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What should be learned from the COVID-19 pandemic for the next coronavirus pandemics?

Authors:
Marwa Osama Elgendy at Nahda University
Marwa Osama Elgendy
Mona A. Abdelrahman at Beni-Suef University
Mona A. Abdelrahman
Mohamed Abdelrahim at Beni-Suef University
Mohamed Abdelrahim
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Abstract

The COVID-19 pandemic showed us that the world should have a proper protocol for the handling of such pandemics. A similar severe coronavirus pandemic occurs in 1918 (The spinach flu pandemic) and took two years to finish. Both pandemics took a lot of lives. The 1918 Spanish flu pandemic was prevented with lower healthcare facilities. The main prevention method was social distancing. The effect of this social distancing was obvious when it was broken in Denver, the USA with its double-humped mortality curve of the Spanish flu pandemic in 1918. Even though this pandemic is also a coronavirus pandemic but some differences were observed in COVID-19. This commentary was to discuss the situation that occurs in COVID-19 and compare it to the Spanish flu pandemic in 1918 to reach a protocol for handling any possible upcoming coronavirus pandemics.
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International Journal of Clinical Medical Research
What should be learned from the COVID-
19 pandemic for the next coronavirus
pandemics?
1,2
Marwa O. Elgendy,
3
Mona A. Abdelrahman,
3
Mohamed E.A. Abdelrahim
*
Correspondence:
Mohamed E.A. Abdelrahim
Department of Clinical Pharmacy,
Faculty of Pharmacy, Beni-Suef
University, Beni-Suef, Egypt
Mohamedemam9@yahoo.com
1Department of Clinical Pharmacy,
Teaching Hospital of Faculty of
Medicine, Faculty of Medicine,
Beni-Suef University, Beni-Suef,
Egypt
2Department of Clinical Pharmacy,
Faculty of Pharmacy, Nahda
University, Egypt
3Clinical Pharmacy Department,
Faculty of Pharmacy, Beni-Suef
University, Beni-Suef, Egypt.
Volume number 1
Issue number 1
Pages 9-11
Abstract
The COVID-19 pandemic showed us that the world should have a proper protocol for
the handling of such pandemics. A similar severe coronavirus pandemic occurs in
1918 (The spinach flu pandemic) and took two years to finish. Both pandemics took a
lot of lives.
The 1918 Spanish flu pandemic was prevented with lower healthcare facilities. The
main prevention method was social distancing. The effect of this social distancing
was obvious when it was broken in Denver, the USA with its double-humped mortality
curve of the Spanish flu pandemic in 1918. Even though this pandemic is also a
coronavirus pandemic but some differences were observed in COVID-19. This
commentary was to discuss the situation that occurs in COVID-19 and compare it to
the Spanish flu pandemic in 1918 to reach a protocol for handling any possible
upcoming coronavirus pandemics.
Keywords: COVID-19, Spanish flu pandemic, mutation, vaccine, social distancing
Introduction
The coronavirus pandemic story
In 1918 a Spanish flu pandemic with coronavirus as the cause of infection took 50
million lives and infected 500 million people. [1] Not much was recorded about it and
the possibility of mutation was not detected at this time because of the lower
healthcare facility and technology. [2] This pandemic ended in 1920. The main
prevention method was social distancing. The effect of this social distancing was
obvious when it was broken in Denver, the USA with its double-humped mortality
curve of the Spanish flu pandemic in 1918. [3] The geography and mortality of the
1918 influenza pandemic were similar to that of COVID-19 with high severity and
mortality in Europe and the USA, low in Asia, and very low in Africa. [4-6] Nowadays
the technology allowed us to detect possible mutations and formulate a vaccine for
the virus. Even though the vaccines were not that affected due to the mutation and
their large number of side effects [7, 8] but it was found to decrease the severity of
the COVID-19 infection. [9] A protocol for handling such a pandemic should be well
prepared by the administrative and health societies to decrease possible mortality.
Since the same pandemic occurs in 1918 and nothing was learned from it which was
obvious in the administrative and health societies panicked handling of the COVID-19
pandemic. The presence of such a protocol could save lives and time rather than the
lives and time wasted at the start of the COVID-19 pandemic.
Frist, we believe from those two worldwide pandemics that the pandemic is not with
the same severity all over the world based on genetic factors or immunization
schedules [4, 5] and other factors like weather or age. [10] These factors should be
taken into account when facing the pandemic not to be surprised by the variation in
the severity that occurs in the COVID-19 pandemic. This was demonstrated in the
same way in the 1918 Spanish flu pandemic. Second, a proper and fast method of
trial and error to find the best treatment is very important in saving lives and time.
That would make the whole world scientists working together for the sake of saving
the world not individual scientists working in a certain way and others are in the
opposite direction and so on without the main target. [11] Third, to acknowledge that
COVID
-
19 story
Page
10
the vaccine is not that important since the coronavirus mutation overcomes its effect. That makes the subjects
taking the vaccine get infected several times after vaccination. These mutations were not recorded or taken care of
in the 1918 pandemic because they did not have such technology that we have now. Also, how long does immunity
last after COVID-19 vaccination? It is the question everybody needs to know, but its answer does not exist yet.
Accordingly, people might require an annual boost for COVID-19 which would depend on the length of duration of
protection. Most of the present vaccination regime includes a second analogous booster dose following a first dose
at a month interval approximately. The latest concern in the mixing of COVID-19 vaccines ascends to increase
protection and provoke a strong long-lasting immune response, but has a risk of augmented side effects and most
vitally, a lack of evidence. The concept of vaccine mixing is not something new but has been previously used for
multiple illnesses including HIV, malaria, Ebola, and influenza. [12]
Fourth, according to the spread and severity of the COVID-19, we believe that mutation was very favorable in the
coronavirus since the severity has decreased much and the spreadability was increased after the mutation [9] to the
extent that we are having nowadays a very mild COVID-19 disease, nothing more than rhinitis and rhinorrhea. This
factor needs more study to understand the reason for the effect of mutation on the severity and spreadability. Fifth
and most important is the prevention by social distancing, proper quarantine of infected subject, awareness of
infected personal and their contacts and masks. [13-17] This factor is very important since we believe that using this
only the Spinach flu pandemic in 1918 ended with their very low healthcare facilities compared to what we have
right now.
Conclusions
We suggest a formulation of a proper handling protocol of any upcoming pandemics by the administrative and
health societies or any important health society taken into account these factors to make the handling easier and
save lives and time compared to what happened at the beginning of the COVID-19 pandemic.
References
1. Johnson, N.P. and J. Mueller, Updating the accounts: global mortality of the 1918-1920" Spanish" influenza
pandemic. Bulletin of the History of Medicine, 2002: p. 105-115.
2. Stevens, K.M., The pathophysiology of influenzal pneumonia in 1918. Perspectives in biology and
medicine, 1981. 25(1): p. 115-125.
3. Markel, H. and J.A. Navarro, To Save Lives, Social Distancing Must Continue Longer Than We Expect. the
washington post, 2020.
4. El-Gendy, A.O., et al., Bacillus Calmette–Guérin vaccine, age and gender relation to COVID-19 spread and
mortality. Vaccine, 2020.
5. Zawbaa, H., et al., A study of the possible factors affecting COVID-19 spread, severity and mortality and
the effect of social distancing on these factors: Machine learning forecasting model. International Journal of
Clinical Practice, 2021. n/a(n/a): p. e14116.
6. Patterson, K.D. and G.F. Pyle, The geography and mortality of the 1918 influenza pandemic. Bulletin of the
History of Medicine, 1991. 65(1): p. 4-21.
7. Elgendy, M.O., et al., SARS-CoV-2 Post Vaccinated Adverse Effects and Efficacy in the Egyptian
Population. Vaccines, 2022. 10(1): p. 18.
8. Elgendy, M.O., et al., Vaccines side effects and efficacy among the Egyptian population. Vaccines, 2022.
10(1): p. 22.
9. Zawbaa, H.M., et al., Effect of mutation and vaccination on spread, severity, and mortality of COVID-19
disease. Journal of Medical Virology, 2022. 94(1): p. 197-204.
10. Chai, S., et al., Effect of age of COVID-19 inpatient on the severity of the disease: A meta-analysis.
International Journal of Clinical Practice, 2021. 75(10): p. e14640.
11. Sayed, A.M., et al., Repurposing of some anti-infective drugs for COVID-19 treatment: A surveillance study
supported by an in silico investigation. International Journal of Clinical Practice, 2020. n/a(n/a): p. e13877.
12. Groß, R., et al., Heterologous ChAdOx1 nCoV-19 and BNT162b2 prime-boost vaccination elicits potent
neutralizing antibody responses and T cell reactivity against prevalent SARS-CoV-2 variants.
EBioMedicine, 2022. 75: p. 103761.
13. Marwa O. Elgendy, et al., Role of repeating quarantine instructions and healthy practices on COVID-19
patients and contacted persons to raise their awareness and adherence to quarantine instructions.
International journal of clinical practice, 2021: p. (In press).
COVID
-
19 story
Page
11
14. Elgendy, M.O., et al., COVID-19 patients and contacted person awareness about home quarantine
instructions. International Journal of Clinical Practice, 2020.
15. Elgendy, M.O., A.O. El-Gendy, and M.E.A. Abdelrahim, Public awareness in Egypt about COVID-19 spread
in the early phase of the pandemic. Patient Education and Counseling, 2020. 103(12): p. 2598-2601.
16. Elgendy, M.O. and M.E.A. Abdelrahim, Public awareness about coronavirus vaccine, vaccine acceptance,
and hesitancy. Journal of Medical Virology, 2021. n/a(n/a).
17. Elgendy, M.O., et al., COVID-19 patients and contacted person awareness about home quarantine
instructions. International Journal of Clinical Practice, 2020. n/a(n/a): p. e13810.
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SARS-CoV-2 Post Vaccinated Adverse Effects and Efficacy in the Egyptian Population
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Heterologous ChAdOx1 nCoV-19 and BNT162b2 prime-boost vaccination elicits potent neutralizing antibody responses and T cell reactivity against prevalent SARS-CoV-2 variants
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Full-text available
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Background Heterologous COVID-19 vaccination regimens combining vector- and mRNA-based vaccines are already administered, but data on solicited adverse reactions, immunological responses and elicited protection are limited. Methods To evaluate the reactogenicity and humoral as well as cellular immune responses towards most prevalent SARS-CoV-2 variants after a heterologous ChAdOx1 nCoV-19 BNT162b2 prime-boost vaccination, we analysed a cohort of 26 clinic employees aged 25-46 (median 30.5) years who received a ChAdOx1 nCoV-19 prime followed by a BNT162b2 boost after an 8-week interval. Serological data were compared to a cohort which received homologous BNT162b2 vaccination with a 3-week interval (14 individuals aged 25-65, median 42). Findings Self-reported solicited symptoms after ChAdOx1 nCoV-19 prime were in line with previous reports and more severe than after the BNT162b2 boost. Antibody titres increased significantly over time resulting in strong neutralization titres two weeks after the BNT162b2 boost and subsequently slightly decreased over the course of 17 weeks. At the latest time point measured, all analysed sera retained neutralizing activity against the currently dominant Delta (B.1.617.2) variant. Two weeks post boost, neutralizing activity against the Alpha (B.1.1.7) and immune-evading Beta (B.1.351) variant was ∼4-fold higher than in individuals receiving homologous BNT162b2 vaccination. No difference was observed in neutralization of Kappa (B.1.617.1). In addition, heterologous vaccination induced CD4⁺ and CD8⁺ T cells reactive to SARS-CoV-2 spike peptides of all analysed variants; Wuhan-Hu-1, Alpha, Beta, Gamma (P.1), and Delta. Interpretation In conclusion, heterologous ChAdOx1 nCoV-19 / BNT162b2 prime-boost vaccination is not associated with serious adverse events and induces potent humoral and cellular immune responses. The Alpha, Beta, Delta, and Kappa variants of spike are potently neutralized by sera from all participants and reactive T cells recognize spike peptides of all tested variants. These results suggest that this heterologous vaccination regimen is at least as immunogenic and protective as homologous vaccinations and also offers protection against current variants of concern. Funding This project has received funding from the European Union's Horizon 2020 research and innovation programme, the German Research Foundation, the BMBF, the Robert Koch Institute (RKI), the Baden-Württemberg Stiftung, the county of Lower Saxony, the Ministry for Science, Research and the Arts of Baden-Württemberg, Germany, and the National Institutes of Health.
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Effect of mutation and vaccination on spread, severity, and mortality of COVID‐19 disease
Article
Full-text available
  • Jan 2022
COVID-19 had different waves within thesame country. The spread rate and severity showed different properties within the COVID-19 different waves. The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID-19 cases and death cases. Real-datasets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID-19 different waves in 12 countries with the highest total performed tests for SARS-Cov-2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID-19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, wave 2 had a much higher number of confirmed cases than that in wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in wave 1 was much higher than that in wave 2. Some countries had waves 3 and 4. Waves 3 and 4 were had lower confirmed cases than wave 2, however, the death cases were variable in different countries. The death cases in waves 3 and 4 were similar to or higher than wave 2 in most countries. Wave 2 of COVID-19 had a much higher spread rate but much lower severity resulting in a lower death rate in wave 2 compared to that of the first wave. Waves 3 and 4 had lower confirmed cases than wave 2; that could be due to the presence of proper treatment and vaccination. However, that was not reflected in the death cases which were similar to or higher than wave 2 in most countries. Further studies are needed to explain these findings. This article is protected by copyright. All rights reserved.
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To Save Lives, Social Distancing Must Continue Longer Than We Expect
Article
  • Apr 2020
https://deepblue.lib.umich.edu/bitstream/2027.42/154812/1/WashPost - To Save Lives, Social Distancing Must Continue Longer Than We Expect - 08Apr2020.docx
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Effect of age of COVID‐19 inpatient on the severity of the disease: A meta‐analysis
Article
  • Oct 2021
Background Clinical symptoms of adults and pediatric inpatients with COVID-19 disease are conflicting. This meta-analysis was conducted to assess the effect of age of COVID-19 inpatient on the severity of the disease. Methods A systematic literature search up to January 2021 was performed and 5 studies included 910 inpatients with COVID-19 disease at the baseline of the study; 773 of them were adult inpatients, and 137 of them were pediatric inpatients. They reported a comparison between adults and children with COVID-19 in the level of symptomatic severity, clinical features, computed tomography (CT) results, and laboratory results. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effect of age of COVID-19 inpatient on the severity of the disease using the dichotomous method with a random or fixed-effect model. Results Adults with COVID-19 disease had significantly lower number of mild cases (OR, 0.18; 95% CI, 0.04-0.77, p=0.02); higher number severe cases (OR, 4.90; 95% CI, 2.03-11.83, p<0.001); higher number of cases with fever (OR, 4.14; 95% CI, 2.31-7.43, p<0.001); and higher number of cases with CT positive COVID-19 disease (OR, 2.04; 95% CI, 1.17-3.55, p=0.001) compared to children. However, no significant difference was found between adults and children in number of cases with shortness of breath (OR, 1.44; 95% CI, 0.41-5.04, p=0.57); dry cough (OR, 1.77; 95% CI, 0.64-4.93, p=0.27); leukopenia (OR, 0.89; 95% CI, 0.47-1.66, p=0.71); lymphopenia (OR, 0.96; 95% CI, 0.49-1.88, p=0.91); high platelets (OR, 0.41; 95% CI, 0.17-1.02, p=0.05); and high D-dimer (OR, 0.82; 95% CI, 0.43-1.56, p=0.54). Conclusions Adults with COVID-19 disease have a much higher level of symptomatic severity, fever, and CT-positive COVID-19 disease than children. However, as shown in our results, the laboratory data were similar in both groups.
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Public awareness about coronavirus vaccine, vaccine acceptance, and hesitancy
Article
  • Jul 2021
Measurement of the population's general knowledge of the coronavirus vaccine is very important to improve public acceptance and decrease vaccine hesitancy to confront the disease. This study aimed to evaluate the knowledge, attitude, and practices of the participants towards the coronavirus vaccine. Data was collected using an online survey, in the form of a structured questionnaire, conducted during April-May 2021 in Egypt and subjects from all over Egypt participated. The questionnaire was divided into 3 parts to assess the knowledge and attitude regarding coronavirus. The first part was to assess participants’ experience about coronavirus infection [8 items], the second was to assess the health beliefs about coronavirus and vaccine [16 items] and the third was to assess general knowledge, attitude, and practices of the participants towards vaccine [28 items]. A total of 871(465 females) participants participated, 81% of them were still committed to the precautionary measures for protection. 88% of them accepted to take the vaccine. 83% of the participants answered that they will encourage family, friends, and colleagues to get the vaccine. 94% knew that the coronavirus vaccine provides immunity against infection for a period of 6 to 12 months. 91.9% believed that the current infection with coronavirus is one of the main contraindications to vaccination. 89% believed that both pregnant women and chronic disease patients can get vaccinated and also that there is no specific age for a specific type of vaccination. 94% of them knew that subjects taking immunosuppressive drugs should be prescribed Sinopharm, not AstraZeneca vaccine. The median score of this survey was 20/22 regarding knowledge about the coronavirus vaccine. Overall, the study participants had good knowledge about the coronavirus vaccine and accepted to take the vaccine which indicates the highly international efforts to confront the coronavirus. This article is protected by copyright. All rights reserved.
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A study of the possible factors affecting COVID-19 spread, severity and mortality and the effect of social distancing on these factors: Machine learning forecasting model
Article
  • Jun 2021
Backgrounds SARS-CoV-2 is affecting different countries all over the world, with significant variation in infection-rate and death-ratio. We have previously shown a presence of a possible relationship between different variables including the Bacillus Calmette–Guérin (BCG) vaccine, average age, gender, and malaria treatment, and the rate of spread, severity, and mortality of COVID-19 disease. This paper focuses on developing machine learning models for this relationship. Methods We have used real-datasets collected from the Johns Hopkins University Center for Systems Science and Engineering and the European Centre for Disease Prevention and Control to develop a model from China data as the baseline country. From this model, we predicted and forecasted different countries' daily confirmed-cases and daily death-cases and examined if there was any possible effect of the variables mentioned above. Results The model was trained based on China data as a baseline model for daily confirmed-cases and daily death-cases. This machine learning application succeeded in modeling and forecasting daily confirmed-cases and daily death-cases. The modeling and forecasting of viral spread resulted in four different regions; these regions were dependent on the malarial treatments, BCG vaccination, weather conditions, and average age. However, the lack of social distancing resulted in variation in the effect of these factors e.g. double-humped spread and mortality cases curves and sudden increases in the spread and mortality cases in different countries. The process of machine learning for time-series prediction and forecasting, especially in the pandemic COVID-19 domain, proved usefulness in modeling and forecasting the end status of the virus spreading based on specific regional and health support variables. Conclusion From the experimental results, we confirm that COVID-19 has a very low spread in the African countries with all the four variables (average young age, hot weather, BCG vaccine, and malaria treatment); a very high spread in European countries and the USA with no variable (old people, cold weather, no BCG vaccine, and no malaria). The effect of the variables could be on the spread or the severity to the extent that the infected subject might not have symptoms or the case is mild and can be missed as a confirmed-case. Social distancing decreases the effect of these factors.
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Repurposing of some anti‐infective drugs for COVID‐19 treatment: A surveillance study supported by an in silico investigation
Article
  • Apr 2021
Objective: The repurposing of nitazoxanide, doxycycline, and azithromycin may be effective to improve the symptoms in mild and moderate COVID-19 subjects. This study aimed to detect and explain the efficacy of reusing of these drugs in treating COVID-19. Methods: The study was divided into two parts; clinical and computational parts. In the clinical part, 80 (30 females) subject with reverse transcription-polymerase chain reaction confirmed COVID-19 with mild and moderate symptoms were enrolled in the study. Subjects were treated with azithromycin or doxycycline, and nitazoxanide were added to the treatment if the subject had diarrhea. Subjects were divided into 4 groups: Group 1: subjects treated with azithromycin (20 subjects); Group 2: subjects treated with doxycycline (20 subjects); Group 3: subjects treated with a combination of nitazoxanide and doxycycline (20 subjects); and Group 4: subjects treated with a combination of nitazoxanide and azithromycin (20 subjects). In the computational part, we docked the three drugs against all currently available COVID-19 related protein targets (viral and non-viral). Subsequently, top hits were subjected to molecular dynamic simulations (50 ns) and binding free energy calculations to further validate the docking experiments and to investigate the binding modes of the potential inhibitors. Results: The symptomatic improvement of mild to moderate subjects was seen on the 5th day after starting treatment in Group 3 and Group 4 and on the 7th day in Group 2. However, for Group 1, the symptomatic improvement of mild to moderate subjects was not seen on the 5th day and required replacement by doxycycline to get the symptomatic improvement. None of the subjects needed intensive care admission and no deaths were reported. In silico, results were in good accordance with the clinical outcomes, where both nitazoxanide and doxycycline achieved the best docking scores against the viral ADP-ribose phosphatase (ADPRP) and the human Adaptor-Associated Kinase 1 (AAK1). Molecular dynamic simulations revealed that both drugs were stable in their bindings indicating that they can be considered as lead molecules for targeting ADPRP and AAK1. Conclusion: The clinical and computational studies applied on three FDA-approved antimicrobials together with their recent clinical findings revealed that both nitazoxanide and doxycycline have great therapeutic potential against COVID-19. The future in-vitro mechanistic investigation may confirm our primary computational outcomes, and in turn, these classes of compounds provide a promising starting point for further anti-COVID-19 therapeutics.
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COVID-19 patients and contacted person awareness about home quarantine instructions
Article
Objective One of the keys elements to control the transmission of COVID‐19 is to decrease the source of infection and transmission to the community. Following the instructions is very important to achieve that. This study aimed to evaluate awareness and practices related to the COVID‐19 quarantine instructions among the home quarantine COVID‐19 patients, and persons who contacted them at home quarantine. Methods During May and June 2020, the home quarantine COVID‐19 patients (mild and moderate cases who need not be admitted to hospital) and the contacting persons were asked to fill an online structured questionnaire. Data were collected to assess the awareness regarding the quarantine instructions. The questionnaire was divided into three sections, consisting of 35 questions for a total possible score of 0‐35. The first section was to assess the participants' awareness [19 items]; the second was to assess the awareness of the participants’ families [11 items]; the third was to assessing awareness and attitude regarding the efforts provided to face COVID‐19 [5 items]. Results A total of 300 subjects participated, 96% of them were committed not to leave the house till the end of the self‐isolation period; 85% cared for house cleanliness and good ventilation of rooms; 63% maintained a balanced diet without fats, oil, and sugar; 70% used vitamins D and A to strengthen the immune system. The important role of the media in informing subjects of COVID‐19 was known by 90%, while 63% of the participants are not satisfied with the hospital services in the area where they live. The average score of this questionnaire was 28.18/35 (80.5%) about the awareness of COVID‐19 quarantine instructions. Conclusion Home quarantined COVID‐19 patients and people in close contact with them in the study had a good awareness of the home quarantine instructions. They had good knowledge about the home quarantine instructions; instructions for family members of infected patients; and awareness and attitude of the efforts provided to counter COVID‐19.
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