job satisfaction, life satisfaction, and turnover intention to enable early actions so that these staff can remain motivated to fight the prolonged COVID-19 pandemic.
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    The curvilinear relationship between the age of adults and their mental health in Iran after its peak of COVID-19 cases
    (Cold Spring Harbor Laboratory, 2020-06-12)
    Abstract The emerging body of research on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective psychiatry screening for mental health assistance. This study aims to identify the predictors of nonsomatic pain, depression, anxiety, and distress, especially focusing on age as a nonlinear predictor. We conducted a survey of 474 adults in Iran during April 1–10, 2020, when Iran had just passed its first peak of the COVID-19 pandemic with new confirmed cases. We found that Age had a curvilinear relationship with nonsomatic pain, depression, and anxiety. Age was associated with pain, depression, and anxiety disorders negatively among adults younger than 45 years, but positively among seniors older than 70 years. Adults who were female, unsure about their chronic diseases, and exercised less per day were more likely to have mental health issues. This study advances the use of age as an effective predictor by uncovering a curvilinear relationship between individuals’ age and mental health issues by using a sample of adults across a wide spectrum of ages. We hope future research on mental health during COVID-19 pays more attention to nonlinear predictors.
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    Belief in Conspiracy Theory about COVID-19 Predicts Mental Health and Well-being: A Study of Healthcare Staff in Ecuador
    (Cold Spring Harbor Laboratory, 2020-05-29)
    Abstract Background Social media are becoming hotbeds of conspiracy theories, which aim to give resolute explanations on the cause of COVID-19 pandemic. Yet, no research has investigated whether individuals’ belief in conspiracy theory about COVID-19 is associated with mental health and well-being issues. This association enables an assessable channel to identify and reach people with mental health and well-being issues during the pandemic. Objective We aim to provide the first evidence of belief in conspiracy theory regarding the COVID-19 virus as a predictor of the mental health and well-being of healthcare workers. Methods We conducted a survey of 252 healthcare workers in Ecuador from April 10 to May 2, 2020. We analyzed the data of distress and anxiety caseness with logistic regression and life and job satisfaction with linear regression. Results Among the sampled healthcare workers in Ecuador, 24.2% believed that the virus was developed intentionally in a lab; 32.54% experienced distress disorder, and 28.17% had anxiety disorder. Compared to healthcare workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to have distress disorder and anxiety disorder and had lower levels of job satisfaction and life satisfaction. Conclusions This paper identifies belief in a COVID-19 conspiracy theory as an important predictor of distress, anxiety, and job and life satisfaction of healthcare workers. It enables mental health services to better target and help mentally vulnerable healthcare workers during the ongoing COVID-19 pandemic.