Adoption Of Social Distancing Measures Research Articles

Social distancing, water demand changes, and quality of drinking water during the COVID-19 pandemic

The COVID-19 pandemic changed daily routines for people around the globe due to the adoption of social distancing measures, such as working from home and restricted travel. Changes in daily routines created new water demand patterns, and the spatial redistribution of water demands in urban water distribution systems affected water quality. A range of factors can influence individual decisions to social distance, including demographics, risk perceptions, and prior experience with infectious disease. This research develops an agent-based modeling framework to simulate decisions to social distance, the effect of social distancing on water demands, and effects on the performance of water infrastructure and the quality of delivered drinking water. This framework couples a hydraulic model, a COVID-19 transmission model, and Bayesian belief network (BBN) driven decision-making models within an agent-based modeling framework. The model is applied for a virtual city, Micropolis, to explore the effects of social distancing decisions on water age. Results demonstrate an increase in average water age and changes to the expected flow directions in pipes under scenarios of increasing social distancing. Nodes near industrial areas experience higher degradation of water quality. This research provides a new framework to develop and evaluate water infrastructure management strategies during pandemics.

Persistence of the Omicron variant of SARS-CoV-2 in Australia: The impact of fluctuating social distancing.

We modelled emergence and spread of the Omicron variant of SARS-CoV-2 in Australia between December 2021 and June 2022. This pandemic stage exhibited a diverse epidemiological profile with emergence of co-circulating sub-lineages of Omicron, further complicated by differences in social distancing behaviour which varied over time. Our study delineated distinct phases of the Omicron-associated pandemic stage, and retrospectively quantified the adoption of social distancing measures, fluctuating over different time periods in response to the observable incidence dynamics. We also modelled the corresponding disease burden, in terms of hospitalisations, intensive care unit occupancy, and mortality. Supported by good agreement between simulated and actual health data, our study revealed that the nonlinear dynamics observed in the daily incidence and disease burden were determined not only by introduction of sub-lineages of Omicron, but also by the fluctuating adoption of social distancing measures. Our high-resolution model can be used in design and evaluation of public health interventions during future crises.

Remote Relaxation and Acceptance Training for the Management of Stress in Cancer Patients: A Study Protocol.

Background: Cancer patients are now facing a double distinctive challenge of survival against both the disease and fear of contracting COVID-19. This challenge has resulted in the forced adoption of social distancing measures and reorganization of the delivery of medical and psychological treatments. The perceived loneliness and uncertainty increased distress and symptoms burden. In the current period, eHealth interventions might provide valuable benefits in the field of cancer care.Objective: The overall goal of the study protocol will be to provide an innovative intervention for cancer patients based on an online platform, to help them manage and prevent psychological problems related to social isolation. Specifically, the efficacy of two web-based interventions aimed at lowering stress in cancer patients will be tested and compared.Methods: One hundred and fifty participants (75 per group) will be enrolled in a two-group randomized trial. The two interventions will be composed either by exercises on relaxation and meditation practices, presented in both automated online content and interactive group sessions or by fixed psychoeducational online content. Stress, anxiety, and depressive symptoms, distress, resilience, and perceived social isolation will be measured before the start of the interventions (T0), 2 weeks (T1), 4 weeks (T2), and 2 months (T3) after the beginning of the interventions in both groups. A repeated measures ANOVA will be performed to test differences in the questionnaires' scores between groups across the four-time points.Expected Results: We hypothesized greater improvement in the specific domain of stress symptoms (IES-R) assessed in the group receiving the interactive intervention, compared to the group which will receive only fully automated psychoeducational content. Secondarily, we expect the same trend of improvement across all the psychological variables in the blended intervention group.Conclusions: Implementing these practices on people who are forced into mandatory social isolation may help them become more aware of their mind-body condition and reduce negative effects. Moreover, relaxation techniques help individuals in achieving a greater state of well-being, increasing the ability to cope with stressful situations (resilience), and strengthening the immune system.

Evaluation of the Spatiotemporal Epidemiological Modeler (STEM) during the recent COVID-19 pandemic

In early December 2019, some people in China were diagnosed with an unknown pneumonia in Wuhan, in the Hubei province. The responsible of the outbreak was identified in a novel human-infecting coronavirus which differs both from severe acute respiratory syndrome coronavirus and from Middle East respiratory syndrome coronavirus. The new coronavirus, officially named severe acute respiratory syndrome coronavirus 2 by the International Committee on Taxonomy of Viruses, has spread worldwide within few weeks. Only two vaccines have been approved by regulatory agencies and some others are under development. Moreover, effective treatments have not been yet identified or developed even if some potential molecules are under investigation. In a pandemic outbreak, when treatments are not available, the only method that contribute to reduce the virus spreading is the adoption of social distancing measures, like quarantine and isolation. With the intention of better managing emergencies like this, which are a great public health threat, it is important to dispose of predictive epidemiological tools that can help to understand both the virus spreading in terms of people infected, hospitalized, dead and recovered and the effectiveness of containment measures.

Evolution of disease transmission during the COVID-19 pandemic: patterns and determinants

Epidemic models are being used by governments to inform public health strategies to reduce the spread of SARS-CoV-2. They simulate potential scenarios by manipulating model parameters that control processes of disease transmission and recovery. However, the validity of these parameters is challenged by the uncertainty of the impact of public health interventions on disease transmission, and the forecasting accuracy of these models is rarely investigated during an outbreak. We fitted a stochastic transmission model on reported cases, recoveries and deaths associated with SARS-CoV-2 infection across 101 countries. The dynamics of disease transmission was represented in terms of the daily effective reproduction number (R_t). The relationship between public health interventions and R_t was explored, firstly using a hierarchical clustering algorithm on initial R_t patterns, and secondly computing the time-lagged cross correlation among the daily number of policies implemented, R_t, and daily incidence counts in subsequent months. The impact of updating R_t every time a prediction is made on the forecasting accuracy of the model was investigated. We identified 5 groups of countries with distinct transmission patterns during the first 6 months of the pandemic. Early adoption of social distancing measures and a shorter gap between interventions were associated with a reduction on the duration of outbreaks. The lagged correlation analysis revealed that increased policy volume was associated with lower future R_t (75 days lag), while a lower R_t was associated with lower future policy volume (102 days lag). Lastly, the outbreak prediction accuracy of the model using dynamically updated R_t produced an average AUROC of 0.72 (0.708, 0.723) compared to 0.56 (0.555, 0.568) when R_t was kept constant. Monitoring the evolution of R_t during an epidemic is an important complementary piece of information to reported daily counts, recoveries and deaths, since it provides an early signal of the efficacy of containment measures. Using updated R_t values produces significantly better predictions of future outbreaks. Our results found variation in the effect of early public health interventions on the evolution of R_t over time and across countries, which could not be explained solely by the timing and number of the adopted interventions.

Comparing Public Perceptions and Preventive Behaviors During the Early Phase of the COVID-19 Pandemic in Hong Kong and the United Kingdom: Cross-sectional Survey Study.

BackgroundGiven the public health responses to previous respiratory disease pandemics, and in the absence of treatments and vaccines, the mitigation of the COVID-19 pandemic relies on population engagement in nonpharmaceutical interventions. This engagement is largely driven by risk perception, anxiety levels, and knowledge, as well as by historical exposure to disease outbreaks, government responses, and cultural factors.ObjectiveThe aim of this study is to compare psychobehavioral responses in Hong Kong and the United Kingdom during the early phase of the COVID-19 pandemic.MethodsComparable cross-sectional surveys were administered to adults in Hong Kong and the United Kingdom during the early phase of the epidemic in each setting. Explanatory variables included demographics, risk perception, knowledge of COVID-19, anxiety level, and preventive behaviors. Responses were weighted according to census data. Logistic regression models, including effect modification to quantify setting differences, were used to assess the association between the explanatory variables and the adoption of social distancing measures.ResultsData from 3431 complete responses (Hong Kong, 1663; United Kingdom, 1768) were analyzed. Perceived severity of symptoms differed by setting, with weighted percentages of 96.8% for Hong Kong (1621/1663) and 19.9% for the United Kingdom (366/1768). A large proportion of respondents were abnormally or borderline anxious (Hong Kong: 1077/1603, 60.0%; United Kingdom: 812/1768, 46.5%) and regarded direct contact with infected individuals as the transmission route of COVID-19 (Hong Kong: 94.0%-98.5%; United Kingdom: 69.2%-93.5%; all percentages weighted), with Hong Kong identifying additional routes. Hong Kong reported high levels of adoption of various social distancing measures (Hong Kong: 32.6%-93.7%; United Kingdom: 17.6%-59.0%) and mask-wearing (Hong Kong: 98.8% (1647/1663); United Kingdom: 3.1% (53/1768)). The impact of perceived severity of symptoms and perceived ease of transmission of COVID-19 on the adoption of social distancing measures varied by setting. In Hong Kong, these factors had no impact, whereas in the United Kingdom, those who perceived their symptom severity as “high” were more likely to adopt social distancing (adjusted odds ratios [aORs] 1.58-3.01), and those who perceived transmission as “easy” were prone to adopt both general social distancing (aOR 2.00, 95% CI 1.57-2.55) and contact avoidance (aOR 1.80, 95% CI 1.41-2.30). The impact of anxiety on adopting social distancing did not vary by setting.ConclusionsOur results suggest that health officials should ascertain baseline levels of risk perception and knowledge in populations, as well as prior sensitization to infectious disease outbreaks, during the development of mitigation strategies. Risk should be communicated through suitable media channels—and trust should be maintained—while early intervention remains the cornerstone of effective outbreak response.

Characterization of the bioaerosol in a natural thermal cave and assessment of the risk of transmission of SARS-CoV-2 virus.

Thermal caves represent an environment characterized by unique chemical/physical properties, often used for treatment and care of musculoskeletal, respiratory, and skin diseases.However, these environments are poorly characterized for their physical and microbiological characteristics; furthermore, the recent pandemic caused by COVID-19 has highlighted the need to investigate the potential transmission scenario of SARS-CoV-2 virus in indoor environments where an in-depth analysis of the aerosol concentrations and dimensional distributions are essential to monitor the spread of the virus.This research work was carried out inside a natural cave located in Viterbo (Terme dei Papi, Italy) where a waterfall of sulfur–sulfate–bicarbonate–alkaline earth mineral thermal water creates a warm-humid environment with 100% humidity and 48 °C temperature. Characterization of the aerosol and bioaerosol was carried out to estimate the personal exposure to aerosol concentrations, as well as particle size distributions, and to give an indication of the native microbial load.The data obtained showed a predominance of particles with a diameter greater than 8 µm, associated with low ability of penetration in the human respiratory system. A low microbial load was also observed, with a prevalence of noncultivable strains generated by the aerosolization of the thermal waters.Finally, the estimation of SARS-CoV-2 infection risk by means of mathematical modeling revealed a low risk of transmission, with a decisive effect given by the mechanical ventilation system, which together with the adoption of social distancing measures makes the risk of infection extremely low.Supplementary informationThe online version contains supplementary material available at (10.1007/s10653-021-00870-w)

Non-pharmaceutical Interventions and the Infodemic on Twitter: Lessons Learned from Italy during the Covid-19 Pandemic

The COVID-19 pandemic changed expectations for information dissemination and use around the globe, challenging accepted models of communications, leadership, and social systems. We explore how social media discourse about COVID-19 in Italy was affected by the rapid spread of the virus, and how themes in postings changed with the adoption of social distancing measures and non-pharmaceutical interventions (NPI). We used topic modeling and social network analysis to highlight critical dimensions of conversations around COVID-19: 1) topics in social media postings about the Coronavirus; 2) the scope and reach of social networks; and 3) changes in social media content as the nation moved from partial to full social distancing. Twitter messages sent in Italy between February 11th and March 10th, 2020. 74,306 Tweets sent by institutions, news sources, elected officials, scientists and social media influencers. Messages were retweeted more than 1.2 million times globally. Non-parametric chi-square statistic with residual analysis to identify categories, chi-square test for linear trend, and Social Network Graphing. The first phase of the pandemic was dominated by social media influencers, followed by a focus on the economic consequences of the virus and placing blame on immigrants. As the crisis deepened, science-based themes began to predominate, with a focus on reducing the spread of the virus through physical distancing and business closures Our findings highlight the importance of messaging in social media in gaining the public’s trust and engagement during a pandemic. This requires credible scientific voices to garner public support for effective mitigation. Fighting the spread of an infectious disease goes hand in hand with stemming the dissemination of lies, bad science, and misdirection.

Impact of first wave of SARS-CoV-2 infection in patients with Systemic Lupus Erythematosus: Weighting the risk of infection and flare.

IntroductionThe aim of this study was to investigate the incidence and clinical presentation of SARS-CoV-2 infections in a Systemic Lupus Erythematosus (SLE) cohort; to assess correlations with disease characteristics and rheumatic therapy; and to evaluate the occurrence of treatment discontinuation and its impact on disease activity.Materials and methodsSLE patients monitored by a single Italian centre were interviewed between February and July 2020. Patients were considered to be positive for SARS-CoV-2 infections in case of 1) positive nasopharyngeal swab; 2) positive serology associated with COVID19 suggesting symptoms. The following data were also recorded: clinical symptoms, adoption of social distancing measures, disease activity and treatment discontinuation.Results332 patients were enrolled in the study. Six patients (1.8%) tested positive for SARS-CoV-2 infection, with the incidence being significantly higher in the subgroup of patients treated with biological Disease-Modifying Anti-Rheumatic Drugs (p = 0.005), while no difference was observed for other therapies, age at enrollment, disease duration, type of cumulative organ involvement or adoption of social isolation. The course of the disease was mild. Thirty-six patients (11.1%) discontinued at least part of their therapy during this time period, and 27 (8.1%) cases of disease flare were recorded. Correlation between flare and discontinuation of therapy was statistically significant (p<0.001). No significant increase of rate of flare in a subgroup of the same patients during 2020 was observed.ConclusionTreatment discontinuation seems to be an important cause of disease flare. Our findings suggest that abrupt drug withdrawal should be avoided or evaluated with caution on the basis of individual infection risk and comorbidities.

Early perceptions and behavioural responses during the COVID-19 pandemic: a cross-sectional survey of UK adults

ObjectiveTo examine risk perceptions and behavioural responses of the UK adult population during the early phase of the COVID-19 epidemic in the UK.DesignA cross-sectional survey.SettingConducted with a nationally representative sample...

Trends and inequalities in food insecurity during the COVID-19 pandemic: results of four serial epidemiological surveys

The objective was to analyze trends and inequalities in the prevalence of food insecurity during the COVID-19 pandemic according to sociodemographic factors and social distancing measures. We analyzed data from four serial epidemiological surveys on COVID-19 in May and June 2020, with adults and elderly living in Bagé, Rio Grande do Sul State, Brazil. Food insecurity was assessed with the short version of the Brazilian Food Insecurity Scale (EBIA), with the recall period adapted to the beginning of the social distancing period in the city. Sociodemographic characteristics and the adoption of social distancing measures were analyzed, and their associations with food insecurity were assessed with chi-square test. The temporal trend in food insecurity according to these characteristics was assessed via linear regression. Inequalities in food insecurity were assessed with the angular inequality index and concentration index. Of the 1,550 individuals studied, 29.4% (95%CI: 25.0; 34.4) presented food insecurity. Analysis of inequality showed higher concentration of food insecurity among the younger and less educated and those living with five or more residents in the same household. Over the course of the four surveys, prevalence of food insecurity decreased most sharply among the younger, those living in households with up to two residents, and those with two or more workers. There was a strong association between food insecurity and sociodemographic factors, which may indicate the pandemic´s potential economic impact on households' food situation.

Social distancing measures and demands for the reorganization of hemotherapy services in the context of Covid-19.

The article aims to discuss the consequences of social distancing measures on the availability of blood and organization of blood therapy services at the beginning of the Covid-19 pandemic in Brazil. News published in April 2020 on the websites of the country's state Blood Service Networks were consulted and organized in an Excel spreadsheet, presented in summary charts, and descriptions of results were prepared. A critical situation of blood supply, especially of some blood types, has been observed in many states. This situation is influenced by the circulation of the new coronavirus. The adoption of social distancing measures associated with unchanged transfusion demands for outpatient, urgency and emergency care required the implementation of strategies and actions for the reorganization of the services. Protection measures were incorporated, flows were changed and new routines were established. This study shows the extent to which the epidemiological situation of Covid-19 and the necessary measures for its control influenced the stocks and availability of blood. Changes in the organization of blood therapy services were fundamental in order to ensure protection, mitigate the risks of spreading the virus, and ensure the blood supply to meet the needs of the health system.

COVID-19: [formula omitted] is lower where outbreak is larger

We use daily data from Lombardy, the Italian region most affected by the COVID-19 outbreak, to calibrate a SIR model on each municipality. Municipalities with a higher initial number of cases feature a lower rate of diffusion, not attributable to herd immunity: there is a robust and strongly significant negative correlation between the estimated basic reproduction number (R0) and the initial outbreak size. This represents novel evidence of the prevalence-response elasticity in a cross-sectional setting, characterized by a same health system and homogeneous social distancing regulations. By ruling out alternative explanations, we conclude that a higher number of cases causes changes of behavior, such as a more strict adoption of social distancing measures among the population, that reduce the spread. This finding calls for the distribution of detailed epidemiological data to populations affected by COVID-19 outbreaks.

A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic.

Introduction and aimPhysiotherapy in urogynecology faces challenges to safely continuing its work, considering the adoption of social distancing measures during the COVID-19 pandemic. Some guidelines have already been published for urogynecology; however, no specific documents have been produced on physiotherapy in urogynecology. This article aimed to offer guidance regarding physiotherapy in urogynecology during the COVID-19 pandemic.MethodsA group of experts in physiotherapy in women’s health performed a literature search in the Pubmed, PEDro, Web of Science and Embase databases and proposed a clinical guideline for physiotherapy management of urogynecological disorders during the COVID-19 pandemic. This document was reviewed by other physiotherapists and a multidisciplinary panel, which analyzed the suggested topics and reached consensus. The recommendations were grouped according to their similarities and allocated into categories.ResultsFour categories of recommendations (ethics and regulation issues, assessment of pelvic floor muscle function and dysfunction, health education and return to in-person care) were proposed. Telephysiotherapy and situations that need in-person care were also discussed. Regionalization is another topic that was considered.ConclusionThis study provides some guidance for continuity of the physiotherapist's work in urogynecology during the COVID-19 pandemic, considering the World Health Organization recommendations and the epidemiological public health situation of each region. Telephysiotherapy can also be used to provide continuity of the care in this area during the COVID-19 pandemic, opening new perspectives for physiotherapy in urogynecology.

Influência do distanciamento social no nível de atividade física durante a pandemia do COVID-19

Este estudo investigou como as medidas de distanciamento social para o combate ao COVID-19 tem influenciado o nível de atividade física. Um questionário estruturado sobre as práticas de atividade física antes e durante o período de distanciamento social foi disponibilizado on-line para coleta das informações dos 2004 adultos (18 anos ou mais de idade) residentes em municípios das cinco regiões brasileiras. Utilizou-se teste Qui-quadrado para avaliar associações entre o nível de atividade física anterior e durante o período da pandemia. Associações entre variáveis intervenientes foram verificadas através do odds ratio. Os participantes reduziram o nível de atividade física após a adoção das medidas de distanciamento social. O maior nível de atividade física durante a pandemia está associado ao sexo masculino, residir em região metropolitana e não pertencer a grupos de risco. Embora estes fatores já influenciassem o nível de atividade física antes da pandemia, os resultados do odds ratio indicaram que no período da pandemia os fatores sexo, região e risco apresentaram reduções no seu poder de predição. Questões levantadas neste estudo podem auxiliar o planejamento de ações voltadas ao incentivo da prática de atividade física em períodos de crise.

Predicting the evolution of the COVID-19 epidemic with the A-SIR model: Lombardy, Italy and São Paulo state, Brazil

The presence of a large number of infected individuals with few or no symptoms is an important epidemiological difficulty and the main mathematical feature of COVID-19. The A-SIR model, i.e. a SIR (Susceptible–Infected–Removed) model with a compartment for infected individuals with no symptoms or few symptoms was proposed by Gaeta (2020). In this paper we investigate a slightly generalized version of the same model and propose a scheme for fitting the parameters of the model to real data using the time series only of the deceased individuals. The scheme is applied to the concrete cases of Lombardy, Italy and São Paulo state, Brazil, showing different aspects of the epidemic. In both cases we see strong evidence that the adoption of social distancing measures contributed to a slower increase in the number of deceased individuals when compared to the baseline of no reduction in the infection rate. Both for Lombardy and São Paulo we show that we may have good fits to the data up to the present, but with very large differences in the future behavior. The reasons behind such disparate outcomes are the uncertainty on the value of a key parameter, the probability that an infected individual is fully symptomatic, and on the intensity of the social distancing measures adopted. This conclusion enforces the necessity of trying to determine the real number of infected individuals in a population, symptomatic or asymptomatic.

Description of a new biosafe procedure for cytological specimens from patients with COVID-19 processed by liquid-based preparations.

BackgroundCoronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and represents the causative agent of a potentially fatal disease. The spread of the infection and the severe clinical disease have led to the widespread adoption of social distancing measures. Special attention and efforts to protect or reduce transmission have been applied at all social levels, including health care operators. Hence, this reports focuses on the description of a new protocol for the safe management of cytological samples processed by liquid‐based cytology (LBC) with an evaluation of the changes in terms of morphology and immunoreactivity.MethodsFrom March 11 to April 25, 2020, 414 cytological cases suspicious for SARS‐CoV‐2 were processed with a new virus‐inactivating method suggested by Hologic, Inc, for all LBC specimens.ResultsThe samples showed an increased amount of fibrin in the background. A slight decrease in cellular size was also observed in comparison with the standard method of preparation. Nonetheless, the nuclear details of the neoplastic cells were well identified, and the immunoreactivity of the majority of those cells was maintained. The cell blocks did not show significant differences in morphology, immunoreactivity, or nucleic acid stability.ConclusionsDespite some minor changes in the morphology of the cells, the results of this study highlight that the adoption of the new protocol for the biosafety of LBC‐processed samples in pathology laboratories is important for minimizing the risk for personnel, trainees, and cytopathologists without impairing the diagnostic efficacy of the technique.

Biosafety at Home: How to Translate Biomedical Laboratory Safety Precautions for Everyday Use in the Context of COVID-19.

.Population adoption of social distancing measures during the COVID-19 pandemic is at times deficient, increasing the risk of SARS-CoV-2 transmission. Healthcare workers and those living in areas of intense transmission may benefit from implementing biosafety measures in their daily lives. A mixed-methods approach, combining components of single negotiation text and the Delphi method, was used to create a COVID-19 biosafety-at-home protocol. A consensus building coordinator liaised with 12 experts to develop the protocol over 11 iterations. Experts had more than 200 years of combined experience in epidemiology, virology, infectious disease prevention, and public health. A flyer, created from the final protocol, was professionally designed and initially distributed via social media and institutional websites/emails in Ecuador beginning on May 2, 2020. Since then, it has been distributed in other countries, reaching ∼7,000 people. Translating research laboratory biosafety measures for the home/street environment might be challenging. The biosafety-at-home flyer addresses this challenge in a user-friendly format.