COVID-19 Related Changes Research Articles

How Employees Adapt to Change Prompted by COVID-19: Importance of Discrete Emotions and Proactivity

The COVID-19 pandemic has initiated unprecedented organizational change. Whereas the organizational change literature has focused on how employees reactively respond to planned strategic change efforts, the COVID-19 pandemic has thrust employees into an active role in which they must adapt to the rapidly evolving demands of their environment. Drawing on appraisal theories, we argue that employees can appraise how the changes prompted by COVID-19 have impacted the meaningfulness of their work and their work effectiveness. In turn, these appraisals can elicit positive and negative discrete emotions, which can provide employees with guidance on how to navigate the opportunities and challenges in their work environment. We test our predictions using a three-wave survey design (N = 402) during the COVID-19 pandemic. Results indicate that COVID-19 related changes that increased the meaningfulness of work elicited pride whereas changes that reduced work effectiveness elicited frustration and anxiety. In turn, these discrete emotions differentially prompted promotion-oriented and prevention-oriented proactive behaviors. Importantly, both promotion-oriented and prevention-oriented proactive behaviors enhanced employees’ subsequent adaptivity to change. Our findings provide insight into how employees can actively respond to change related to the COVID-19 pandemic, including how they can self-initiate changes to their jobs in response to rapid change in their environment, how discrete emotions (i.e., pride, anxiety, and frustration) can differentially propel proactive behaviors, how negative emotions may prompt behaviors that can enhance adaptivity (rather than being dysfunctional for change), and how both promotion and prevention-oriented proactive behaviors can enhance employees’ adaptivity to change.

Factors Influencing Physical Activity During The COVID-19 Pandemic In Adults From Utah

PURPOSE: The novel coronavirus pandemic (COVID-19) has resulted in disruptions to daily routines, including physical activity (PA). PA is a behavior that could assist in both prevention of and recovery from SARS-CoV-2 infection. Therefore, the purpose of this study was to evaluate changes in PA and the factors that associate with PA during COVID-19 in a sample of adults from Utah. METHODS: Participants were a sample of 201 adults (52.7% Female; Age: 40.6 ± 18.5 yrs; BMI: 26.7 ± 5.8 kg/m2) living in the state of Utah who were given 3 sets of online questionnaires during the first 3 waves of the COVID-19 pandemic in the US (wave 1: April-July; wave 2: Aug-Sept; wave 3: Oct-Dec). Moderate-to-vigorous physical activity (MVPA) was self-reported at three study time points via the short form International Physical Activity Questionnaire (IPAQ). Self-efficacy for exercise (via the Self-Efficacy for Exercise Scale), self-reported COVID-19 related changes to work/occupation, and working from home were also examined in the relationship with MVPA. A general linear mixed-effects model was used to examine the associations between pandemic wave, self-efficacy, occupation change, and working from home status with MVPA. Effect modification was tested using interaction terms. RESULTS: Individuals who worked from home tended to have lower self-reported log-MVPA compared to those not working from home (b = -0.77; 95%CI = -1.31 - -0.23; p = 0.005). However, those who reported only that their work was affected by the pandemic did not exhibit significantly higher or lower log-MVPA (p = 0.67). Finally, those with high self-efficacy had higher log-MVPA compared to those with low self-efficacy (b = 0.58; 95%CI = 0.04 - 1.12; p = 0.034). CONCLUSIONS: These results suggest that MVPA during COVID-19 is affected by specific work-related variables and self-efficacy for PA. These findings can help to inform and establish interventions to improve health outcomes during and after global pandemics, such as COVID-19.

Mental and Social Health of Children and Adolescents With Pre-existing Mental or Somatic Problems During the COVID-19 Pandemic Lockdown.

Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems.Methods: We included participants (8–18 years) from a psychiatric (N = 249) and pediatric (N = 90) sample, and compared them to a general population sample (N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents.Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population.Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.

Examining retirees perceptions of the effects of COVID-19 mitigation strategies on leisure participation and social relationships

ABSTRACT In response the designation of COVID-19 as a global pandemic in March of 2020, people across the world have been tasked with adopting extreme social distancing protocols and lockdowns resulting in substantial interruptions to their daily lives. Specific to leisure, COVID-19-related changes have presented unanticipated disruptions to activities in areas where opportunities were once abundant, especially for retirees. The purpose of the current study is to examine adult retirees’ perceptions of COVID-19 related change to their recreation and leisure activities and social relationships. Findings revealed that a majority of participants reported experiencing varying levels of modification to recreation and leisure participation and changes to relationships with friends. A qualitative comparison revealed a general trend among participants where a majority of those who reported modifications to recreation and leisure activities also reported negative impacts to relationships with friends.

Cross-national comparison of psychosocial well-being and diabetes outcomes in adults with type 1 diabetes during the COVID-19 pandemic in US, Brazil, and Iran

BackgroundThe COVID-19 pandemic is a global public health emergency, which presents wide-ranging negative impacts on individuals with diabetes. To examine psychosocial well-being and diabetes outcomes in individuals with type 1 diabetes during the COVID-19 pandemic, and investigate how these factors vary in different countries.MethodsBetween April and June 2020 we employed a cross national comparative research study in the United States (US), Brazil, and Iran to collect data from 1788 adults with type 1 diabetes using web-based survey. Study participants answered questions relevant to diabetes distress, diabetes burnout, depressive symptoms, COVID-19 related changes, and socio-demographic characteristics. They also reported their last Hemoglobin A1c (HbA1c) and daily Time-in-Range (TiR) blood glucose. We analyzed data using comparative tests (Chi-square, Kruskal–Wallis and McNemar test), logistic and linear regression adjusted for fixed effects.ResultsThere were significant changes prior and during the pandemic regarding access to diabetes care, diabetes supplies and medications, healthy food and safe places to exercise in all countries (p < 0.05). Participants in Iran experienced higher levels of diabetes distress (57.1%), diabetes burnout (50%), and depressive symptoms (60.9%), followed by Brazil and US (p < 0.0001). US participants reported better glycemic control (HbA1c = 6.97%, T1R = 69.64%) compared to Brazil (HbA1c = 7.94%, T1R = 51.95%) and Iran (HbA1c = 7.47%, T1R = 51.53%) (p < 0.0001). There were also significant relationships between psychosocial well-being, diabetes outcomes, socio-demographic data, and COVID-19 related challenges in overall sample (p < 0.05).ConclusionsRegardless of differences among US, Brazil, and Iran, our findings revealed that different countries may experience similar challenges related to the COVID-19 pandemic which can impact negatively diabetes outcomes and psychosocial well-being in individuals with type 1 diabetes. Countries need to consider modifiable variables associated with poor diabetes outcomes and sub optimal psychosocial well-being and target vulnerable population using significant socio-demographic variables.

Pharmacy student stress with transition to online education during the COVID-19 pandemic

IntroductionPharmacy student-perceived stress may impact academic experiences. This research aimed to investigate whether there was an increase in student-perceived stress due to the COVID-19 pandemic. MethodsCurrent pharmacy students were surveyed in May 2020 at a public pharmacy school that utilizes an active learning design and follows a flipped classroom approach. In addition to measuring perceived stress, the survey measured coping behaviors, self-efficacy, and emotional status. The collected data were compared with archived data that were collected for internal use in 2018. Student's t-test analyses were used to compare 2020 with 2018 data. ResultsA total of 66 students completed the 2020 survey (response rate 26.2%) and 192 students completed the 2018 survey (response rate 63.2%). On a scale from 0 (never or not applicable) to 5 (multiple times each day), average student-perceived stress was 1.75 (SD = 0.93) in 2020. This value of perceived stress presented a slight, but not statistically significant, reduction from 1.85 (SD = 1.04) in 2018. Comparing 2018 and 2020 datasets showed no significant differences in coping behavior, self-efficacy, or emotional status. ConclusionsBased on the sample with the lower response rate that completed the survey in 2020, student-perceived stress did not increase during online, remote learning associated with the COVID-19 pandemic as compared to the sample with a higher response rate prior to the pandemic. Perhaps the COVID-19 related changes were seamless to students due to their aptitude for remote, online learning.

Pandemic-induced knowledge gaps in operations and supply chain management: COVID-19’s impacts on retailing

PurposeThis Impact Pathways paper aims to provide a timely and structured discussion of real-world problems at Marks and Spencer and in retail in general, evoked through the current COVID-19 pandemic.Design/methodology/approachThe article presents collaborative research based on more than five hours of interviews and several iterative paper writing steps between management scholars and Marks &amp; Spencer’s Head of Procurement - Logistics and Supply Chain. Continuous discussions for more than ten months among the research team assure the timeliness and relevance of the findings. The exceptional position of the executive and his career biography allowed the integration of a variety of intra-organisational and inter-organisational stakeholders.FindingsThis paper highlights the impacts of the current COVID-19 pandemic on operations and supply chain management (OSCM) in the retail industry, structured in upstream, internal and operational, and downstream and customer perspectives. The paper concludes with a practice-infused research agenda, which aims to trigger relevant research about the current and potential future crises.Research limitations/implicationsAlthough the research agenda is directly related to the COVID-19 pandemic and the retail industry, the future research pathways are expected to inform business responses to potential future external shocks other than pandemics and in different industries as well.Originality/valueDespite a plethora of studies already published on COVID-19 and OSCM, little is known on how the outbreak affects specific firms and industries. This paper offers an overview of COVID-19 related change as it happens at the retailer and in the retailing industry in general. This article is among the first to provide a practice-infused call for research on urgent issues being faced by business leaders directly relevant to our domain.

P201 Therapists' experiences of remotely delivered cognitive-behavioural and graded-exercise interventions to lessen the impact of fatigue in inflammatory rheumatic diseases: a qualitative evaluation

Background/Aims There is evidence for non-pharmacological interventions to support patients to self-manage fatigue, however implementation in clinical practice is a challenge. LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using a remotely delivered cognitive-behavioural approach (CBA) or personalized exercise programme (PEP) interventions, in addition to usual care, compared to normal care alone. Interventions were delivered to patients by rheumatology health professionals using a manual, after training. The aim of this nested qualitative evaluation was to understand their perspectives of delivering the interventions. Methods A subgroup of rheumatology healthcare professionals who had delivered the CBA and PEP interventions took part in semi-structured telephone interviews to explore their experiences of training and delivery, the challenges and benefits of learning new skills, and the barriers and facilitators to supporting patients remotely (mainly by telephone) using the LIFT manual. Results A total of 17 rheumatology healthcare professionals (13 women, 4 men) from the CBA (n = 9) and PEP (n = 8) arms contributed. SB conducted an inductive thematic analysis of the data set. ED, CA, AW and KL reviewed a sub-set of transcripts. Five main themes were identified: The benefits of informative, structured training: Rheumatology healthcare professionals reflected how training, including role-play, helped them to practice their skills, even though this could feel uncomfortable. Those allocated shorter four-hour training sessions would have liked more time to practice. Many felt anxious before meeting patients for the first time but liked the manual to refer to.Getting into the swing of it: Practice gave rheumatology healthcare professionals the confidence to tailor content to individual patients’ requirements. Clinical supervision in the PEP and CBA arm supported rheumatology healthcare professionals to query their own practice, gain valuable feedback, and request assistance where needed. Benefits of telephone delivery: The initial face-to-face session enabled rheumatology healthcare professionals to build rapport with patients. Thereafter, patients seemed engaged and valued the opportunity to address their fatigue and challenge their own beliefs via the telephone.Some patients not ready to change: Rheumatology healthcare professionals struggled to work collaboratively with a minority of patients who were not willing to make changes, lacked motivation to complete tasks or stopped engaging with the intervention.LIFT developing clinical skills: Rheumatology healthcare professionals were confident that they were doing the ‘right thing’ for patients with fatigue and gained professional satisfaction seeing patients’ fatigue improve. Many felt that the skills they acquired and their experiences of remote delivery were helping them to respond to the current COVID-19 related changes in service provision. Conclusion Findings support the value of skills training for rheumatology health professionals to deliver fatigue management interventions remotely. These insights can inform service provision and clinical practice. Disclosure S.E. Bennett: None. E. Dures: None. C. Almeida: None. E. Bachmair: None. K. Lovell: None. L. Paul: None. A. Wearden: None. G.J. Macfarlane: None. N. Basu: None.

P56 Gastrointestinal manifestations of COVID-19: a retrospective analysis

IntroductionEmerging data suggests that SARS-CoV-2 acts via the angiotensin-converting-enzyme-2 (ACE2) receptors in the cells, also present in the gastrointestinal and liver cells, resulting in gastrointestinal manifestations of COVID-19. It is challenging to diagnose COVID-19 in patients presenting with only gastrointestinal symptoms, with early suspicion and visualisation of the lung bases on computerised tomography(CT) abdomen scans being helpful.MethodsSingle-centre retrospective analysis of abdominal/chest CT scans was conducted within a District General Hospital. From the 6000 CT scans between March and April 2020, 1557(26%) were abdominal, 230 of which had chest CT scans with COVID-19 positive changes. 49 patients with CT abdomen and a positive CT Chest were shortlisted. All recorded documentation was assessed using online clinical portal and tabulated using Microsoft Excel®. Subdivision into 3 groups was: 1) primary gastrointestinal symptom, normal CT abdomen, 2) common COVID-19 symptoms with gastrointestinal symptoms, normal CT abdomen 3) gastrointestinal symptoms, abdominal pathology on radiology.ResultsCOVID-19 related changes were seen on CT scans with no abdominal pathology noted in 33% (n = 16) patients with primary gastrointestinal symptoms. Further 18% (9 patients) presented with gastrointestinal symptoms alongside other common COVID-19 symptoms, however abdominal CT scan was normal. CT abdomen of these 25 patients were studied by a consultant radiologist, who examined the lung bases on the abdominal CT scan for COVID-19 related changes, which was seen in 92% patients. In 8% of the cases where the lung bases on the CT abdomen were normal, COVID-19 related changes were apparent on the CT chest.ConclusionsCT scans of the abdomen should be supplemented with CT scans of the chest, when appropriate, for early accurate diagnosis, early treatment and triage to the correct wards, especially at the height of the pandemic.

Mental health of israeli employees with autism spectrum disorders following COVID-19-related changes in employment status

IntroductionThe COVID-19 pandemic caused employment related challenges worldwide. Adults diagnosed with Autism Spectrum Disorders (ASD) are especially vulnerable, due to pre-existing employment challenges, intolerance to changes and uncertainty and high levels of related anxiety.ObjectivesTo examine COVID-19 related changes in work experiences and mental health of employees with ASD who held a steady job before the COVID-19 outbreak.Methods Data were collected from 23 participants diagnosed with ASD (4 females), aged 20–49, who answered an online administered survey at two timepoints: prior to the COVID-19 outbreak, and during the outbreak. Self-reports included measures of background and employment status; mental health (General Health Questionnaire-12); job satisfaction (Minnesota Satisfaction Questionnaire); and satisfaction of psychological needs at work (Psychological Need Satisfaction and Frustration – Work domain).Results Participants who continued to physically attend work maintained pre-COVID-19 levels on all assessed variables. Participants who transitioned to remote work from home preserved their salary levels and job satisfaction, but showed a marginally significant deterioration in mental health and a significant decrease in the satisfaction of their needs for competence and autonomy at work. Unemployed participants showed a significant decrease in mental health.Conclusions Results highlight employment as a protective factor from the potential negative implications of COVID-19 on mental-health of employees with ASD. Employees who transition to working from home require personalized work-support plans due to the possible negative effects of this transition on mental health. Maintaining the routine of physically reporting to work should be preferred, when possible.

993 Did health care delivery changes driven by COVID alter pregnancy and postpartum visits?

As a result of the COVOD-19 pandemic our hospital system introduced several changes to prenatal and postpartum care delivery, including expanded telemedicine visits and early postpartum discharge. We sought to examine how these policies influenced care delivery. Using a hospital database, we collected data on deliveries from April 1st, 2020 through July 1, 2020 and compared it to data from the same time period in 2019. We examined number of prenatal visits (PNV), length of hospital stay (LOS, hours from delivery to discharge), maternal and infant readmissions and emergency department (ED) visits and postpartum visit (PPV) attendance (defined as a visit from 7-84 days post delivery). Outcomes were also stratified by mode of delivery and insurance type (Medicaid versus Commercial). T- test were used to compare means, chi-square tests were used to compare proportions. COVID-19 related changes to care delivery did not impact the number of prenatal or postpartum visits overall (Table1). As expected, the LOS for all deliveries was less in 2020. Deliveries with postpartum ED visits were less common in 2020 (10.0% vs. 12.0%, p=0.02), but postpartum readmissions were not different. There were no overall differences in infant readmissions or ED visits between the two epochs. Stratified results are presented in Table 2. By mode of delivery, the decrease in postpartum ED visits was seen only in the vaginal deliveries with 7.8% in 2020 vs. 10.1% in 2019 (p=0.02). When stratified by insurance type, the fewer ED visits were seen only in the Medicaid group with 12.8% of deliveries having an ED visit in 2020 vs 16.5% in 2019 (p=0.04). People with commercial insurance were less likely to have an infant ED visit during COVID (3.1% vs. 4.5%, p=0.03). COVID-19 related changes to care did not impact attendance to prenatal or postpartum visits. The early discharge pathway resulted in significantly shorter LOS without increasing maternal and infant readmission. There were fewer ED visits postpartum, which may have been due to families avoiding the ED due to COVID-19 related concerns.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Role of Attitudes, Affect, and Income in Predicting COVID-19 Behavioral Intentions.

Handwashing is important in preventing infectious diseases like COVID-19. The current public health emergency has required rapid implementation of increased handwashing in the general public; however, rapidly changing health behavior, especially on this scale, is difficult. This study considers attitudes and affective responses to handwashing as possible factors predicting COVID-19 related changes to handwashing behavior, future intentions, and readiness to change during the early stages of the pandemic in the United States. Income was explored as a potential moderator to these relationships. To explore these issues, data from 344 community participants were analyzed. Results indicate that stronger affective responses toward handwashing relate to increases in handwashing since the outbreak of COVID-19, and both attitudes and affect uniquely predict handwashing intentions. Income significantly moderated the relationship between affect and readiness to change. Those with low income were more influenced by both affective responses and attitudes. These results suggest messages targeting both cognitions and affective responses are needed to increase the handwashing behavior during a global pandemic and these variables are critical in increasing readiness to change in low-income individuals.

Stress, Dependence, and COVID-19-related Changes in Past 30-day Marijuana, Electronic Cigarette, and Cigarette Use among Youth and Young Adults.

BackgroundStudies show smoking and vaping behaviors increase risk of contracting and worse symptoms of COVID-19. This study examines whether past 30-day youth and young adult users of marijuana, e-cigarettes, and cigarettes self-reported changes in their use of these substances due to the COVID-19 pandemic; and cross-sectional associations between perceived stress, nicotine or marijuana dependence, and COVID-19–related changes in use.MethodsParticipants were 709 past 30-day self-reported substance users from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS; mean age = 19; 58% female; 38% Hispanic, 35% white). Multiple logistic regression models assessed cross-sectional associations between perceived stress and dependence and increased, decreased, or sustained past 30-day use of marijuana, e-cigarettes, and cigarettes due to COVID-19 (e.g., “Has your marijuana use changed due to the COVID-19 outbreak?”). Covariates included age, race/ethnicity, socio-economic status (SES), dependence (exposure: stress), and stress (exposure: dependence).ResultsMost participants reported sustained (41%, 43%, 49%) or increased (37%, 34%, 25%) use of marijuana, e-cigarettes, and cigarettes due to COVID-19, respectively. Participants who reported symptoms of dependence were significantly more likely than their non-dependent peers to report increasing their marijuana (AOR: 1.66; 95% CI: 1.15–2.39) and e-cigarette (AOR: 2.57; 95% CI: 1.38–4.77) use. Those who reported higher perceived stress were significantly more likely to report increasing their marijuana use (AOR: 1.55; 95% CI: 1.01–2.42).ConclusionsMost youth and young adults did not decrease their substance use amid a global, respiratory disease pandemic. Health messaging and interventions that address the health effects of smoking and vaping as well as factors like stress and dependence that may be barriers to decreasing use are vital in curbing the COVID-19 pandemic.

Orthopaedic surgeons' perceptions and attitudes on COVID-19 related changes in practice: an international cross-sectional survey.

Introductionthe purpose of this study was to assess the orthopaedic surgeons' perceptions and attitudes on COVID-19 related changes in their practice.Methodsan online survey was shared with orthopaedic surgeons practicing in different countries.Resultsthis study showed that orthopaedic surgery plan management was adapted to respond more effectively to the COVID-19 pandemic while maintaining the continuity of health care and ensuring protection of medical staff and patients. Among the introduced measures, elective surgery was postponed to free-up beds for suspected or COVID-19 positive patients requiring hospitalization. Additionally, the number of outpatient visits was considerably decreased and non-urgent visits were postponed to reduce the flow of patients in and out of hospitals and therefore minimize the risk of contamination. Interestingly, data revealed the willingness of orthopaedic surgeons to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed.Conclusionorthopaedic surgery departments have adapted their programs to face the unprecedented challenges due to the COVID-19 pandemic. Quick measures were taken to reduce the risk of contamination in patients, medical staff and to allow hospitals to free up beds for treatment of patients with positive or suspected COVID-19.

Post-Traumatic Growth among High School during the COVID-19 Pandemic: A Survey Study

Background: Following major life crisis or traumatic events, people can change their perspectives and experience personal growth, a process known as posttraumatic growth (PTG). The goal of this study was to evaluate the stress experienced by high school students during the COVID-19 pandemic and to determine whether they have experienced post-traumatic growth. Methods: An anonymous online survey regarding stress and PTG related to the COVID-19 pandemic was distributed to 500 students from a high school in Massachusetts between March 01-21, 2021. Results: A total of 167 of 500 surveys were completed (33.4% response rate). Most students (83.2%) reported moderate and severe stress during the COVID-19 pandemic, with more 12th grade students experienced severe stress (40.0% vs. 34.0% of 11 graders, 34.3% of 10 graders, and 22.5% of 9th graders). Furthermore, more female students experienced severe stress (40.7% vs. 22.5% of males). Participants were most stressed about the outlook for their future, followed by social isolation, personal or familial risk of becoming infected with COVID-19, the quality of education during the pandemic, and financial difficulties. The most positive COVID-19 related change reported by the surveyed students was increased compassion for others, followed by development of new interests, feeling that they can rely on people in times of trouble, increased willingness to try to change situations that they are unsatisfied with, changed priorities about what is important in life, greater appreciation for their own life's value, better able to accept the way things work out, greater sense of personal strength, increased appreciation of each day, greater sense of closeness with others, being more willing to express emotions, appreciation of new opportunities, and better understanding of spiritual matters. Female participants reported more personal growth in all PTG categories. Conclusions: While high school students experience significant stress during the COVID-19 pandemic, this study suggests that they can also experience positive life changes as a result of such a traumatic event. Teachers, counselors, and parents should work together to adequately support high school students during the COVID-19 pandemic.

From the chair

These are strange times, and like many of you we have been pulled in many directions at once over the past several months. You may have noticed that we missed a newsletter issue and delayed another one. This year that issue coincided with the beginning of the major COVID-19 related changes in all of our work and personal lives, and it just made more sense to defer publication. Keep an eye out for a special issue on SC20's switch to a virtual format.

Predictive Modeling on the Number of Covid-19 Death Toll in the United States Considering the Effects of Coronavirus-Related Changes and Covid-19 Recovered Cases

COVID-19 is caused by a coronavirus called SARS-CoV-2. Many countries around the world implemented their own policies and restrictions designed to limit the spread of Covid-19 in recent months. Businesses and schools transitioned into working and learning remotely. In the United States, many states were under strict orders to stay home at least in the month of April. In recent weeks, there are some significant changes related restrictions include social-distancing, reopening states, and staying-at-home orders. The United States surpassed 2 million coronavirus cases on Monday, June 15, 2020 less than five months after the first case was confirmed in the country. The virus has killed at least 115,000 people in the United States as of Monday, June 15, 2020, according to data from Johns Hopkins University. With the recent easing of coronavirus-related restrictions and changes on business and social activity such as stay-at-home, social distancing since late May 2020 hoping to restore economic and business activities, new Covid-19 outbreaks are on the rise in many states across the country. Some researchers expressed concern that the process of easing restrictions and relaxing stay-at-home orders too soon could quickly surge the number of infected Covid-19 cases as well as the death toll in the United States. Some of these increases, however, could be due to more testing sites in the communities while others may be are the results of easing restrictions due to recent reopening and changed policies, though the number of daily death toll does not appear to be going down in recent days due to Covid-19 in the U.S. This raises the challenging question: • How can policy decision-makers and community leaders make the decision to implement public policies and restrictions and keep or lift staying-at-home orders of ongoing Covid-19 pandemic for their communities in a scientific way? In this study, we aim to develop models addressing the effects of recent Covid-19 related changes in the communities such as reopening states, practicing social-distancing, and staying-at-home orders. Our models account for the fact that changes to these policies which can lead to a surge of coronavirus cases and deaths, especially in the United States. Specifically, in this paper we develop a novel generalized mathematical model and several explicit models considering the effects of recent reopening states, staying-at-home orders and social-distancing practice of different communities along with a set of selected indicators such as the total number of coronavirus recovered and new cases that can estimate the daily death toll and total number of deaths in the United States related to Covid-19 virus. We compare the modeling results among the developed models based on several existing criteria. The model also can be used to predict the number of death toll in Italy and the United Kingdom (UK). The results show very encouraging predictability for the proposed models in this study. The model predicts that 128,500 to 140,100 people in the United States will have died of Covid-19 by July 4, 2020. The model also predicts that between 137,900 and 154,000 people will have died of Covid-19 by July 31, and 148,500 to 169,700 will have died by the end of August 2020, as a result of the SARS-CoV-2 coronavirus that causes COVID-19 based on the Covid-19 death data available on June 13, 2020. The model also predicts that 34,900 to 37,200 people in Italy will have died of Covid-19 by July 4, and 36,900 to 40,400 people will have died by the end of August based on the data available on June 13, 2020. The model also predicts that between 43,500 and 46,700 people in the United Kingdom will have died of Covid-19 by July 4, and 48,700 to 51,900 people will have died by the end of August, as a result of the SARS-CoV-2 coronavirus that causes COVID-19 based on the data available on June 13, 2020. The model can serve as a framework to help policy makers a scientific approach in quantifying decision-makings related to Covid-19 affairs.

A Shared Electronic Health Record in a Rural Setting Maintains Hematological Cancer Services Remotely during the COVID-19 Pandemic

IntroductionThe COVID-19 pandemic has had drastic effects on healthcare provision across Australia and the world. Rural hematology patients who may rely on visiting medical officers from larger cities or long distance travel for reviews are particularly vulnerable to having their treatment affected by the recent changes to healthcare delivery given severe travel restrictions.The Griffith Hematology/Oncology Unit is based in Griffith Base Hospital, a regional hospital in New South Wales, Australia. It is serviced by consultant hematologists from St Vincent's Hospital at the capital city of Sydney, Australia, who visit fortnightly to run hematology outreach clinics and supervise chemotherapy delivery. Griffith is located 575km from Sydney and has an estimated population of over 26,000(1). The COVID-19 pandemic imposed significant travel restrictions, such that visiting haematologists have been unable to travel to continue in-person clinics since April 2020. This has led to the exclusive reliance on telemedicine (telehealth and telephone reviews) and remote chemotherapy delivery supervision. Having an electronic health record (EHR) containing all relevant patient information which is remotely accessible to treating physicians has been integral to the continuity of comprehensive specialist cancer care in this rural setting via telemedicine.MethodsThe previously reported shared EHR between Griffith and St Vincent's Hospital, Sydney was used to review the impact of COVID-19 on service delivery in Griffith(2). All rural patient information was accessible from the metropolitan location including comprehensive documentation of a patient's clinical findings, routine observations, diagnostic pathology and radiology results, and details of treatment at the Griffith site. Remote chemotherapy prescribing and telemedicine notes were documented through the EHR.ResultsThe number of new referrals, follow ups and total patients over the four months prior to the COVID-19 related changes (December 2019 to March 2020) and the four months following (April to July 2020) were compared. From April 2020 onwards, the Griffith clinic patients underwent reviews via telemedicine or telephone with no in-person reviews able to be conducted in Griffith due to the travel restrictions. The number of new referrals, follows up visits and the total number of patients seen following the change to telemedicine had all increased with no reduction in service delivery seen (Table 1). The total number of patient reviews was 167 visits over the four months prior to the change, which increased to 186 reviews after the travel restrictions were applied.Despite the travel restrictions, the hematology outreach services to Griffith were maintained through telemedicine reviews in a similar manner to the metropolitan service. Griffith rural hematology patients continue to undergo regular telemedicine reviews with monitoring of laboratory and imaging results through the EHR, receiving the same level of care as metropolitan patients.Chemotherapy is still able to be prescribed, adjusted and reviewed from the Sydney location for all patients. The total number of chemotherapy treatment cycles delivered in Griffith only slightly decreased despite the changes to service provision, which was attributed to normal variation in patients requiring treatment over 2020 (Table 2). 32 chemotherapy treatment cycles were delivered prior to the change compared to 26 cycles following, for the primary indications of lymphoma and myeloma.ConclusionIn recent months, the centralised EHR has proven critical in minimising clinical service disruptions caused by the COVID-19 pandemic by facilitating telemedicine links and remote patient management. We demonstrate how the shared EHR has been integral to the continuation of complex rural patient management during the COVID-19 pandemic due to the availability of remotely accessible patient information and chemotherapy prescribing. No significant change in clinical service activity was seen following the drastic travel restrictions due to the pandemic. Given these travel restrictions are expected to continue, it is encouraging that the shared EHR will allow rural Griffith patients continued access to appropriate specialist hematology care over the coming months. This work demonstrates how an EHR is fundamental to the sustainability of vital cancer services for rural communities.DisclosuresHamad:Abbvie: Honoraria; Novartis: Honoraria.

Experience, Perceptions, and Recommendations Concerning COVID-19-Related Clinical Research Adjustments.

During the COVID-19 public health emergency, the FDA and NIH altered clinical trial requirements to protect participants and manage study conduct. Given their detailed knowledge of research protocols and regular contact with patients, clinicians, and sponsors, clinical research professionals offer important perspectives on these changes. We developed and distributed an anonymous survey assessing COVID-19-related clinical trial adjustment experiences, perceptions, and recommendations to Clinical Research Office personnel at the Harold C. Simmons Comprehensive Cancer Center. Responses were compared using the Fisher exact test. A total of 94 of 109 contacted research personnel (87%) responded. Among these individuals, 58% had >5 years' professional experience in clinical research, and 56% had personal experience with a COVID-19-related change. Respondents perceived that these changes had a positive impact on patient safety; treatment efficacy; patient and staff experience; and communication with patients, investigators, and sponsors. More than 90% felt that positive changes should be continued after COVID-19. For remote consent, telehealth, therapy shipment, off-site diagnostics, and remote monitoring, individuals with personal experience with the specific change and individuals with >5 years' professional experience were numerically more likely to recommend continuing the adjustment, and these differences were significant for telehealth (P=.04) and therapy shipment (P=.02). Clinical research professionals perceive that COVID-19-related clinical trial adjustments positively impact multiple aspects of study conduct. Those with greatest experience-both specific to COVID-19-related changes and more generally-are more likely to recommend that these adjustments continue in the future.

“Physical Sex Is Over for Now”: Impact of COVID-19 on the Well-Being and Sexual Health of Adolescent Sexual Minority Males in the U.S.

PurposeThis study aimed to explore how the COVID-19 pandemic and physical distancing measures have impacted the well-being and sexual health among adolescent sexual minority males (ASMM) during the initial phase of physical distancing mandates in the U.S. MethodsFrom March 27, 2020, to May 8, 2020, U.S. ASMM (N = 151; aged 14–17 years) completed the online baseline survey of a sexual health intervention trial. COVID-19–related closed- and open-ended questions were included. A mixed-methods approach assessed COVID-19–related changes in well-being and sexual health by outness with an accepting guardian. ResultsThe majority (57%) of participants reported being worried about COVID-19. Almost all (91%) were physically distancing. Participants noted that COVID-19 changed school, home, work, and family life. Participants highlighted that COVID-19 reduced their ability to socialize and had a deleterious effect on their mental health. In the past 3 months, participants reported seeing sexual partners in person less often, masturbating and viewing pornography more often, and sexting and messaging on men-seeking-men websites/phone applications about the same amount. Many described being physically distanced from sexual partners, and some noted an increase in their use of virtual ways to connect with partners (e.g., video chatting). There were no differences by outness with an accepting guardian in quantitative or qualitative responses. ConclusionsThese findings provide a snapshot of the initial effects of the COVID-19 pandemic among a convenience sample of U.S. ASMM and underscore the need to provide access to resources sensitive to their social, developmental, and sexual health needs during this crisis.