SARS-CoV-2, surgeons and surgical masks

The exact risk association of coronavirus disease 2019(COVID-19)for surgeons is not quantified which may be affected by their risk of exposure and individual factors.The objective of this review is to quantify the risk of COVID-19 among surgeons,and explore whether facemask can minimise the risk of COVID-19 among surgeons.A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers(HCWs)especially those work in surgical specialities including surgical nurses and intensivists.Additionally,systematic reviews that assessed the effectiveness of facemask against viral respiratory infections,including COVID-19,among HCWs were identified.Data from identified articles were abstracted,synthesised and summarised.Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask(and other personal protective equipment)were summarised.Although the risk of COVID-19 could not be quantified precisely among surgeons,about 14%of HCWs including surgeons had COVID-19,there could be variations depending on settings.Facemask was found to be somewhat protective against COVID-19,but the HCWs’compliance was highly variable ranging from zero to 100%.Echoing surgical societies’guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

Vaccinations against respiratory infections in Arabian Gulf countries: Barriers and motivators

AIM To study the uptake, barriers and motivators of influen-za, pneumococcal, meningococcal and pertussis vaccines among members of public in Arabian Gulf countries.METHODS A cross-sectional survey among the Gulf Cooperation Council(GCC) countries' residents. Data collected electronically through a smartphone app. The survey variables aimed to investigate the respondents' awareness about vaccines against influenza, pneumococcal, meningococcal and pertussis infections. Collected data concerning the respondents' socio-demographic characteristics, their perception toward vaccine uptake and the factors that motivate or demotivate them from taking influenza vaccine. The data were analysed statistically using the SPSS v.23.0. Differences in the characteristics of users from different countries were quantified through bivariate analysis. Other important variables and controlling factors were studied using logistic regression. RESULTS A total of 1812 respondents participated in the study. Their mean age was 27 years, 82% were male and 24% had ≥ 1 chronic diseases. The overall uptake of influenza vaccine was 17%(21% among "at risk" people) and ranged from 15% in Saudi Arabia to 24% in Qatar. Doctor's advice(23%) and a perception of having low body immunity(21%) were the main cited reasons for being vaccinated, whereas unawareness about the vaccine(43%) was the main barrier. The overall uptake of pneumococcal vaccine in the preceding three years was 22%(25% among "at risk" individuals) and ranged from 0% in Bahrain to 79% in Kuwait. The overall uptake of pertussis vaccine was 16%(31% among "vulnerable" people), and ranged from 7% in Saudi Arabia to 75% in Oman. The overall uptake of meningococcal vaccine was 20%(29% among the "at risk" people) and ranged from 3% in Oman to 50% in Bahrain.CONCLUSION The vaccination uptake across GCC countries is suboptimal and varies widely across the countries. Further research is needed to unearth the reasons and formulate action plan.

Mandatory meningococcal vaccine, and other recommended immunisations: Uptake, barriers, and facilitators among health care workers and trainees at Hajj

AIM To evaluate the uptake of a mandatory meningococcal, a highly recommended influenza, and an optional pneumococcal vaccine, and to explore the key factors affecting vaccination rate among health care workers(HCWs) during the Hajj.METHODS An anonymous cross-sectional online survey was distributed among HCWs and trainees who worked or volunteered at the Hajj 2015-2017 through their line managers, or by visiting their hospitals and healthcare centres in Makkah and Mina. Overseas HCWs who accompanied the pilgrims or those who work in foreign Hajj medical missions were excluded. Pearson's χ2 test was used to compare categorical variables and odds ratio(OR) was calculated by "risk estimate" statistics along with 95% confidence interval(95%CI).RESULTS A total of 138 respondents aged 20 to 59(median 25.6) years with a male to female ratio of 2.5:1 participated in the survey. Only 11.6%(16/138) participants reported receiving all three vaccines, 15.2%(21/138) did not receive any vaccine, 76.1%(105/138) received meningococcal, 68.1%(94/138) influenza and 13.8%(19/138) pneumococcal vaccine. Females were more likely to receive a vaccine than males(OR 3.6, 95%CI: 1.0-12.7, P < 0.05). Willingness to follow health authority's recommendation was the main reason for receipt of vaccine(78.8%) while believing that they were up-to-date with vaccination(39.8%) was the prime reason for non-receipt. CONCLUSION Some HCWs at Hajj miss out the compulsory and highly recommended vaccines; lack of awareness is a key barrier and authority's advice is an important motivator. Health education followed by stringent measures may be required to improve their vaccination rate.