Role of academic institutions during the COVID-19 pandemic

1 Resources Himalaya Foundation, Sanepa, Lalitpur, Nepal 2 Environmental Graduates in Himalaya, Sanepa, Lalitpur, Nepal 3 Central Department of Botany, Tribhuvan University, Nepal 4 Patan Multiple Campus, Tribhuvan University, Lalitpur, Nepal 5 Institute of Forestry, Hetauda, Nepal 6 Nepal Academy of Science and Technology, Kathmandu, Nepal International Journal of Infection Control ISSN 1996-9783 www.ijic.info


Introduction
Coronavirus disease (COVID-19) is an infectious disease caused by the new coronavirus SARS-CoV-2 that was first reported in China in December 2019. 1 This COVID-19 has now spread in 214 countries and territories, 2 and threatened millions of human lives, devastated social and economic conditions and even nature and wildlife. 3 To prevent and decelerate transmission of communicable disease, it is important to intensify health information through reliable sources. 4 Websites are the virtual front door of organizations. As they have more advantages than the newspaper, radio, television, magazine and billboards, universities devote a greater share to websites and social media for their promotions.
Public perceptions, beliefs and knowledge have a crucial impact on the spread of pandemics. Early and timely communication with parents help control the infectious diseases. 5 People can play a critical role in curbing the spread of the pandemic, if they are provided with accurate and accessible information about the disease and appropriate responses. Academia plays important role in controlling and planning pandemic in the country, 6 as educational institutions with their large concentrations of young people have potential to effectively disseminate information on COVID-19 awareness. This may have a positive effect in the community indirectly. This study aimed to examine the role of academic institutions in combating COVID-19.

Methods
We selected 44 countries with high COVID-19 infection. The countries represented six continents, namely Asia, Europe, America, Africa, South Africa, and Oceania (Figure 1). At least five high ranking universities from each country were selected (Appendix A), their official webpages were visited, and the initiatives they have taken in order to create COVID-19 education and awareness were noted. Different parameters such as general awareness, up-to-date information and availability of emergency contacts were studied. Under general awareness, basic information on combating COVID-19 was considered. Up-to-date information included if COVID-19 information was updated regularly. Availability of emergency contacts included consideration of information on hotline and/ or phone number at the time of urgency. Data relating to COVID-19 were taken on May 02, 2020 from the Worldometer (www.worldometer.com). Economic status (developed or developing) of the countries was referenced from United Nations. 7 Obtained data were analyzed by descriptive analysis and further Chisquare test was done to identify any differences in data among the regions.

Disseminating COVID-19 awareness information
About 78% of the top academic institutions in the world had information on COVID-19 in their webpages. Out of the six continents, a higher percentage of academic institutions of Oceania followed by Europe and North America disseminated COVID-19 information on their websites ( Figure  2). Websites of all universities in Oceania, 96.7% universities in North America, 96.6% in Europe, 83%  in South America, 61.3% in Asia, and 56% in Africa displayed the information regarding COVID-19. Most of this information was of the general type. Two-third sof the universities were found to have up-to-date awareness information. Some universities included their research initiatives on COVID-19. Figure 3 presents a comparison between academic institutions in updating the COVID-19 information.

Emergency contact information in combating COVID-19
No information about emergency and/or a dedicated mobile app was found in all the universities' webpage.
Only 37.8% of the institutions had emergency contact information and/or mobile app in their websites. Among the six continents, the majority of the universities in Europe (58%) followed by Oceania and North America each (50%) shared such information in their websites. Only one-third of the universities from other continents shared such information ( Figure 4).
From the perspective of countries' economic status, over 96% of the universities from high income countries and 82.7% in upper-middle income countries had information of COVID-19 on their websites. In case of lower-middle income countries and low income countries, such information was uploaded in only 55% and 25% of the universities respectively ( Figure 5). Disseminating COVID-19 information was statsitically significantly higher in universities from developed countries (high income and upper middle income) in comparison to developing countries (lower middle income and low income) (p < 0.001). However, majority of the universities (85.71%) in high income countries had provided up-to-date information, 57.35% universities in upper-middle income country and only 37.5% universities in lower-middle income countries and while 20% universities in low income countries have been updating information on ongoing pandemic ( Fig. 6). Moreover, updating COVID-19 information in the webpage was significantly higher in universities from developed countries in comparison to that of developing countries (p < 0.001).
In North America, 4% of universities had the COVID-19 related message delivered by their university presidents, while in 24% the message was by department heads or other faculty members, whereas 72% of universities did not have such a position mentioned. About 27% of the universities in South America had a special message on COVID-19 from high level officials including Vice Chancellor/ University President, and Rector. About 80% of the universities in Oceania had a COVID-19 message   from a high level. About 68% of the universities in Europe had a COVID-19 message from high level officials. About 18% of the universities in Africa were able to put forward messages regarding COVID-19 from high level officials in their websites.
The numbers of infected people and deaths due to COVID-19 varied in the continents (Figure 7). Europe had the highest number of COVID-19 cases/million followed by North America and South America, whereas Africa had low COVID-19 cases/ million. Similarly, Europe had the highest COVID-19 deaths/million but Oceania and Africa had the fewest COVID-19 deaths/million. Based on the economic status of the countries, COVID-19 cases per/million and COVID-19 deaths/million both were highest in high income countries followed by upper middle income countries, while it was found lowest in low income countries (Fig. 8).

Discussion
This paper collected the data at a given time in the evolving COVID-19 scenery, and resulted in limited variables included in the analysis to understand the role of academic institutions in disseminating information to combat COVID-19 that could naturally and understandably be skewed towards these variables. Academic institutions can play an important role in pandemic preparedness including planning for disease outbreaks or disasters. 6 This study provided a snapshot that the universities from the western world (Europe and North America) and Oceania were disseminating more information to combat COVID-19. It seems that the level of involvement of academic institutions in combating COVID-19 is determined by how the pandemic has impacted the countries. At the time of greater impact, academic institutions become more active in educating their staff, faculties, students, and even the general public.
The availability of medical facilities, human resources, and mechanisms of reporting outbreaks varied among developed vs. developing countries. Case identification in developed countries is fast and precise in comparison to developing countries due to availability of proper medical facilities in developed countries. 14 Economic status of the country determines the involvement of academic institutions in educating students and informing faculty members regarding COVID-19. Institutions from economically better countries were found to be more aggressive in disseminating awareness materials. The developing   world including Asia and Africa has fewer universities disseminating the information. 8 As the countries from North America and Europe were impacted severely from COVID-19 pandemic when this study was undertaken, their academic institutions were more active in disseminating information.
Importantly, high income countries and upper middle income countries were more active in disseminating information regarding COVID-19 pandemic and the majority of the universities from these countries provided up-to-date information. Such information outreaching would help combat the pandemic. Community knowledge regarding the pandemic would not be enough, and research on the effective ways to flow information to the general public is of utmost need. 9 Educational involvement is required to promote awareness of the threat of pandemic in the community and assist with the resources and coping mechanisms for the effective response on a wide level to flatten the curve of the growing pandemic. 10 Pandemic preparedness should be considered as a global perspective. However, the level of planning varies and developing countries are most likely to face difficult challenges in terms of pharmaceutical commodities, public health and clinical infrastructure, and deaths will be higher in such pandemics. 11 The academic institutions from the developing countries are less active in combating the pandemic. There is a huge opportunity for advancing community education around the continuing threat of future pandemics through links to online resources. 12 Readily accessible preparedness tips and emergency resources on the webpage are of great need during sudden or future disasters including a pandemic to disseminate proper information to the public. 13 University websites provide information in a clear and accessible format, promoting the best user experience possible. At the time of an epidemic/ pandemic, such sites can play a greater role in arousing public understanding of the problem. However, universities in developing nations compared to those in developed nations are paying less attention in their websites. Thus, there exists a gap in understanding the effectiveness of websites among the universities in developing nations.