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      COVID-19 in Rural Nigeria: Diminishing Social Support for Older People in Nigeria

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          Abstract

          Social support provided by family, friends and neighbors has been essential for the survival and wellbeing of older people in Nigeria. However, the reduced social contact between older people and their social network because of the social distancing recommendations and other non-pharmaceutical approaches to protect them from COVID-19 may threaten their social support. Our study investigated the impact of the COVID-19 pandemic on rural older people in Nigeria using qualitative data collected from 11 older adults residing in rural Nigeria through in-depth interviews. The collected data was translated and transcribed, coded using Nvivo12 and analyzed thematically. Findings show that the COVID-19 pandemic has led to a reduction in both material support in the forms of food and money, and intangible support in the forms of assistance, communication and care, due to limited social contact. Furthermore, the economic consequence of the pandemic may have severe implications for the health and wellbeing of older people. Social workers should therefore advocate the distribution of food and care supplies to rural older people to cushion the economic impact of diminishing social support, and also creatively help them maintain social connectedness.

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          Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study

          Abstract Objective To describe outcomes of people admitted to hospital with coronavirus disease 2019 (covid-19) in the United States, and the clinical and laboratory characteristics associated with severity of illness. Design Prospective cohort study. Setting Single academic medical center in New York City and Long Island. Participants 5279 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection between 1 March 2020 and 8 April 2020. The final date of follow up was 5 May 2020. Main outcome measures Outcomes were admission to hospital, critical illness (intensive care, mechanical ventilation, discharge to hospice care, or death), and discharge to hospice care or death. Predictors included patient characteristics, medical history, vital signs, and laboratory results. Multivariable logistic regression was conducted to identify risk factors for adverse outcomes, and competing risk survival analysis for mortality. Results Of 11 544 people tested for SARS-Cov-2, 5566 (48.2%) were positive. After exclusions, 5279 were included. 2741 of these 5279 (51.9%) were admitted to hospital, of whom 1904 (69.5%) were discharged alive without hospice care and 665 (24.3%) were discharged to hospice care or died. Of 647 (23.6%) patients requiring mechanical ventilation, 391 (60.4%) died and 170 (26.2%) were extubated or discharged. The strongest risk for hospital admission was associated with age, with an odds ratio of >2 for all age groups older than 44 years and 37.9 (95% confidence interval 26.1 to 56.0) for ages 75 years and older. Other risks were heart failure (4.4, 2.6 to 8.0), male sex (2.8, 2.4 to 3.2), chronic kidney disease (2.6, 1.9 to 3.6), and any increase in body mass index (BMI) (eg, for BMI >40: 2.5, 1.8 to 3.4). The strongest risks for critical illness besides age were associated with heart failure (1.9, 1.4 to 2.5), BMI >40 (1.5, 1.0 to 2.2), and male sex (1.5, 1.3 to 1.8). Admission oxygen saturation of 1 (4.8, 2.1 to 10.9), C reactive protein level >200 (5.1, 2.8 to 9.2), and D-dimer level >2500 (3.9, 2.6 to 6.0) were, however, more strongly associated with critical illness than age or comorbidities. Risk of critical illness decreased significantly over the study period. Similar associations were found for mortality alone. Conclusions Age and comorbidities were found to be strong predictors of hospital admission and to a lesser extent of critical illness and mortality in people with covid-19; however, impairment of oxygen on admission and markers of inflammation were most strongly associated with critical illness and mortality. Outcomes seem to be improving over time, potentially suggesting improvements in care.
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            Loneliness and social isolation as risk factors for mortality: a meta-analytic review.

            Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
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              Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020

              A novel coronavirus (2019-nCoV) is causing an outbreak of viral pneumonia that started in Wuhan, China. Using the travel history and symptom onset of 88 confirmed cases that were detected outside Wuhan in the early outbreak phase, we estimate the mean incubation period to be 6.4 days (95% credible interval: 5.6–7.7), ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). These values should help inform 2019-nCoV case definitions and appropriate quarantine durations.
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                Author and article information

                Journal
                Gerontol Geriatr Med
                Gerontol Geriatr Med
                GGM
                spggm
                Gerontology and Geriatric Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2333-7214
                28 December 2020
                Jan-Dec 2020
                : 6
                : 2333721420986301
                Affiliations
                [1 ]University of Nigeria, Nsukka, Choose, Nigeria
                Author notes
                [*]Prince Chiagozie Ekoh, Department of Social Work, University of Nigeria, Nsukka, Choose 410001, Nigeria. Email: Princechiagozie.ekoh@ 123456unn.edu.ng
                Author information
                https://orcid.org/0000-0002-1787-536X
                https://orcid.org/0000-0003-1685-3449
                Article
                10.1177_2333721420986301
                10.1177/2333721420986301
                7783879
                33457460
                ff68bd14-7988-4429-a4b0-3f132763b3e7
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 6 November 2020
                : 15 December 2020
                : 16 December 2020
                Categories
                The COVID-19 Pandemic Effects on Older Adults, Families, Caregivers, Health Care Providers and Communities
                Article
                Custom metadata
                January-December 2020
                ts1

                covid-19,social support,older people,rural nigeria
                covid-19, social support, older people, rural nigeria

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