Coronavirus Disease 2019 Social Distancing Research Articles

The COVID-19 pandemic's impact on prostate cancer screening and diagnosis in Korea

Background: The global coronavirus disease 2019 (COVID-19) pandemic, which started in early 2020, has had multiple impacts on cancer care. This study assessed how the COVID-19 pandemic influenced prostate cancer (PCa) screening and diagnosis in South Korea. Methods: Patients who visited the outpatient clinic at a single institution for PCa evaluation were included in this study and divided into a pre-COVID-19 group and a COVID-19 pandemic group, based on the start of the COVID-19 pandemic and social distancing policies on March 1, 2020. The number of prostate-specific antigen (PSA) tests, patients with elevated PSA levels, and prostate biopsy results were analyzed. Results: In total, 8,926 PSA tests were administered during the COVID-19 pandemic, compared to 15,654 before the pandemic (p<0.05). Of 2,132 patients with high PSA levels, 1,055 (49.5%) received prostate biopsies before the pandemic and 1,077 (50.5%) did so during the COVID-19 pandemic. The COVID-19 pandemic group had a higher detection rate of PC, and increased rates of Gleason scores (GS) 7 and 9–10, while the rate of GS 6 decreased compared to the pre-COVID-19 group (p<0.05). The rate of clinically significant PCa (csPCa) was also higher during the pandemic (p<0.05). In both magnetic resonance imaging-guided and standard biopsies, the GS 6 rate decreased, and the csPCa rate increased during the COVID-19 pandemic (each, p<0.05). Conclusions: During the COVID-19 pandemic, the detection rate of prostate biopsies and the rate of csPCa increased significantly. Thus, PCa was diagnosed at a more advanced state in Korea during the COVID-19 pandemic.

Qualitative analysis of community pharmacy–based COVID-19 immunization service operations

BackgroundThe unprecedented coronavirus disease 2019 (COVID-19) pandemic has generated worldwide impacts while positioning community pharmacies as easily accessible immunizers to rollout the COVID-19 vaccine. ObjectivesThis study describes community pharmacists’ experiences, success stories, and lessons learned from providing COVID-19 immunization services. MethodsThis study was conducted in February to March 2022 using semistructured interviews with licensed pharmacists practicing full-time in Alabama community pharmacies. Transcribed interviews’ content analysis was conducted by 2 independent coders in ATLAS.ti software. ResultsNineteen interviews were completed. Pharmacists’ experiences in the implementation of COVID-19 immunization services are described across 4 themes: (1) on-site and off-site immunization locations, (2) roles and responsibilities of pharmacy personnel, (3) vaccine storage and administration, and (4) vaccine waste reduction and immunization uptake strategies. This study found that pharmacists’ ability to adapt is vital to maintaining their ability to offer immunization services and other services. Pharmacists’ capacity for adapting is exemplified through their ability to acclimate to becoming a primary hub of outpatient health care services, accommodating to COVID-19 social distancing and vaccine guidelines, and disseminating a novel vaccine with varying supply and demand. In addition, pharmacies gathered and maintained waitlists of patients and adopted an appointment-based model as to predict, plan, and provide for patients. Pharmacists also used reactive techniques and workflow aspects to dissuade COVID-19 vaccine waste such as in contacting interested patients on waitlists or switching to a walk-in acceptance model. The COVID-19 pandemic elicited unprecedented alterations to the legal, health care responsibilities granted to pharmacy staff with participants describing pharmacy technicians as making a considerable impact to pharmacies’ workflow. ConclusionsPharmacists stepped up as frontline providers during a time of public health emergency with their diverse experiences granting policy makers and researchers much to learn from as, in their communities, pharmacists have continued to increase access to care during a national health crisis.

COVID-19 and its impact on the control of Aedes (Stegomyia) aegypti mosquito and epidemiological surveillance of arbovirus infections.

In American countries, simultaneously with the coronavirus disease 2019 (COVID-19) pandemic, epidemics caused by different arboviruses (dengue, chikungunya and Zika viruses) are occurring. In Mexico, several of the strategies to control the Aedes aegypti mosquito, which transmits arboviruses, involve the interaction of health personnel with the community. Due to the COVID-19 pandemic, social distancing and home confinement measures have been implemented. To obey these measures and avoid the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, the National Center for Preventive Programs and Disease Control (CENAPRECE) has presented the vector control strategy in the scenario of simultaneous dengue and COVID-19 transmission in Mexico. In this work, we mention the routine comprehensive mosquito control measures and describe the adaptations that have been made. Furthermore, we discuss the relevance of medical personnel training and supervision, especially focusing on the similarity of symptoms between both pathologies.

Emergency Department Virtual Happy Hour: A Novel Approach to Peer Group Support During a Pandemic.

Introduction Communities responded to the coronavirus disease 2019 (COVID-19) pandemic with mandatory social-distancing regulations. Pandemic and disaster research shows that social isolation can often cause negative emotions and medical provider burnout. The primary objective of this study was to create and evaluate a novel wellness program, the Happy Hour Wellness Initiative (HHWI), based on peer support group concepts to foster resilience for emergency healthcare providers in response to a novel disaster. Methods The study was performed at a large emergency department with physicians, advanced practice providers, and staff invited to attend weekly "virtual happy hour" sessions. Participants individually opted into each of the six weekly sessions, with no obligation to attend. The program was designed based on the tenets of a peer support group and implemented by video conferencing. Participants completed a demographic questionnaire and answered open-ended questions after the six-session HHWI ended. Results Of the 40 survey respondents, 30% reported feeling stressed and 40% felt isolated at the early declaration of the pandemic. Regarding the HHWI, 90% of participants had no expectations from the HHWI, but 90% reported that their favorite part of the initiative was the feeling of togetherness. Most participants (95%) requested a continuation of the HHWI, even if not by a video-conferencing platform, and 90% reported feeling sad after the HHWI ended. Conclusion The emergency department HHWI was a welcome opportunity for employees to combat stress and anxiety brought on by the COVID-19 pandemic and social distancing. The initiative fostered team building, comradery, group advocacy, stress relief, and cheerfulness. The initiative was so greatly welcomed as a tool for wellness that almost all participants recommended that the HHWI should be available, not just in times of hardship, but year-round. The HHWI has provided a new approach to promote wellness in emergency care providers using a peer support group.

Fracture incidence and fracture-related mortality decreased with decreases in population mobility during the early days of the COVID-19 pandemic: an epidemiological study.

We investigated the impact of coronavirus disease 2019 (COVID-19) social distancing measures on fracture incidence and fracture-related mortality, as well as associations with population mobility. In total, 47 186 fractures were analysed across 43 public hospitals from 22 November 2016 to 26 March 2020. Considering the smartphone penetration of 91.5% in the study population, population mobility was quantified using Apple Inc's Mobility Trends Report, an index of internet location services usage volume. Fracture incidences were compared between the first 62 days of social distancing measures and corresponding preceding epochs. Primary outcomes were associations between fracture incidence and population mobility, quantified by incidence rate ratios (IRRs). Secondary outcomes included fracture-related mortality rate (death within 30 days of fracture) and associations between emergency orthopaedic healthcare demand and population mobility. Overall, 1748 fewer fractures than projected were observed during the first 62 days of COVID-19 social distancing (fracture incidence: 321.9 vs 459.1 per 100 000 person-years, P<0.001); the relative risk was 0.690, compared with mean incidences during the same period in the previous 3 years. Population mobility exhibited significant associations with fracture incidence (IRR=1.0055, P<0.001), fracture-related emergency department attendances (IRR=1.0076, P<0.001), hospital admissions (IRR=1.0054, P<0.001), and subsequent surgery (IRR=1.0041, P<0.001). Fracture-related mortality decreased from 4.70 (in prior years) to 3.22 deaths per 100 000 person-years during the COVID-19 social distancing period (P<0.001). Fracture incidence and fracture-related mortality decreased during the early days of the COVID-19 pandemic; they demonstrated significant temporal associations with daily population mobility, presumably as a collateral effect of social distancing measures.

COVID-19 Risk Perception and Loneliness among Korean Adults: The Mediating Effects of Social Distancing and Social Connectedness

This study examined the complex associations among coronavirus disease 2019 (COVID-19) risk perception, social distancing, social connectedness, and loneliness, as well as the mediating effects of social distancing and social connectedness in these associations in younger, middle-aged, and older Korean adults. We used multigroup structural equation modeling to analyze the results of a cross-sectional survey of 2,400 Korean adults aged 20 years or older. We found statistically significant age group differences in the mean values of COVID-19 risk perception, social distancing, social connectedness, and loneliness. The younger group showed significant associations among all major variables in the structural equation model, while their older counterparts demonstrated a significant association between COVID-19 risk perception and loneliness. Social distancing and social connectedness mediated the effect of COVID-19 risk perception on loneliness only for the younger group. In addition, we found significant mediating effects of social connectedness on the association between COVID-19 risk perception and loneliness in the middle-aged and older groups. Our findings imply that social distancing and social connectedness have impacted Korean adults’ mental health during the COVID-19 pandemic.

Smoking among Brazilian adolescents during the COVID-19 pandemic: a cross-sectional study.

The social distancing measures during the coronavirus disease 2019 (COVID-19) pandemic resulted in mental suffering among adolescents, leading to risky consumption of psychoactive substances such as tobacco. To analyze the factors associated with tobacco use among adolescents during the COVID-19 social distancing period in Brazil. Cross-sectional study used data from ConVid Adolescentes survey in Brazil. Tobacco use was assessed before and during social distancing. The explanatory variables investigated were sex, age, race/skin color, type of school, maternal education, region of residence, adherence to social restriction measures, number of close friends, sleep quality during the pandemic, mood, passive smoking, use of alcoholic beverages during the pandemic, sedentary behavior, and physical activity. A logistic regression model was used for the data analysis. Tobacco use by adolescents did not change during the pandemic (from 2.58% to 2.41%). There was a higher chance of tobacco use among adolescents aged between 16 and 17 years, self-reported black ones, residing in the South and Southeast regions, reported feeling sad and loneliness, had sleeping problems that worsened, were using alcoholic beverages during the pandemic, and were passive smokers at home. Adolescents whose mothers had completed high school or higher, had strict social restrictions, and increased their physical activity during the pandemic had a lower chance of tobacco use. Tobacco uses during the COVID-19 pandemic was higher in vulnerable groups, such as black adolescents and those with mental suffering.

The Impact of the COVID-19 Pandemic and Social Distancing on Cognition of Alzheimer's Disease Patients.

The risk of rapid cognitive decline in Alzheimer's disease (AD) during the coronavirus disease 2019 (COVID-19) pandemic has been recognized. The purpose of this study was to investigate the cognitive decline in such patients during the COVID-19 pandemic by evaluating changes in their cognitive measure parameters before and after the pandemic. This was a retrospective cohort study conducted in AD patients during their first visit and one-year regular follow-up for testing cognitive function at the Geriatric Psychiatry Clinic of Seoul St. Mary's Hospital. Changes in the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Sum of Box for CDR (CDR-SB) scores were investigated. A time series analysis was performed to determine whether there was a significant difference in the MMSE, CDR, and CDR-SB scores of AD patients in pre- and post-COVID-19 periods. Overall, 130 AD patients aged 60 to 93 years were assessed. Their baseline mean MMSE score was 22.30 which had decreased to 21.08 at the one-year follow-up. Before November 2019, the average CDR differences for one year was 0.06, but after November 2019, it increased to 0.36 (p<0.001). Before November 2019, the average of the CDR-SB change value for one year was 1.69, but after November 2019, it increased to 3.00 (p<0.001). The difference in MMSE values for one year was not statistically significant. The time series analysis revealed a significant increase in the CDR and CDR-SB scores by approximately 0.47 (p=0.005) and 2.39 (p=0.002), before and after November 1, 2019, respectively. This study revealed that the COVID-19 pandemic and social distancing worsen cognitive function in AD patients rapidly. Exposure to the COVID-19 pandemic and social distancing for at least seven months worsen cognitive decline significantly. Therefore, in order to minimize the adverse effects of the cognitive decline in these patients, the period of social distancing should be minimized.

Decreased incidence of febrile neutropenia in Michigan following masking and social distancing orders for the COVID-19 pandemic: A population based cohort study.

BACKGROUNDIt has been theorized that 75%-80% of febrile neutropenia (FN) is caused by endogenous pathogens, while up to 20% of cases are thought to be caused by a viral infection. It is unknown if precautions such as masking and social distancing reduce the risk of FN in susceptible populations.AIMTo determine whether coronavirus disease 2019 (COVID-19) infection mitigation efforts, namely masking and social distancing, were associated with a reduction in the incidence of FN.METHODSThis was a retrospective population based cohort study comparing the incidence of FN in the 13 mo prior to (Year 0) and 13 mo following (Year 1) the public health executive orders (PHEO) in Michigan. Data was queried for all emergency department (ED) visits from April 1, 2019 to March 31, 2021 from the National Syndromic Surveillance Program, a program which collects data that is voluntarily submitted by approximately 89% of Michigan EDs. The primary study outcome was the incidence of FN as a proportion of ED visits in the 13-mo before and 13-mo after COVID-19 mitigations efforts, namely masking and social distancing. We hypothesized that there would be a significant decrease in the incidence of FN in the period following the PHEO aimed at reducing the spread of the severe acute respiratory syndrome coronavirus 2 virus.RESULTSThere was a total of 8979221 total ED visits captured during the study period. In Year 0 there were 5073081 recorded ED visits and 3906140 in Year 1. There was a significant reduction in the proportion of total ED visits with a diagnosis of FN, decreasing 13.3% across periods (0.15% vs 0.13%, P = 0.036). In patients with a hematologic malignancy a more impressive reduction in the incidence of FN was evident following PHEO (22% vs 17%, P = 0.02).CONCLUSIONWe found a significant association between social distancing and mask guidelines implemented on a large public scale with decreased rates of FN, particularly in those with a hematologic malignancy. These findings may be useful in the design of future research and recommendations regarding the prevention of FN.

Predicting COVID-19 county-level case number trend by combining demographic characteristics and social distancing policies.

ObjectivePredicting daily trends in the Coronavirus Disease 2019 (COVID-19) case number is important to support individual decisions in taking preventative measures. This study aims to use COVID-19 case number history, demographic characteristics, and social distancing policies both independently/interdependently to predict the daily trend in the rise or fall of county-level cases.Materials and MethodsWe extracted 2093 features (5 from the US COVID-19 case number history, 1824 from the demographic characteristics independently/interdependently, and 264 from the social distancing policies independently/interdependently) for 3142 US counties. Using the top selected 200 features, we built 4 machine learning models: Logistic Regression, Naïve Bayes, Multi-Layer Perceptron, and Random Forest, along with 4 Ensemble methods: Average, Product, Minimum, and Maximum, and compared their performances.ResultsThe Ensemble Average method had the highest area-under the receiver operator characteristic curve (AUC) of 0.692. The top ranked features were all interdependent features.ConclusionThe findings of this study suggest the predictive power of diverse features, especially when combined, in predicting county-level trends of COVID-19 cases and can be helpful to individuals in making their daily decisions. Our results may guide future studies to consider more features interdependently from conventionally distinct data sources in county-level predictive models. Our code is available at: https://doi.org/10.5281/zenodo.6332944.

The Wicked Problem of Physician Well-Being.

The collective threat to physician well-being is a complex issue with no clear solution. Even before the coronavirus disease 2019 pandemic, physicians suffered from widespread burnout and moral injury, with negative consequences for patient care, physician health, and the health care system. Initial clinician well-being efforts leaned heavily on individual-focused interventions. However, workplace culture and environment are key factors that affect burnout, and therefore clinician well-being efforts require both individual-focused and systems-level interventions. A sustainable culture of support in medicine is necessary to foster physician well-being.

Shifts in Older Adults' Social Connections Throughout the Initial Year of the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic exposed older adults to increased health risks, yet social distancing precautions also heightened risks to their social well-being. This mixed-methods study explores changes in older adults' satisfaction with social engagement and interpersonal connections throughout the first year of the COVID-19 pandemic. A Midwestern sample of 76 older adults aged 70-97 completed a series of 4 interviews from March 2020 through April 2021 about their experiences with COVID-19 social distancing precautions. Participants reported social engagement satisfaction and frequency of contact with family and friends. Additionally, they responded to open-ended questions about social connection experiences. Satisfaction with social engagement rebounded with significant increases across the year of the pandemic, whereas frequency of contact shifted from high remote contact early in the pandemic to greater in-person contact over time, with nuanced distinctions between family and friends. Qualitative thematic analysis identified themes including: (1) shifts in family support, (2) adaptable and flexible friendships, (3) social isolation fatigue, and (4) communication through technology. Within each theme, perceptions of interpersonal connections shifted over time. Findings suggest diverse social connection experiences among older adults, yet general patterns of strong social connections and adaptation over time. Future research should build upon these findings to better understand older adults' social needs and seek to explore ways to best foster social connections during instances of forced social isolation or historical crises.

Psychological Distress During COVID-19 Curfews and Social Distancing in Saudi Arabia: A Cross-Sectional Study.

Background: Coronavirus disease 2019 (COVID-19) has spread to over 150 countries worldwide. Since the first case of COVID-19 was confirmed in Saudi Arabia, cases have continued to escalate exponentially. The COVID-19 outbreak has had a negative effect on mental health and well-being. The study aimed to investigate the effects of the strict national regulations associated with the COVID-19 pandemic on mental health.Methods: This was a cross-sectional study of a convenience sample of Saudi residents. Saudi residents aged 18 years or older were invited to complete an online questionnaire after one month of a nationwide 24-h curfew between May 6, 2020 and May 13, 2020. We measured psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21). We ran binary logistic regression analyses to detect variables that significantly predicted DASS-21 scores.Results: A sample of 2252 participants was recruited from the general population of Saudi Arabia. The DASS-21 score means and standard deviations for depression and anxiety for the whole sample (10.73 ± 10.29 and 6.98 ± 8.30, respectively) were in the range of mild depression and anxiety. In contrast, the mean DASS-21 stress score was within the normal range (11.97 ± 10.80). The mean stress score for healthcare workers was within the normal range (13.70 ± 10.68) but was significantly higher than the mean score for the public (11.56 ± 10.89; P = 0.0006). Several variables (e.g., age, gender, and history of contact with confirmed COVID-19 cases) were significantly associated with higher DASS-21 scores.Conclusions: The COVID-19 pandemic has created a psychological burden. Therefore, there is an urgent need to implement emergency public health interventions that ameliorate the risk perception of COVID-19 through the dissemination of adequate and targeted health information that could be a successful measure to mitigate the psychological impact of the Covid-19 pandemic.

Human Factors and Multidisciplinary Response to COVID-19 Social Distancing

As health care organizations begin to recover from the impact of COVID-19 (coronavirus disease 2019), we must provide careful modifications to ensure patient and staff safety. Human Factors Engineers conducted pilot studies to begin understanding the impact social distancing can have on required work tasks. Next, an enterprise-level Social Distancing Work Group developed a Quick-Start Guide with recommendations for facility/environmental changes as well as workflow/process changes. The work group met on-location with leaders and staff from various areas across the organization who needed additional guidance beyond the general recommendations. We leveraged our event-reporting software as a way for staff to report ongoing social distancing concerns.

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID-19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease.

BackgroundWe aimed to compare concerns, social distancing, health care disruptions, and telemedicine use in patients with autoimmune rheumatic disease (ARD) and non‐ARD and to evaluate factors associated with immunomodulatory medication interruptions.MethodsPatients in a multistate community rheumatology practice network completed surveys from April 2020 to May 2020. Adults with common ARD (rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus) or non‐ARD (gout, osteoarthritis, osteoporosis) were evaluated. Concerns about coronavirus disease 2019 (COVID‐19), social distancing, health care disruptions, and telemedicine use were compared in patients with ARD versus non‐ARD, adjusting for demographics, rural residence, and zipcode‐based measures of socioeconomic status and COVID‐19 activity. Factors associated with medication interruptions were assessed in patients with ARD.ResultsSurveys were completed by 2319/36 193 (6.4%) patients with non‐ARD and 6885/64 303 (10.7%) with ARD. Concerns about COVID‐19 and social distancing behaviors were similar in both groups, although patients receiving a biologic or Janus kinase (JAK) inhibitor reported greater concerns and were more likely to avoid friends/family, stores, or leaving the house. Patients with ARD were less likely to avoid office visits (45.2% vs. 51.0%, odds ratio [OR] 0.79 [0.70‐0.89]) with similar telemedicine use. Immunomodulatory medications were stopped in 9.7% of patients with ARD, usually (86.9%) without a physician recommendation. Compared with patients with an office visit, the likelihood of stopping medication was higher for patients with a telemedicine visit (OR 1.54 [1.19‐1.99]) but highest for patients with no visits (OR 2.26 [1.79‐2.86]).ConclusionPatients with ARD and non‐ARD reported similar concerns about COVID‐19 and similar social distancing behaviors. Missed office visits were strongly associated with interruptions in immunomodulatory medication.

Older Adults' Loneliness in Early COVID-19 Social Distancing: Implications of Rurality.

ObjectivesOlder adults face greater health risks due to coronavirus disease 2019 (COVID-19), yet preventative social distancing measures may cause increased social isolation, potentially heightening risk of loneliness. In this mixed-methods study we examine changes in older adults’ loneliness due to social distancing, explore variability in perceptions, and identify whether such changes differ by rurality.MethodsA Midwestern sample of 76 older adults aged 70–97 (mean age = 82; 74% female; 95% White; 39% rural) completed a phone interview about their experiences with social distancing due to COVID-19. Interviews were conducted during early weeks of regional social distancing. Participants completed retrospective and current assessments of loneliness, including providing explanations of their responses.ResultsOn average, loneliness increased during early social distancing, yet variability was evident. Those experiencing increased loneliness described a feeling of loss or lack of control, whereas those experiencing stability in loneliness identified adaptability in social connection modes or feeling accustomed to social isolation. Rural older adults experienced a significantly smaller increase in loneliness than their nonrural counterparts.DiscussionThese findings suggest nuanced experiences among older adults, but generally negative implications for loneliness. Interventions to address older adults’ social isolation and loneliness during COVID-19 are warranted.

Anti-intellectualism and the mass public's response to the COVID-19 pandemic.

Anti-intellectualism (the generalized distrust of experts and intellectuals) is an important concept in explaining the public's engagement with advice from scientists and experts. We ask whether it has shaped the mass public's response to coronavirus disease 2019 (COVID-19). We provide evidence of a consistent connection between anti-intellectualism and COVID-19 risk perceptions, social distancing, mask usage, misperceptions and information acquisition using a representative survey of 27,615 Canadians conducted from March to July 2020. We exploit a panel component of our design (N = 4,910) to strongly link anti-intellectualism and within-respondent change in mask usage. Finally, we provide experimental evidence of anti-intellectualism's importance in information search behaviour with two conjoint studies (N ~ 2,500) that show that preferences for COVID-19 news and COVID-19 information from experts dissipate among respondents with higher levels of anti-intellectual sentiment. Anti-intellectualism poses a fundamental challenge in maintaining and increasing public compliance with expert-guided COVID-19 health directives.

The Impact of the COVID-19 Pandemic on Child Protection System Referrals and Responses in Colorado, USA.

Although the coronavirus disease 2019 (COVID-19) has amplified risk factors known to increase children's vulnerability to abuse and neglect, emerging evidence suggests declines in maltreatment reporting and responding following COVID-19 social distancing protocols in the United States. Using statewide administrative data, this study builds on the current state of knowledge to better understand the volume of child protection system (CPS) referrals and responses in Colorado, USA before and during the early phase of the COVID-19 pandemic and to determine whether there were differences in referral and response rates by case characteristics. Results indicated an overall decline in referrals and responses during COVID-19 when compared to the previous year. Declines were specific to case characteristics, such as reporter and maltreatment type. Implications regarding the impact of the COVID-19 pandemic on child maltreatment reporting and CPS response are discussed.

Social Isolation and Loneliness Before and During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults Older Than 50.

ObjectivesThe potential impact of social distancing policies during the coronavirus disease 2019 (COVID-19) pandemic on social isolation and loneliness is of increasing global concern. Although many studies focus primarily on loneliness, patterns of social isolation—particularly physical and digital isolation—are understudied. We examined changes in social isolation, physical isolation, digital isolation, and loneliness in U.S. adults older than 50 before and during the lockdown.MethodsTwo waves of the Health and Retirement Study, a national panel sample of U.S. adults older than 50 years, were used. Fixed-effects regression models were fitted to identify within-person change from 2016 to 2020 to examine the impact of social distancing policies during the pandemic.ResultsThere was an increase in physical isolation and social isolation among respondents during the COVID-19 social distancing policies. However, respondents experienced no change in digital isolation or loneliness. The increase in physical isolation was only present for people with high COVID-19 concern, whereas people with low concern experienced no change in physical isolation.DiscussionDespite an increase in physical isolation due to the social distancing policies, U.S. adults aged older than 50 stayed connected through digital contact and were resilient in protecting themselves from loneliness.

Cigarette and E-Cigarettes Dual Users, Exclusive Users and COVID-19: Findings from Four UK Birth Cohort Studies.

Introduction: The relationship between current cigarette and electronic cigarette (e-cigarette) dual use, exclusive use and COVID-19-related measures are still unclear. This study aims to assess the association between different tobacco use patterns and coronavirus disease 2019 (COVID-19) symptoms, testing, self-reported infection and social distancing behaviors in the United Kingdom (UK). Methods: Data come from the first wave of the Centre for Longitudinal Studies (CLS) COVID-19 survey, comprising four birth cohorts (N = 13,077, aged 20–63 years) surveyed between 2 to 31 May 2020, during the COVID-19 pandemic. Sociodemographic characteristics and COVID-19-related outcomes (symptoms, testing, diagnosis and social distancing behaviors) were compared across different product user groups (non-users, exclusive cigarette users, exclusive e-cigarettes users and dual use) using Cochran–Mantel–Haenszel χ2 test. Multivariable logistic regression models were used to explore associations between COVID-19-related outcomes and different smoking patterns. Results: Across all four cohorts, 12.6% and 4.9% of the respondents were current exclusive cigarette and e-cigarette users, respectively, with approximately 3% of the respondents being dual users. Significant differences in prevalence were observed between different tobacco use patterns and COVID-19 symptoms (p = 0.02), self-reported infection (p = 0.04) and social distancing behaviors (p < 0.001). Current cigarette and e-cigarette dual use was associated with 2.15-fold higher odds for reporting COVID-19 infection (aOR = 2.15; CI [1.15–4.05]). Compliance of social distancing behaviors were the lowest for current dual users (aOR = 0.58; CI [0.41–0.83]) and exclusive cigarette users (aOR = 0.72; CI [0.63–0.92]). Conclusions: The findings highlight dual users’ higher prevalence of having COVID-19 symptoms, infection and incompliance of social distancing behaviors. Self-reported infection was associated with dual product use; dual users and exclusive cigarette users were linked to poor adherence to social distancing behaviors. Smoking cessation support and further monitoring on multiple tobacco use among these populations should be reinforced as preventive measures to tackle the pandemic.