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by Josh W. Newbury, Wee Lun Foo, Matthew Cole, Adam L. Kelly, Richard J. Chessor, S. Andy Sparks, Mark A. Faghy, Hannah C. Gough, Lewis A. Gough

Strict lockdown measures were introduced in response to the COVID-19 pandemic, which caused mass disruption to adolescent swimmers’ daily routines. To measure how lockdown impacted nutritional practices in this cohort, three-day photograph food diaries were analysed at three time points: before (January), during (April), and after (September) the first UK lockdown. Thirteen swimmers (aged 15 ± 1 years) from a high-performance swimming club submitted satisfactory food diaries at all time points. During lockdown, lower amounts of energy (45.3 ± 9.8 vs. 31.1 ± 7.7 kcal∙kg BM∙day-1, p

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by Haorui Wu

From an out-of-province/state and international post-secondary student perspective, this article (a) explores mass email risk communication facilitation during the COVID-19-triggered campus-wide evictions in Canada and the United States; and (b) develops relative recommendations to improve mass email risk communication strategies for future emergency response. Investigating mass email risk communication-related impacts on students in a tertiary educational context has revealed a significant deficit in emergency response research, practice, and policymaking. Mandatory temporary university and college closures during the COVID-19 first wave provided an opportunity to address this research and practice deficit, as most Canadian and American universities/colleges administered their eviction communication via daily mass email chains. Through a phenomenological lens, this study interviewed twenty out-of-province/state and international students, ten from each country respectively, to examine student eviction experiences associated with intensive mass email risk communication. This research identified four factors linked to mass email risk communication: email chain characteristics, student interpretation, interdepartmental cooperation, and frontline voices. Synthesizing these findings, four evidence-based recommendations were developed: to efficiently convey risk information to students, to understand student perceptions and to inform their behaviors, to enhance interdepartmental cooperation, and to enable mutual dialogue in decision making. These recommendations could assist post-secondary institutions, and other organizations, in strengthening their mass email risk communication strategies and advancing organizational emergency response plans for future extreme events.

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by Sayed K. Ali, Jasmit Shah, Katie Du, Nidhi Leekha, Zohray Talib
Background Healthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands. Methods This cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale–Revised Questionnaire and Stanford Professional Fulfillment Index Questionnaire. Results A total of 100 residents completed the survey (participation rate 77.5%). Participants were about equal in gender (women [53%]), with a median age of 31.28 years, and majority were single (66.7%). A total of 66 participants (66%) were directly engaged in COVID-19 care. Depression: 64.3%, anxiety: 51.5%, insomnia: 40.5%, distress: 35.4%, and burnout: 51.0% were reported in all participants. Statistical significance was found in median depression, professional fulfillment and interpersonal disengagement when comparing frontline resident directly involved in care of COVID-19 patient versus second line residents. Conclusion Residents directly involved with caring for COVID-19 patients had statistically higher incidences of depression and interpersonal disengagement and lower professional fulfillment compared to second line residents. Keeping in mind the limited resources in sub-Saharan Africa, urgent and geographically specific strategies are needed to help combat mental health disorders in this specific population.

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by Fatmah Fatmah, Nur Asiah, Etty Rekawati

Most undernourished preschool-aged children have low hemoglobin and albumin levels, which leads to a higher risk of infections, including COVID-19. This study was designed to determine whether potato almond orange cookies increase weight, hemoglobin, and albumin) in undernourished preschool-aged children during the COVID-19 pandemic. A pre-post intervention study was conducted with 30 subjects during 8 weeks in which hemoglobin and albumin levels were recorded at the beginning and end. Education on balanced nutrition was provided to mothers using leaflets, flipcharts, and videos. The results showed increases in weight (0.4 kg), height (1.98 cm), hemoglobin level (0.1 g/dL), and albumin level (0.1 g/dL) accompanied by a significant increase in weight, height, and the Z-score index for weight for age, whereas those for Hb and albumin levels were not. Energy, carbohydrate, fat, vitamin C, vitamin E, and iron intake increased significantly. Further, there was a significant difference in mothers’ knowledge of balanced nutrition and COVID-19 at the end of the study. Thus, high levels of cookie consumption increased the weight of underweight preschool-aged children. Future studies may wish to consider examining the issue using stunted, wasted, and anemic preschool-aged children as the research subjects.

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by Ngwa Niba Rawlings, Emmanuela Ambe Akwah, James Musisi, Kimonia Awanchiri, Rachel Babirye, Diana Emalieu, Lawrence Nduhukyire, Ronald Kakeeto, Lem Ngongalah
Background This study explored students’ perceptions of COVID-19 risks and preventive measures and assessed the impacts of the national lockdown on students in Uganda. Methods A web-based survey was conducted to explore students’ perceived risks of COVID-19 and preventive measures; sources of COVID-19 information and impacts of the lockdown. Both undergraduate and post-graduate students (n = 398) participated in the study. Data were analysed using IBM-SPSS-26. Results Students acknowledged COVID-19 as a health risk, and their preventive behaviours were influenced by age, gender, marital status and living situation. Most students followed face mask guidelines but did not comply with lockdown restrictions. Social distancing was not always possible due to overcrowding. Students’ main sources of COVID-19 information were local media (e.g., TV, radio) and social media. Most students (especially females) were unable to access online learning platforms due to poor internet connectivity, high costs and no access to computers. Meanwhile, a majority of those who studied online did not enjoy the experience. Students experienced depression, frustration, stress and anxiety during the lockdown; became less physically active and spent most of their time on social media, sleeping, eating or watching movies. Some students indulged in smoking, drinking alcohol, taking drugs and gambling for their first time, while others did them more often than before. Conclusion The increase in sedentary activity, poor mental health and substance use over the lockdown period puts students at risk of health complications and poses a potential threat to the healthcare system. These risks may also negatively impact their future learning and academic potential. Further research is needed to understand the transitional experiences of students between physical and virtual learning, and how they can be supported. There is also a need to ascertain the feasibility of guidelines such as social distancing in developing countries, to increase compliance.

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by Tharaka Ranathunge, Jeevanie Harishchandra, Hamidou Maiga, Jeremy Bouyer, Y. I. Nilmini Silva Gunawardena, Menaka Hapugoda
Background The Sterile Insect Technique (SIT) is presently being tested to control dengue in several countries. SIT aims to cause the decline of the target insect population through the release of a sufficient number of sterilized male insects. This induces sterility in the female population, as females that mate with sterilized males produce no offspring. Male insects are sterilized through the use of ionizing irradiation. This study aimed to evaluate variable parameters that may affect irradiation in mosquito pupae. Methods An Ae. aegypti colony was maintained under standard laboratory conditions. Male and female Ae. aegypti pupae were separated using a Fay and Morlan glass sorter and exposed to different doses of gamma radiation (40, 50, 60, 70 and 80 Gy) using a Co60 source. The effects of radiation on survival, flight ability and the reproductive capacity of Ae. aegypti were evaluated under laboratory conditions. In addition, mating competitiveness was evaluated for irradiated male Ae. aegypti mosquitoes to be used for future SIT programmes in Sri Lanka. Results Survival of irradiated pupae was reduced by irradiation in a dose-dependent manner but it was invariably greater than 90% in control, 40, 50, 60, 70 Gy in both male and female Ae. aegypti. Irradiation didn’t show any significant adverse effects on flight ability of male and female mosquitoes, which consistently exceeded 90%. A similar number of eggs per female was observed between the non-irradiated groups and the irradiated groups for both irradiated males and females. Egg hatch rates were significantly lower when an irradiation dose above 50 Gy was used as compared to 40 Gy in both males and females. Irradiation at higher doses significantly reduced male and female survival when compared to the non-irradiated Ae. aegypti mosquitoes. Competitiveness index (C) scores of sterile and non-sterile males compared with non-irradiated male mosquitoes under laboratory and semi-field conditions were 0.56 and 0.51 respectively at 50 Gy. Signification Based on the results obtained from the current study, a 50 Gy dose was selected as the optimal radiation dose for the production of sterile Ae. aegypti males for future SIT-based dengue control programmes aiming at the suppression of Ae. aegypti populations in Sri Lanka.

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by Rawan Abdeen

The 2019 novel coronavirus pandemic has not only created massive public health issues, it has also produced excessive psychological disorders in healthcare professionals, including radiology staff. The aim of this study is to assess the risk perception and mental health of radiology staff in Saudi Arabia during the COVID-19 pandemic. The researcher asked radiology staff to complete an online Google Forms questionnaire, between June 10, 2020 and June 17, 2020, which contained demographic data and self-designed questions related to anxiety, insomnia, depressive symptoms, and mental health services during the pandemic. A total of 168 radiology staff participated in the study. The results indicated that 53.05% and 57.14% of the participants were experiencing mild to severe symptoms of anxiety and depression, respectively. Moreover, 47.02% of the participants were experiencing insomnia symptoms. Among all the participants, only 16.61% had received psychological materials from their hospital during the pandemic, while 22.02% had accessed online psychological assistance techniques. The health of roughly one-third (30.95%) of the participants was worse than it had been before the pandemic. COVID-19 is a source of mental health disorders for healthcare professionals, particularly radiology staff. The findings of this study indicate that more than 70% of radiology staff in Saudi Arabia are concerned about insufficient protective measures and the risk of infection. In addition, a large percentage of them have experienced mental health disorders, such as anxiety, insomnia, and depression. Regular mental healthcare services are required to decrease the negative impact of the pandemic and enhance the overall mental health of the radiology staff.

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by Kirsti Riiser, Kåre Rønn Richardsen, Kristin Haraldstad, Sølvi Helseth, Astrid Torbjørnsen
Purpose The aim of this study was to explore how adolescents accessed, understood, appraised, and applied information on pandemic preventive measures, how their lives were impacted by long-lasting regulations and how they described their quality of life. Methods A qualitative design with focus group interviews was used to elaborate on the quantitative survey results obtained and analyzed in a previous survey study from the first phase of the Covid-19 pandemic. Five focus groups with seventeen adolescents were conducted digitally during the second pandemic phase in November and December 2020. The interview data were analyzed with directed content analysis. Results The adolescents reported using traditional media and official websites as sources for Covid-19 information. They engaged in preventive behavior, and washing hands and keeping a distance from strangers had become a habit. However, not being physically close to friends felt strange and unpleasant. The measure most frequently discussed was limiting social contact, which was a constant struggle. No one disputed the authorities’ guidelines and rules, but the social restrictions caused boredom and despair, particularly due to interrupted schooling and missed opportunities to engage in life events, and freely socialize with friends. Conclusion The adolescents gave an overall impression of being health literate, which corresponds well with the results from our previous survey study. Their descriptions of how they translated protective measures into their everyday lives demonstrate that they took responsibility and accepted personal costs for the collective good. However, life with social restrictions decreased their quality of life.

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by Sou Hyun Jang

Most studies on COVID-19 preventive behaviors have focused on single-level factors such as national policy, community social capital, or individuals’ sociodemographic characteristics. Through a social-ecological model, this study attempts to comprehensively examine the multilevel factors associated with COVID-19 preventive practices in South Korea. Accordingly, a web survey involving 1,500 participants was conducted in December 2020. An ordinary least squares (OLS) regression was used to examine the multilevel factors (individual, interpersonal, community, and policy levels) related to COVID-19 preventive measures, which are based on wearing a mask, washing hands, covering the mouth when coughing or sneezing, and social distancing. When factors at each level were investigated, higher scores of COVID-19 fear and correct knowledge at the individual level, COVID-19 information share at the interpersonal level, and better evaluation of the national government policies in regard to COVID-19 at the policy level were positively associated with COVID-19 preventive behaviors. Community-level factors—neighborhood perception and community participation—were negatively significantly related to COVID-19 preventive behaviors. Additionally, older age, being female, and having a graduate-level education were positively related to better preventive behaviors. The findings of the current study suggest that multilevel efforts are needed to promote preventive behaviors. Specifically, more effort to alleviate COVID-19-related fear and disseminate correct knowledge among Korean citizens is needed as the individual-level characteristics explained the preventive behaviors more than the factors at upper levels.

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by Amanda Steil, Ana Bresser Pereira Tokeshi, Luca Silveira Bernardo, Geraldo Pio da Silva Neto, Ronald Ferreira Davi Júnior, Amanda Ferreira Santa Bárbara, Vitor S. Mendonca, Thiago M. Fidalgo, Aécio Flávio Teixeira Gois
Purpose Medical residents’ mental health is currently an issue of concern for medical educators worldwide. The COVID-19 pandemic has raised the greatest concerns given the psychological effects of this scenario on medical residents on the frontlines of the pandemic. To assess the psychological impact of the COVID-19 pandemic on physicians in residency training, the collective symptoms of burnout, depression and anxiety are used to identify the residents’ beliefs and clinical practices related to COVID-19 patients and their behaviors concerning disease prevention. Method This observational study involved 3071 medical residents from all regions of Brazil. An online questionnaire assessed the presence of burnout using the Oldenburg Burnout Inventory, depressive symptoms using the Patient Health Questionaire-9, anxiety symptoms using the Generalized Anxiety Disorder-7, and COVID-19 Impact Questions to assess the residents’ beliefs and clinical practices related to COVID-19 patients. Exploratory analyses, logistic regression and multinomial regression analysis were performed in this investigation. Results Moderate and severe depressive symptoms were the most common (67.7%) followed by anxiety symptoms (52.8%) and burnout (48.6%). The difference between residents with or without contact with COVID-19 patients was significant increased when analyzing different aspects of clinical practice, behavior, substance use and mental health. Conclusions These results suggest an increase in depression and anxiety symptoms among medical residents dealing with COVID-19, upstaging previous concerns about medical residents’ mental health. The prevalence of burnout is similar to that of a nonpandemic scenario. Considering the severity of the pandemic scenario and the overburden of healthcare services, medical residents’ mental health deserves special care.

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by Joan Christodoulou, Anne E. Fehrenbacher, Elizabeth H. Shaw, Eleanor M. Vincent, Jessica L. Saleska

The current study examines COVID-19 prevention behaviors and vaccine intentions among 83 youth at high risk for HIV. Most youth self-identified as Latinx (52%), cisgender men (84%), and homosexual (66%). Youth self-reported COVID-19 prevention behaviors and intentions to vaccinate. Participants reported wearing face masks, washing hands, and staying six feet apart, but fewer reported leaving home only for essential needs. About one-third reported that they would not get a vaccine, and lack of trust in their doctors and the government were significantly associated with non-intention. To improve efforts towards herd immunity, interventions to improve health messaging from trusted sources for at-risk youth may be necessary to achieve higher vaccine uptake.

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by Masoud Behzadifar, Afshin Aalipour, Mohammad Kehsvari, Banafsheh Darvishi Teli, Mahboubeh Khaton Ghanbari, Hasan Abolghasem Gorji, Alaeddin Sheikhi, Samad Azari, Mohammad Heydarian, Seyed Jafar Ehsanzadeh, Jude Dzevela Kong, Maryam Ahadi, Nicola Luigi Bragazzi
Background The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for all healthcare systems worldwide, and besides generating a high toll of deaths, it has caused economic losses. Hospitals have played a key role in providing services to patients and the volume of hospital activities has been refocused on COVID-19 patients. Other activities have been limited/repurposed or even suspended and hospitals have been operating with reduced capacity. With the decrease in non-COVID-19 activities, their financial system and sustainability have been threatened, with hospitals facing shortage of financial resources. The aim of this study was to investigate the effects of COVID-19 on the revenues of public hospitals in Lorestan province in western Iran, as a case study. Method In this quasi-experimental study, we conducted the interrupted time series analysis to evaluate COVID-19 induced changes in monthly revenues of 18 public hospitals, from April 2018 to August 2021, in Lorestan, Iran. In doing so, public hospitals report their earnings to the University of Medical Sciences monthly; then, we collected this data through the finance office. Results Due to COVID-19, the revenues of public hospitals experienced an average monthly decrease of $172,636 thousand (P-value = 0.01232). For about 13 months, the trend of declining hospital revenues continued. However, after February 2021, a relatively stable increase could be observed, with patient admission and elective surgeries restrictions being lifted. The average monthly income of hospitals increased by $83,574 thousand. Conclusion COVID-19 has reduced the revenues of public hospitals, which have faced many problems due to the high costs they have incurred. During the crisis, lack of adequate fundings can damage healthcare service delivery, and policymakers should allocate resources to prevent potential shocks.

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by María Elena Brenlla, Guadalupe Germano, Mariana S. Seivane, Rocío Fernández da Lama, Ruth Ogden

The Coronavirus-19 global pandemic has forced many governments around the world to enforce “lockdowns” to curtail the spread of the virus. Studies conducted in the UK, France, Italy and Brazil have demonstrated that one consequence of these lockdowns is significant distortion to the speed of the passage of time. The current study sought to establish how the passage of time was experienced during the Argentinian lockdown. An online questionnaire was used to measure passage of time judgments for the day and the week, physical activity, satisfaction with social interaction, the extent to which daily routines had changed due to covid and demographic data. The results show that distortions to the passage of time were widely experienced during the lockdown in Argentina. There was a tendency for participants to report time passing more quickly than normal. A faster passage of time was associated with being a woman, of younger age and more physically active. A slower passage of time was therefore associated with being a man, of older age and less physically active. The results indicate that whilst distortions to the passage of time during the covid-19 crisis appear to be a global phenomenon, cross-cultural differences are apparent in the factors which influence temporal experience.

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Title: Excesso e alta velocidade das informações científicas: impactos da COVID-19 no trabalho de jornalistas
Authors: Massarani, Luisa; Neves, Luiz Felipe Fernandes; Silva, Carla Maria da
Abstract: Neste artigo, analisamos a percepção de jornalistas brasileiros que cobrem ciência sobre como a pandemia de COVID-19 impactou seu trabalho. O estudo foi realizado por meio de um questionário on-line com 26 profissionais: 14 mulheres e 12 homens, a maioria com mais de 40 anos, com experiências variadas no jornalismo científico e que trabalham em veículos de comunicação ou de forma autônoma nos estados do PR, RJ e SP. Entre as principais mudanças desse período estão o aumento na produção de matérias e a necessidade de adotar estratégias na busca por informações científicas confiáveis, muitas delas divulgadas rapidamente ou na forma de pré-print (sem revisão por pares).
Description: Licença atribuída ao artigo pela revista: CC BY-ND.

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by Mikio Hayashi, Katsumi Nishiya, Kazunari Kaneko
Introduction Interruptions in undergraduate clinical clerkship during the COVID-19 pandemic have reduced the confidence and preparedness of residents beginning their postgraduate training. We explore the thoughts of new residents about this transition and reflect on the support needed. Methods An exploratory qualitative case study was conducted with 51 residents. All had experienced interruptions in clinical training due to the pandemic and had just started their postgraduate training. Qualitative data were collected through 6 focus groups and 12 individual follow-up interviews. A thematic analysis was undertaken, and the data were categorised using a Strengths, Weaknesses, Opportunities, and Threats (SWOT) framework. Results Graduates beginning their residency were aware of their professionalism and independence during the transition. They also faced the predicament of needing close supervision while their supervisors managed pandemic conditions. Residents emphasised the importance of developing relationships with colleagues and supervisors during the transition to residency and wanted direct observation and detailed feedback from their supervisors during procedures. Conclusions The experiences of residents were not uniformly negative. In fact, some had developed a positive mindset when entering the clinical field. Medical faculty members reflecting on interactions with new residents and planning future clinical internships could benefit from placing a high value on building relationships among residents, who may expect direct observation and detailed feedback from their supervisors.

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by Samuel J. Raymond, Sam Baker, Yuzhe Liu, Mauricio J. Bustamante, Brett Ley, Michael J. Horzewski, David B. Camarillo, David N. Cornfield

Respiratory failure complicates most critically ill patients with COVID-19 and is characterized by heterogeneous pulmonary parenchymal involvement, profound hypoxemia and pulmonary vascular injury. The high incidence of COVID-19 related respiratory failure has exposed critical shortages in the supply of mechanical ventilators, and providers with the necessary skills to treat. Traditional mass-produced ventilators rely on an internal compressor and mixer to moderate and control the gas mixture delivered to a patient. However, the current emergency has energized the pursuit of alternative designs, enabling greater flexibility in supply chain, manufacturing, storage, and maintenance considerations. To achieve this, we hypothesized that using the medical gasses and flow interruption strategy would allow for a high performance, low cost, functional ventilator. A low-cost ventilator designed and built-in accordance with the Emergency Use guidance from the US Food and Drug Administration (FDA) is presented wherein pressurized medical grade gases enter the ventilator and time limited flow interruption determines the ventilator rate and tidal volume. This simple strategy obviates the need for many components needed in traditional ventilators, thereby dramatically shortening the time from storage to clinical deployment, increasing reliability, while still providing life-saving ventilatory support. The overall design philosophy and its applicability in this new crisis is described, followed by both bench top and animal testing results used to confirm the precision, safety and reliability of this low cost and novel approach to mechanical ventilation. The ventilator meets and exceeds the critical requirements included in the FDA emergency use guidelines. The ventilator has received emergency use authorization from the FDA.

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by Chi-Ling Joanna Sinn, Heebah Sultan, Luke Andrew Turcotte, Caitlin McArthur, John P. Hirdes
Objective The objective was to compare home care episode, standardised assessment, and service patterns in Ontario’s publicly funded home care system during the first wave of the COVID-19 pandemic (i.e., March to September 2020) using the previous year as reference. Study design and setting We plotted monthly time series data from March 2019 to September 2020 for home care recipients in Ontario, Canada. Home care episodes were linked to interRAI Home Care assessments, interRAI Contact Assessments, and home care services. Health status measures from the patient’s most recent interRAI assessment were used to stratify the receipt of personal support, nursing, and occupational or physical therapy services. Significant level and slope changes were detected using Poisson, beta, and linear regression models. Results The March to September 2020 period was associated with significantly fewer home care admissions, discharges, and standardised assessments. Among those assessed with the interRAI Home Care assessment, significantly fewer patients received any personal support services. Among those assessed with either interRAI assessment and identified to have rehabilitation needs, significantly fewer patients received any therapy services. Among patients receiving services, patients received significantly fewer hours of personal support and fewer therapy visits per month. By September 2020, the rate of admissions and services had mostly returned to pre-pandemic levels, but completion of standardised assessments lagged behind. Conclusion The first wave of the COVID-19 pandemic was associated with substantial changes in Ontario’s publicly funded home care system. Although it may have been necessary to prioritise service delivery during a crisis situation, standardised assessments are needed to support individualised patient care and system-level monitoring. Given the potential disruptions to home care services, future studies should examine the impact of the pandemic on the health and well-being of home care recipients and their caregiving networks.

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by Arnab K. Ghosh, Sara Venkatraman, Evgeniya Reshetnyak, Mangala Rajan, Anjile An, John K. Chae, Mark A. Unruh, David Abramson, Charles DiMaggio, Nathaniel Hupert
Background City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households. Methods We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown. Findings Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22–96%); Q3 vs. Q1: 48% (17–89%); Q4 vs. Q1: 66% (30–211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7–76%). Interpretation By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.

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by Charikleia Lampraki, Adar Hoffman, Angélique Roquet, Daniela S. Jopp

In early pandemic waves, when vaccination against COVID-19 was not yet an option, distancing and reduced social contact were the most effective measures to slow down the pandemic. Changes in frequency and forms of social contact have reduced the spread of the COVID-19 virus and thus saved lives, yet there is increasing evidence for negative side effects such as mental health issues. In the present study, we investigate the development of loneliness and its predictors to examine the role of changes in social networks due to social distancing and other COVID-19-related life changes. A total of 737 participants (age range = 18–81 years) completed an online survey in three waves during the last quarter of 2020 at one-month intervals. Latent growth and multilevel modeling revealed that emotional loneliness increased over time, while social loneliness remained stable. Moreover, socially lonely individuals were likely to also develop emotional loneliness over time. Increased social distancing and sanitary measures were accompanied by decreased social interactions and loss of individuals considered SOS contacts and confidants. Changes in specific social network indicators were differentially associated with changes in emotional vs social loneliness: Loss of friends considered confidants was associated with increasing emotional loneliness, whereas loss of friends considered SOS contacts and reduced overall social interactions were related to increasing social loneliness. Lastly, individuals with more family-and-friend SOS contacts, more friends as confidants and an overall higher number of social interactions were more protected from feeling socially or emotionally lonely. Study findings enhance the understanding of underlying mechanisms differentially contributing to social and emotional loneliness and offer practical suggestions to reduce mental-health side effects of social distancing.

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Title: Boletim BiblioCovid: pandemia e impactos na educação no ensino básico e superior
Authors: Silva, Adrianne Oliveira de Andrade da; Silva, Adriano da; Alves, Mayara
Description: Apoio: Letícia Ramalho – Estagiária (ICICT/CRBF). Projeto gráfco: Luciana Rocha Mariz Clua – Multimeios|ICICT|FIOCRUZ. Diagramação: Letícia Ramalho – Estagiária – ICICT/CRBF; Luciana Rocha Mariz Clua – Multimeios|ICICT|FIOCRUZ. Ilustração BiblioCovid: Luciana Rocha Mariz Clua - Multimeios|ICICT|FIOCRUZ. Imagens: Pixabay.

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by Masashi Kamo, Michio Murakami, Wataru Naito, Jun-ichi Takeshita, Tetsuo Yasutaka, Seiya Imoto

In this study, we quantitatively assessed the effectiveness of systems for COVID-19 testing in small groups of sport teams that are semi-isolated from the general population by countermeasures against infection. Two types of group were assumed, and the dynamics of infection within each group was modeled by using a compartment model of infectious disease. One group (Group A) comprised domestic professional sports teams that play many games over a season while remaining within a relatively small region. Polymerase chain reaction (PCR) tests were routinely conducted once every 2 weeks, and the number of infected individuals that could not be quarantined after identification by testing or checking for symptoms was defined as the risk. The other group (Group B) comprised teams that travel across borders for mass-gathering events like the Olympic and Paralympic Games. The teams were isolated for 2 weeks at their destination; frequent testing and checking for symptoms was conducted, and any infected individuals were quarantined. The number of infected individuals participating in games after the isolation period was defined as the risk. In Group A, the number of infected individuals detected by routinely conducted PCR testing was lower than the number of infected individuals detected by checking for symptoms, indicating that routine testing every 2 weeks was not very effective. In Group B, daily PCR testing was the most effective, followed by daily antigen testing. Dual testing, in which individuals with a positive antigen test were given an additional PCR test, was the least effective with an effect equal to PCR testing every other day. These results indicate that repeated testing does not necessarily increase the detection of infected individuals.

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by Kathryn S. Taylor, James W. Taylor
Background A combined forecast from multiple models is typically more accurate than an individual forecast, but there are few examples of studies of combining in infectious disease forecasting. We investigated the accuracy of different ways of combining interval forecasts of weekly incident and cumulative coronavirus disease-2019 (COVID-19) mortality. Methods We considered weekly interval forecasts, for 1- to 4-week prediction horizons, with out-of-sample periods of approximately 18 months ending on 8 January 2022, for multiple locations in the United States, using data from the COVID-19 Forecast Hub. Our comparison involved simple and more complex combining methods, including methods that involve trimming outliers or performance-based weights. Prediction accuracy was evaluated using interval scores, weighted interval scores, skill scores, ranks, and reliability diagrams. Results The weighted inverse score and median combining methods performed best for forecasts of incident deaths. Overall, the leading inverse score method was 12% better than the mean benchmark method in forecasting the 95% interval and, considering all interval forecasts, the median was 7% better than the mean. Overall, the median was the most accurate method for forecasts of cumulative deaths. Compared to the mean, the median’s accuracy was 65% better in forecasting the 95% interval, and 43% better considering all interval forecasts. For all combining methods except the median, combining forecasts from only compartmental models produced better forecasts than combining forecasts from all models. Conclusions Combining forecasts can improve the contribution of probabilistic forecasting to health policy decision making during epidemics. The relative performance of combining methods depends on the extent of outliers and the type of models in the combination. The median combination has the advantage of being robust to outlying forecasts. Our results support the Hub’s use of the median and we recommend further investigation into the use of weighted methods.

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by Daniela Costa, Nuno Fernandes, Joana Arantes, José Keating

Uncertainty has been shown to reduce the willingness to cooperate in various social dilemmas and negatively affect prosocial behavior. However, some studies showed that uncertainty does not always decrease prosocial behavior, depending on the type of uncertainty. More specifically, recent research has shown that prosocial behavior tends to increase under impact uncertainty—uncertainty about the consequences for others if they become infected. In addition, researchers have argued that intuition favors prosocial behavior while deliberation leads to selfish behavior. Our study explored how intuitive (time pressure) or deliberate mental processing, under outcome, or impact uncertainty affect prosocial behavior in the context of the COVID-19 pandemic. Our sample consists of 496 participants, and we used a 4 (COVID-19 scenario: Control vs. Impact Uncertainty vs. Worst-Case vs. Indirect Transmission) by 2 (decision time: time delay vs. time pressure) between-subjects design. Results suggest that participants are more inclined to stay at home (prosocial intention) when forced to make their decisions intuitively rather than deliberately. Additionally, we found that uncertainty does not always decrease prosocial behavior. It seems that uncertainty does not affect the prosocial intention in a scenario with a real infectious disease. These findings suggest that the distinction between outcome and impact uncertainty may be due to the realism of experimental stimuli interventions.

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by Kristin J. Cummings, John Beckman, Matthew Frederick, Robert Harrison, Alyssa Nguyen, Robert Snyder, Elena Chan, Kathryn Gibb, Andrea Rodriguez, Jessie Wong, Erin L. Murray, Seema Jain, Ximena Vergara
Background Information on U.S. COVID-19 mortality rates by occupation is limited. We aimed to characterize 2020 COVID-19 fatalities among working Californians to inform preventive strategies. Methods We identified laboratory-confirmed COVID-19 fatalities with dates of death in 2020 by matching death certificates to the state’s COVID-19 case registry. Working status for decedents aged 18–64 years was determined from state employment records, death certificates, and case registry data and classified as “confirmed working,” “likely working,” or “not working.” We calculated age-adjusted overall and occupation-specific COVID-19 mortality rates using 2019 American Community Survey denominators. Results COVID-19 accounted for 8,050 (9.9%) of 81,468 fatalities among Californians 18–64 years old. Of these decedents, 2,486 (30.9%) were matched to state employment records and classified as “confirmed working.” The remainder were classified as “likely working” (n = 4,121 [51.2%]) or “not working” (n = 1,443 [17.9%]) using death certificate and case registry data. Confirmed and likely working COVID-19 decedents were predominantly male (76.3%), Latino (68.7%), and foreign-born (59.6%), with high school or less education (67.9%); 7.8% were Black. The overall age-adjusted COVID-19 mortality rate was 30.0 per 100,000 workers (95% confidence interval [CI], 29.3–30.8). Workers in nine occupational groups had age-adjusted mortality rates higher than this overall rate, including those in farming (78.0; 95% CI, 68.7–88.2); material moving (77.8; 95% CI, 70.2–85.9); construction (62.4; 95% CI, 57.7–67.4); production (60.2; 95% CI, 55.7–65.0); and transportation (57.2; 95% CI, 52.2–62.5) occupations. While occupational differences in mortality were evident across demographic groups, mortality rates were three-fold higher for male compared with female workers and three- to seven-fold higher for Latino and Black workers compared with Asian and White workers. Conclusion Californians in manual labor and in-person service occupations experienced disproportionate COVID-19 mortality, with the highest rates observed among male, Latino, and Black workers; these occupational group should be prioritized for prevention.

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by Ana Paula Santana, Lars Korn, Cornelia Betsch, Robert Böhm
Background Regarding the COVID-19 pandemic, concerted efforts have been invested in research to investigate and communicate the importance of complying with protective behaviors, such as handwashing and mask wearing. Protective measures vary in how effective they are in protecting the individual against infection, how much experience people have with them, whether they provide individual or societal protection, and how they are perceived on these dimensions. Methods This study assessed the willingness to follow recommended measures, depending on these features, among participants from Germany (n = 333), Hong Kong (n = 367), and the U.S. (n = 495). From April 24th to May 1st, 2020, individuals completed an online survey that assessed the antecedents of interest. Results It was shown that assumed effectiveness, previous experience, and intended self- and other-protection positively predicted willingness to comply across countries. When measures were mainly perceived as protecting others (vs. the self), individuals were less prone to adopt them. When a measure’s effectiveness to protect the individual was perceived as lower, willingness to adopt the measure increased with higher levels of prior experience and collectivism. Moreover, protecting others was more strongly related to adoption when individuals had higher levels of collectivism and lower levels of individualism. Conclusions Emphasizing the benefit for others could be a means to lower the potential detrimental effects of low assumed effectiveness for individual protection.

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by Daniele Pala, Vittorio Casella, Cristiana Larizza, Alberto Malovini, Riccardo Bellazzi

In the last century, the increase in traffic, human activities and industrial production have led to a diffuse presence of air pollution, which causes an increase of risk of several health conditions such as respiratory diseases. In Europe, air pollution is a serious concern that affects several areas, one of the worst ones being northern Italy, and in particular the Po Valley, an area characterized by low air quality due to a combination of high population density, industrial activity, geographical factors and weather conditions. Public health authorities and local administrations are aware of this problem, and periodically intervene with temporary traffic limitations and other regulations, often insufficient to solve the problem. In February 2020, this area was the first in Europe to be severely hit by the SARS-CoV-2 virus causing the COVID-19 disease, to which the Italian government reacted with the establishment of a drastic lockdown. This situation created the condition to study how significant is the impact of car traffic and industrial activity on the pollution in the area, as these factors were strongly reduced during the lockdown. Differently from some areas in the world, a drastic decrease in pollution measured in terms of particulate matter (PM) was not observed in the Po Valley during the lockdown, suggesting that several external factors can play a role in determining the severity of pollution. In this study, we report the case study of the city of Pavia, where data coming from 23 air quality sensors were analyzed to compare the levels measured during the lockdown with the ones coming from the same period in 2019. Our results show that, on a global scale, there was a statistically significant reduction in terms of PM levels taking into account meteorological variables that can influence pollution such as wind, temperature, humidity, rain and solar radiation. Differences can be noticed analyzing daily pollution trends too, as—compared to the study period in 2019—during the study period in 2020 pollution was higher in the morning and lower in the remaining hours.

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by Justyna Modrzejewska, Adriana Modrzejewska, Kamila Czepczor-Bernat, Paweł Matusik

The COVID-19 related lockdown made it much more difficult for people to control their eating behaviours and body weight with the methods and means they had used before. This is reflected in reports that show that eating behaviours deteriorated significantly during the COVID-19 pandemic (including in Poland). Therefore, it is important to determine what factors may be conducive to healthy eating behaviours among people with different BMI. As previous studies show, the use of healthy eating related-apps and training programs may be a protective factor against the development of unhealthy eating behaviours. Therefore, it is worth checking whether their action will be a protective factor during COVID-19. The aim of this cross sectional study was to analyse whether the current use of healthy eating-related apps and previous participation in training in this field (educational activities) as well as body mass index may play a role in eating motives and behaviours among women during COVID-19. Our final sample included 1,447 women (age: M = 31.34 ± 11.05). Participants completed: the Eating Motivation Survey, the Emotional Overeating Questionnaire, the Mindful Eating Questionnaire, socio-demographic survey and questions about healthy eating-related apps and training (educational activities). Referring to the selected significant results, our study shows that during COVID-19, the use of healthy eating-related apps alone, as well as the use of apps and prior training participation promote healthy eating motives and behaviours. It suggests that promoting the use of healthy eating applications and the acquisition of knowledge and skills in this field could be one way of shaping resources that can be effectively used to deal with crisis situations.

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Title: A percepção de crianças cariocas sobre a pandemia de COVID-19, SARS-CoV-2 e os vírus em geral
Authors: Folino, Carolina Habergric; Alvaro, Marcela Vitor; Massarani, Luisa; Chagas, Catarina
Abstract: Apesar de as crianças serem apontadas como o grupo menos afetado pelos sintomas da COVID-19, embora não ileso à doença e suas formas graves, seu cotidiano foi afetado de várias formas, incluindo a interrupção da vida escolar presencial e o contato com colegas de aula, além de impactos relacionados ao isolamento social e, em muitos casos, problemas financeiros e de saúde enfrentados por familiares. Neste trabalho, temos como objetivo compreender a percepção de crianças cariocas sobre o SARS-CoV-2, a COVID-19 e os vírus em geral, por meio de um estudo qualitativo. Entrevistamos 20 crianças por meio de plataformas de serviços de conferência. Os resultados indicam que elas estão conscientes dos riscos e cuidados necessários para a prevenção do coronavírus, mostrando-se apreensivas, com medo de pegar a doença e passar para os seus familiares. Quanto aos vírus em geral, observamos que suas percepções são relacionadas diretamente ao coronavírus, isto é, à situação com que estão lidando atualmente. O estudo traz subsídios que podem ajudar na concepção de estratégias de divulgação científica.

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by Bilal Mahmood Beg, Tariq Hussain, Mehmood Ahmad, Sadaf Areej, Arfa Majeed, Muhammad Adil Rasheed, Muhammad Moin Ahmad, Qurat-ul-Ain Shoaib, Sadaf Aroosa
Background The coronavirus disease has become a global pandemic, and it continues to wreak havoc on global health and the economy. The development of vaccines may offer a potential eradication of COVID-19. This study evaluated the general knowledge, attitude, and perception of COVID-19 vaccines in the Pakistani population. Methods A self-reporting e-survey and questionnaire-based survey from vaccination centers of different cities of Pakistan among 502 participants were conducted. The questionnaire comprised four sections inquiring demographics, vaccination status, and perception or attitude towards the vaccine. Univariate logistic regression was applied to predict the knowledge, attitude and behavior of participants. Results The mean age of participants was 50.8±20.3 years. 53% of the participants have both doses of vaccine administered. Pain on the site of injection (49.8%) was the most common symptom, followed by asthenia (43.0%), muscle pain (29.5%), and swelling (24.5%) on the site of vaccine administration. Females complain of more symptoms than males. More severe symptoms were reported after the first dose of vaccine administration; these symptoms subsided within a week for most participants. Overall, the respondents have a positive attitude towards the vaccine. 47.4% are sure about the vaccine’s efficacy, 48.6% said getting vaccinated was their own decision, and 79.9% also recommended others to get vaccinated. Conclusion The study concluded that the Pakistani population has a positive attitude but inadequate knowledge towards COVID-19 vaccines. Immediate awareness and vaccination education programs should be conducted by the authorities to complete the mass vaccination schedule.

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by Marlyn Khouri, Dana Lassri, Noga Cohen

The current worldwide COVID-19 pandemic has elicited widespread concerns and stress. Arguably, healthcare workers are especially vulnerable to experience burnout during these times due to the nature of their work. Indeed, high prevalence of burnout was found among healthcare workers during the outbreak. However, the individual differences predicting burnout among healthcare workers during the pandemic have been understudied. The aim of the current study was, therefore, to identify risk and protective factors contributing to the severity of burnout among healthcare workers, above and beyond levels of current psychological distress. The survey was distributed online during the period April 13–28, 2020, approximately two months after the first COVID-19 case was identified in Israel. Ninety-eight healthcare workers completed an online survey administered cross-sectionally via the Qualtrics platform that included questionnaires assessing habitual emotion regulation strategies (i.e., trait worry, reappraisal, and suppression), psychological distress, COVID-19 related concerns, and burnout. A hierarchical linear regression analysis revealed that only trait worry and psychological distress were significant predictors of job burnout among healthcare workers. These findings highlight the role of maladaptive emotion regulation tendencies, specifically trait worry, in job burnout among healthcare workers. These findings have implications for both the assessment and treatment of healthcare workers. We discuss potential mechanisms and implications for practice.

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