Health in Emergencies and Disasters Quarterly
Volume:5 Issue: 3, Spring 2020

The Coronavirus disease 2019 (COVID-19) was identified in late 2019 and has gradually spread to all countries. Following the outspread of this virus as a community-acquired disease, many researchers have been trying to identify various factors involved in the transmission of the virus, as well as the ways to prevent its transmission from person to person. For example, researchers have found that ambient temperatures above 40°C and proper ventilation prevent the growth, proliferation, and transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however; environmental humidity is largely ineffective for its transmission [1, 2].

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus. Iran is one of the countries affected by the disease. Health center services have a critical role in response to the COVID-19 outbreak. This study with the aim of providing the functions and services of primary health care was performed by a health center in Iran during the COVID-19 outbreak. Based on the results, of the functions and services of the primary health care included purposive inter-organizational interaction and cooperation, risk analysis, planning, education and consultation, exercise, risk communication, environmental health, occupational health, and development of health infrastructures. Iran established and developed specific approaches for case identification, screening, and resource allocation to protect public health by primary health care services. Health center services are effective for a proper response to COVID-19 and a reduction in mortality by screening, rapid identification, and public education.

In January 2020, the World Health Organization (WHO) declared the COVID-19’s outbreak as an international public health emergency. In March 2020, WHO evaluation showed that COVID-19 could be considered a pandemic disease. Nowadays, the spread of COVID-19 threatens all aspects of human living conditions. In this regard, the objectives of this research are to investigate the anxieties and concerns of the Iranian people regarding the spread of COVID-19 in the initial months of its outbreak.

This study was conducted with a qualitative methodology employing the conventional content analysis method. Data of anxieties and concerns of the general population were collected through social workers working at university/ medical schools throughout the country, affiliated healthcare centers, hotline 190, and social networks. The data collection process was saturated with 2920 theoretical data from February 27, 2020, to April 3, 2020.

Anxieties and concerns of community members were categorized into 8 areas: 1- Confusion in communication with the surrounding environment, 2- Concerns about vulnerable groups being affected, 3- The necessity of informational support, 4- Economic turmoil, 5- Shortage of preventive and treatment facilities, 6 -weakness of social capital, 7- Stressful and destructive atmosphere, 8- Approaches for crisis management situation.

Based on the research findings, focusing and attention on people’s concerns in a transparent manner, and designing novel psychosocial support systems based on people’s real needs to control the disease spread result in the enhancement of social capital between community members to get through this crisis quickly.

After presenting the novel coronavirus (SARS-CoV-2) in china, it has spread rapidly in the community and now has declared as a pandemic causing coronavirus disease 2019 (COVID-19). At the date of writing this report, the COVID-19 has affected 192 countries and one international conveyance (the Diamond Princess cruise ship harbored in Yokohama, Japan) around the world with the total cases of 341,529. In Iran, the emergence of the disease was reported with two cases of COVID-19 deaths in Qom city on February 19, 2020, that caused great concern for the health system and the general public. It was rapidly spread around the country and reach to 21,638 definite cases by March 22, 2020. The special nature of the disease in rapid transmission among individuals in society requires urgent measures and serious actions to control it as quickly as possible. In this report, we describe the current status of the COVID-19 response strategy for reducing transmission in public and patient load in hospitals in Iran. Although Iran has tried to use the successful experience of other countries, such as China, for various reasons, such as non-quarantine of Qom province, as the primary site of disease propagation, lack of public quarantine, lack of seriousness by some citizens and officials, the lack of facilities and personal protective equipment needed for staff use, and restrictions regarding purchasing equipment from other countries due to international sanctions, have served as obstacles to achieve good results.

Iran detected its first COVID-19 case in February 2020 in Qom province, which rapidly spread to other cities in the country. Iran, as one of those countries with the highest number of infected people, has officially reported 1812 deaths from a total number of 23049 confirmed infected cases that we used in the analysis.

Geographic distribution by the map of calculated incidence rates for COVID -19 in Iran within the period was prepared by GIS 10.6 Spatial autocorrelation (Global Moran’s I) and hot spot analysis were used to assess COVID -19 spatial patterns. The ordinary least square method was used to estimate the relationship between COVID -19 and the risk factors. The next step was to explore Geographically Weighted Regression (GWR) models that might better explain the variation in COVID -19 cases based on the environmental and socio-demographic factors.

The spatial autocorrelation (Global Moran’s I) result showed that COVID-19 cases in the studied area were in clustered patterns. For statistically significant positive z-scores, the larger the z-score is, the more intense the clustering of high values (hot spot), such as Semnan, Qom, Isfahan, Mazandaran, Alborz, and Tehran. Hot spot analysis detected clustering of a hot spot with confidence level 99% for Semnan, Qom, Isfahan, Mazandaran, Alborz, and Tehran, as well. The risk factors were removed from the model step by step. Finally, just the distance from the epicenter was adopted in the model. GWR efforts increased the explanatory value of risk factor with better special precision (adjusted R-squared=0.44)

The highest CIR was concentrated around Qom. Also, the greater the distance from the center of prevalence (Qom), the fewer the patients. Hot spot analysis also implies that the neighboring provinces of prevalence centers exhibited hot spots with a 99% confidence level. Furthermore, the results of OLS analysis showed the significant correlation of CIR is with the distance from epicenter (Qom). The GWR can result in the spatial granularity providing an opportunity to well understand the relationship between environmental spatial heterogeneity and COVID-19 risk as entailed by the infection of CIR with COVID-19, which would make it possible to better plan managerial policies for public health.