A snapshot of the practicality and barriers to COVID-19 interventions: Public health and healthcare workers’ perceptions in high and low- and middle-income countries

Abstract

Background In response to the COVID-19 pandemic, governments have implemented a range of non-pharmaceutical interventions (NPIs) and pharmaceutical interventions (PIs) to reduce transmission and minimise morbidity and mortality, whilst maintaining social and economic activities. The perceptions of public health workers (PHWs) and healthcare workers (HCWs) are essential to inform future COVID-19 strategies as they are viewed as trusted sources and are at the forefront of COVID-19 response. The objectives of this study were to 1) describe the practicality of implementing NPIs and PIs and 2) identify potential barriers to implementation, as perceived by HCWs and PHWs. Methods We conducted a cross-sectional study of PHWs and HCWs perceptions of the implementation, practicality of, and barriers to implementation of NPIs and PIs using an online survey (28/9/2020-1/11/2020) available in English, French and Portuguese. We used descriptive statistics and thematic analysis to analyse quantitative and qualitative responses. Results In total, 226 respondents (67 HCWs and 159 PHWs) from 52 countries completed the survey and 222 were included in the final analysis. Participants from low and middle-income countries (LMICs) accounted for 63% of HCWs and 67% of PHWs, with the remaining from high-income (HICs). There was little difference between the perceptions of PHWs and HCWs in HICs and LMICs, with the majority regarding a number of common NPIs as difficult to implement. However, PHWs in HICs perceived restrictions on schools and educational institutions to be more difficult to implement, with a lack of childcare support identified as the main barrier. Additionally, most contact tracing methods were perceived to be more difficult to implement in HICs than LMICs, with a range of barriers reported. A lack of public support was the most commonly reported barrier to NPIs overall across both country income and professional groups. Similarly, public fear of vaccine safety and lack of vaccine supply were the main reported barriers to implementing a COVID-19 vaccine. However, PHWs and HCWs in LMICs perceived a lack of financial support and the vaccine being manufactured in another country as additional barriers. Conclusion This snapshot provides insight into the difficulty of implementing interventions as perceived by PHWs and HCWs. There is no one-size-fits-all solution to implementing interventions, and barriers in different contexts do vary. Barriers to implementing a vaccine programme expressed here by HCWs and PHCWs have subsequently come to the fore internationally.

Building citizen science intelligence for outbreak preparedness and response: a mixed-method study in nine countries to assess knowledge, readiness and feasibility

“…Taking COVID-19 as an example, literature suggests that citizens were mostly engaged in data generation, with limited involvement in other aspects of research such as problem definition, data interpretation and dissemination 9 12 13. As past outbreaks have demonstrated, this undermines mutual trust between citizens, researchers and policymakers, resulting in decreased willingness of citizens to follow public health guidelines 14–16. It is thus important to emphasise that CS is not merely about data provision, citizens need to be seen as essential active participants across the full spectrum of research in a complex health information environment 17–20…”

“…9 12 13 As past outbreaks have demonstrated, this undermines mutual trust between citizens, researchers and policymakers, resulting in decreased willingness of citizens to follow public health guidelines. [14][15][16] It is thus important to emphasise that CS is not merely about data provision, citizens need to be seen as essential active participants across the full spectrum of research in a complex health information environment. [17][18][19][20] To date, majority of CS research, especially for outbreak preparedness and response has been done in highincome countries with limited knowledge in low-income and middle-income countries (LMICs).…”

Meditation-induced bloodborne factors as an adjuvant treatment to COVID-19 disease

“…Spikes, surges, waves, and variants have continued to upend the normalcy of life over the past two years, impacting work, school, social interactions, travel, and the economy across the globe. Though vaccines are mainstays in well-resourced countries, there is a significant minority of individuals that will not participate in such interventions due to political, ideological, trust, ethnicity, and socioeconomic inequity issues in resourced countries and fear of vaccine safety and lack of availability in low and middle income countries ( Glazik et al, 2021 ; Omer et al, 2021 ). Several experimental compounds have been proposed for the treatment of COVID-19, including hydroxychloroquine, remdesivir, lopinavir, interferon-β1, ivermectin, convalescent plasma; however, many of these treatments result in more harm than overall benefit ( Bishara et al, 2020 ; Buonfrate et al, 2022 ; Consortium et al, 2021 ; Ortigoza et al, 2021 ).…”

Nurses’ Work–Family Strategies during COVID-19 Lockdown and Their Association with Individual Health and Family Relations

“…Due to the lack of childcare support and the closure of schools during the pandemic, nurses struggled to fulfill both their work and family roles [13,14]. Their childcare responsibility reduced their participation in work [13,[15][16][17] and further led to burnout and depression [16,[18][19][20][21].…”