Healthcare providers’perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic:An international pilot survey

BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using theχ2 test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

The COVID-19 Pandemic: Present or Gone, Where Do Adolescents Stand?

Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.

Delay Times and Clinical Outcomes in Acute Myocardial Infarction: Comparison of Periods before and during the COVID-19 Pandemic—Myocardial Infarction and the Pandemic

Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020;and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II;p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.

Prothrombotic state and thrombotic events in COVID-19 pandemic period,including portal vein and splenic artery thromboses

This editorial article is intended to perform a discussion on the manuscript entitled“Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient:A case report and review of literature”written by Abramowitz et al.The article focuses on the diagnostic processes in a 77-year-old-male patient with a simultaneous portal vein and splenic artery thrombosis accompanying coronavirus disease 2019(COVID-19).The authors postulated that splanchnic thrombosis should be on the list of differential diagnoses in a patient presenting with abdominal pain in presence of a COVID-19 infection.The tendency for venous and arterial thrombosis in COVID-19 patients is encountered,largely attributed to hypercoagulopathy.In general,venous thromboembolism mostly manifest as deep vein thrombosis(DVT),pulmonary embolism(PE)or catheterrelated thromboembolic events.Acute PE,DVT,cerebrovascular events and myocardial infarction are seen as the most common thromboembolic complications in COVID-19 patients.COVID-19-associated hemostatic abnormalities include mild thrombocytopenia and increased D-dimer level.Similar to other coagulopathies,the treatment of the underlying condition is the mainstay.Addition of antiplatelet agents can be considered in critically ill patients at low bleeding risk,not on therapeutic anticoagulation,and receiving gastric acid suppression Early administration of antithrombotic drugs will have a beneficial effect in both the prevention and treatment of thrombotic events,especially in non-ambulatory patients.Low molecular weight heparin(LMWH)should be started if there is no contraindication,including in non-critical patients who are at risk of hospitalization LMWH(enoxaparin)is preferred to standard heparin.

The Impact of COVID-19 Pandemic on Mother-Infant Bond: A Systematic Review

Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.

Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.the COVID era and pre-COVID era.METHODS We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital.Data was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines.Chi-square was applied to test the statistical association between qualitative variables.Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.RESULTS A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID era.The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

Impact of COVID-19 pandemic on routine childhood vaccinations

Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.

Occupational health risks among healthcare workers during the COVID-19 pandemic in Saudi Arabia: preparing for the future pandemics

Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.

The dynamics of price discovery between the U.S.and Chinese soybean market:a wavelet approach to understanding the effects of Sino-US trade conflict and COVID-19 pandemic

During geopolitical crises,the price stability of agricultural commodities is critical for national security.Understanding the dynamics of pricing power between the U.S.and China and how it varies over time can help smaller nations navigate unpredictable moments.This study uses a unified framework and wavelet approach to examine soybean price discovery in the U.S.and China from the standpoints of price interdependence and information flows.We begin by illustrating the integrated link between the soybean futures markets in the U.S.and China,which includes multiple structural breaks.The pricing difference between the two nations acts as the primary information spillover route for their integrated relationship.Furthermore,we show that the direction and degree of information spillover change dramatically in proportion to the strength of the U.S.–Chinese soybean interaction.Finally,we find that China’s recent retaliatory tax on the U.S.soybeans gave the Chinese market a more powerful position in soybean futures price discovery.After the first-stage trade deal was reached,and during the epidemic phase of the coronavirus pandemic,the pricing power of the U.S.soybean market showed no signs of full recovery.

Impacts of the COVID-19 pandemic on rural poverty and policy responses in China

Given the sudden outbreak of the COVID-19 pandemic,a timely study on the impacts of and policy response to the pandemic on rural poverty in China is critically important because China has aimed to completely eradicate extreme poverty by the end of 2020.This paper uses data from the latest round of a nationally representative household panel survey to examine the impacts of the pandemic on rural poverty in China.Our data show that 11.9%of sample households were ever officially registered as poor households between 2013 and 2019,and this poverty incidence fell to 2.7%by the end of 2019.In the middle February of 2020,23%of the households who have graduated from poverty since 2013 perceived that they would fall back into poverty due to the COVID-19.Among those never poor households,7.1%perceived that they would possibly fall into poverty due to the pandemic.Results from both descriptive and multivariate analyses consistently show the interruptions that the pandemic caused in off-farm employment is an important channel that led households to perceive of falling back into or falling into poverty.We also find households in the bottom four quintiles when ranked in terms of household income per capita are much more likely to perceive themselves of falling back into or falling into poverty during this pandemic than those in the richest quintile.Meanwhile,our results show that the education and age of household heads,as well as being from Hubei Province matter in explaining household perception about falling back into or falling into poverty in some cases but not all.The paper concludes with a set of policy responses that China has taken to mitigate the impact of COVID-19 pandemic on poverty alleviation.

Impact of the COVID-19 pandemic on agricultural exports

The COVID-19 outbreak has shocked the world’s economies in the year of 2020.As this pandemic spreads around the globe,many experts feared that the global food supplies might start running short,especially if supply chains were disrupted.COVID-19 also added to the uncertainty of the business operation.Therefore,it is critical to understand how COVID-19 pandemic affected global food supply and market.In this study,we investigate the impact of COVID-19 on agricultural export companies in China using a unique firm-level survey data.We found that although on average agricultural businesses experienced declines in the exports,exports of some agricultural products especially grain and oil held strong and even increased,implying the essential demand for staple food during the pandemic.Not surprisingly,exports of medicinal herb also increased significantly during the pandemic.However,exports of goods such as edible fungus and horticultural products sharply decreased.Our results also showed that in general,impact of COVID-19 on smaller firms was more severe than that on larger firms.The results of this study can provide useful guidance and implications for agricultural businesses and policy makers on their COVID-19 mitigation efforts to navigate this global pandemic.

Assessing the Effect of Global Travel and Contact Restrictions on Mitigating the COVID-19 Pandemic

Travel restrictions and physical distancing have been implemented across the world to mitigate the coronavirus disease 2019(COVID-19)pandemic,but studies are needed to understand their effectiveness across regions and time.Based on the population mobility metrics derived from mobile phone geolocation data across 135 countries or territories during the first wave of the pandemic in 2020,we built a metapopulation epidemiological model to measure the effect of travel and contact restrictions on containing COVID-19 outbreaks across regions.We found that if these interventions had not been deployed,the cumulative number of cases could have shown a 97-fold(interquartile range 79–116)increase,as of May 31,2020.However,their effectiveness depended upon the timing,duration,and intensity of the interventions,with variations in case severity seen across populations,regions,and seasons.Additionally,before effective vaccines are widely available and herd immunity is achieved,our results emphasize that a certain degree of physical distancing at the relaxation of the intervention stage will likely be needed to avoid rapid resurgences and subsequent lockdowns.

Intelligent Manufacturing Systems in COVID‑19 Pandemic and Beyond:Framework and Impact Assessment

Pandemics like COVID-19 have created a spreading and ever-higher healthy threat to the humans in the manufacturing system which incurs severe disruptions and complex issues to industrial networks.The intelligent manufacturing(IM)systems are promising to create a safe working environment by using the automated manufacturing assets which are monitored by the networked sensors and controlled by the intelligent decision-making algorithms.The relief of the production disruption by IM technologies facilitates the reconnection of the good and service flows in the network,which mitigates the severity of industrial chain disruption.In this study,we create a novel intelligent manufacturing framework for the production recovery under the pandemic and build an assessment model to evaluate the impacts of the IM technologies on industrial networks.Considering the constraints of the IM resources,we formulate an optimization model to schedule the allocation of IM resources according to the mutual market demands and the severity of the pandemic.

Mental health of parents of children with autism spectrum disorder during COVID-19 pandemic: A systematic review

BACKGROUND Children diagnosed with autism spectrum disorder(ASD)may have great difficulties when their routines change,and this may affect the psychological wellbeing of their parents.For this reason,it is important to examine studies that address the mental health of parents in order to adapt to the coronavirus disease 2019(COVID-19)pandemic.AIM To determine the mental health status of parents with children diagnosed with ASD in the COVID-19 pandemic.METHODS The study,which is a systematic review,was conducted between December 15,2020 and December 30,2020 by scanning articles in English.The Scopus,Science Direct,PubMed,Cochrane,Web of Science,and Google Scholar databases were used for scanning.The keywords COVID-19 AND(“autism”OR“autistic”OR“autism spectrum disorder”)AND parent AND(“mental health”OR“anxiety”OR“stress”)were used in the search process.The inclusion criteria in the study were findings regarding the mental health of parents with children diagnosed with ASD in the COVID-19 pandemic,addressing their anxiety and stress situations,being a research article,and accessing the full text of the article.RESULTS In the study,a total of 6389 articles were reached,and the full texts of 173 articles were evaluated for eligibility.After the articles excluded by the full-text search were eliminated,12 studies involving 7105 parents were included in the analysis.The findings obtained from the articles containing data on mental health in the COVID-19 pandemic of parents with children with autism spectrum disorder were discussed in three groups.These were findings on the experiences of parents with children with ASD in the COVID-19 pandemic regarding the areas where parents with children with ASD need support in the COVID-19 pandemic and methods of coping with the COVID-19 pandemic for parents with children with ASD.In the systematic review,it was determined that the anxiety and stress of the parents increased,they needed more support compared to the pre-pandemic period,and they had difficulty coping.CONCLUSION In this systematic review,it was concluded that the COVID-19 pandemic negatively affected the mental health of the parents of children with ASD.

Pig farmers’ willingness to recover their production under COVID-19 pandemic shock in China-Empirical evidence from a farm survey

Pig farmers’willingness to recover production under the COVID-19 pandemic shock is significant to recover live pigs’supply in China in 2020.Increasing farmers’willingness to recover pig production contributes to enhance pig supply,stabilize the pig and pork market,and to improve pig farmers’income.This research studies the determinants of pig farmers’willingness to recover production under COVID-19 pandemic shock by applying survey data of 201 farmers in Huai’an City and Lin’an City and a logit regression model.The estimation results show that a farmer’s risk perception,the duration time of a farmer’s feed supply under COVID-19 pandemic shock,whether or not being a cooperative member,and a farmer’s knowledge on government’s policy designed to encourage pig production,a farmer’s education level and production experience are the key determinants to a farmer’s willingness to recover pig production.Thus,it’s important for policymakers to solve the problems for farmers to get access to feed during the pandemic,to encourage the development of cooperatives,as well as to issue and advocate policies to encourage pig production.The study contributes to the scant literature by providing fresh empirical evidences on determinants of farmers’willingness to recover pig production.It has significance to farmers and governments to enhance farmers’willingness to recover production,which contributes to secure pig supply in China after the COVID-19 pandemic.

Impacts of the COVID-19 pandemic on the dairy industry: Lessons from China and the United States and policy implications

The purposes of this study are to assess the COVID-19 pandemic’s impacts on the dairy industries in China and the United States and to derive policy recommendations for enhancing the diary industries’resilience to pandemics and other market shocks.Specifically,data from the two nations are used to analyze and compare the mechanisms through which the pandemic has affected their dairy industries and to discuss potential lessons from their experiences.The findings suggest that this pandemic has heavily affected the dairy industries in both China and the United States through similar mechanisms,such as decreased farmgate milk prices,disruption and difficulties of moving milk within the supply chains,worker shortages,increased production costs,and lack of operating capital.There were also significant differences in the affecting mechanisms between the two nations,including transportation difficulties from widespread road closures and significant reduction in holiday sales of dairy products in China,and the shutdown of many dairy processors in the United States due to the closing of schools,restaurants,and hotels.While government financial reliefs are highly needed to help many dairy farms and processors survive this pandemic in the short term,the dairy industries and governments need to work together to develop long-term strategies and policies to balance the industries’efficiency and flexibility,product specialization and diversification,supply chain integration and local food systems,and market mechanisms and policy regulations and interventions.

The Effectiveness of Infection Control Practices among Health Care Workers Responding to the COVID-19 Pandemic in Nigeria

Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.

Management and implementation strategies of pre-screening triage in children during coronavirus disease 2019 pandemic in Guangzhou, China

BACKGROUND Emerging infectious diseases are a constant threat to the public’s health and health care systems around the world.Coronavirus disease 2019(COVID-2019),which was defined by the World Health Organization as pandemic,has rapidly emerged as a global health threat.Outbreak evolution and prevention of international implications require substantial flexibility of frontline health care facilities in their response.AIM To explore the effect of the implementation and management strategy of prescreening triage in children during COVID-19.METHODS The standardized triage screening procedures included a standardized triage screening questionnaire,setup of pre-screening triage station,multi-point temperature monitoring,extensive screenings,and two-way protection.In order to ensure the implementation of the pre-screening triage,the prevention and control management strategies included training,emergency exercise,and staff protection.Statistical analysis was performed on the data from all the children hospitalized from January 20,2020 to March 20,2020 at solstice during the pandemic period.Data were obtained from questionnaires and electronic medical record systems.RESULTS A total of 17561 children,including 2652 who met the criteria for screening,192 suspected cases,and two confirmed cases without omission,were screened from January 20,2020 to March 20,2020 at solstice during the pandemic period.There was zero transmission of the infection to any medical staff.CONCLUSION The effective strategies for pre-screening triage have an essential role in the prevention and control of hospital infection.

A Novel Heuristic Algorithm for theModeling and Risk Assessment of the COVID-19 Pandemic Phenomenon

Themodeling and risk assessment of a pandemic phenomenon such as COVID-19 is an important and complicated issue in epidemiology,and such an attempt is of great interest for public health decision-making.To this end,in the present study,based on a recent heuristic algorithm proposed by the authors,the time evolution of COVID-19 is investigated for six different countries/states,namely New York,California,USA,Iran,Sweden and UK.The number of COVID-19-related deaths is used to develop the proposed heuristic model as it is believed that the predicted number of daily deaths in each country/state includes information about the quality of the health system in each area,the age distribution of population,geographical and environmental factors as well as other conditions.Based on derived predicted epidemic curves,a new 3D-epidemic surface is proposed to assess the epidemic phenomenon at any time of its evolution.This research highlights the potential of the proposed model as a tool which can assist in the risk assessment of the COVID-19.Mapping its development through 3D-epidemic surface can assist in revealing its dynamic nature as well as differences and similarities among different districts.