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      COVID-19 pandemic response fatigue in Africa: causes, consequences, and counter-measures

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          Abstract

          A notable decline in adherence to COVID-19 preventive measures has been observed despite the increasing number of cases following the suspension of lockdown measures. The African governments have positively responded to the COVID-19 pandemic in previous times, however presently the COVID-19 response on the African continent is in a state of fatigue. Therefore, public vigilance on COVID-19 needs to be reinvigorated through behavioral change communication via different channels of disseminating information. In addition, support systems and social protection should be established to address the COVID-19 pandemic fatigue. Also, increased funding should be made available for enhancing the COVID-19 outbreak response.

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          How to fight an infodemic

          WHO's newly launched platform aims to combat misinformation around COVID-19. John Zarocostas reports from Geneva. WHO is leading the effort to slow the spread of the 2019 coronavirus disease (COVID-19) outbreak. But a global epidemic of misinformation—spreading rapidly through social media platforms and other outlets—poses a serious problem for public health. “We’re not just fighting an epidemic; we’re fighting an infodemic”, said WHO Director-General Tedros Adhanom Ghebreyesus at the Munich Security Conference on Feb 15. Immediately after COVID-19 was declared a Public Health Emergency of International Concern, WHO's risk communication team launched a new information platform called WHO Information Network for Epidemics (EPI-WIN), with the aim of using a series of amplifiers to share tailored information with specific target groups. Sylvie Briand, director of Infectious Hazards Management at WHO's Health Emergencies Programme and architect of WHO's strategy to counter the infodemic risk, told The Lancet, “We know that every outbreak will be accompanied by a kind of tsunami of information, but also within this information you always have misinformation, rumours, etc. We know that even in the Middle Ages there was this phenomenon”. “But the difference now with social media is that this phenomenon is amplified, it goes faster and further, like the viruses that travel with people and go faster and further. So it is a new challenge, and the challenge is the [timing] because you need to be faster if you want to fill the void…What is at stake during an outbreak is making sure people will do the right thing to control the disease or to mitigate its impact. So it is not only information to make sure people are informed; it is also making sure people are informed to act appropriately.” About 20 staff and some consultants are involved in WHO's communications teams globally, at any given time. This includes social media personnel at each of WHO's six regional offices, risk communications consultants, and WHO communications officers. Aleksandra Kuzmanovic, social media manager with WHO's department of communications, told The Lancet that “fighting infodemics and misinformation is a joint effort between our technical risk communications [team] and colleagues who are working on the EPI-WIN platform, where they communicate with different…professionals providing them with advice and guidelines and also receiving information”. Kuzmanovic said, “In my role, I am in touch with Facebook, Twitter, Tencent, Pinterest, TikTok, and also my colleagues in the China office who are working closely with Chinese social media platforms…So when we see some questions or rumours spreading, we write it down, we go back to our risk communications colleagues and then they help us find evidence-based answers”. “Another thing we are doing with social media platforms, and that is something we are putting our strongest efforts in, is to ensure no matter where people live….when they’re on Facebook, Twitter, or Google, when they search for ‘coronavirus’ or ‘COVID-19’ or [a] related term, they have a box that…directs them to a reliable source: either to [the] WHO website to their ministry of health or public health institute or centre for disease control”, she said. Google, Kuzmanovic noted, has created an SOS Alert on COVID-19 for the six official UN languages, and is also expanding in some other languages. The idea is to make the first information that the public receive be from the WHO website and the social media accounts of WHO and Dr Tedros. WHO also uses social media for real-time updates. WHO is also working closely with UNICEF and other international agencies that have extensive experience in risk communications, such as the International Federation of Red Cross and Red Crescent Societies. Carlos Navarro, head of Public Health Emergencies at UNICEF, the children's agency, told The Lancet that while a lot of incorrect information is spreading through social media, a lot is also coming from traditional mass media. “Often, they pick the most extreme pictures they can find…There is overkill on the use of [personal protective equipment] and that tends to be the photos that are published everywhere, in all major newspapers and TV…that is, in fact, sending the wrong message”, Navarro said. David Heymann, professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, told The Lancet that the traditional media has a key role in providing evidence-based information to the general public, which will then hopefully be picked up on social media. He also observed that for both social and conventional media, it is important that the public health community help the media to “better understand what they should be looking for, because the media sometimes gets ahead of the evidence”.
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            Ten considerations for effectively managing the COVID-19 transition

            Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a 'new normal'; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated.
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              Perception and practices during the COVID-19 pandemic in an urban community in Nigeria: a cross-sectional study

              Background Various perceptions and practices have been associated with the COVID-19 pandemic. In this study, we assessed the perception and practices regarding COVID-19 among residents in selected urban communities of Ibadan, Oyo State, Nigeria. Methods A descriptive cross-sectional study design using a multi-stage sampling technique was used to recruit 360 respondents (Mean age: 33.2 ± 10.6 years; 62.5% females) from households in Ibadan. Data were collected using an interviewer-administered questionnaire from 3rd to 6th June 2020. Those who demonstrated washing of the palm, back of the hand, spaces between the fingers, fingernails, wrist, and thumbs had six points and were categorized to have had a good practice of handwashing. Descriptive statistics were conducted. Bivariate analyses of sociodemographic characteristics and good handwashing practices were conducted using Chi-square test. Logistic regression was conducted to identify the determinants of good handwashing practices. P-values < 0.05 were statistically significant. Results Going to the hospital (95%) and calling the COVID-19 help number (58.3%) were the frequently reported practices among respondents following the development of COVID-19 symptoms. Also, 89 (26%) knew they could contract COVID-19, while 41 (12%) perceived it as an exaggerated event. The effects most frequently reported by respondents were hunger/low income (48.8%) and academic delay (8.8%). Use of face masks by 64.5% and social distancing (48%) were the most frequently reported practices for prevention. Only 71 (20.8%) demonstrated good handwashing practices. The perception of the likelihood to contract COVID-19 and practices to prevent COVID-19 had a weak correlation of 0.239 (p < 0.001). Conclusion Gaps exist in the practices that prevent COVID-19. There is a need to improve handwashing, use of face masks and other practices that prevent COVID-19. Implications across public health communication and policies were stated.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                16 November 2020
                2020
                : 37
                : Suppl 1
                : 37
                Affiliations
                [1 ]Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria,
                [2 ]Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria,
                [3 ]Department of Pharmacy, University College Hospital, Ibadan, Oyo State, Nigeria
                Author notes
                Corresponding author: Aanuoluwapo Adeyimika Afolabi, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria. afoannade@ 123456gmail.com
                Article
                PAMJ-SUPP-37-1-37
                10.11604/pamj.supp.2020.37.37.26742
                7796831
                33456661
                604678e1-4fb5-43a1-b16d-7c76cbe9bc88
                Copyright: Olayinka Stephen Ilesanmi et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 October 2020
                : 11 November 2020
                Categories
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                Medicine
                covid-19,pandemic fatigue,behavioral change communication,africa
                Medicine
                covid-19, pandemic fatigue, behavioral change communication, africa

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