Omicron:Egyptian nurses’ knowledge and attitudes

Mostafa SHABAN, Marwa Mamdouh SHABAN,Osama RAMADAN, Huda Hamdy MOHAMMED

1Department of Nursing, College of Applied Medical Sciences,Jouf University, Sakaka, Saudi Arabia; 2Department of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt; 3Department of Maternal and New-born Health Nursing, Faculty of Nursing, Helwan University, Helwan, Egypt

ABSTRACT

Objective:The current study aimed to assess the knowledge and attitudes of nurses toward the current COVID-19 pandemic and Omicron variant.

Materials and Methods:A cross-sectional online survey was used.Totally 277 Egyptian nurses completed an electronic questionnaire comprising demographics with 5 items, nurses’ knowledge on Omicron with 18 questions, and nurses’ attitudes on Omicron with 5 questions.The data collected were expressed using numbers, percentages, and mean and standard deviation.

Results:The mean age of nurses was 27 ± 5 years, nearly 50% of the nurses were bachelor degrees.The total score of correct answers related to knowledge was 75%, showing the different degrees of knowledge about Omicron.The majority of nurses showed positive attitudes toward controlling and managing the COVID-19 pandemic.

Conclusions:Egyptian nurses have average knowledge about Omicron and a positive attitude toward controlling the COVID-19 pandemic.There should be scope for further assessment to enhance understanding about COVID-19.Moreover, health education programs should be developed for nursing staff to improve information, beliefs, behaviors, and attitudes towards the Omicron variant in particular and the COVID-19 pandemic in general.

Keywords:Attitude, COVID-19, Egypt, knowledge, Omicron, pandemic

INTRODUCTION

As the COVID-19 pandemic continues to wreak havoc on people’s physical, mental, and financial well-being,Omicron emerges in the middle of this mounting fury and frustration.A period when natural immunity to Omicron infections was frequent, initial infection originated when vaccine immunity was rising globally.[1]It is important to know if Omicron is more harmful or infectious than other generations of COVID-19 and if it can get around vaccine protection.[2]Although immunological and clinical data are not yet available, we can extrapolate from what we know about Omicron’s mutations to get a sense of how it spreads, how severe it is, and how the immune system can fight it off.Omicron has some deletions and more than 30 mutations.[3]

The role of the nursing authorities in the face of these successive waves of corona is clear, and their possession of the correct information and behaviors helps them complete this task.[4]Therefore, the current study aimed to assess the knowledge and attitudes of nurses toward the current COVID-19 pandemic and Omicron variant.

MATERIALS AND METHODS

Study design

The researcher conducted a cross-sectional study to assess nurses’ readiness to join in facing the Omicron by measuring information and attitude toward confronting the Omicron.

Participants

The study sample was 277 nursing staff who voluntarily participated in the survey.The inclusion criteria were as follows:(1) both female and male nurses were invited;(2) those who had completed at least 3 years of nursing experience.

Tool and data collection

An electronic questionnaire was created and composed of three parts.The first part was related to demographic data such as gender, age, education level, marital status, and obtaining a license to practice nursing.The second part was related to measuring information about the Corona pandemic.It consisted of 18 questions about the nature of the pandemic and the method of spread, infection, and disease prevention.The third part was about behavioral attitudes toward prevention and protection from the coronavirus,with five questions.

The questionnaire was distributed to nursing staff in the Arab Republic of Egypt on social media such as Facebook and WhatsApp and took approximately 15 min to be completed.

Ethical considerations

This study was approved by the Ethics Committee of Faculty of Nursing, Cairo University, Egypt, with the approval number RHDIRB2019041701 in January, 2022.The participants’written consent was sought before they were allowed to participate.To guarantee anonymity, the participants’ names were not shown, and it was ensured that the participants were allowed to be free to decline participation or exit from the research at any time.

Statistical analysis

Results were presented and tabulated.The age of the participants was presented as mean ± standard deviation.The data of other demographic information, and nurses’knowledge and attitude toward Omicron were expressed as numbers and percentages.

RESULTS

As shown in Table 1, a total of 277 male and female nurses agreed to participate in the research.The average age of the participants in the study was 27 ± 5 years.The mostsignificant percentage represented the age group 19-25 years by 42.0%, while the lowest rate was the age group from 40 to 45 years by 0.7%; males represented 38.3%.As for the level of education, nearly half of the participants had a bachelor’s degree in nursing, by 49%.The lowest participation rate was nurses who obtained a nursing diploma, at a rate of 7.2%.About 49.1% of the participants were unmarried.Concerning obtaining a professional license, most participants received a professional license to practice the profession of nursing at a rate of 68.2%.Regarding the readiness to participate in caring for patients infected with the Omicron, the results indicated that most participants are ready to join in caring for patients infected with Omicron, at a rate of 67.1%.The results also showed that 56.7% of the participants expressed their willingness to work in isolation hospitals for patients infected with coronavirus.

Table 1:Demographic characteristics of participants (n=277)

Table 2 outlines the knowledge of the nurses on Omicron in Egypt.The total percentage of the correct answer was 75%.Regarding total general information about pandemics, most participants recognized the proper definition of epidemic and pandemic (84.8% and 79.4% accurate); however, the proportion of correct answers of the endemic definition was 41.9%.Moreover, with general information about the pandemic spread, almost 100% of the participants correctly answered that people who had contacted with a person infected with Omicron should be isolated immediately in a suitable location.Even 98.2% of the participants correctly answered the main clinical symptoms of Omicron were fever, fatigue, dry cough, and muscle pain; however, only 22% of the participants correctly answered, “to reach the pandemic stage, the number of deaths must be associated.”

Table 2:Nurses knowledge toward Omicron (n=277)

Table 3 outlines the nurse’s attitude toward the current Omicron pandemic in Egypt.Results showed 89.2% of nurses participating in the study agreed that Omicron was a controllable disease.In the same line, the majority of the nurses (71.8%) agreed that the country could manage the current pandemic, regarding the risk of getting the infection in a crowded area, almost 99.1% of the nurses agreed that being in crowded areas increased the risk of getting the infection.Approximately 93.1% of the nurses believed that wearing masks in overcrowded areas reduced the risk of infection.Regarding wearing gloves only without washing hands, the majority of nurses (94.2%) disagreed that wearing gloves only without handwashing prevented the risk of infection.

Table 3:Nurses attitudes toward current Omicron pandemics (n=277)

DISCUSSION

This study investigated the knowledge and attitudes of nurses in Egypt regarding the current Omicron variant.This is an important issue as the nurses shape the first line of defense against the spread of the current pandemic and form the backbone of Egypt’s health care delivery system.Furthermore, the nurses are in direct contact with the patients as they deliver the daily health care of all patients,especially those with the Omicron virus.[5]

The knowledge of nurses on the COVID-19 pandemic and Omicron variant in this study appeared to be average.Nurses displayed different levels of information, especially about general information about pandemics, where less than half of the nurses correctly answer the meaning of endemic disease, although Egypt is affected by at least seven vector-borne diseases of public health concern,including lymphatic filariasis, malaria, schistosomiasis, and Rift Valley fever.[6]On the other hand, majority of the nurses’participating in the study correctly answer the meaning of epidemic and pandemic disease meaning, and this can be a result of the spread of the COVID-19 as progressed from epidemic to pandemic stage on March 19, 2020, by Dr.Tedros Adhanom Ghebreyesus, the Director-General of World Health Organization (WHO).[7]

As regarding general information about the spread of the Omicron virus, almost all nurses participating in the study correctly answered that people who had contacted with a person infected with COVID-19 should be isolated immediately in a suitable location for 14 days, as Leeet al.[8]recommended that contacts should be isolated as prophylaxis strategy for 14 days, although recently contacting with a case of Omicron required 10 days of prophylaxis isolation.[9]

Participants appeared to lack knowledge about the pandemic occurrence stage as most of the nurses wrongly related the occurrence of the pandemic to the number of deaths related to health events.A pandemic is a disease outbreak that spreads across countries or continents.It affects more people and takes more lives than an epidemic.WHO declared Omicron to be a pandemic when it became clear that the illness was severe and that it was spreading quickly over a wide area.[10]

Besides, nurses wrongly answered that Omicron can be spread through airborne transmission.According to current evidence, the Omicron virus is transmitted through respiratory droplets and contact routes.Droplet transmission occurs when a person comes into close contact (within 1 m)with someone who is coughing or sneezing and is thus at risk of having his/her mucosae (mouth and nose) or conjunctiva (eyes) exposed to potentially infective respiratory droplets (which are generally considered to be ＞5-10 m in diameter).Droplet transmission may also occur through fomites in the immediate environment around the infected person.[11]Therefore, the transmission of the Omicron virus,like other coronaviruses, can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects (e.g., stethoscope or thermometer) used on the infected person.[12]

The overall total score of knowledge displayed that not all nurses were fully equipped with correct information about the current Omicron virus pandemic, especially in the area of modes of transmission and the endemic state of the disease;this may be concurrent with the report by WHO in 2021,[13]which was mentioned that still there was lack of knowledge regarding the new mutant (Omicron).

Nurses in this study displayed a positive attitude toward the control of the current pandemic, as the majority of nurses agreed that the disease could be controlled, in a survey by Nadimet al.[14]in 2020, who performed short-term predictions and prevention strategies for Omicron and declared that COVID-19 was a controllable disease based on the current spread and effective management of quarantined individuals was more effective than management of isolated individuals to reduce the disease burden.In the same line, Zhaoet al.[15]stated in 2020 that Egypt could control the disease by May 2021.The independent report concluded that American people felt that dealing with Omicron can be handled through vaccination of the community.[16]Most nurses believed that the Egyptian government could manage the current situation.[17]

The majority of the nurses agree that being in a crowded area increases the risk of getting an infection.Maintaining social distancing norms between humans has become a necessary precaution to slow down the transmission of Omicron.Coronavirus is predominantly because of touch or droplet transmission attributed to pretty massive breathing debris,which can be an issue to gravitational forces and tour best about 1 m from the affected person.Airborne transmission might also arise if the affected person’s breathing hobby or scientific techniques generate breathing aerosols.[18]In a similar vein, Bloomberg stated in its weekly coronavirus update that Ireland’s top medical officer advised people to avoid stores and not interact with individuals from other houses indoors, as coronavirus cases continue to rise.[19]

These aerosols comprise debris that could tour a lot longer distances and continue to be airborne longer; however,their infective capacity is uncertain.Contact, droplet, and airborne transmission are applicable at some stage in airway maneuvers in inflamed sufferers, particularly at some stage in tracheal intubation.The personal defensive gadget is a vital component, however best one part, of a machine shielding group of workers and different sufferers from COVID-19 cross-infection.Appropriate use substantially reduces the threat of viral transmission.[20]

Moreover, nurses in this study believed that wearing medical gloves only maybe not be the primary protector without frequent hand washing; despite the risk of Omicron infection, popular media reported that many people were apprehensive about wearing or not wearing a mask or gloves.[21]Still, the current COVID-19 pandemic has seen a focal point of instruction and data on handwashing pointed at individuals working inside the wellbeing area just as to the overall population.There has been a multiplication of general wellbeing messages through different sources about the significance of handwashing and the right strategies for handwashing.Images and short recordings pointed toward contacting individuals on their handheld gadgets,just as through online media, and standard TV, radio, print promotions, and boards are all being used, and all with the same message that successful handwashing is critical to halting the spread of COVID-19.[22]

Innovative approaches to increase the knowledge and information of the Egyptian nurses about Omicron are acquired in the Egyptian hospitals and community setting;[23]one process of increasing nurses’ information is enhancing their participation in health education programs provided by the health-care system and the authorities concerned with providing health programs, such as the Ministry of Health or hospitals, as well as the awareness programs offered by Egyptian universities and civil society institutions.

CONCLUSIONS

This study emphasizes the need to conduct and strengthen the nurse’s knowledge and create a positive attitude toward managing the current Omicron pandemic; it also highlights the nurse’s role in confronting current challenges, arming and disseminating information among all groups of society,not just health system workers.

Acknowledgment

Thanks to all nurses participating in the current study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.