Osong Public Health and Research Perspectives

Original Article

Vaccine hesitancy in patients with COVID-19 who have back pain: Askeri Türken, Haşim Çapar; Received January 7, 2023 Accepted February 7, 2023 Published online March 24, 2023; DOI: https://doi.org/10.24171/j.phrp.2023.0003 [Epub ahead of print]

49 View
12 Download

Abstract PDF: Objectives
Musculoskeletal pain is among the most common symptoms in patients diagnosed with coronavirus disease 2019 (COVID-19), and it has placed a significant burden on health worldwide during the pandemic. This study explored vaccine hesitancy and associated factors in patients with positive COVID-19 polymerase chain reaction test results who were hospitalized and had back pain.
Methods
A cross-sectional study was conducted among 170 hospitalized COVID-19 patients over 18 years of age. Data were analyzed using descriptive statistics with IBM SPSS ver. 25.0.
Results
COVID-19 patients who were married considered COVID-19 vaccinations riskier than unmarried COVID-19 patients. Patients who had not been vaccinated expressed higher levels of distrust towards COVID-19 vaccines than patients who had been vaccinated. Participants had relatively little hesitation toward the Sinovac vaccine. High vaccine confidence was found in all participants regardless of vaccination status. Those who had not received the COVID-19 vaccine reported higher risk perceptions than those who had received at least 1 dose of any COVID-19 vaccine.
Conclusion
Measurements of the hesitancy of vaccinated and non-vaccinated patients or members of society towards vaccines can be an important parameter for health authorities to find solutions.

Special Article

A framework for nationwide COVID-19 vaccine safety research in the Republic of Korea: the COVID-19 Vaccine Safety Research Committee: Na-Young Jeong, Hyesook Park, Sanghoon Oh, Seung Eun Jung, Dong-Hyun Kim, Hyoung-Shik Shin, Hee Chul Han, Jong-Koo Lee, Jun Hee Woo, Byung-Joo Park, Nam-Kyong Choi; Osong Public Health Res Perspect. 2023;14(1):5-14. Published online February 28, 2023; DOI: https://doi.org/10.24171/j.phrp.2023.0026

591 View
51 Download

Graphical Abstract Abstract PDF: With the introduction of coronavirus disease 2019 (COVID-19) vaccines, the Korea Disease Control and Prevention Agency (KDCA) commissioned the National Academy of Medicine of Korea to gather experts to independently assess post-vaccination adverse events. Accordingly, the COVID-19 Vaccine Safety Research Committee (CoVaSC) was launched in November 2021 to perform safety studies and establish evidence for policy guidance. The CoVaSC established 3 committees for epidemiology, clinical research, and communication. The CoVaSC mainly utilizes pseudonymized data linking KDCA’s COVID-19 vaccination data and the National Health Insurance Service’s claims data. The CoVaSC’s 5-step research process involves defining the target diseases and organizing ad-hoc committees, developing research protocols, performing analyses, assessing causal relationships, and announcing research findings and utilizing them to guide compensation policies. As of 2022, the CoVaSC completed this research process for 15 adverse events. The CoVaSC launched the COVID-19 Vaccine Safety Research Center in September 2022 and has been reorganized into 4 divisions to promote research including international collaborative studies, long-/short-term follow-up studies, and education programs. Through these enhancements, the CoVaSC will continue to swiftly provide scientific evidence for COVID-19 vaccine research and compensation and may serve as a model for preparing for future epidemics of new diseases.

Brief Report

Early countermeasures to COVID-19 at long-term care facilities in Gwangju Metropolitan City, Republic of Korea: Hye-Jin Kim, Jieun Kim, Yoon Suk Jang, Hanul Park, Jong Mu Kim, Young Joon Park, So-Yeon Ryu, Jun Hwi Cho, So Yeong Park, Sang-Eun Lee; Osong Public Health Res Perspect. 2023;14(1):59-65. Published online February 1, 2023; DOI: https://doi.org/10.24171/j.phrp.2022.0293

406 View
29 Download

Graphical Abstract Abstract PDF: Objectives
The coronavirus disease 2019 (COVID-19) pandemic has continued since its first detection in the Republic of Korea on January 20, 2020. This study describes the early countermeasures used to minimize the risk of COVID-19 outbreaks during cohort quarantine and compares the epidemiological characteristics of 2 outbreaks in long-term care facilities (LTCFs) in Gwangju Metropolitan City in summer 2020. Methods: An epidemiological investigation was conducted via direct visits. We investigated epidemiological characteristics, including incidence, morbidity, and mortality rates, for all residents and staff members. Demographic characteristics were analyzed using a statistical program. Additionally, the method of managing infection in LTCFs is described. Results: Residents and caregivers had high incidence rates in LTCF-A and LTCF-B, respectively. LTCF-B had a longer quarantine period than LTCF-A. The attack rate was 20.02% in LTCF-A and 27.9% in LTCF-B. The mortality rate was 2.3% (1/43) in LTCF-B, the only facility in which a COVID-19 death occurred. Conclusion: Extensive management requires contact minimization, which involves testing all contacts to mitigate further transmission in the early stages of LTCF outbreaks. The findings of this study can help inform and prepare public health authorities for COVID-19 outbreaks, particularly for early control in vulnerable facilities.

Original Articles

Association between face covering policies and the incidence of coronavirus disease 2019 in European countries: Sookhyun Kim, Jiyoung Oh, Sangwoo Tak; Osong Public Health Res Perspect. 2023;14(1):31-39. Published online February 1, 2023; DOI: https://doi.org/10.24171/j.phrp.2022.0287

384 View
18 Download

Graphical Abstract Abstract PDF: Objectives
This study was conducted to determine the impact of the strengthening or relaxation of face covering mandates on the subsequent national case incidence of coronavirus disease 2019 (COVID-19) in Europe as the full vaccination rate was increasing.
Methods
European countries in which case incidence increased for 3 consecutive weeks were monitored and analyzed using COVID-19 incidence data shared by the World Health Organization (WHO). The epidemic trend of COVID-19 in Europe was compared with that of countries elsewhere in the world based on WHO weekly epidemiological reports from June 20 to October 30, 2021. In addition, this study provided insight into the impact of government mask mandates on COVID-19 incidence in Europe by measuring the index scores of those facial covering policies before and after mandate relaxation or strengthening. The effects of the vaccination rate and the speed of vaccination on COVID-19 incidence were also analyzed.
Results
The incidence of COVID-19 after the relaxation of face covering mandates was significantly higher than before relaxation. However, no significant difference was observed in vaccination rate between countries with increased and decreased incidence. Instead, rapid vaccination delayed the resurgence in incidence.
Conclusion
The findings suggest that face covering policies in conjunction with rapid vaccination efforts are essential to help mitigate the spread of COVID-19.

Evaluation and follow-up of pain, fatigue, and quality of life in COVID-19 patients: Sevda Adar, Petek Şarlak Konya, Ali İzzet Akçin, Ümit Dündar, Neşe Demirtürk; Osong Public Health Res Perspect. 2023;14(1):40-50. Published online February 1, 2023; DOI: https://doi.org/10.24171/j.phrp.2022.0275

383 View
26 Download

Graphical Abstract Abstract PDF: Objectives
We evaluated pain, fatigue, anxiety, depression, and quality of life in patients hospitalized for coronavirus disease 2019 (COVID-19) and observed them over a period of 3 months. We also investigated the relationship of these symptoms to age, sex, disease severity, and levels of anxiety and depression. Methods: The study included 100 confirmed COVID-19 patients (i.e., positive on a polymerase chain reaction test) between the ages of 18 and 75 years. Pain (visual analog scale [VAS]), fatigue (fatigue severity scale), anxiety, and depression (hospital anxiety and depression scales) were evaluated on the first day of hospitalization and at 1-month and 3-month follow-ups. The short form-12 questionnaire was used to measure quality of life at the 1-month and 3-month followups. Results: No differences were found in pain, fatigue, anxiety levels, depression levels, and quality of life according to disease severity. High VAS scores at hospital admission were related to continued pain at the 3-month follow-up (odds ratio [OR], 1.067; p<0.001). High VAS (OR, 1.072; p=0.003) and anxiety levels (OR, 1.360; p=0.007) were related to severe fatigue at the 3-month evaluation. Conclusion: Pain, fatigue, anxiety, and depression appear to be long-term sequelae of COVID-19 and can affect quality of life. High VAS and anxiety levels were found to be associated with long-term fatigue.

Brief Report

The effectiveness of Paxlovid treatment in long-term care facilities in South Korea during the outbreak of the Omicron variant of SARS-CoV-2: Hanul Park, Young Joon Park, Hye Young Lee, Mi Yu, Yeong-Jun Song, Sang Eun Lee, Ji-Joo Lee, Eun-Sol Lee, Yeonjung Kim; Osong Public Health Res Perspect. 2022;13(6):443-447. Published online December 23, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0262

1,291 View
130 Download

Graphical Abstract Abstract PDF: Objectives
On November 5, 2021, Pfizer Inc. announced Paxlovid (nirmatrelvir +ritonavir) asa treatment method that could reduce the risk of hospitalization or death for patients withconfirmed coronavirus disease 2019 (COVID-19).Methods: From February 6, 2022 to April 2, 2022, the incidence of COVID-19 and the effectsof treatment with Paxlovid were analyzed in 2,241 patients and workers at 5 long-term carefacilities during the outbreak of the Omicron variant of severe acute respiratory syndromecoronavirus 2 in South Korea.Results: The rate of severe illness or death in the group given Paxlovid was 51% lower thanthat of the non-Paxlovid group (adjusted risk ratio [aRR], 0.49; 95% confidence interval [CI],0.24−0.98). Compared to unvaccinated patients, patients who had completed 3 doses of thevaccine had a 71% reduced rate of severe illness or death (aRR, 0.29; 95% CI, 0.13−0.64) and a65% reduced death rate (aRR, 0.35; 95% CI, 0.15−0.79).Conclusion: Patients given Paxlovid showed a lower rate of severe illness or death and alower fatality rate than those who did not receive Paxlovid. Patients who received 3 dosesof the vaccine had a lower rate of severe illness or death and a lower fatality rate than theunvaccinated group.

Original Articles

mRNA vaccine effectiveness against SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant transmission from home care cases to household contacts in South Korea: Hanul Park, Young Joon Park, Sang Eun Lee, Min Jei Lee, Hyungtae Ahn; Osong Public Health Res Perspect. 2022;13(6):435-442. Published online November 28, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0243

2,529 View
128 Download

Graphical Abstract Abstract PDF: Objectives
Household contacts of confirmed cases of coronavirus disease 2019 (COVID-19) areexposed to a high risk of viral transmission, and secondary incidence is an important indicatorof community transmission. This study analyzed the secondary attack rate and mRNA vaccineeffectiveness against transmission (VET) for index cases (patients treated at home) confirmedto be infected with the Delta and Omicron variants.Methods: The subjects of the study were 4,450 index cases and 10,382 household contacts.Logistic regression analysis was performed to compare the secondary attack rate byvaccination status, and adjusted relative risk and 95% confidence intervals were identified.Results: The secondary attack rate of the Delta variant was 27.3%, while the secondary attackrate of the Omicron variant was 29.8%. For the Delta variant, groups with less than 90 daysand more than 90 days after 2 doses of mRNA vaccination both showed a VET of 37%. For theOmicron variant, a 64% VET was found among those with less than 90 days after 2 doses ofmRNA vaccination.Conclusion: This study provides useful data on the secondary attack rate and VET of mRNAvaccines for household contacts of COVID-19 cases in South Korea.

Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates: Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak; Osong Public Health Res Perspect. 2022;13(6):424-434. Published online November 28, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0212

973 View
84 Download

Graphical Abstract Abstract PDF: Objectives
Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.

Review Article

SARS-CoV-2 in brief: from virus to prevention: Hassan Karami, Zeinab Karimi, Negin Karami; Osong Public Health Res Perspect. 2022;13(6):394-406. Published online November 28, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0155

742 View
73 Download
1 Citations

Abstract PDF

The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.

Citations

Citations to this article as recorded by

Surveillance of endemic coronaviruses during the COVID‐19 pandemic in Iran, 2021–2022
Hassan Karami, Kaveh Sadeghi, Sevrin Zadheidar, Fatemeh Saadatmand, Negar Mirsalehi, Nima Hoveidi Ardestani, Shirin Kalantari, Mohammad Farahmand, Jila Yavarian, Talat Mokhtari‐Azad
Influenza and Other Respiratory Viruses.2023;[Epub] CrossRef

Original Article

Clinical outcomes of remdesivir-treated COVID-19 patients in South Korea: Mi Yu, Bryan Inho Kim, Jungyeon Kim, Jin Gwack; Osong Public Health Res Perspect. 2022;13(5):370-376. Published online October 18, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0138

784 View
52 Download

Abstract PDF: Objectives
This study analyzed the clinical outcomes of remdesivir treatment in coronavirus disease 2019 (COVID-19) patients in South Korea.
Methods
This retrospective cohort study involved the secondary analysis of epidemiological data. Among patients diagnosed with COVID-19 from July 2, 2020 to March 23, 2021 (12 AM), 4,868 who received oxygen therapy and were released from isolation after receiving remdesivir treatment were assigned to the treatment group, and 6,068 patients who received oxygen therapy but not remdesivir were assigned to the untreated group. The study subjects included children under the age of 19. The general characteristics and severity were compared between the groups. Differences in the time to death and mortality were also compared.
Results
In the untreated group, the hazard ratio [HR] for mortality was 1.59 among patients aged ≥70 years and 2.32 in patients with severe disease in comparison to the treatment group. In a comparison of survival time among patients with severe disease aged ≥70 years, the HR for mortality before 50 days was 2.09 in the untreated group compared to the treatment group.
Conclusion
Patients with remdesivir treatment showed better clinical outcomes in this study, but these results should be interpreted with caution since this study was not a fully controlled clinical trial.

Brief Reports

Adverse events of the Pfizer-BioNTech COVID-19 vaccine in Korean children and adolescents aged 5 to 17 years: Seontae Kim, Yeseul Heo, Soon-Young Seo, Do Sang Lim, Enhi Cho, Yeon-Kyeng Lee; Osong Public Health Res Perspect. 2022;13(5):382-390. Published online October 14, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0233

1,037 View
82 Download

Abstract PDF: Objectives
This study aimed to identify potential safety signals and adverse events following the primary Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccination series among children and adolescents aged 5 to 17 years in the Republic of Korea. Methods: Adverse events reported through the COVID-19 vaccination management system (CVMS, a web-based passive vaccine safety surveillance system) and adverse events and health conditions collected from a text message-based survey were analyzed. Results: A total of 14,786 adverse events among 5 to 17-year-old children and adolescents were reported in the CVMS; 14,334 (96.9%) were non-serious and 452 (3.1%) were serious, including 125 suspected cases of acute cardiovascular injury and 101 suspected cases of anaphylaxis. The overall reporting rate was lower in 5 to 11-year-old children (64.5 per 100,000 doses) than in 12 to 17-year-old adolescents (300.5 per 100,000 doses). The text message survey identified that local and systemic adverse events after either dose were reported less frequently in 5 to 11-year-old children than in 12 to 17-year-old adolescents (p<0.001). The most commonly reported adverse events were pain at the injection site, myalgia, headache, and fatigue/tiredness. Conclusion: The overall results are consistent with the results of controlled trials; serious adverse events were extremely rare among 5 to 17-year-old children and adolescents following Pfizer-BioNTech COVID-19 vaccination. Adverse events were less frequent in children aged 5 to 11 years than in adolescents aged 12 to 17 years.

Presumed population immunity to SARS-CoV-2 in South Korea, April 2022: Eun Jung Jang, Young June Choe, Seung Ah Choe, Yoo-Yeon Kim, Ryu Kyung Kim, Jia Kim, Do Sang Lim, Ju Hee Lee, Seonju Yi, Sangwon Lee, Young-Joon Park; Osong Public Health Res Perspect. 2022;13(5):377-381. Published online October 14, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0209

1,301 View
56 Download

Graphical Abstract Abstract PDF: Objectives
We estimated the overall and age-specific percentages of the Korean population with presumed immunity against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) as of April 2022 using the national registry.
Methods
We used the national coronavirus disease 2019 (COVID-19) infection and vaccination registry from South Korea, as described to define individuals with a previous history of COVID-19 infection, vaccination, or both, as persons with presumed immunity.
Results
Of a total of 53,304,627 observed persons, 24.4% had vaccination and infection, 58.1% had vaccination and no infection, 7.6% had infection and no vaccination, and 9.9% had no immunity. The SARS-CoV-2 Omicron variant emerged at a time when the presumed population immunity ranged from 80% to 85%; however, nearly half of the children were presumed to have no immunity.
Conclusion
We report a gap in population immunity, with lower presumed protection in children than in adults. The approach presented in this work can provide valuable informed tools to assist vaccine policy-making at a national level.

Review Article

India’s efforts to achieve 1.5 billion COVID-19 vaccinations: a narrative review: Kapil Singh, Ashwani Verma, Monisha Lakshminarayan; Osong Public Health Res Perspect. 2022;13(5):316-327. Published online October 14, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0104

1,439 View
66 Download
2 Citations

Graphical Abstract Abstract PDF

The initial case of coronavirus disease 2019 (COVID-19) in India was reported on January 30, 2020, and subsequently, the number of COVID-19-infected patients surged during the first wave of April 2020 and the second wave in the same month of 2021. The government of India imposed a strict nationwide lockdown in April 2020 and extended it until May 2020. The second wave of COVID-19 in India overwhelmed the country’s health facilities and exhausted its medical and paramedical workforce. This narrative review was conducted with the aim of summarizing the evidence drawn from policy documents of governmental and non-governmental organizations, as well as capturing India's COVID-19 vaccination efforts. The findings from this review cover the Indian government's vaccination initiatives, which ranged from steps taken to combat vaccine hesitancy to vaccination roadmaps, deployment plans, the use of digital health technology, vaccination monitoring, adverse effects, and innovative strategies such as Har Ghar Dastak and Jan Bhagidari Andolan (people’s participation). These efforts collectively culminated in the successful administration of more than 1.8 billion doses of COVID-19 vaccines in India. This review also provides insights into other countries’ responses to COVID-19 and guidance for future pandemics.

Citations

Citations to this article as recorded by

Digital health technology used in emergency large-scale vaccination campaigns in low- and middle-income countries: a narrative review for improved pandemic preparedness
Paula Mc Kenna, Lindsay A. Broadfield, Annik Willems, Serge Masyn, Theresa Pattery, Ruxandra Draghia-Akli
Expert Review of Vaccines.2023; 22(1): 243. CrossRef
Media Reporting Relating to COVID-19 Vaccination as a Driver of Vaccine Hesitancy Prior to the Second Wave of the COVID-19 Pandemic in India: A Content Analysis of Newspaper and Digital Media Reports
Saurav Basu, Himanshi Sharma
Cureus.2023;[Epub] CrossRef

Original Articles

The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran: Mansour Rezaei, Nader Rajabi Gilan, Ali Almasi, Mehdi Khezeli, Fatemeh Jamshidi Nazar, Zahra Jorjoran Shushtari, Yahya Salimi, Farid Najafi, Neda Sarabi, Shahram Saeidi, Saeid Saeidi; Osong Public Health Res Perspect. 2022;13(4):282-289. Published online August 31, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0345

948 View
38 Download

Abstract PDF: Objectives
This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample.
Methods
This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8.
Results
The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (β=−0.482), risk perception (β=0.047), and risk communication (β=0.662) were significant determinants.
Conclusion
Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.

Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021: U Jin Cho, Seongjin Wang, Seonju Yi, Yeon Hwa Choi, Eun-Young Kim, Jin A Kim, Sanghwan Bae, Jungyeon Yu, Jangkyu Choi, Young-Joon Park; Osong Public Health Res Perspect. 2022;13(4):263-272. Published online July 27, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0149

1,350 View
96 Download

Abstract PDF: Objectives
It is crucial to establish the characteristics of coronavirus disease 2019 (COVID-19) outbreaks at army training centers to develop preventive measures. Therefore, this study aimed to determine the COVID-19 transmission patterns and risk factors in a sequence of outbreaks at an army training center from June to August 2021.
Methods
This study included 1,324 trainees at an army training center where outbreaks occurred from June to August 2021. The outbreak was qualitatively analyzed according to the period, attack rate, demographic characteristics, vaccination history, and living areas. An aerodynamic experiment was performed to evaluate aerosol transmission in living areas.
Results
Three outbreaks occurred at the army training center from June to August 2021. The first, second, and third outbreaks lasted for 32, 17, and 24 days, and the attack rates were 12.8%, 18.1%, and 8.9%, respectively. Confirmed cases were distributed in all age groups. Recruits and the unvaccinated were at higher risk for COVID-19. The aerodynamic experiment verified the possibility of aerosol transmission within the same living area.
Conclusion
COVID-19 transmission at army training centers should be minimized through quarantine and post-admission testing during the latency period as part of integrated measures that include facility ventilation, vaccination, indoor mask-wearing, and social distancing.

First
Prev
Page of 5
Next
Last

Search