**The Impact of COVID-19 Pandemic, Related Protective Measures (Containment), Environmental Change and Variation on the Emergency Demands: Results Based on 107,066 Primary Missions in Switzerland**

**Séverine Vuilleumier1 , Assunta Fiorentino1 , Sandrine Dénéréaz2 , and Thierry Spichiger2** <sup>1</sup> La Source, University of Applied Sciences and Arts, Western Switzerland (HES-SO), Lausanne, Switzerland <sup>2</sup> ES ASUR, Vocational Training College for Registered Paramedics and Emergency Care, Switzerland

The COVID-19 pandemic impacts not only the COVID-19 patients but also the patients seeking emergency help due to other health issues. Besides, climate changes and environment conditions increased seasonality in emergency demands. Also, the role of paramedics, which is initially to respond to vital emergency situations, now must face new emergency demands. To better understand this transition in prehospital activities, it appears necessary to perform a detailed comparative analysis of missions, typology, and severity of cases encountered. The aim of this study is to delineate the impact of the COVID-19 pandemic, related protective measures (containment), environmental change, and variation on the emergency demands to provide recommendations on the allocation of prehospital resources. Statistical analysis of 107,066 ambulance primary emergency missions during the years 2018, 2019, and 2020 (n=107,066) in the State of Vaud in Switzerland. Variables analyzed were the number of missions, patient age and gender, health issues (33 categories), the severity of cases encountered (NACA scores), and mission time and locations. Our results quantified the difference in health issues, severity, and the patient population before and during the outbreak and identified the consequences of COVID-19 on paramedic missions as well as potential collateral effects. Comparative analysis is performed month by month. The results describe the primary missions in the State of Vaud in 2018 and show in particular that around 87% of missions are "non-urgent". Over half of patients are 65 or older, and only 23% of missions are for traumas. Most missions take place between 7:00 am and 6:00 pm (67%), and around 12% of missions lead to the non-transport of the patient. COVID-19 pandemic waves significantly increased health issues such as respiratory issues, and confinement decreased the number of trauma and intoxication significantly while a significant increase in the number of cases of allergy is measured through time. COVID-19 pandemic, containment, as well as environmental variations impact emergency demands. Reflecting upon their role in emergency demands appears necessary, as well as the related prehospital resource allocation and paramedics' skills to respond to the current needs.

Séverine Vuilleumier1, Assunta Fiorentino1, Sandrine Dénéréaz2, and Thierry Spichiger2

<sup>1</sup> La Source, University of Applied Sciences and Arts, Western Switzerland (HES-SO), Lausanne, Switzerland <sup>2</sup> ES ASUR, Vocational Training College for Registered Paramedics and Emergency Care, Switzerland


#### Results


• Confinement significantly decreased the amount of trauma (around 30%) and intoxication (around 30%) while a significant increase in number of cases of allergy is measured through time.

#### Conclusion

The COVID-19 pandemic, containment, and environmental variations significantly impacted emergency demands during the pandemic.

#### NACA score: National Advisory Committee for Aeronautics Score

The Impact of the COVID-19 Pandemic, Related Protective Measures (Containment), Environmental Change and Variation on the Emergency Demands: Results Based on 107,066 Primary Missions in Switzerland

#### Methods

Statistical analysis of 107,066 ambulance primary emergency missions during the years 2018, 2019 and 2020 in the State of Vaud in Switzerland

#### Background

The COVID-19 pandemic impacted not only the COVID-19 patients but also patients seeking pre-hospital emergency help due to other health issues.

#### The Aims


**Engaging Urban Health Champions for Promoting Healthy Lifestyles and Preventing COVID-19 among Urban Under-Settlement Communities in the Colombo District of Sri Lanka: An Initiative by the Estate and Urban Health Unit of the Ministry of Health, Sri Lanka**

**Enoka Wickramasinghe1 , Charles Nugawela2 , Nadeeja Herath1 , Saseela Subaskaran1 , Chanuka Sumanapala1 , and Sarasi Withana1**

1Estate and Urban Health Unit

<sup>2</sup> National Institute for Nephrology Dialysis and Transplantation of Ministry of Health, Sri Lanka

Nearly 4-7 million (18%-30%) Sri Lankan population reside in the urban sector spanning 64 Municipal and urban council areas. Most urban people are clustered in under-settled communities with high population density, low living conditions, and poor health indicators. These socio-demographic characteristics challenge the health of these communities. Also, urban under-settlement areas faced the highest COVID impact. Focused interventions are needed to improve their health and promote healthy lifestyles. Urban Development Authority (UDA) of Sri Lanka aims to relocate these communities to settlement flats by 2030, particularly in the Colombo district, as it has the highest urban population. Currently, nearly 13,000 families are relocated to 21 settlement flats in the Colombo district. The estate and urban unit, together with Colombo Municipal Council and UDA, initiated the Urban Health Champion model project in these flats. Objectives were to mobilize urban community groups to promote healthy lifestyles and to prevent the spread of COVID-19 among these communities. All managers, health instructors, and Public Health Midwives serving in these flats were trained in community engagement and health promotion. Groups of 10-15 urban champions were formed in each flat and empowered to promote healthy lifestyles among themselves and to prevent COVID spread. Health needs assessment and prioritization were done by the groups.

Promoting exercise, preventing public spitting and COVID spread, and community screening for noncommunicable disease (NCD) risk factors were prioritized health needs. Activities conducted were: regular risk communication announcements; awareness through religious leaders; community engagement for COVID protection using family checklist; establishment of wash stations; conducting exercise sessions; awareness on banning public spitting and establishment of Urban Wellness Centers for community-based NCD risk factor screening and healthy lifestyle promotion. Urban community group involvement has been shown to be effective in promoting healthy lifestyles and COVID prevention. None of these flats were locked down after starting the project. Regular engagement of health and other service personnel with these groups would be necessary to strengthen the sustainability of this initiative. The urban champion engagement model has shown positive results in promoting health and healthy lifestyles among urban under-settled communities.

Enoka Wickramasinghe1, Charles Nugawela2, Nadeeja Herath1, Saseela Subaskaran1, Chanuka Sumanapala1, and Sarasi Withana1

#### <sup>1</sup> Estate and Urban Health Unit

2National Institute for Nephrology Dialysis and Transplantation of Ministry of Health, Sri Lanka

#### Methods

1st stage: Training of coordinators on community mobilization, engagement and health promotion concepts. 2nd stage: formation of urban champion groups in each flat. Identifying and prioritizing health needs of each setting by coordinators and champion groups. 3rd stage: Conducting community-based activities with the engagement of urban champions to promote healthy lifestyles and prevent COVID-19 spread in each flat complex.

#### Conclusions

The urban health champion project showed positive results in promoting health and healthy lifestyles among urban under-settled communities.

#### Introduction

Nearly 4–7 million (18%-30%) Sri Lankans reside in the urban sector. Most urban people are clustered in under-settlements with high population density, low living conditions and poor health indicators. Urban under- settlements faced the highest COVID impact. Focused interventions are needed to improve their health and promote healthy lifestyles. Sri Lanka aims to relocate these communities to settlement flats by 2030. Currently 13,000 families have been relocated to 21 flat complexes in the Colombo district. The Estate and Urban Health unit, together with Colombo Municipal Council and UDA, initiated the Urban Health Champion model project in these flats. The project aimed to mobilize settlement flat champion groups to promote health.

#### Methods, cont.

Prioritized health needs:

Improving knowledge and skills in preventing Non Communicable Diseases (NCD)


Engaging Urban Health Champions for Preventing COVID-19 and Promoting Healthy Lifestyles among Urban Under-Settlement Communities in the Colombo District: An Initiative by the Estate and Urban Health Unit of the Ministry of Health, Sri Lanka

### **Cameroonians' Views on the COVID-19 Vaccine**

**Jeannette Wogaing and Fabrice Taku Kammou**

#### University Of Douala, Cameroon

The pathology known as COVID-19 is an infectious disease that has claimed lives in almost every country in the world, hence the term "global pandemic". Referred to as a "white man's disease", "traveler's disease" or "whiten", it has led to confinements around the world and the introduction of barrier measures to limit contagion. Despite these precautions, the number of deaths has continued to stagnate or increase. Moreover, the virus is mutating. Despite the controversy surrounding the disease and the vaccine's side effects on some people, several countries around the world have considered vaccinating their populations, including Cameroon. However, public attitudes remain mixed. In a comprehensive analysis based on observations, interviews, and case studies in Bafoussam, Douala, and Yaoundé, we not only collected people's views on the COVID vaccination project, but also sought to understand the reasons behind this practice. This exploratory study shows that vaccination is far from being the solution to the coronavirus epidemic. The people interviewed believe that the Cameroonian government should raise awareness of the need to naturally strengthen the immune system, respect barrier measures due to the non-immunizing nature of the vaccine, and make use of proven endogenous knowledge. It is imperative to take into account both conventional medical procedures and local expertise in phytotherapy.

Jeanette Wogaing and Fabrice Taku Kammou

#### University of Douala, Cameroon

#### Introduction

Les tout premiers travaux sur la pandémie à coronavirus étaient de deux catégories:






#### Materiel et Methode



#### Résultats et discussion

#### De la conception populaire aux réticences à la vaccination

La perception et le vécu de la maladie sont fort distincts d'une communauté à une autre (Mbonji, 2009; Jaffré et Sardan, 1999). 03 interprétations différentes ont été dégagées:


Le déni et donc le refus d'accepter l'existence réelle de la Covid-19:


#### La vaccination au crible des opinions

Tous les informateurs ont avoué savoir l'existence d'un vaccin contre le corona virus.

• « Que cela prévient le risque d'être infecté par le virus et de

développer la forme sévère de COVID-19 si l'on attrape l'infection » Informateur de Yaoundé

Dans un échantillon résiduel d'une trentaine d'informateurs, seulement 16% ont reconnu s'être vacciné. À l'image de la majorité, le scepticisme développé contre ce vaccin peut se comprendre ainsi:

vaccin protège de la maladie et un vaccin se développe pendant au moins

10 ans, pas en 3 mois ! » Informateur de Douala.

#### La vaccinopsychose au Cameroun


#### La vaccination: un choix difficile

Selon les données officielles, seule 3,1% de la population camerounaise est vaccinée (Ministère de la santé publique, 2020).

#### Pourquoi?

La grosse controverse qu'il y a eu autour du vaccin venant des experts en la matière n'était pas de nature à rassurer. Le doute a été semé dans l'esprit de plusieurs personnes interviewées.


La fiabilité du vaccin a fait l'objet de plusieurs débats contradictoires.


La pandémie n'avait pas partout la même ampleur.



Une partie importante du personnel soignant n'a pas été à même de convaincre la population.

### Conclusions



### Références bibliographiques

