Determining the effectiveness of stress management program by using hair cortisol concentration

Many studies have shown that healthcare workers are exposed to higher levels of stress than other occupations. However, little research has been conducted on the use of biomarker tools to assess chronic stress and assess the effectiveness of stress management programs for healthcare workers. The aim of this study was to measure the effectiveness of a Stress Management Program by measuring Depression Anxiety Stress Scale (DASS-21) scores and hair cortisol concentration (HCC) levels of healthcare workers in public healthcare facilities. This study was a three-group, quasi-experiment study with pre- and post-study assessment sessions. A total of 119 healthcare workers (28 from Group A, 21 from Group B, and 70 from Group C) were followed for 6 months. Significant favorable intervention effects on DASS-21 scores were found in Group A (Effect size =0.6) as compared to Group B (Effect size=0.2) and Group C (Effect size =02) at the end of the program. Time and group interaction effects were examined using the repeated measure ANOVA test in which there was a significant group *time interaction and effect size of 0.2 (p-value <0.01) across all the groups with a reduction in hair cortisol concentrations following the program. The study showed that stress management under healthy communities, building the nation (KOSPEN PLUS) program was successful in reducing stress levels, as seen through a decrease in both stress scores and hair cortisol levels. This is the first study in Malaysia to use hair cortisol as a biomarker for stress management, suggesting its reliability

Tracking the early depleting transmission dynamics of COVID-19 with a time-varying SIR model

The susceptible-infectious-removed (SIR) model offers the simplest framework to study transmission dynamics of COVID-19, however, it does not factor in its early depleting trend observed during a lockdown. We modified the SIR model to specifically simulate the early depleting transmission dynamics of COVID-19 to better predict its temporal trend in Malaysia. The classical SIR model was fitted to observed total (I total), active (I) and removed (R) cases of COVID-19 before lockdown to estimate the basic reproduction number. Next, the model was modified with a partial time-varying force of infection, given by a proportionally depleting transmission coefficient, βt and a fractional term, z. The modified SIR model was then fitted to observed data over 6 weeks during the lockdown. Model fitting and projection were validated using the mean absolute percent error (MAPE). The transmission dynamics of COVID-19 was interrupted immediately by the lockdown. The modified SIR model projected the depleting temporal trends with lowest MAPE for I total, followed by I, I daily and R. During lockdown, the dynamics of COVID-19 depleted at a rate of 4.7% each day with a decreased capacity of 40%. For 7-day and 14-day projections, the modified SIR model accurately predicted I total, I and R. The depleting transmission dynamics for COVID-19 during lockdown can be accurately captured by time-varying SIR model. Projection generated based on observed data is useful for future planning and control of COVID-19

The Effect of Movement Control Order for Various Population Mobility Phases during COVID-19 in Malaysia

Background: COVID-19 was declared a pandemic by the World Health Organization on 11 March 2020. From the beginning of the pandemic, there was no effective pharmaceutical intervention to halt or hold up the spread of this novel disease. Therefore, most countries, including Malaysia, resorted to break the chain of transmission by restricting population mobility through the implementation of the Movement Control Order (MCO). We aim to determine the population mobility trend across the various phases of the MCO during the COVID-19 pandemic in Malaysia by studying the confirmed COVID-19 cases with the Google mobility data. Methodology: The average mobility percentage changes in Retail and Recreation, Grocery and Pharmacy, Parks, Transit Stations, and Workplaces were the components studied in relation to the various MCO phases and daily COVID-19 confirmed cases. The percentage difference was calculated by subtracting the average percentage changes for each MCO phases from the pre-MCO level. Additionally, the percentage difference was also calculated for inter-MCO phases as well. Results: The average mobility percentage changes reduced most drastically during the MCO phases across all the mobility components as compared to the other phases. The average mobility percentage changes in comparison to the pre-MCO levels across Retail and Recreation, Grocery and Pharmacy, Parks, Transit Stations, and Workplaces was −45.8%, −10.6%, −27.7%, −60%, and −34.3%, respectively. In addition, the average mobility percentage changes increased the most during CMCO as compared to MCO. Discussions: Malaysia implemented multiple measures to contain the COVID-19 pandemic since January 2020, culminating in the execution of the MCO. Though doubts on the effectiveness of the MCO were raised at the early stage of its implementation as mass movements persisted, strict enforcement and improved awareness of the impacts of COVID-19 brought significant improvement in compliance, which has been deemed the main reason behind the decrease in new COVID-19 cases since mid-April of 2020. Conclusion: Based on the downtrends of new and active COVID-19 cases, it can be concluded that the MCO has been effective, provided that compliance to the MCO is maintained. This study could serve to a certain degree to governments and policy makers as a tool to consider the relaxation of the lockdown conditions