Closest Facility Research Articles

Resilient communities? A qualitative interview study on sustaining a community project for health promotion among socially disadvantaged women during the first two years of the COVID-19 pandemic

ObjectivesWith the emergence of SARS-CoV-2 a global pandemic impacted on health promotion, overlapping and hindering efforts to overcome the worldwide pandemic of lacking physical activity (PA). Nationwide lockdowns, the closure of public facilities and sports venues, made it significantly more difficult to sustain community-run PA projects. In our case study, we explore (a) under which circumstances a community-basedhealth promotion project can be maintained during crisis and (b) what resilience capacities are important for community project coordinators to deal with those aggravating circumstances.MethodsOur case study looks at a community-based project called BIG, an exercise promotion project for women in difficult life circumstances. The case study was conducted between July 2021 and January 2022 with six municipalities implementing the project. Following a triangulation approach, we used minutes from short exchanges (n=17) with community project coordinators, information brochures about current exercise classes (n=6) and semi-structured qualitative interviews with project coordinators (n=6). All data were analyzed using the framework approach.ResultsAll sites showed a high level of willingness to adapt to the pandemic situation and to maintain the project as best as possible. Findings highlight that coordinators whose work routine was characterized by intense relationship management with participants and trainers demonstrated higher levels of adaptive and absorptive capacities on an individual level than coordinators of those communities with less social cohesion. At a community level, important resources for strengthening adaptive and absorptive resilience capacities were job security of the coordinators, sufficient financial resources to adapt classes to changing circumstances, and a supportive organizational climate in the coordinators’ working environment to allow them to react flexibly according to current pandemic regulations.ConclusionDespite high resilience capacities especially on an individual level, the low-threshold nature of the project could not be maintained at a pre-pandemic level. For many women, participation in the project was no longer possible at times. Awareness should be raised in communities that PA promotion programs are crucial to strengthening physical and mental health, even in times of crisis. It seems necessary to find permanent funding options for such programs, to integrate them permanently into municipal structures.

Modelling and analysing supply chain disruption: a case of online grocery retailer

Supply Chains (SCs) are becoming more vulnerable to disruption risks because of globalisation, competitiveness, and uncertainties. This study is motivated by an online grocery retailer in the UK that experienced multiple disruption risks, such as demand and supply shocks, facility closures, and disruption propagation simultaneously in 2020. The main purpose of this study is to model and perform quantitative analyses of a range of SC disruption risks affecting the UK online retailer. We have attempted to study how UK retailers responded to the first and second waves of the pandemic and the effect on multiple products. Six scenarios are developed based on SC disruption risks and their impacts on SC performance are analysed. The quantitative analysis of two strategies used by grocery retailers during the pandemic, namely vulnerable priority delivery slots and rationing of products, illustrates that rationing of products had a greater SC impact than the use of priority delivery slots. The effects of two resilience strategies, backup supplier and ramping up distribution centre capacity, are also quantified and discussed. Novel managerial insights and theoretical implications are discussed to make online grocery SC more resilient and robust during future disruptions.

Application of School Bus Routing Problem in GIS to Organize School Buses in Kandy City, Sri Lanka

Generally, Kandy city and traffic congestion go hand in hand. This situation becomes worse during school time. The geographical location of the city, the limited number of entrances and the large number of schools located within a small area are contributing to this condition. This study attempts to propose a new model to reduce school time traffic congestion using School Bus Routing Problem (SBRP) method. Network analysis in GIS facilitates the build of this system. SBRP seeks to plan an efficient schedule for school buses to pick up students from a bus stop and drop them to school by satisfying various constraints like; school time window, maximum walking distance and riding time, and the traffic. SBRP selects the nearest bus stops, generates suitable bus routes and visualizes traffic congestion on roads in Kandy city. Vehicle Routing Problem (VRP), closest facility, and location-allocation tools identify GIS-based solutions to SBRP. The proposed model selected suitable bus stops to drop students to a school and to generate the fastest bus route for the school buses. Visualizing a 12-hour daytime traffic in Kandy City, all schools are covered by the 56 fastest bus routes. The maximum riding time and distance limits to 59 minutes and 16 km respectively. Historical traffic data identifies 6.00 am to 8.00 am and 12.00 pm to 2.00 pm as the most traffic-congested time in the city. Finally, all problems of SBRP are solved and a systematic method is introduced to transport school students by optimizing the traveling time of students with existing traffic congestion.

Changes in adult leisure-time physical activity during and after COVID-19 restrictions in Colorado Springs, Colorado

ABSTRACT The public health response to the COVID-19 pandemic may have changed leisure-time physical activity (PA) behaviour, as many ‘Stay-at-Home’ policies mandated closure of indoor recreational facilities. This study examined changes in adult leisure-time PA in more and less active groups during and after COVID-19 restrictions in a relatively active region where outdoor PA was not limited. Self-reported data on walking, moderate, and vigorous PA before, during, and after restrictions were collected via a retrospective internet survey with convenience and snowball sampling. Respondents (N = 183) were categorised as either meeting (n = 129) or not meeting (n = 54) the national recommendation of 150 minutes/week of moderate-to-vigorous aerobic PA (MVPA) during the period before restrictions. Minutes of walking, MVPA, and total PA were compared across groups and periods with two-way repeated-measure ANOVAs. Those who met PA guidelines decreased MVPA by 51.0 minutes/week during restrictions compared to before. Those not meeting PA guidelines increased total PA by 88.1 minutes/week during restrictions. This study highlights a need to better understand interactions between built environment and social cognitive factors related to leisure-time PA, which may help inform future PA interventions.

Understanding cardiac rehabilitation delivery in Scotland during the COVID-19 pandemic: lessons for the future

Background/Aims Cardiac rehabilitation services were disrupted during the early stages of the COVID-19 pandemic because of limitations on interpersonal contact, exercise facility closures and clinical service reorganisation. This necessitated urgent service redesign. The authors aimed to understand the changes to cardiac rehabilitation service delivery in Scotland, the impacts on staff and participant experiences, and implications for future delivery. Methods A concurrent mixed-methods study was conducted between April and December 2021. A quantitative online survey compared service provision before the pandemic (21 March 2019 to 20 November 2019) with provision after the onset of the pandemic (21 March 2020–20 November 2020). Quantitative data were analysed descriptively. Semi-structured telephone interviews were conducted with cardiac rehabilitation professionals and participants. These qualitative data were thematically analysed using the framework approach. Results Representatives (n=11) from 11 services completed the survey, while 11 staff and 17 patients completed the interviews. Services reported staffing reductions, delayed initial patient contact, replacement of face-to-face rehabilitation with telephone and online support, compromised initial assessments and reduced exit assessments. Patients relied more heavily on cardiac rehabilitation staff as a result of reduced access to other health professionals, and experienced issues with continuity of care. Technology presented remote service opportunities, but challenges around poor access to systems and technological literacy issues created barriers to service delivery. Service evaluation data were inaccessible. Conclusions Scottish cardiac rehabilitation services were adversely impacted by the COVID-19 pandemic and responded by developing remote options. These can be enhanced by screening patients to assess their access to technology and identify any literacy issues, as well as developing online educational videos and downloadable resources. Staff education is needed to encourage use of technology, including exercise monitoring via wearables. A national audit is required to assess delivery and outcomes.

Facility Closures and Distance Traveled to Receive Dialysis Care in the United States.

Facility Closures and Distance Traveled to Receive Dialysis Care in the United States.

Using mobile phone data to evaluate access to essential services following natural hazards.

Natural hazards bring about changes in the access to essential services such as grocery stores, healthcare, schools, and day care because of facility closures, transportation system disruption, evacuation orders, power outages, and other barriers to access. Understanding changes in access to essential services following a disruption is critical to ensure equitable recovery and more resilient communities. However, past approaches to understanding facility closures and inaccessibility such as surveys and interviews are labor-intensive and of limited geographic scope. In this article, we develop an approach to understanding facility-level inaccessibility across a broad geographic area based on location-based services data collected from cell phones. This approach supplements current approaches and helps both researchers and emergency response planners better understand which communities lose access to essential services and for how long. We demonstrate our approach by analyzing loss of access to supermarkets, schools, healthcare facilities, and home improvement stores in Southwest Florida leading up to and following the landfall of Hurricane Irma in 2017.

Understanding cardiac rehabilitation delivery during Covid-19; lessons for future delivery; a mixed methods study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Scottish Funding Council (additional research funding for universities 2020-21) Background/introduction Cardiac rehabilitation (CR) services were disrupted during early COVID-19 due to limited interpersonal contacts, exercise facility closures, and clinical service reorganisation to meet COVID-19 patients’ needs. This necessitated urgent service reorganisation. Purpose We aimed to understand CR delivery changes in Scotland, the impact on staff and participant experiences, and implications for future delivery. Methods A concurrent mixed methods study with data collected between April-December 2021. A quantitative online survey compared CR service provision pre-COVID-19 (21 March 2019 – 20 November 2019) with provision during early COVID-19 (21 March 2020 – 20 November 2020). Quantitative data were analysed descriptively using SPSSv26. Qualitative semi-structured telephone interviews were conducted with CR professionals and CR participants. These were thematically analysed using the framework approach. Data were integrated during study design by aligning survey and interview questions, and at the discussion stage. Results Eleven CR services completed the online survey, and 11 individual CR staff and 17 CR participants from six services completed qualitative interviews. Services reported staffing reductions, delayed initial patient contact, replacing face-to-face CR with web-based and telephone support, and a reduction in goal setting, functional capacity testing and exit assessments. Three main qualitative themes represented the challenges and opportunities of changing CR delivery during COVID-19: 1) Access to health professional support; 2) Disruption in continuity of care and 3) CR technology use (Figure 1). Conclusions Initially, Covid-19 adversely affected CR delivery. Telephone support, the provision of web-based information and exercise options, wearables and mHealth apps can enhance future CR delivery. Technological resources must be accessible, and staff require training to ensure competency.

Beirut Port Blast 2020: New Lessons Learned in Mass Casualty Incident Management in the Emergency Department

BackgroundOn August 4, 2020, Lebanon suffered its largest mass casualty incident (MCI) to date: the Beirut Port blast. Hospital emergency response to MCIs is particularly challenging in low- and middle-income countries, where emergency medical services are not well developed and where hospitals have to rapidly scale up capacity to receive large influxes of casualties. This article describes the American University of Beirut Medical Center (AUBMC) response to the Beirut Port blast and outlines the lessons learned. DiscussionThe Beirut Port blast reinforced the importance of proper preparedness and flexibility in managing an MCI. Effective elements of AUBMC's MCI plan included geographic-based activation criteria, along with use of Wi-Fi messaging systems for timely notification of disaster teams. Crowd control through planned facility closures allowed medical teams to focus on patient care. Pre-identified surge areas with prepared disaster cart deployment allowed the teams to scale up quickly. Several challenges were identified related to electronic medical records (EMRs), including patient registration, staff training on EMR disaster modules, and cumbersome EMR admission process workflows. Finally, this experience highlights the importance of psychological debriefs after MCIs. ConclusionsHospital MCI preparedness plans can integrate several strategies that are effective in quickly scaling up capacity to respond to large MCIs. These are especially necessary in countries that lack coordinated prehospital systems.

The COVID-19 pandemic and leisure providers—Challenges, opportunities and adaptation strategies for ski area operators in Austria

The COVID-19 crisis and the related nationwide lockdowns reduced the available types of physical activity, especially in the winter season. Besides closed indoor sports facilities, some outdoor sports were also inaccessible because of curfews and/or the closure of outdoor sports facilities. However, in Austria, the operation of alpine ski areas was permitted even during the full lockdown in the winter season 2020/21, albeit under strict hygiene requirements and capacity restrictions. This posed a challenge for ski area operators, with those heavily dependent on foreign multi-day guests facing severe declines in demand due to closed accommodation and closed borders while others were challenged by demand pressures from nearby population centers. We therefore want to examine how Austrian ski area operators managed these challenges, how they evaluated this extraordinary season and whether these new experiences and established measures can be used to improve customer experience in the future. We used a mixed-methods approach with a quantitative survey (n = 65) and follow-up qualitative interviews with managers (n = 20) of Austrian ski areas. For 75% of respondents, the reason for keeping the ski areas open, despite the fact that 95 % suffered average revenue declines of 80%, was to provide an outlet for physical activity for the local population. Respondents noticed a lot of gratitude and growing trust from local customers that could be used to increase the approval of tourism in the local population. The COVID-19 pandemic has also advanced the spread of technological innovations in the cable car industry, such as online ticketing and dynamic pricing. Furthermore, the COVID-19 crisis has continued to drive the sustainability debate around ski resorts. Customers are seeking further deceleration resulting in a stronger focus on qualitative rather than quantitative development for Austrian ski area operators.

Assessing the impact of COVID-19 on STEM (science, technology, engineering, mathematics) researchers in India.

Background: The coronavirus disease 2019 (COVID-19) pandemic and the nationally mandated lockdown has resulted in facility closures, decreased laboratory activities, and shifting to remote working. The effects of the pandemic have spread across all professions, including academia. Hence, the present study aims to understand the extent of the impact of the COVID-19 pandemic on STEM (science, technology, engineering, mathematics) researchers and stakeholders in India. Methods: The study employed a mixed method design. Both quantitative (survey) and qualitative (interview) methods were used to gain a comprehensive understanding on the impact of the COVID-19 pandemic on STEM (science, technology, engineering, mathematics) early career researchers (ECRs), graduate students, Heads of Institutes, suppliers of scientific equipment, funders, and other stakeholders in India. Results: A total of 618 researchers completed the survey, and 24 stakeholders were interviewed for this study. Our findings highlight the importance of institutional and social support for mental well-being and scientific productivity among researchers, especially during the pandemic. It also shows the impact of the disruptions in grant disbursals on research activities of scientists. Further, the gendered impact between these relationships was also noted, all of which hint at a need for structured reform within STEM. Conclusions: The study highlights the various challenges faced by early career researchers, and STEM scientists at various positions in their careers during the COVID-19 restrictions in India.

Preparing for the Just Transition from Local Economies’ Perspective: Belchatow Brown Coal Basin Case Study (Central Poland)

This article addresses the matter of investment decisions undertaken by the local authorities of coal-dependent economies in the context of oncoming transition resulting from the industrial facilities closure. The article offers an analysis of investment expenditures in three areas: technical infrastructure, social infrastructure, and environmental protection. The theoretical part of the article is focused on the issues of the just transition process and the role of institutions in effective planning for the post-coal future. Examples of concrete investments mitigating the negative effects of the coal phase-out are presented. The research is also completed by the recommendations and suggestions for policy makers.

Factors that influenced utilization of antenatal and immunization services in two local government areas in The Gambia during COVID-19: An interview-based qualitative study.

Evidence is being consolidated that shows that the utilization of antenatal and immunization services has declined in low-income countries (LICs) during the COVID-19 pandemic. Very little is known about the effects of the pandemic on antenatal and immunization service utilization in The Gambia. We set out to explore the COVID-19-related factors affecting the utilization of antenatal and immunization services in two Local Government Areas (LGAs) in The Gambia. A qualitative methodology was used to explore patients' and providers' experiences of antenatal and immunization services during the pandemic in two LGAs in The Gambia. Thirty-one study participants were recruited from four health facilities, applying a theory-driven sampling framework, including health workers as well as female patients. Qualitative evidence was collected through theory-driven semi-structured interviews, and was recorded, translated into English, transcribed, and analysed thematically, applying a social-ecological framework. In our interviews, we identified themes at five different levels: individual, interpersonal, community, institutional and policy factors. Individual factors revolved around patients' fear of being infected in the facilities, and of being quarantined, and their anxiety about passing on infections to family members. Interpersonal factors involved the reluctance of partners and family members, as well as perceived negligence and disrespect by health workers. Community factors included misinformation within the community and mistrust of vaccines. Institutional factors included the shortage of health workers, closures of health facilities, and the lack of personal protective equipment (PPEs) and essential medicines. Finally, policy factors revolved around the consequences of COVID-19 prevention measures, particularly the shortage of transport options and mandatory wearing of face masks. Our findings suggest that patients' fears of contagion, perceptions of poor treatment in the health system, and a general anxiety around the imposing of prevention measures, undermined the uptake of services. In future emergencies, the government in The Gambia, and governments in other LICs, will need to consider the unintended consequences of epidemic control measures on the uptake of antenatal and immunization services.

Strategic Facility Location with Clients That Minimize Total Waiting Time

We study a non-cooperative two-sided facility location game in which facilities and clients behave strategically. This is in contrast to many other facility location games in which clients simply visit their closest facility. Facility agents select a location on a graph to open a facility to attract as much purchasing power as possible, while client agents choose which facilities to patronize by strategically distributing their purchasing power in order to minimize their total waiting time. Here, the waiting time of a facility depends on its received total purchasing power. We show that our client stage is an atomic splittable congestion game, which implies existence, uniqueness and efficient computation of a client equilibrium. Therefore, facility agents can efficiently predict client behavior and make strategic decisions accordingly. Despite that, we prove that subgame perfect equilibria do not exist in all instances of this game and that their existence is NP-hard to decide. On the positive side, we provide a simple and efficient algorithm to compute 3-approximate subgame perfect equilibria.

The Impact of COVID-19-Induced Responsibilities on Women’s Employment in Arab Countries

The COVID-19 pandemic has created massive challenges for women’s employment. Women’s responsibilities were exacerbated by the closure of schools and child daycare facilities. Investigating the determinants of job losses among women is critical to avoiding dropouts and supporting re-entry into the labor market. This study investigates the factors driving women’s workforce losses during the pandemic in five Arab countries (Egypt, Tunisia, Morocco, Jordan, and Sudan). The current study focuses mainly on how COVID-19-induced responsibilities affected women’s employment during the pandemic. The study depends on the COVID-19 MENA Monitor Household Survey produced by the Economic Research Forum. The factor analysis of mixed data is used to construct the women’s responsibilities index that is made up of 18 variables. The mixed-effect logistic model is used to consider changes in working arrangements across economic activities. The results indicate that women with high family caregiving responsibilities were more likely to lose their jobs. Women working in the government sector and with health insurance were protected from job losses. Telecommuting played a significant role in helping women maintain their jobs. Work arrangements should be improved to consider increased unpaid domestic work. Family-friendly policies must be activated, and childcare leave must be facilitated and funded. The private sector should also be urged to improve workplace flexibility.

Exact solution approaches for the discrete α-neighbor p-center problem.

The discrete -neighbor -center problem (d--CP) is an emerging variant of the classical -center problem which recently got attention in literature. In this problem, we are given a discrete set of points and we need to locate facilities on these points in such a way that the maximum distance between each point where no facility is located and its -closest facility is minimized. The only existing algorithms in literature for solving the d--CP are approximation algorithms and two recently proposed heuristics. In this work, we present two integer programming formulations for the d--CP, together with lifting of inequalities, valid inequalities, inequalities that do not change the optimal objective function value and variable fixing procedures. We provide theoretical results on the strength of the formulations and convergence results for the lower bounds obtained after applying the lifting procedures or the variable fixing procedures in an iterative fashion. Based on our formulations and theoretical results, we develop branch-and-cut (B&C) algorithms, which are further enhanced with a starting heuristic and a primal heuristic. We evaluate the effectiveness of our B&Calgorithms using instances from literature. Our algorithms are able to solve 116 out of 194 instances from literature to proven optimality, with a runtime of under a minute for most of them. By doing so, we also provide improved solution values for 116 instances.

Effects of the COVID-19 Pandemic on Anxiety Symptoms in Long-Term Care Residents: A Multilevel Growth Curve Analysis.

The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted the mental health functioning of older adults residing in long-term care (LTC) settings. This study examines the impact of the lockdown on anxiety symptoms over time in LTC residents. Secondary data analysis was conducted on clinical data obtained with permission from a large behavioral health company that provides behavioral health services in long-term care (LTC) and assisted living (AL) facilities. Data were obtained from 1149 adults (mean age 72.37, 70% female) in LTC and AL facilities across the United States who were receiving psychological services 1 year prior, and 1 year after, the COVID-19 pandemic lockdown. Changes in anxiety (measured using a clinician rating scale) over time before and after the pandemic were assessed using latent growth curve modeling with psychiatric diagnosis, psychiatric medication, and demographic factors included as covariates. Anxiety severity decreased over time before and after the onset of the COVID-19 pandemic. Although pandemic-level factors such as facility closure and telehealth availability did not affect anxiety over time, individual treatment factors such as obsessive compulsive disorder diagnosis, initial anxiety severity, bipolar disorder diagnosis, and prescriptions for anxiolytic and antipsychotic medications affected the trajectory of anxiety during the pandemic. These results demonstrate that individual covariates such as diagnosis, symptom severity, and medication use impacted the trajectory of anxiety symptoms before and during the COVID-19 pandemic more strongly than pandemic-related circumstances (facility closure, telehealth availability). The impact of the COVID-19 pandemic may be better observed through treatment-relevant variables, rather than pure symptom severity. In preparation for future pandemics or other large-scale disasters potentially impacting service delivery, facilities should continue to prioritize continuity of care or a timely resumption of services attending to individual treatment factors.

A qualitative study regarding perception and challenges faced by providers and beneficiaries of Rashtriya Bal Swasthya Karyakram in general and also amid the COVID-19 pandemic at an urban health center from Ahmedabad City

Background: During COVID-19 pandemic, service providers and beneficiaries of Rashtriya Bal Swasthya Karyakram (RBSK) faced certain challenges. Objectives: The objective was to assess the perception and challenges faced by service providers and beneficiaries in general and amid the pandemic for availing the services at an urban health center in Ahmedabad. Methodology: Data of registered cases under RBSK at Urban Health Center (UHC) Ognaj in 2018–2019 and 2019–2020 were compared. In depth interviews (IDIs) of Medical Officer RBSK were done. Home visits were done to document the perception and challenges of beneficiaries through semi/unstructured questionnaire. Results: Considering the cases of 2018–2019 as base, registered cases decreased by 22.8% in 2019–2020 and 92.4% in 2020–2021. The pandemic affected 15.6% of beneficiaries in availing the services. Program was affected due to: (1) less workforce (vacant pharmacist post), (2) target-based approach, and (3) birth defects, deficiency disorders, chronic diseases, and development delays, especially deficiency not perceived a serious health issue by beneficiaries. Corona-specific reasons included: (1) staff deployment in COVID-19 activities, (2) reluctance/fear in visiting District Early Intervention Center (DEIC)/health facility, (3) reduced screening due to the closure of schools/Anganwadi Kendras, and (4) enforced lockdown. Conclusions: RBSK mobile health teams found it difficult to reach all 4Ds, more so for follow-up. RBSK was badly affected due to the engagement of providers in COVID-19 work, the closure of facilities, perception of beneficiaries that 4Ds are not of urgent medical concern, prevailing myths. A clear strategy is required to address such problems when the same or a similar type of pandemic strikes us in future.

Land-use and Energy Practices on US Golf Courses

Golf facilities require a large area and consume energy to operate. As such, golf facilities have the potential to influence ecosystems and contribute to national and regional energy demands. The objective of this study was to document the land-use and energy practices of US golf facilities in 2021 and to determine if changes have occurred since 2005. A survey was distributed via e-mail to 13,938 US golf facilities, with 1861 responding. From 2005 to 2021, the projected acres of maintained turfgrass declined by 14.2%, whereas the median maintained turfgrass acreage declined by 3.0% indicating the decline in projected acres was likely a result of facility closures. In 2021, water features, turfgrass, and natural areas accounted for 92% of the total projected facility acres. More golf facilities used cleaner energy sources, such as natural gas and solar-electric, and fewer golf facilities used gasoline and diesel in 2021 than in 2005. The percentage of golf facilities at which behavioral changes were implemented to decrease energy use declined but design changes increased from 2005 to 2021. Golf facilities became more land and energy efficient from 2005 to 2021 by reducing the acreage of maintained turfgrass and increasing the use of clean energy sources, but room for improvement still exists in human behaviors that affect energy use.

Kids back to school – parents back to work? School and daycare opening and parents’ employment in the early phase of the COVID-19 pandemic

Around the globe, the coronavirus pandemic has triggered various reactions of governments designed to contain the pandemic. Among other things, the pandemic led to an unforeseen and unprecedented closure of schools and daycare facilities. In turn, these closures might have forced parents to stay at home to care for their children who could not attend schools or kindergartens. From a social policy perspective, this raises the question of the extent to which parents’ employment has been affected, as time spent on childcare might make parents reduce their working hours. To answer this question, we exploit within-country variations in school and childcare policies across the federal states of Germany to analyse their effect on parents’ working time. In specific, we compare the working time of parents who live in different federal states with different restrictions regarding childcare in a difference-in-differences and difference-in-difference-in-differences framework. Our results reveal a non-negligible positive effect of an earlier and more far-reaching reopening of schools and daycare facilities on parents’ employment. Our results indicate that prolonged closure goes along with negative employment effects for parents. Hence, containment and closure policies to prevent the spread of COVID-19 have substantial economic and social side effects.