Objectives Home diagnostics are essential to assist members of the general population become active agents of case detection. In Indonesia, a country with an over‐burdened healthcare system, individuals could use rapid SARS‐CoV‐2 antigen tests to self‐detect COVID‐19. To assess the general population's values and attitudes towards SARS‐CoV‐2 self‐testing, a survey was conducted in mid‐2021 in Jakarta and the provinces of Banten and North Sulawesi. Methods This was a quantitative survey that approached respondents in >600 randomly selected street‐points in the three study geographies in July–August 2021. A 35‐item questionnaire was used to collect data on key variables, such as likelihood to use a SARS‐CoV‐2 self‐test, willingness to pay for a self‐test device, and likely actions following a positive self‐test result. Bivariate and multivariate regression analyses were performed. Results Of 630 respondents (318 were female), 15.53% knew about COVID‐19 self‐testing, while 62.70% agreed with the idea of people being able to self‐test at home, unassisted, for COVID‐19. If self‐tests were available in Indonesia, >60% of respondents would use them if they felt it necessary and would undertake regular self‐testing for example weekly if recommended. Upon receiving a positive self‐test result, most respondents would communicate it (86.03%), request post‐test counselling (80.79%), self‐isolate (97.46%), and/or warn their close contacts (90.48%). Conclusions The use of rapid SARS‐CoV‐2 antigen detection tests for self‐testing appears acceptable to a majority of the Indonesian public, to learn whether they have COVID‐19. Self‐testing should be prioritised to complement to an over‐burdened healthcare system by helping the public, asymptomatic individuals included, become agents of change in epidemiological surveillance of SARS‐CoV‐2 in their communities.

Objectives: Innovative diagnostics are essential to assist members of the general population become active agents of case detection. In Indonesia, a country with an over-burdened healthcare system, individuals could use self-tests for SARS-CoV-2 to determine their COVID-19 status. To assess the acceptability of SARS-CoV-2 self-testing among the general population in Indonesia, a cross-sectional, population-based survey was conducted in mid-2021 in Jakarta and the provinces of Banten and North Sulawesi. Methods: This was a survey that approached respondents in >600 randomly selected street-points in the three study geographies. A 35-item questionnaire was used to collect data on key variables, such as willingness to use and to pay for a SARS-CoV-2 self-test and likely actions following a positive result. Bivariate and multivariate regression analyses were performed. Results: Of 630 respondents, (318 were female), 14% knew about COVID-19 self-testing, while 62.7% agreed with the concept of people being able to self-test at home, unassisted, for COVID-19. If self-tests were available in Indonesia, >60% of respondents would use them if they felt it necessary and would undertake regular self-testing e.g., weekly if recommended. Upon receiving a positive self-test result, most respondents would communicate it (86.03%), request post-test counseling (80.79%), self-isolate (97.46%), and/or warn their close contacts (n=570, 90.48%). Conclusions: SARS-CoV-2 self-testing would be acceptable to a majority of the Indonesian public, to learn whether they have COVID-19. Self-testing could contribute to an over-burdened healthcare system by helping COVID-19-infected people become agents of change in epidemiological surveillance of SARS-CoV-2 in their communities.

Background Despite concern that the global pandemic will worsen depression and suicide rates, there remain little data on its actual effect. The purpose of this study was to determine the effect of the COVID‐19 pandemic on suicidal ingestions reported to the California Poison Control System (CPCS). Methods This was a cross‐sectional comparison of suicidal ingestions reported to the CPCS during the 2020 COVID‐19 pandemic compared to suicidal ingestions reported during the same period in 2018 and 2019. Results The CPCS received 19,607 call for suicidal ingestions during the study periods, of which 13,800 were in the pre‐COVID era (2018 and 2019) and 5,807 were in the COVID era. The median (IQR) number of suicidal ingestions per month decreased from 2,286 (2,240–2,364) to 1,940 (1,855–2,045; p = 0.02). This decrease was consistent and significant across all age groups except those age 70 or older. Ingestions without adverse events decreased by 101 cases/month (95% confidence interval [CI] = 136.8 to 65; p = 0.0003), minor outcomes decreased by 156.6 cases/month (95% CI = 226.2 to 87.1; p = 0.001), and moderate outcomes decreased by 96 cases/month (95% CI = 143.9 to 48.1; p = 0.00021). Major outcomes decreased from 793 (4.99%) cases in the pre‐COVID era to 315 (4.60%) cases in the COVID era (risk ratio = 0.92, 95% CI = 0.81 to 1.05). The number of deaths decreased by 3.7 cases/month (95% CI = –8.3 to 0.92, p = 0.10). Conclusions Despite concern for worsening suicidality, calls regarding suicidal ingestions to the nation's largest poison control center decreased during the COVID era compared to the pre‐COVID era. This study provides evidence that the pandemic's effects on modern society remain difficult to predict. Further effort is needed to understand how pandemic will affect American's mental health.

Alongside mass vaccination for COVID-19, sustainable diagnostic strategies for SARS-CoV-2 are needed to empower local communities and help them complement health authorities’ efforts to end the pandemic in low- and middle-income countries. Indonesia is among the nations with an overstretched health system that may benefit from technological innovations, such as rapid SARS-CoV-2 antigen-detection tests for self-testing, to detect asymptomatic cases and interrupt the transmission of the virus to healthy individuals. In mid-2021, we conducted a qualitative research study with the aim of understanding key decision-makers’ values and preferences regarding the implementation of COVID-19 self-testing in Indonesia. This research received ethics approval from the Universitas Katolik Indonesia Atma Jaya and used a thematic analysis approach to explore the insights expressed by healthcare workers, representatives of civil society, and potential self-testing implementers in three geographies: Jakarta, Banten, and North Sulawesi. Thirty semi-structured interviews and six focus group discussions were carried out. As per the informants’ narratives, the Indonesian public might accept rapid SARS-CoV-2 antigen-detection self-testing as a tool that will enable them to test for COVID-19 at their own convenience. Concerns were expressed that the public might doubt the reliability of self-testing kits if these were not properly regulated and if counterfeit kits were known to be on the market. Fear of stigma, isolation, and clinical care costs were perceived to be among the drivers for self-test users to not report a reactive result. These fears might be mitigated, as per the informants’ opinions, by awareness raising, passing of regulations, and participatory engagement of a range of community actors, such as village officers. Decision-makers consider rapid SARS-CoV-2 antigen-detection self-testing to be a welcomed screening tool that could contribute to ensuring earlier access to treatment and decrease transmission of SARS-CoV-2 in Indonesia.

Stroke survivors must transition from their previous life to a new and initially unwelcome way of being. Rehabilitation should respect this process and support stroke survivors as they undertake this individual journey.