Coronavirus Disease 2019 Lockdown Research Articles

Decade-low aerosol levels over the Bohai and Yellow Seas amid the COVID-19 lockdown.

Coronavirus disease 2019 (COVID-19) has crucially influenced anthropogenic activities, which in turn impacts upon the environment. In this study, we investigated the variations on aerosol optical depth (AOD) at 550 nm over the Bohai Sea and Yellow Sea during the COVID-19 lockdown (from February to March in 2020) of China mainland based on Moderate-resolution Imaging Spectroradiometer (MODIS) observation by comparing with historical AOD records (2011–2019). Our results show that with the lockdown implementation, the decade-low AOD levels are achieved in February and March 2020 (0.39 ± 0.18 and 0.37 ± 0.19, respectively), which are 22% and 28% (p < 0.01) lower than the average AOD between 2011 and 2019 (0.50 ± 0.08 and 0.52 ± 0.05, respectively). After the lockdown restrictions were relaxed and industrial production gradually resumed, the AOD in April 2020 rebounded to the historical average level. Besides, compared with historical observations (2011–2019), the AOD temporal variability from February to April 2020 showed different pattern, with the decade-high increase from March to April (+0.11) and decade-low increase from February to March (-0.01). Independent observations and simulation, including fine particulate matter (PM2.5) from ground-based measurements, wind field from Cross-Calibrated Multi-Platform, satellite-derived aerosol type, and back trajectories calculation by Hybird Single Paricle Lagrangian Intergrated Trajectory (HYSPLIT) model, indicated that the above abnormal AOD variation can be attributed to reduction of anthropogenic emissions during the COVID-19 lockdown period. The results of this paper, therefore, indicate that aerosols over the Bohai and Yellow Seas are strongly influenced by human activities, and the public health events such as the epidemic may alter the intensity of human activities and thus the spatio-temporal pattern of aerosol over ocean. With the global spread of the epidemic and the corresponding significant changes in human behavior patterns (restrictions on human activities, etc.), more studies should be carried out in the future about the aerosol variability and its potential impact on the marine environment.

Adverse Impacts of Temporomandibular Disorders Symptoms and Tooth Loss on Psychological States and Oral Health-Related Quality of Life During the COVID-19 Pandemic Lockdown.

BackgroundEmotion and quality of life may have been impacted by the coronavirus disease 2019 (COVID-19) crisis, especially in the lockdown. The impact of temporomandibular disorders (TMD) symptoms and tooth loss on mental status and Oral Health-Related Quality of Life (OHRQoL) are not fully understood in a stressful situation.ObjectivesWe aimed to investigate whether TMD and tooth loss were the impaired risks of psychological states and OHRQoL in COVID-19 lockdown, and attempt to explore other potential risk factors.MethodsThis cross-sectional study surveyed residents via an online self-reported questionnaire, when Yangzhou was in lockdown. Demographic data, clinical information, the level of anxiety, depression and OHRQoL were collected and analyzed.ResultsPainful TMD symptoms and tooth loss are the risks of more severe anxiety and depression. TMD symptoms and tooth loss worsened OHRQoL. Lower education degree (OR: 6.31, P = 0.019), TMD-related pain symptoms (OR: 10.62, P = 0.005), tooth loss (OR: 3.12, P = 0.035), sleep disorders (OR: 2.92, P = 0.049) and relatively close contacts (OR: 3.95, P = 0.020) were verified as risk factors for increased level of anxiety. With respect to depression, low socio-economic status (OR: 6.22, P = 0.021), TMD-related pain (OR: 7.35, P = 0.012), tooth loss (OR: 4.48, P = 0.009), sleep disorders (OR: 5.13, P = 0.007) and relatively close contacts (OR: 12.94, P = 0.001) were identified as independent factors for developing depression. Additionally, drinking (B: −2.584, P = 0.013) and never going to the dental clinic (B: −3.675, P = 0.024) were relevant to better OHRQoL, while TMD without pain (B: 2.797, P = 0.008), TMD-related pain (B: 12.079, P < 0.001), tooth loss (B: 2.546, P = 0.006), sleep disorders (B: 2.598, P = 0.003) were independent factors for impaired OHRQoL.ConclusionPainful TMD symptoms, tooth loss and sleep disorders were the impaired risks of psychological states. TMD symptoms and tooth loss damaged OHRQoL when the city was in lockdown. Therefore, individualized psychological counseling is supposed to maintain control of mental health and OHRQoL under the stressful event.

Impact of Covid-19 on the Buying Behaviour of Consumers with Respect to Purchase of Medicines Through online and Retail Outlets

The unprecedented impact of Novel Coronavirus Disease 2019 (COVID-19) on the economy is transforming consumer behaviour in purchasing various drugs. This study examines the change in consumer awareness levels and purchasing patterns concerning online pharmacies and generic drugs in the wake of the recent pandemic. It also explores the reasons behind changing attitudes, implications of these new consumer habits, and measures pharmaceutical retailers can take to evolve stronger. We conducted a cross-sectional survey of 260 randomly selected consumers attending a retail pharmacy attached to a secondary diabetes care centre in Andhra Pradesh from December 2020 to January 2021. The study involved 150 males and 110 females. We collected each consumer's demographic data, including age, gender, location, annual household income, and educational level. We used a questionnaire to assess consumers' awareness levels and buying patterns regarding online pharmacies and generic drugs, as well as their favored approaches to future shopping. In our study, 63.8% of subjects knew about online pharmacies, but 20.5% of them were aware only after the outbreak. Thirteen percent of consumers purchased medicines online, while 35.3% of them did so in response to the pandemic. On the other hand, 64.6% of the subjects know about generic medicines, but 8.3% of them have not heard of them until after the pandemic. Furthermore, consumers purchased generic medicines in 20.8% of cases, and 11.1% of those who purchased generics did so after the pandemic. In addition, we found that 79.2% opted for branded medicines in the future, while 56.9% chose local stores. 'COVID-19 lockdown brought a surge in awareness about online pharmacies and generic medicines, as well as a surge in online and generic purchases. Yet consumer sentiments towards local stores and branded medicines are positive during the COVID-19 times. The post-COVID-19 sentiment is as well looking optimistic for local stores and branded medicines.&#x0D;

Changes in physical and chemical properties of urban atmospheric aerosols and ozone during the COVID-19 lockdown in a semi-arid region

The synergistic response of urban atmospheric aerosols and ozone (O3) to reduction of anthropogenic emissions is complicated and still needs further study. Thus, the changes in physical and chemical properties of urban atmospheric aerosols and O3 during the Coronavirus Disease 2019 (COVID-19) lockdown were investigated at three urban sites and one rural site in Lanzhou with semi-arid climate. Fine particulate matter (PM2.5) decreased at four sites by ∼ 20% while O3 increased by >100% at two urban sites during the COVID-19 lockdown. Both primary emissions and secondary formation of PM2.5 decreased during the lockdown. Significant increase in both sulfur and nitrogen oxidation ratios was found in the afternoon, which accounted for 48.7% of the total sulfate and 40.4% of the total nitrate, respectively. The positive matrix factorization source apportionment revealed increased contribution of secondary formation and decreased contribution of vehicle emissions. Aerosol scattering and absorption decreased by 33.6% and 45.3%, resulting in an increase in visibility by 30% and single scattering albedo (SSA) at 520 nm slightly increased by 0.02. The enhanced O3 production was explained by increased volatile organic compounds to nitrogen oxides ratio, decreased aerosol, as well as increased SSA. The primary emissions of secondary aerosol precursors significantly decreased while Ox (i.e., NO2 and O3) exhibited little change. Consequently, Ox to CO ratio, PM2.5 to elemental carbon (EC) ratio, secondary inorganic aerosols to EC ratio, and secondary organic carbon to EC ratio increased, confirming enhanced secondary aerosol production efficiency during the lockdown. Positive feedback among O3 concentration, secondary aerosol formation, and SSA was revealed to further promote O3 production and secondary aerosol formation. These results provide scientific guidance for collaborative management of O3 and particulate matter pollution for cities with semi-arid climate.

Disruption in Daily Occupational Patterns, Optimism, and Positive Affect During Israel’s COVID-19 Lockdown

Abstract Date Presented 03/31/2022 The coronavirus disease 2019 (COVID-19) outbreak caused disruptions in people’s daily occupations. This study results showed that pattern of daily occupation has changed differently for everyone during the lockdown period. A positive correlation was found between positive affect and recreational activities during lockdown. This study expanded the understanding of occupational disruption as a complex phenomenon, suggesting that recreational activities at home might promote resilience and coping with future epidemics. Primary Author and Speaker: Orit Segev-Jacubovski Additional Authors and Speakers: Yael Fogel

Dietary Habits and Meal Pattern of People Residing in Anand District during COVID-19 Lockdown

Background: Coronavirus disease-2019 (COVID-19) is a condition caused by the novel coronavirus SARS-CoV-2. It was declared as global pandemic as it affected millions of people worldwide. A nationwide lockdown was announced to prevent the spread of the disease in India on March 24, 2020. The sudden change in routine lifestyle, home confinement, and fear of this pandemic caused stress and anxiety among the people and this has affected many habits of the people. Objective: The present study was conducted to evaluate changes in the dietary habits and meal pattern of people residing in Anand district during COVID-19 lockdown. Methodology: An online survey was conducted through semi-structured questionnaire to study the dietary habits and meal consumption pattern before and during COVID-19 lockdown. Result: The result showed a change in the regularity of meal consumption, type, and number of meals consumed by the respondents. More than 25% of respondents have reported an increase in the number of meals cooked, quantity of food cooked, and number of food items in one meal during the lockdown. Moreover, higher consumption of fruits and vegetables, protein rich foods, herbs, spices, and limited use of fats, oils, sugar, and salt was reported by more than 30% respondents. Conclusion: The present study concludes that this shift toward healthier food habits if sustained could have positive effects on health of people.

“Bloody amazing really”: voices from Scotland’s public libraries in lockdown

PurposeThe research examined Scottish public libraries and the libraries' response to the coronavirus disease 2019 (COVID-19) pandemic of 2020–2021. The research focussed particularly around the way that the libraries helped to support community resilience and cohesion during periods of lockdown. The study considered issues around the closure of services in March 2020, digital services, the loss of physical library spaces and governance models. The research presents the voice of service managers rather than being a user study. The research was funded by the Arts and Humanities Research Council (AHRC), part of UKRI (United Kingdom Research and Innovation), as a part of the council's scheme to provide response to the pandemic of 2020.Design/methodology/approachThis was an exploratory study examining how Scottish public library services responded to the COVID-19 lockdown in 2020. Three methods were deployed in the investigation. First, the gathering social media and other web-based content from library services over the months March–September 2020 (amounting to over four thousands snips of content) were analysed thematically. Second, 19 semi-structured interviews with service managers across Scotland were conducted. These were recorded, transcribed and analysed. These elements formed the cornerstone of the research but were supported by a short survey distributed to all public library services in Scotland focussed on e-lending during lockdown.FindingsFindings are presented in respect of the lessons to be learnt from the closure of physical services and the migration to digital only provision, the contribution made to supporting communities, health and well-being, the importance of the balance of physical and digital library services around governance models for library services, as well as around the process of reopening services. This research explores how staff responded to this unparalleled situation, how the staff maintained close relationship with the communities the staff serve, what services themselves learnt through lockdown, and how the staff's management practices adapted. The findings present voices from Scottish libraries during 2020.Research limitations/implicationsThe research presents a snapshot of activities during a period of fast-moving change. The research, therefore, presents a snapshot of March–December 2020, which is, however, an extremely important snapshot. The first lockdown was perhaps most interesting to study from a research perspective because the authors witnessed, real-time, how the staff responded and reacted (with lessons learnt and applied in subsequent regional or national lockdowns later in 2020 and in the 2021). The second lockdown and subsequent periods were outside the scope of this research.Practical implicationsRecommendations are offered around the need for a national conversation about digital content provision in public libraries and the exploration of possibilities of a national approach, the role libraries have as digital enablers (in supporting effort to overcome the digital divide in society), the crucial nature of continued strong advocacy for public libraries, the importance of the library as a physical space, and on how to maintain the flexibility, agility and autonomy which emerged during lockdown.Social implicationsThe research presents strong testimony about the social value of public libraries as free, safe and public spaces within communities. It also highlights the continued digital divide which exists in many places and the important role that public libraries have in being digital enablers for many members of the public. The closeness of library service staff to users is strongly evidenced in the testimony from managers as is the need for parent organisation (local authorities or in culture or leisure trusts) to recognise more fully the breadth of services the public library provides and how these are “essential” for many users.Originality/valueThe value and distinctiveness of this research lies in the fact that the research captured the voices, thoughts and perceptions of Scotland’s public libraries during the period of lockdown in 2020. The evidence gathered suggests important conversations are required around equity of e-lending provision, the role of libraries as digital enablers, the balance between physical and digital provision and around the ways libraries are managed (directly by local authorities or in culture trusts). The research affords lessons for public library provision beyond Scotland with many issues being transferable to other contexts.

COVID-19 lockdown introduces human mobility pattern changes for both Guangdong-Hong Kong-Macao greater bay area and the San Francisco bay area.

In response to the coronavirus disease 2019 (COVID-19) pandemic, various countries have sought to control COVID-19 transmission by introducing non-pharmaceutical interventions. Restricting population mobility, by introducing social distancing, is one of the most widely used non-pharmaceutical interventions. Although similar population mobility restriction interventions were introduced, their impacts on COVID-19 transmission are often inconsistent across different regions and different time periods. These differences may provide critical information for tailoring COVID-19 control strategies. In this paper, anonymized high spatiotemporal resolution mobile-phone location data were employed to empirically analyze and quantify the impact of lockdowns on population mobility. Both the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) in China and the San Francisco Bay Area (SBA) in the United States were studied. In response to the lockdowns, a general reduction in population mobility was observed, but the structural changes in mobility are very different between the two bays: 1) GBA mobility decreased by approximately 74.0–80.1% while the decrease of SBA was about 25.0–42.1%; 2) compared to SBA, the GBA had smoother volatility in daily volume during the lockdown. The volatility change indexes for GBA and SBA were 2.55% and 7.52%, respectively; 3) the effect of lockdown on short- to long-distance mobility was similar in GBA while the medium- and long-distance impact was more pronounced in SBA.

Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

BackgroundDuring the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions.MethodsA national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave.ResultsTwo hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic.ConclusionsVisiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted.

CPAP setup by mail: we're not there yet.

CPAP setup by mail: we're not there yet.

Mental Health of Children With Attention Deficit and Hyperactivity Disorder and Their Parents During the COVID-19 Lockdown: A National Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) pandemic has caused a real disruption of children's lives. Children with neurodevelopmental disorders and their parents seem to be particularly vulnerable to adverse mental health effects due to lockdown policies. This study explores the psychological state of children with Attention Deficit Hyperactivity Disorder (ADHD) and their parents during the first lockdown in France. A national prospective cross-sectional parent-reported study was conducted using an online survey disseminated through different social networks of French ADHD associations during the first lockdown. The survey consisted of open-ended, multiple-choice questions and standardized questionnaires such as the Strengths and Difficulties Questionnaire (SDQ), the coping self-report questionnaire (Brief COPE) and the Patient Health Questionnaire-2 (PHQ-2). A total of 538 parents completed the online survey between the 6th and the 15th of April 2020. These results suggest that most children (65.29%) did not experience a worsening of their behavior but still had pathological levels of hyperactivity (56.47%) and behavioral (57.60%) symptoms at the time of the first lockdown. In addition, some parents (26.27%) showed responses indicating possible major depressive disorder. Positive parental coping strategies were associated with both improved child behavior and fewer parental depressive symptoms. Strengthening parents' coping strategies may be an effective intervention to protect both parents and children with ADHD from the negative psychological effects of lockdown. In times of pandemic, psychological care modalities must evolve to provide quality online interventions for families of children with ADHD.

Different Variation of Intra-familial Body Mass Index subjected to Covid-19 Lockdown

Background and Aims: Coronavirus disease 2019 (COVID-19) lockdown has represented an inedited model of increased metabolic risk in all age groups, due to negative changes in dietary habits, physical activity, lifestyle. These effects have been generally explored at a population level in distinct age groups. Potential intra-familial, specific effects in adults and children sharing the same socio-economic, cultural level and living habits have been scarcely explored. We aimed to characterize changes of anthropometric indices in parents and in their children during COVID-19 lockdown.&#x0D; Methods: A cohort of 149 couple parent/children were prospectively enrolled. By a validated questionnaire we explored changes of body mass index (BMI) and individual lifestyle during a 2-month lockdown (May- July 2020).&#x0D; Results: BMI increased in 70.5% of parents and in 67.8% of their children, with a Δ-BMI of 1.44+0.09 kg/ m 2 and 0.36+0.02 Kg/m 2 , respectively. BMI increments, however, were only significant in adults and did not correlate in the couple parents/children. Most adults (80.5%) and children (71.4%) did not perform regular physical activity during the lockdown. Direct correlations between dietary changes and BMI variations became evident in children, mainly in terms of a decreased consumption of fresh fruit, pulses, fish, and an increased consumption of cereals, carbohydrates, dairy products, olive oil. In normal weight, overweight and obese children, but not in adults, the increase in sleep hours increased with BMI.&#x0D; Conclusions: Despite marked lifestyle changes imposed by the COVID-19 lockdown, BMI variations in parents were independent from those observed in their children, pointing to different outcomes in response to the same external, critical event. Thus, primary prevention measures aimed at maintaining a healthy lifestyle require different approaches according to age.

From Protection to Repression: State Containment of COVID-19 Pandemic and Human Rights Violations in Nigeria

ABSTRACT While previous studies have assessed the linkages between the implementation of the coronavirus disease 2019 (COVID-19) lockdown and human rights issues in non-African contexts, how the state containment of COVID-19 pandemic affected human rights in African context has been understudied, particularly in Nigeria. Using a qualitative-dominant mixed methods approach, this study assessed how state containment of COVID-19 pandemic affected human rights in Nigeria. It demonstrated that the state’s security operatives repressed the citizens during the implementation of COVID-19-induced full and partial lockdown in Nigeria. Despite the prospects of COVID-19 lockdown in mitigating the spread of the virus, state repression of citizens has implications for shrinking the civic spaces and engendering human rights violations. The study concluded that judicial reform and promotion of rights-based education among security operatives involved in the implementation of COVID-19 lockdown present opportunities for regulating the excesses of the state officials during public health emergencies, preserving human rights as well as advancing democracy and development in Nigeria.

Longitudinal changes in mental health following the COVID-19 lockdown: Results from the Survey of Health, Ageing, and Retirement in Europe

BackgroundTo limit the spread of the coronavirus disease 2019 (COVID-19) pandemic, different restriction measures were implemented aiming to ensure social distancing and isolation. However, it is well known that such measures may lead to adverse effects on mental health. MethodsData from 36,478 adults aged 50+ from the Survey of Health, Ageing and Retirement in Europe was used to investigate the longitudinal changes in mental health from pre-COVID-19 to during the pandemic (summer 2020), considering national restriction levels across 26 European countries and Israel. Multilevel logistic regression models were used to assess changes in feeling 'sad or depressed', sleeping problems, and loneliness. ResultsCompared with the mental health status before the COVID-19 outbreak, participants had a lower risk of feeling “sad or depressed” (–14.4%) and having sleeping problems (–9.9%), while the risk of feeling lonely slightly increased (1.2%). However, for individuals in countries with high restriction levels, the risk of feeling “sad or depressed” was attenuated and the risk of loneliness was greater compared to countries with low restriction levels. ConclusionOlder people felt less depressed and had fewer sleeping problems during the pandemic as compared to before the pandemic, while the risk of loneliness increased slightly. Stricter policy measures attenuated the otherwise positive impact on mental health. Future studies are needed to investigate the long-term effects of COVID-19 on mental health.

Psychological Distress and Access to Mental Health Services Among Undergraduate Students During the COVID-19 Lockdown in Uganda

BackgroundLockdown is an important public health approach aimed at curbing the raging effect of the coronavirus disease-2019 (COVID-19). This study aimed at determining the impact of prolonged lockdown on mental health and access to mental health services among undergraduate students in Uganda.MethodsAn online cross-sectional study was conducted anonymously among undergraduates across 10 universities in Uganda. The Distress Questionnaire-5 (DQ-5) and the Patient Health Questionnaire-2 (PHQ-2) were used. Logistic regression analysis was conducted to determine factors associated with psychological distress.ResultsWe enrolled 366 participants with a mean age of 24.5 ± 4.6 years. The prevalence of psychological distress was 40.2% (n = 147) (cut off 14/25 based on DQ-5) while depression stood at 25.7% (n = 94; cut off 3/6 based on PHQ-2) with mean scores of 12.1 ± 4.6 and 1.7 ± 1.6 respectively. Female gender (aOR: 1.6, 95%CI: 1.0–2.6, p = 0.032), pursuing a non-medical program (aOR: 2.2, 95%CI: 1.3–3.7, p = 0.005) were factors associated with psychological distress while non-medical program (aOR: 2.2, 95%CI: 1.3–3.7, p = 0.005) was associated with increased depression. Access to mental health services was associated with both reduced distress (aOR: 0.5, 95%CI: 0.3–0.8, p = 0.005) and depression (aOR: 0.6, 95%CI: 0.3–0.9, p = 0.034). A majority (65.3%) of the participants reported knowing how to access mental health care and 188 (51.4%) reported having needed emotional support but, only 67 (18.3%) ever sought care from a mental health professional. Of those who had access, only 10 (7%), and 13 (9%) accessed a counselor or a mental health unit, respectively. The barriers to accessibility of mental health care included financial limitations (49.5%), lack of awareness (32.5%), lack of mental health professionals (28.4%), and stigma (13.9%).ConclusionAmong university students in Uganda during the COVID- 19 lockdown, the burden of psychological distress and depression was substantial. However, access to mental health services was limited by several factors.

The Influences of Attitude, Religiosity, and Subjective Norm on Muslim’s Donation Intention During COVID-19 Lockdown in Malaysia

Charitable giving appears to be one of the most critical approaches to mitigating the impact of the global crisis such as coronavirus disease (COVID-19) on the poor and vulnerable people in Malaysia. Therefore, this study investigates the influences of religiosity, subjective norms, and attitude on donation intention among Malaysian Muslims during the coronavirus disease (COVID-19) lockdown in Malaysia. This study obtained a primary dataset consisting of 328 responses among Muslims throughout 14 states and the Federal Territories of Malaysia. Partial least square-structural equation modeling (PLS-SEM) were employed to analyze the primary data. Consequently, the results have found that religiosity and attitude are significant factors that directly predict monetary donation intention. Furthermore, attitude acted as a mediator in the relationship between religiosity and subjective norms on Malaysian Muslims’ donation intention. Ultimately, this study proposed relevant policies to identify specific factors that affect the donation intention as a practical response for vulnerable groups impacted by COVID-19 in Malaysia.

Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant Enterobacterales Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study.

Antimicrobial-resistant Enterobacterales carriage and the coronavirus disease 2019 (COVID-19) lockdown measures may impact the incidence all-cause mortality rate among nursing home residents. To determine the all-cause mortality rate in the presence/absence of antimicrobial-resistant Enterobacterales carriage and the incidence all-cause mortality rate before and during COVID-19 pandemic lockdown, this prospective closed-cohort study was conducted at various types of nursing homes in Bangkok, Thailand, from June 2020 to December 2021. The elderly residents included 142 participants (aged ≥60 years) living in nursing homes ≥3 months, who did not have terminal illnesses. Time-to-event analyses with Cox proportional hazards models and stratified log-rank tests were used. The all-cause mortality rate was 18%, and the incidence all-cause mortality rate was 0.59/1000 person-days in residents who had antimicrobial-resistant Enterobacterales carriage at baseline. Meanwhile, the incidence all-cause mortality rate among noncarriage was 0.17/1000 person-days. The mortality incidence rate of carriage was three times higher than residents who were noncarriage without statistical significance (HR 3.2; 95% CI 0.74, 13.83). Residents in nonprofit nursing homes had a higher mortality rate than those in for-profit nursing homes (OR 9.24; 95% CI 2.14, 39.86). The incidence mortality rate during and before lockdown were 0.62 and 0.30, respectively. Effective infection-control policies akin to hospital-based systems should be endorsed in all types of nursing homes. To limit the interruption of long-term chronic care, COVID-19 prevention should be individualized to nursing homes.

Injuries During Return to Sport After the COVID-19 Lockdown: An Epidemiologic Study of Italian Professional Soccer Players.

Background:The injury rate in professional soccer players may be influenced by match frequency.Purpose:To assess how changes in match frequency that occurred because of coronavirus disease 2019 (COVID-19) influenced training and match injuries in the Italian Serie A league.Study Design:Descriptive epidemiology study. Methods:Three phases in the Serie A league, each 41 days long, were evaluated: phase A was the beginning of the 2019-2020 season; phase B was a period after the COVID-19 lockdown was lifted, when the remaining matches of the season were played with greater frequency; and phase C was the beginning of the 2020-2021 season. All male professional soccer players who were injured during the 3 phases were included. Player age, height, position, injury history, and return to play (RTP) were retrieved from a publicly available website. Training- and match-related injuries during each of the 3 phases were collected and compared. Moreover, match injuries that occurred after the lockdown phase (phase B), in which there were 12 days designated for playing matches (“match-days”), were compared with injuries in the first 12 match-days of phases A and C.Results:When comparing 41-day periods, we observed the injury burden (per 1000 exposure-hours) was significantly lower in phase B (278.99 days absent) than in phase A (425.4 days absent; P < .05) and phase C (484.76 days absent; P < .05). A longer mean RTP period was recorded in phase A than in phase B (44.6 vs 23.1 days; P < .05). Regarding 12–match day periods (81 days in phase A, 41 days in phase B, and 89 days in phase C), there was a significantly higher match injury rate (0.56 vs 0.39 injuries/1000 exposure-hours; P < .05) and incidence (11.8% vs 9.3%; P < .05) in phase B than in phase A and a longer mean RTP period in phase A than in phase B (41.8 vs 23.1 days; P < .05). Finally, the rate and incidence of training-related injuries were significantly higher in phase B (4.6 injuries/1000 exposure-hours and 6.5, respectively) than in phase A (1.41 injuries/1000 exposure-hours and 2.04, respectively) (P < .05).Conclusion:Both training- and match-related injuries were greater during the abbreviated period after the COVID-19 lockdown. These may be linked to the greater match frequency of that period.

Commentary: COVID-19 pandemic and stress level of residents and fellows during ophthalmology training.

The ongoing coronavirus disease 2019 (COVID-19) pandemic not only affected the physical health of those infected but also the mental health of healthcare workers including residents, doctors, nurses, and other staff. As ophthalmic examination requires close contact with the patient, and with conjunctivitis as a possible clinical manifestation of COVID-19, ophthalmologists are highly vulnerable to infection.[1] This prevailing fear of acquiring an infection while examining a patient has hampered the quality of clinical examination and training for the ophthalmology residents and fellows. Adding to the challenges, to prevent spread of infection, a lockdown was imposed with suspension of elective medical services, and residents from all departments (including ophthalmology) were posted in COVID-19 screening areas, wards, and intensive care units (ICUs) to handle the crisis. The most commonly performed surgery by an ophthalmology trainee is cataract surgery (an elective surgery), and it was significantly curtailed or stopped. Compared to other surgical branches, ophthalmological surgeries are microsurgeries that require continuous training, learning to handle the operating microscope, and good hand–eye and foot coordination. This essential hands-on training was absent, and the trainees were in despair. Since the ophthalmology residents were posted in COVID-19 areas (with hectic shifts), besides loss of ophthalmology training, they were also isolated from their family members, performing tasks they were ill-prepared for. Thus, fear of infection, hampered training, shifting of work to COVID-19 areas, a necessity to use adequate personal protective equipment (PPE), unavailability of definitive treatment modality for COVID-19, and isolation from family members significantly affected their mental health. Based on an online survey among trainee ophthalmologists (n = 716) in India, Mishra et al. reported that 80.7% of them felt that the COVID-19 lockdown had negatively impacted their surgical training.[2] In a survey by Alahmadi of Saudi ophthalmology residents (n = 142), most of the participants reported that the number of elective surgeries (93.8% of the participants) and office-based procedures (82.9%) had markedly reduced during the COVID-19 pandemic, and only half of them were satisfied with the virtual model of education.[3] A recent study by Aragão et al. on 271 ophthalmology residents and fellows reported that the participants whose surgical training was interrupted during the pandemic had a higher level of stress.[4] They also stated that the women participants had a higher level of stress compared to the men. This could be attributed to the gender difference in domestic workload and coping mechanisms added to the professional shortcomings due to the pandemic. Most of the studies reported that one-third to half of the ophthalmology trainees were dealing with depression with a significant increase in anxiety, stress, and insomnia during this pandemic.[25] The increased level of anxiety during the COVID-19 pandemic among ophthalmologists was also attributed to fear of transmitting the disease to their family members. For the well-being of the trainees, mental health awareness sessions must be conducted regularly and affected individuals must be asked to seek professional help. Since the COVID-19 pandemic has significantly affected clinical experience, it is necessary to take adequate measures to catch up on the lost training before it is too late. As multiple waves of this pandemic are a distinct possibility, training programs need to evolve accordingly. During the peak time of COVID-19 cases, virtual theory classes and case discussions have to be continued to educate the residents. A wet-lab or simulator-based hands-on surgical training facility has to be implanted in all the ophthalmology training centers based on feasibility. Surgical training on animal and cadaveric eyes in the wet lab is a simple and relatively inexpensive option where most of the surgical procedures (cataract surgeries, squint surgeries, corneal surgeries, glaucoma surgeries) can be practiced and mastered.[678] Discussions on previously recorded and unedited surgical videos to highlight how each step has to be performed, the complications that can occur, and how they can be avoided/managed can also help to improve surgical training. Whenever there is a drop in COVID-19 cases, clinical ward rounds with case discussions and physical theory classes should be conducted with increased frequency. Compared to virtual classes, physical classes have the advantage of better one-to-one interaction and also internet connectivity issues cannot interrupt the flow. The consultant or trainer should reduce the number of surgeries performed by them and give more chances to the residents and fellows compared to pre-COVID-19 times. Preference has to be given to the final year residents and fellows as they have lesser time to catch up. It is incumbent upon ophthalmic educators and teachers to continuously innovate their teaching methods based on current challenges so that the training of the next generation of ophthalmologists does not remain incomplete.

The Impact of the COVID-19 Lockdown "Home Quarantine" on the Physical Activity and Lifestyle of Children in Qatar.

BackgroundSeveral studies have investigated how the coronavirus disease 2019 (COVID-19) pandemic impacted children's lifestyle. To our knowledge, this is the first study that assesses the impact of quarantine on physical activity, screen time, sleep, and diet in children aged 5 to 12 in Qatar.MethodsCross-sectional data from an online survey distributed in Qatar was analyzed. The survey measured the parents' or caregivers' assessment on the change in the child's physical activity, sleep, screen time, and diet between the two periods (before quarantine and during quarantine). The data was analyzed using frequency distributions, paired t-test and McNemar's test.ResultsData from 144 respondents were analyzed. Due to the quarantine, the total weekly average hours of physical activity significantly decreased with a greatest reduction for the school and after school durations. Only 4.5% of the children were engaging in at least 60 minutes of physical activity per day (in contrast to 25.6% prior to quarantine). The reported barriers for physical activity were screen time for school (52.8%) and leisure (51.4%). There was a significant increase in the total number of main meals per day, with a higher consumption of unhealthy food. The majority of the children had their bedtime and waketime shifted to later because of the quarantine. The parents' or caregivers' satisfaction with the child's lifestyle during quarantine showed that 49.1% were disappointed or very disappointed. Also, 53.8% described their child's mental health as “better before quarantine.”ConclusionsQuarantine had a negative impact on the lifestyle of children in Qatar. When implementing restrictions, authorities should consider some interventions to counterpart such impact.