The coronavirus (COVID-19) epidemic in Germany began in March 2020, with high new daily case numbers still being recorded during 2023. The pandemic is ongoing.

Staying home

The coronavirus (COVID-19) outbreak was declared a pandemic by the World Health Organisation on March 11, 2020. This declaration immediately impacted life in Germany on all levels. Rising coronavirus (COVID-19) case numbers in March-April led to the swift implementation of nationwide distancing and crowd control measures to stop further spread of the virus, which primarily transferred most easily from person to person. From a large-scale economic shutdown, venue, school, daycare and university closures, to social distancing and the contact ban officially implemented by the German government, seemingly in the space of days life as the population knew it came to a standstill in the whole country.

Unlockdown

Later in April 2020, Germany began easing some of the restrictions related to the coronavirus (COVID-19) outbreak as case numbers began to drop. Elements of uncertainty remain and touch on various aspects, for example, regarding national mental and physical health, both among adults and children, the possibility of long-term effects from the virus, immunity. A rising worry among European nations was economic recovery.

Observed and predicted number of diagnoses during and after the first phase of the COVID-19 pandemic in Finland.

Background: Although inactivated COVID-19 vaccines are proven to be safe and effective in the general population, the dynamic response and duration of antibodies after vaccination in the real world should be further assessed. Methods: We enrolled 1067 volunteers who had been vaccinated with one or two doses of CoronaVac in Zhejiang Province, China. Another 90 healthy adults without previous vaccinations were recruited and vaccinated with three doses of CoronaVac, 28 days and 6 months apart. Serum samples were collected from multiple timepoints and analyzed for specific IgM/IgG and neutralizing antibodies (NAbs) for immunogenicity evaluation. Antibody responses to the Delta and Omicron variants were measured by pseudovirus-based neutralization tests. Results: Our results revealed that binding antibody IgM peaked 14–28 days after one dose of CoronaVac, while IgG and NAbs peaked approximately 1 month after the second dose and then declined slightly over time. Antibody responses had waned by month 6 after vaccination and became undetectable in the majority of individuals at 12 months. Levels of NAbs to live SARS-CoV-2 were correlated with anti-SARS-CoV-2 IgG and NAbs to pseudovirus, but not IgM. Homologous booster around 6 months after primary vaccination activated anamnestic immunity and raised NAbs 25.5-fold. The neutralized fraction subsequently rose to 36.0% for Delta (p=0.03) and 4.3% for Omicron (p=0.004), and the response rate for Omicron rose from 7.9% (7/89) to 17.8% (16/90). Conclusions: Two doses of CoronaVac vaccine resulted in limited protection over a short duration. The inactivated vaccine booster can reverse the decrease of antibody levels to prime strain, but it does not elicit potent neutralization against Omicron; therefore, the optimization of booster procedures is vital. Methods Study design and participants The cross-sectional investigation was conducted in five counties of Zhejiang Province, mainland China (Xihu, Yuecheng, Shangyu, Kaihua, and Longyou Districts), after nationwide COVID-19 vaccinations from May to October 2021. Potential participants aged 18–59 years who had no prior vaccinations or were vaccinated with one or two doses of CoronaVac (Sinovac Life Sciences, Beijing, China) were recruited from the community. Individuals with a history of infection with SARS-CoV-2 (based on epidemic surveillance system) or the use of blood products or immunosuppressive drugs were excluded. We randomly enrolled 1067 volunteers, including those on day 0 (V-0, no vaccination), day 14 ± 2 (V1-14d), and day 28 ± 3 (V1-28d) after the first vaccine dose, and day 30 ± 3 (V2-1m), day 90 ± 7 (V2-3m), day 180 ± 14 (V2-6m), day 270 ± 14 (V2-9m), and day 365 ± 30 (V2-12m) after the second dose and collected their venous blood samples (3–5 ml) to detect serum antibody levels (Figure 1A). This was not a longitudinal survey, as different subjects were enrolled at each point in time. We employed a questionnaire survey at blood drawing visits to gather demographic information. In the prospective cohort study, we recruited 90 healthy adults aged 18–80 years from Jiaxing city, Zhejiang, in June 2021. The main exclusion criteria included previous or later SARS-CoV-2 infection; allergy to any ingredient included in the vaccine; those who had received any blood products or any research medicines or vaccines in the past month; those who had uncontrolled epilepsy or other serious neurological diseases, acute febrile disease, acute onset of chronic diseases, or uncontrolled severe chronic diseases; and those who were unable to comply with the study schedule. Subjects were administered 4 µg/0.5 mL of CoronaVac following a 3-shot vaccine schedule 28 days and 6 months apart. Following that, venous blood (3–5 ml) was collected from recipients at five time points: day 0 (Pre-V, before vaccination), day 30 ± 3 (V2-1m), day 90 ± 7 (V2-3m), and day 180 ± 14 (V2-6m) after the second dose, and day 30 ± 3 (V3-1m) after the third dose (Figure 1B). SARS-CoV-2-specific IgG and IgM assay The commercial detection kit iFlash-2019-nCoV NAb assay (Shenzhen YHLO Biotech Co. Ltd., Shenzhen, China) was employed to measure the levels of IgG and IgM against SARS-CoV-2 spike glycoprotein (S) and nucleocapsid protein (N) by chemiluminescence immunoassay. Briefly, serum samples were allowed to form a complex with SARS-CoV-2 S- and N-protein antigen-coated paramagnetic microparticles, then an acridinium-ester-labeled ACE2 conjugate was added to competitively combine with the particles, forming another reaction mixture. The analyzer converted relative light units (RLUs) into an antibody titer (AU/mL) through a two-point calibration curve. An inverse relationship existed between the amount of SARS-CoV-2 NAb in the sample and the RLUs detected by the iFlash optical system. According to the manufacturer, titers of ≥10.0 AU/mL and ≥1.0 AU/mL are considered positive (or reactive) for IgG and IgM, respectively. IgG and IgM against SARS-CoV-2 receptor binding domain (RBD) were detected using a commercial ELISA kit (Bioscience Biotech Co. Ltd., Chongqing, China). The positive cutoff values for RBD-specific IgG and IgM antibodies were defined as titers of ≥1.0 AU/mL. All tests were performed according to the manufacturer’s protocols (Chan et al. 2021; Li et al. 2021). Live virus neutralization antibody assays The levels of neutralizing antibodies to live SARS-CoV-2 were assessed by the reduction in the cytopathic effect (CPE) in Vero cells with infectious SARS-CoV-2 strain 19nCoVCDC-Tan-HB01 (HB01) in a BSL-3 laboratory(Zhang et al. 2021). Briefly, serum samples were heat-inactivated for 30 min at 56°C and successively diluted from 1:4 to the required concentration in a 2-fold series. An equal volume of challenge solution containing 100 TCID50 virus was added. After neutralization in a 37°C incubator for 2 h, a 1.5–2.5 × 105/ml cell suspension was added to the wells. The CPE (cytopathic effect) on VeroE6 cells was analyzed at 4-days post-infection. NT50 (50% neutralization titer, the reciprocal of the highest dilution protecting 50% of the cells from virus challenge) was used to show the neutralization titers. NT50 above 1:4 was defined as positive. Pseudovirus-based neutralization test Serum samples were also quantified for their content of SARS-CoV-2-neutralizing antibodies to wildtype (Wuhan), Delta (B.1.617.2), and Omicron (B.1.1.529) using the pseudovirus-based virus neutralization test (Nie et al. 2020). Briefly, serum samples and a positive or negative reference sample were each diluted 50 times with phosphate-buffered saline combined with 50 µl of pseudovirus diluent per well in a 96-well plate. The mixed sample/pseudovirus was incubated at 37°C and 5% CO2 for 1 h. A 2 × 105/ml BHK-21-ACE2 cell suspension was added to each well of the plate containing the sample/pseudovirus mixture, then the plate was incubated in a 37°C and 5% CO2 cell incubator for 48 h. Finally, the number of green-fluorescence-protein-positive cells per well was read with a porous plate imager (Tecan, Shanghai, SparkCyto). The results were determined by comparing the neutralized fraction using the following calculation: (1 – (fluorescence value of each well/average virus control value)) × 100%(Karaba et al. 2022). At least 4 wells were left blank for calibration to 0% inhibition. The conversion of neutralized fraction to serum titer was shown in Table S2. Statistical analysis Sex, age, BMI, and other clinical characteristics were collected for each vaccination recipient. We used the medians and interquartile ranges (IQR) for age, and numbers (percentages) for categorical variables. Specific binding antibodies against SARS-CoV-2 (IgG, IgM) and neutralized fraction of SARS-CoV-2-neutralizing antibodies are presented as mean ± standard error (SEM). Neutralizing antibodies are presented as geometric mean titers (GMT), and their 95% confidence interval (CI) was calculated with Student’s t distribution on log-transformed data and then back-transformed. Comparisons of titer-level differences between the two groups were performed using the paired Student's t-test. One-way analysis of variance (one-way ANOVA) was used to analyze the differences between the mean values at different timepoints. Correlations between NAb titers, neutralized fraction, and IgG/IgM levels were evaluated by Pearson’s correlation coefficient. Statistical tests were two-sided, and we considered p-values of less than 0.05 as statistically significant. All statistical analyses were conducted in SPSS 18.0 (IBM Corporation, Armonk, NY, USA) and GraphPad Prism 9 (San Diego CA, USA).

COVID-19 compulsory vaccination for healthcare professionals (HCPs) is a sensitive and controversial topic, with different support rates worldwide. Previous studies in Cyprus identified a low COVID-19 vaccination acceptance among HCPs, however, no studies have investigated their perceptions toward mandatory COVID-19 vaccination. This is the first study to investigate the attitudes of HCPs toward mandatory COVID-19 vaccination and its association with general vaccination knowledge. A cross-sectional study was conducted, using an online self-administered, anonymous questionnaire to collect data on sociodemographic and health-related characteristics, trust and satisfaction with the healthcare system, utilization of preventive healthcare services, COVID-19 vaccination information, vaccination knowledge, and attitudes among HCPs toward mandatory COVID-19 vaccination. A total of 504 HCPs participated in the survey, with 34% being in favor of mandatory COVID-19 vaccination. A sufficient vaccination knowledge score was identified among the HCPs, with higher scores being associated with mandatory vaccination support (p < 0.001). As age increases by one year, the odds of supporting mandatory vaccination increase by 1.03 units (95% CI: 1.01–1.06). In addition, as the general vaccination knowledge score increases by one unit, the odds of supporting mandatory COVID-19 vaccination increase by 1.55 units (95% CI: 1.33–1.81). Our findings show that about two-thirds of the HCPs in Cyprus were opposed to a mandatory COVID-19 vaccination policy. Older age and general vaccination knowledge were found to be the strongest predictors of mandatory vaccination support. To avoid unforeseen outcomes, mandatory vaccination policies should be implemented with caution and consultation.

The enforcement of nationwide lockdowns and social distancing measures severely restricted behavior and led to increases in stress, anxiety, and depression during the COVID-19 Pandemic. However, contrary to expectations, studies show that well-being did not decrease significantly during the Pandemic. The present study examined whether intentional increases in alternative behaviors contributed to maintaining well-being. We predicted an increase in indoor activities as alternatives to outdoor activities and that these behavioral changes contribute to maintaining well-being. Focusing on leisure activities, transport mode, and working environments, we tested these predictions in an online survey of 1,000 participants (M = 40.4 years; SD = 10.9). The results demonstrated that the decrease in outdoor leisure activities (e.g., traveling and shopping), use of public transportation, and working at office led to a reduction in well-being. It was also demonstrated that the subsequent increase in indoor leisure activities (e.g., exercising at home and online shopping) and use of a private car led to an increase in well-being, which supported our predictions. These results suggest that increasing alternative behaviors can maintain overall well-being during pandemics. These findings highlight the significance of intentional behavioral changes in maintaining well-being during pandemics.

Associations between the intervention and self-reported COVID-19 vaccine uptake in Ukraine.

The coronavirus COVID-19, which originated in Wuhan, China, has spread worldwide. Across the different regions in the world, the number of cases is continuously increasing. As of May 3, 2023, Quezon City reported over 277 thousand cases of COVID-19 – the highest among other cities and provinces in the Philippines.

Lesser restrictions in major cities Despite having the highest number of COVID-19 cases among cities and provinces nationwide, Quezon City was placed under Alert Level 1 for the month of June 2022 – the lowest alert level status for the pandemic. This meant freer movements across populations and full capacity of most establishments. The alert level status will be updated depending on the possible rise of new cases. The lowering down of restriction level was implemented after the vaccination target of 71 million was met. As of July 2022, over 71 million people have already been fully vaccinated from COVID, with over 15 million having received a booster dose.

Unmasking
The possibility of lifting the mandatory wearing of face masks in the country towards the end of 2022 was raised if the government successfully vaccinates 90 million of its 110 million population. In addition, the Philippine government will also start encouraging its population to take the booster shot, in efforts to control the spread of the Omicron subvariant. As of July 2022, the National Capital Region accounted for the highest share of the population with booster shots.

ObjectivesPrevious studies suggested that coronavirus disease 2019 (COVID-19) could lead to pulmonary fibrosis, but the incidence of newly diagnosed interstitial lung disease (ILD) after COVID-19 is unclear. We aimed to determine whether COVID-19 increases the risk of newly diagnosed ILD and whether vaccination against COVID-19 can reduce this risk.MethodsThis retrospective cohort study used data from the Korean National Health Insurance claim-based database. Two study groups and propensity score (PS)-matched control groups were constructed: Study 1: participants diagnosed with COVID-19 (COVID-19 cohort) and their PS-matched controls; Study 2: COVID-19 vaccinated participants (vaccination cohort) and their PS-matched controls.ResultsIn Study 1, during a median 6 months of follow-up, 0.50% of the COVID-19 cohort (300/60,518) and 0.04% of controls (27/60,518) developed newly diagnosed ILD, with an incidence of 9.76 and 0.88 per 1,000 person-years, respectively. The COVID-19 cohort had a higher risk of ILD [adjusted hazard ratio (aHR), 11.01; 95% confidence interval (CI), 7.42–16.32] than controls. In Study 2, the vaccination cohort had a lower risk of newly diagnosed ILD than controls (aHR, 0.44; 95% CI, 0.34–0.57).ConclusionUsing nationwide data, we demonstrated that COVID-19 was associated with a higher incidence rate of newly diagnosed ILD, but that this risk could be mitigated by COVID-19 vaccination.

BackgroundDespite numerous efforts to assess the impact of the COVID-19 pandemic on mental health, there are few longitudinal studies that examine the change in the burden of psychological distress over time and its associated factors, especially in developing countries.ObjectiveThe primary aim of this study was to assess the levels of psychological distress at two time points during the COVID-19 outbreak based on a representative community sample in Chile. The secondary aim was to identify groups that are more vulnerable to psychological distress during the pandemic.MethodsA nationally representative, longitudinal telephone survey of Chilean adults was conducted. This study analyses panel data from two waves in 2020: May 30 to June 10 and September 15 to October 9. A total of 823 people participated in both surveys. Changes in mental health outcomes (anxiety and depressive symptoms) were assessed, estimating the effect of demographic characteristics, psychosocial and economic factors, household conditions, and health status.ResultsThere was a significant increase in psychological distress (PHQ-4 ≥ 6) between Waves 1 (22.6%) and 2 (27.0%), especially among younger participants. Overall, the results of this study show that being female, living in or near the capital, living in overcrowded households and having a perceived lack of space in the home, loneliness or perceived social isolation, and having received mental health treatment within the last year are significantly associated with psychological distress over time (p < 0.05).ConclusionThis study highlights the need to implement psychosocial programs to protect people's psychological well-being, as well as social policies to improve household living conditions and levels of social connectedness during the COVID-19 outbreak.

The coronavirus (COVID-19) pandemic had a major impact on travel in the Netherlands, with international tourist arrivals falling by 97 percent in April 2020 over the same month in 2019. While this scenario improved during the summer, inbound tourist arrivals started to decrease again since September and reached 123 thousand in December 2020. In April 2021, the number of international arrivals rose over the previous year, reaching 136 thousand. However, this figure was still far below pre-pandemic levels.

The Netherlands imposed a nationwide lockdown on March 15 to prevent the spread of the virus. This included shutting down non-essential businesses, and non-essential travels were also banned for all countries. The travel ban was gradually lifted during May and June, then new restrictions were implemented in October.

Discrete choice experiment attributes and attribute levels.

The COVID-19 emergency has severely affected the Italian population. During a pandemic, those with high health anxiety are at risk of adverse mental health outcomes, including peritraumatic distress and mood disturbance. No prior research has explored the role of psychological flexibility in protecting people at high risk of poorer mental health impacts due to health anxiety during a pandemic. Psychological flexibility is the cornerstone of psychological health and resiliency. According to acceptance and commitment therapy (ACT), it involves behaving consistently with one’s chosen values even in the presence of emotional and mental discomfort. This study examined the mediating and moderating roles of psychological flexibility in the link between trait health anxiety and three mental health outcomes: COVID-19 peritraumatic distress, anxiety, and depression. We hypothesized that higher psychological flexibility would decrease the negative impacts of trait health anxiety on mental health outcomes. During the mandatory national lockdown (M = 35.70 days, SD = 8.41), 944 Italian adults (75.5% female, M = 38.86 years, SD = 13.20) completed an online survey consisting of standardized measures of psychological flexibility, trait health anxiety, COVID-19 distress, anxiety, and depression. Results indicated that psychological flexibility did not moderate the link between trait health anxiety and mental health outcomes. Rather, greater psychological flexibility mediated decreases in the adverse effects of trait health anxiety on COVID-19 distress, anxiety, and depression. In particular, two psychological flexibility processes, observing unhelpful thoughts rather than taking them literally (defusion) and values-based action (committed action), mediated decreases in the negative effects of trait health anxiety on all mental health outcomes. In contrast, the psychological flexibility process acceptance, which involves openness to inner discomfort, mediated increases in negative mental health outcomes. Overall, the combination of these processes mitigated the detrimental impacts of trait health anxiety on mental health during the emergency mandatory COVID-19 nationwide lockdown. Consistent with the ACT conceptualization of psychological flexibility, findings suggest embracing (rather than avoiding) inner discomfort and observing associated unhelpful thoughts, while also engaging in values-based action, increases resilience during adversity. Evidenced-based large-scale online public health interventions that target psychological flexibility in those experiencing health anxiety in the context of a pandemic are urgently needed. Many empirically-based ACT interventions are suited for this purpose.

Model-based estimates for the proportion of non-COVID-19 excess deaths attributable to opioids.

Background: The COVID-19 epidemic has disrupted care and access to care in many ways. It was accompanied by an excess of cardiovascular drug treatment discontinuations. We sought to investigate a deeper potential impact of the COVID-19 epidemic on antihypertensive drug treatment disruptions by assessing whether the epidemic induced some changes in the characteristics of disruptions in terms of duration, treatment outcome, and patient characteristics.Methods: From March 2018 to February 2021, a repeated cohort analysis was performed using French national health insurance databases. The impact of the epidemic on treatment discontinuations and resumption of antihypertensive medications was assessed using preformed interrupted time series analyses either on a quarterly basis.Results: Among all adult patients on antihypertensive medication, we identified 2,318,844 (18.7%) who discontinued their antihypertensive treatment during the first blocking period in France. No differences were observed between periods in the characteristics of patients who interrupted their treatment or in the duration of treatment disruptions. The COVID-19 epidemic was not accompanied by a change in the proportion of patients who fully resumed treatment after a disruption, neither in level nor in trend/slope [change in level: 2.66 (−0.11; 5.42); change in slope: −0.67 (−1.54; 0.20)]. Results were similar for the proportion of patients who permanently discontinued treatment within 1 year of disruption [level change: −0.21 (−2.08; 1.65); slope change: 0.24 (−0.40; 0.87)].Conclusion: This study showed that, although it led to an increase in cardiovascular drug disruptions, the COVID-19 epidemic did not change the characteristics of these. First, disruptions were not prolonged, and post-disruption treatment outcomes remained unchanged. Second, patients who experienced antihypertensive drug disruptions during the COVID-19 outbreak were essentially similar to those who experienced disruptions before it.

Covid-19 has significantly affected people's food purchasing and consumption habits. Fears of disruptions in the food supply chain have caused an increase in the quantity and type of food bought by households. However, increases in food purchases could give rise to food waste with negative ramifications for the environment in terms of greenhouse emissions and groundwater pollution. To assess whether household food waste has changed during Covid-19 lockdown, we conducted a nationwide survey of household food purchasers in Italy. Although the amount of food purchases increased during the lockdown, our results show that food waste actually decreased as people mainly bought more non-perishable food. Interestingly, concerns about the impact that the pandemic could have on the waste management system and the desire not to add pressure to the waste management system are key drivers of decreased food waste in Italy during the pandemic. Our findings seem to suggest that Italian consumers are developing a new level of awareness about food waste with potential positive impacts on the environment in terms of reducing greenhouse gas emissions and groundwater pollution.

Factors associated with attitude toward COVID-19 in the study population (n = 4870).

Factors associated with knowledge on COVID-19 in the study population (n = 4870).

Dengue is a significant public health problem in mostly tropical countries, including Timor-Leste. Dengue continues to draw attention from the health sector during the COVID-19 phenomenon. Therefore, the goal of this study is to evaluate the dengue incidence rate in comparison with the COVID-19 cumulative number and associated dengue risk factors, including the fatality rate of dengue infection in each municipality during the COVID-19 phenomenon in Timor-Leste, by applying the data processing program in Geographic Information Systems (GIS). A descriptive study using GIS was performed to provide a spatial-temporal mapping of dengue cases. Secondary data, which were sourced from the Department of Health Statistics Information under the Ministry of Health Timor-Leste, were collected for the period during the COVID-19 outbreak in 2020–2021. These data were grounded at the municipal (province) level. Quantum GIS and Microsoft Excel were used to analyze the data. During the COVID-19 outbreak (2020–2021), dengue spread nationwide. It was found that there was an increase in municipalities with high dengue cases and cumulative COVID-19 numbers. The high number of dengue cases associated with the COVID-19 cumulative number found in municipalities with an urban characteristic and in terms of severity, dengue fever (DF) is most commonly reported with a total of 1,556 cases and is followed by dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Most cases were reported in the months of the monsoon season, such as December, January, and March. Dengue GIS mapping helps understand the disease's presence and dynamic nature over time.

BackgroundAny infectious disease outbreak may lead to a negative detrimental psychological impact on individuals and the community at large, however; there was no systematic review nor meta-analysis that examined the relationship between the psychological/mental health impact of SARS and COVID-19 outbreak in Asia.Methods and designA systematic search was conducted using PubMed, EMBASE, Medline, PsycINFO, and CINAHL databases from 1/1/2000 to 1/6/2020. In this systematic review and meta-analysis, we analyzed the psychological impact on confirmed/suspected cases, healthcare workers and the general public during the Severe Acute Respiratory Syndrome (SARS) outbreak and Coronavirus disease (COVID-19) epidemics. Primary outcomes included prevalence of depression, anxiety, stress, post-traumatic stress disorder, aggression, sleeping problems and psychological symptoms.ResultTwenty-three eligible studies (N = 27,325) were included. Random effect model was used to analyze the data using STATA. Of these studies, 11 were related to the SARS outbreak and 12 related to COVID-19 outbreaks. The overall prevalence rate of anxiety during SARS and COVID-19 was 37.8% (95% CI: 21.1–54.5, P < 0.001, I2 = 96.9%) and 34.8% (95% CI: 29.1–40.4), respectively. For depression, the overall prevalence rate during SARS and COVID-19 was 30.9% (95% CI: 18.6–43.1, P < 0.001, I2 = 97.3%) and 32.4% (95% CI: 19.8–45.0, P < 0.001, I2 = 99.8%), respectively. The overall prevalence rate of stress was 9.4% (95% CI: −0.4 −19.2, P = 0.015, I2 = 83.3%) and 54.1% (95% CI: 35.7–72.6, P < 0.001, I2 = 98.8%) during SARS and COVID-19, respectively. The overall prevalence of PTSD was 15.1% (95% CI: 8.2–22.0, P < 0.001) during SARS epidemic, calculated by random-effects model (P < 0.05), with significant between-study heterogeneity (I2 = 93.5%).ConclusionThe SARS and COVID-19 epidemics have brought about high levels of psychological distress to individuals. Psychological interventions and contingent digital mental health platform should be promptly established nationwide for continuous surveillance of the increasing prevalence of negative psychological symptoms. Health policymakers and mental health experts should jointly collaborate to provide timely, contingent mental health treatment and psychological support to those in need to reduce the global disease burden.Systematic review registrationCRD42020182787, identifier PROSPER.

In 2022, there were 148 government hospitals and 207 private licensed hospitals in Malaysia. During the COVID-19 pandemic, the Malaysian hospitals were prepared by the government to accommodate infected patients by increasing bed numbers. Although the country has now entered the post-COVID time, the pandemic had an impact on the healthcare system.

COVID-19 hospitals

During the COVID-19 pandemic in 2020 and 2021, many of public and private hospitals provide screenings for coronavirus. However, these are paid services. Only the high-risk groups such as elderly population who live in a nursing home and healthcare workers were provided free COVID-19 tests by the government. About 59 hospitals that are owned by the Ministry of Health handled patients under investigation (PU) and suspected positive COVID-19 cases. In July 2020, these hospitals prepared over 400 beds in the in the intensive care unit (ICU) and an additional thousand-odd ventilators for COVID-19 patients exclusively. With the availability of vaccination against the disease, the number of patients significantly decreased. As of March 2022, around 80 percent of Malaysian population have been vaccinated.

Digitalization of patient records

In 2019, the Ministry of Health announced a plan to use electronic medical record (EMR) systems across all hospitals and clinics nationwide. The digitalization of patient records would then provide ease the healthcare processes. Just like in most countries, the pandemic has also accelerated the digital evolution demand in Malaysia. To achieve this goal, the government has also improved connectivity and bandwidth infrastructure across the country. In 2019, Malaysia had a digital readiness index of 14.31 out of 25, putting it in the Accelerate Stage. In comparison, neighboring Singapore has made progress in its e-government strategy with a head start in 2011.