Easing Of Lockdown Research Articles

The Lagos State COVID-19 Think-tank, a Potential Framework for Decision-making in a Pandemic Era.

Lagos state remains the epicenter of COVID-19 infection in Nigeria. To facilitate the emergency preparedness and response to COVID-19, the State Governor and Incident Commander constituted a Think Tank comprising 13 experts from various disciplines committed to the health of the public. The Think Tank assisted the government with decision-making strategies and supported the emergency operation centre (EOC) for the COVID-19 response. Their main achievements were developing frameworks for decision-making and strategies for phased easing of the State-wide lockdown. The challenges encountered were that it was often viewed as a parallel structure to the EOC and separated from the traditional civil service structure; causing some reluctance to implement ideas generated by the Think Tank. Nevertheless, the Think Tank played an important role during the COVID-19 pandemic; the lessons learned might help other states and resource-limited countries wishing to adopt this approach to emergency response.

Non-fatal suicide behaviours across phases in the COVID-19 pandemic: a population-based study in a Catalan cohort

The COVID-19 pandemic has been extensively discussed in the context of its effect on mental health. Although global suicide rates have remained stable during the pandemic, the specific effect on non-fatal suicide behaviours during and after the pandemic remains underexplored. This study aims to investigate patterns of non-fatal suicide behaviours before, during, and after the pandemic. In this cohort study, we used data from all hospitals in Catalonia, Spain, collected through the Catalan Suicide Risk Code, which is a specifically designed suicide attempt surveillance protocol, involving a face-to-face, in-depth psychiatric evaluation, after a Catalan resident presents any suicide risk behaviour in any public health-care setting. This evaluation centralises data from suicide registries across the territory. We included non-fatal suicide behaviours, meaning suicidal ideation or attempts that did not result in death, and excluded self-harm behaviours not judged to be linked with suicidal ideation. We considered three periods: the pre-confinement period (Jan 1, 2018, to the enforcement of the lockdown in Spain on March 14, 2020); the confinement period (March 14, 2020, to the end of lockdown on June 21, 2020); and the post-confinement period (June 21, 2020, to Dec 31, 2022). We used Bayesian structural time series models to assess the effect of pandemic phases on non-fatal suicide behaviours, and we ran stratified analyses by sex and age to identify distinct patterns among demographic cohorts. We obtained 26 482 records from Jan 1, 2018, to Dec 31, 2022. The mean age was 37·94 years (SD 18·07), and the sample included 17 584 (66·4%) women and 8898 (33·6%) men. Data on ethnicity were not collected. Temporal trends showed a mild increase in non-fatal suicide behaviours from Jan 1, 2018, to March 13, 2020; a reduction during the confinement period; and a subsequent rise after confinement. Bayesian models suggested a significant causal effect of lockdown easing, resulting in a 50·77% increase in non-fatal suicide behaviours (95% credible interval [CrI] 26·62-76·58; p<0·0001). Stratified analyses indicated that the easing of lockdown resulted in a significant increase in non-fatal suicide behaviours among women (25·92%; 6·71-44·72; p=0·011) and among individuals aged 18 years and younger (72·75%; 38·81-108·11; p<0·0001). This study provides a comprehensive examination of non-fatal suicide behaviours in Catalonia, Spain, emphasising the dynamics of different COVID-19 pandemic phases. The initial reduction during strict lockdown aligns with Joiner's Interpersonal Theory of Suicide, whereas the post-confinement rise reflects complex factors, including social isolation and economic challenges. Sex-specific and age-specific analyses underscore distinct vulnerabilities, emphasising the need for targeted preventive strategies. Centro de Investigación Biomédica en Red de Salud Mental annual budget of G21, Agència de Gestió d'Ajuts Universitaris i de Recerca of the Generalitat de Catalunya. For the Catalan and Spanish translations of the abstract see Supplementary Materials section.

A Susceptible Vaccinated Exposed Infected Hospitalized and Removed/Recovered (SVEIHR) Model Framework for COVID-19

In reaction to the severe socio-economic effects and upheavals that the Covid-19 sickness had on the world within the first few weeks of its introduction, everyone involved had to act quickly to look for possible solutions for preventing the ensuing epidemics. A prompt response is more critical given Nigeria's subpar social, economic, and healthcare infrastructure. Investigated was the efficacy of various pharmacological, non-pharmaceutical, or a combination of both therapies in flattening the Covid-19 incidence curve. In order to investigate the impact of these interventions, a deterministic SVEIHR model was created and applied. The Nigerian Center for Disease Control (NCDC) portal's Covid-19 data were used to parametrize the model. For simulations using a system dynamic simulation, estimated parameters were employed. The fundamental reproduction number, R0, was used to evaluate the success of our suggested intervention in effectively managing COVID-19 transmission. The simulation results demonstrated that the use of only non-pharmaceutical interventions, such as the use of face masks, a light lockdown, and hand washing at baseline or high levels, is insufficient, with the R0 varying from vaccination at the vaccination rate of 0.5% with non-pharmaceutical interventions at any level of compliance, and a combination of vaccination at 0.05% and high hygiene level were effective in flattening the Covid-19 disease incidence curve in Nigeria, returning a R0 less than 1. Furthermore, maintaining a high level of cleanliness, which includes hand washing and the use of a face mask, would be sufficient to stop the spread of Covid-19 disease and eventually flatten Covid-19 disease incidence curve in Nigeria, given a low turnout of 0.05% for vaccination and the easing of lockdown.

The Implications of COVID-19 on Catholic Education at the Catholic University of Zimbabwe: The Case of Bulawayo Campus 2019–2023

The main aim of this article is to unravel the implications of the COVID-19 pandemic on Catholic education at the Catholic University of Zimbabwe (CUZ), Bulawayo campus. The research, qualitative in nature, has been guided by the importance of Catholic education nationally. It has interrogated the effects of COVID-19 on that educational system. It does emerge quite prominently that Catholic education is key, and it is important in the lives of many citizens. The researcher establishes that the distinctive features of Catholic education have been part of the Bulawayo campus community. It is also shown that the implications of COVID-19 have been at two extremes. The researcher has managed to establish problems that were created by the pandemic such as the disruption in liturgy, learning and living daily life in an environment inspired by Jesus Christ. Furthermore, the history of the Catholic presence in Zimbabwe has played an important role in developing citizens, from the colonial era to the present day. The practices rooted in the principles of the church have been lived and practiced by many. Post-COVID-19 life slowly returned, and the researcher has managed to unravel factors that previously affected the lives of students and members of staff. Respondents highlighted changes and improvements in their well-being following the easing of lockdown (since March 2023) in relation to the values of Catholic education. Life in the “new normal” has brought hope as worship through Mass and other platforms of human contact have led to the cross-fertilisation of ideas amongst members of the university. The Catholic education features that were affected by the pandemic have been restored. In that regard, it can be argued that the restoration of traditional ways of doing things—the post-COVID-19 era—has brought hope to the CUZ community in Bulawayo and that it will produce men and women who will be morally upright citizens. Such citizens will use their knowledge to better the world following the principles acquired from a Catholic Education. Recipients of Catholic education have expressed optimism in the importance of being part of the Catholic community in its multi-faceted dimensions.

Sexual and reproductive health needs of young women living with perinatally acquired HIV.

Increasingly, young women living with perinatally acquired HIV (YWLPaHIV) have transitioned from paediatric to adult services. There remains a paucity of data on the sexual and reproductive health (SRH) needs of YWLPaHIV and their access to youth-friendly care. Amidst healthcare changes due to COVID-19 pandemic restrictions, we explored SRH needs of a cohort of YWLPaHIV. Evaluation of SRH needs of YWLPaHIV attending a UK NHS-youth HIV service with data collected from patient records and self-reported questionnaires amongst women attending between July and November 2020 following easing of the first lockdown and reintroduction of in-person appointments. 71 of 112 YWLPaHIV registered at the clinic completed questionnaires during the study period and were included in the analysis. Median age was 23y (IQR 21-27, range 18-36). 51/71(72%) reported coitarche, average age 17.6y (IQR 16-18, range 14-24). 24 women reported 47 pregnancies resulting in 16 (34%) HIV-negative live-births, 19 (40%) terminations, 9(19%) miscarriages, with 3 pregnancies ongoing. 31/48(65%) sexually active women reported current contraception: 10 (32%) condoms, 19 (62%) long-acting, and 3(10%) oral contraceptive pill. 18/51(35%) reported a previous sexually transmitted infection; human papillomavirus (HPV) (11), Chlamydia trachomatis (9) and herpes simplex (2). 27/71(38%) women had undergone cervical cytology including 20/28(71%) women aged ≥25y with abnormalities documented in 29%. HPV vaccination was reported in 83%, with protective hepatitis B titres in 71%. High rates of unplanned pregnancy, STIs and cervical abnormalities highlight the continuing SRH needs of YWLPaHIV and requirement for open access to integrated HIV/SRH services despite pandemic restrictions.

The hammer and the jab: Are COVID-19 lockdowns and vaccinations complements or substitutes?

The COVID-19 pandemic has devastated lives and economies around the world. Initially a primary response was locking down parts of the economy to reduce social interactions and, hence, the virus’ spread. After vaccines have been developed and produced in sufficient quantity, they can largely replace broad lock downs. This paper explores how lockdown policies should be varied during the year or so gap between when a vaccine is approved and when all who wish have been vaccinated. Are vaccines and lockdowns substitutes during that crucial time, in the sense that lockdowns should be reduced as vaccination rates rise? Or might they be complementary with the prospect of imminent vaccination increasing the value of stricter lockdowns, since hospitalization and death averted then may be permanently prevented, not just delayed? We investigate this question with a simple dynamic optimization model that captures both epidemiological and economic considerations. In this model, increasing the rate of vaccine deployment may increase or reduce the optimal total lockdown intensity and duration, depending on the values of other model parameters. That vaccines and lockdowns can act as either substitutes or complements even in a relatively simple model casts doubt on whether in more complicated models or the real world one should expect them to always be just one or the other. Within our model, for parameter values reflecting conditions in developed countries, the typical finding is to ease lockdown intensity gradually after substantial shares of the population have been vaccinated, but other strategies can be optimal for other parameter values. Reserving vaccines for those who have not yet been infected barely outperforms simpler strategies that ignore prior infection status. For certain parameter combinations, there are instances in which two quite different policies can perform equally well, and sometimes very small increases in vaccine capacity can tip the optimal solution to one that involves much longer and more intense lockdowns.

Seroprevalence and socioeconomic impact of the first SARS-CoV-2 infection wave in a small town in Navarre, Spain

The characterization of the antibody response to SARS-CoV-2 and its determinants are key for the understanding of COVID-19. The identification of vulnerable populations to the infection and to its socioeconomic impact is indispensable for inclusive policies. We conducted an age-stratified cross-sectional community-based seroprevalence survey between June 12th and 19th 2020—during the easing of lockdown—in Cizur, Spain. We quantified IgG, IgM and IgA levels against SARS-CoV-2 spike and its receptor-binding domain in a sample of 728 randomly selected, voluntarily registered inhabitants. We estimated a 7.9% seroprevalence in the general population, with the lowest seroprevalence among children under ten (n = 3/142, 2.1%) and the highest among adolescents (11–20 years old, n = 18/159, 11.3%). We found a heterogeneous immune-response profile across participants regarding isotype/antigen-specific seropositivity, although levels generally correlated. Those with technical education level were the most financially affected. Fifty-five percent had visited a supermarket and 43% a sanitary centre since mid-February 2020. When comparing by gender, men had left the household more frequently. In conclusion, few days after strict lockdown, the burden of SARS-CoV-2 infection was the lowest in children under 10. The findings also suggest that a wider isotype-antigen panel confers higher sensitivity. Finally, the economic impact biases should be considered when designing public health measures.

Reporting on the shadow pandemic in Nigeria: An analysis of five media organizations’ coverage of gender-based violence during the COVID-19 pandemic

This study fills a gap in research by examining how the COVID-19 pandemic laid bare structural and systemic gender inequities in Nigeria. In particular, women and girls are at increased risk of gender-based violence (GBV). We analysed a corpus of 361 articles on GBV published between 1 January 2019 and 31 December 2020 by Daily Trust, The Guardian, Leadership, The Punch and Vanguard, to determine how effectively Nigerian media reported on GBV during the pandemic. Analysis centred on five phases of reporting during those 24 months: (1) pre-lockdown; (2) early lockdown period, 29 March–26 May; (3) response to a rise in GBV, 26 May–30 July; (4) easing of lockdown and (5) sixteen days of activism against GBV, 25 November–10 December 2020. Key themes emerging in the media coverage include the shadow pandemic of GBV in Nigeria, response to the rise in GBV, NGOs combating GBV and calls for improved legislation.

A parent-school initiative to assess and predict air quality around a heavily trafficked school

Many primary schools in the UK are situated in close proximity to heavily-trafficked roads, yet long-term air pollution monitoring around such schools to establish factors affecting the variability of exposure is limited. We co-designed a study to monitor particulate matter in different size fractions (PM1, PM2.5, PM10), gaseous pollutants (NO2, O3 and CO) and meteorological parameters (ambient temperature, relative humidity) over a period of one year. The period included phases of national COVID-19 lockdown and its subsequent easing and removal. Statistical analysis was used to assess the diurnal patterns, pollution hotspots and underlying factors driving changes. A pollution episode was observed early in January 2021, owing to new year celebration fireworks, when the daily average PM2.5 was around three-times the World Health Organisation limit. PM2.5 and NO2 exceeded the threshold limits on 15 and 10 days, respectively, as the lockdown eased and the school reopened, despite the predominant wind direction often being away from the school towards the roads. The peak concentration levels for all pollutants occurred during morning drop-off hours; however, some weekends showed higher or comparable concentrations to those during weekdays. The strong disproportional Pearson correlation between CO and temperature demonstrated the possible contribution of local sources through biomass burning. The impact of lifting restrictions after removing the weather impact showed that the average pollution levels were low in the beginning and increased by up to 22.7 % and 4.2 % for PM2.5 and NO2, respectively, with complete easing of lockdown. The Prophet algorithm was implemented to develop a prediction model using an NO2 dataset that performed moderately (R2, 0.48) for a new monthly dataset. This study was able to build a local air pollution database at a school gate, which enabled an understanding of the air pollution variability across the year and allowed evidence-based mitigation strategies to be devised.

ECG-COVID: An end-to-end deep model based on electrocardiogram for COVID-19 detection

The early and accurate detection of COVID-19 is vital nowadays to avoid the vast and rapid spread of this virus and ease lockdown restrictions. As a result, researchers developed methods to diagnose COVID-19. However, these methods have several limitations. Therefore, presenting new methods is essential to improve the diagnosis of COVID-19. Recently, investigation of the electrocardiogram (ECG) signals becoming an easy way to detect COVID-19 since the ECG process is non-invasive and easy to use. Therefore, we proposed in this paper a novel end-to-end deep learning model (ECG-COVID) based on ECG for COVID-19 detection. We employed several deep Convolutional Neural Networks (CNNs) on a dataset of 1109 ECG images, which is built for screening the perception of COVID-19 and cardiac patients. After that, we selected the most efficient model as our model for evaluation. The proposed model is end-to-end where the input ECG images are fed directly to the model for the final decision without using any additional stages. The proposed method achieved an average accuracy of 98.81%, Precision of 98.8%, Sensitivity of 98.8% and, F1-score of 98.81% for COVID-19 detection. As cases of corona continue to rise and hospitalizations continue again, hospitals may find our study helpful when dealing with these patients who did not get significantly worse.

Unnao Tanneries Limited: Post COVID Business Strategy

Unnao Tanneries Limited (UTL), formerly known as Monir Leather Works, was set up in the 1980s and has been a family-owned business for over four decades. The primary activity of UTL in the initial years was leather jackets and purses. It sold its products under the brand name Brown Cliff. It shifted its manufacturing units from Kanpur to the nearby town of Unnao to cut costs and increase capacity in 1990. It later expanded its product range to primarily include leather footwear, targeting the menswear market. It became one of the top players in the northern part of the country with a proper business strategy. The footwear segment was growing rapidly and profitably for UTL. The business was smooth for almost four decades with minor hiccups until the government imposed a ban on its functioning due to a sparse wastewater disposal system in May 2019. The initial ban was prolonged further due to the COVID-19 pandemic in the country in March 2020. As a result, UTL suffered a significant loss in sales and clients. Reviving demand for the products after the easing of partial lockdown in the country was a daunting task. UTL became a contractual manufacturer for CONTE to utilize its idle resources and reduce its financial burden. Later, UTL got an offer from Batla Leather Products Limited (BLPL) to become its contract manufacturer. BLPL was one of the top players in the national and international market and it was looked for facilities to quickly scale up its operations. This case allows the readers to put themselves in Mr Sadiq Monir’s shoes and analyse an unforeseen business situation. The choice between short-term profits and sustainability versus long-term growth of the family brand Brown Cliff had to be made. The case gives several macro and micro factors supporting the choices and the decision to be made. The decision dilemma has two facets—to gain expertise in improving operations and to have a steady flow of income for the next 2–3 years versus risking the loss of independence and dilution of the family brand Brown Cliff.

Technology and Medical Care in India: Growth of Telehealth Awareness during the COVID-19 Pandemic.

COVID-19 pandemic has highlighted the importance of telemedicine in health care delivery worldwide. However, the true success of telemedicine depends on patients' acceptance, which in turn is decided by their interest in telemedicine. In this study, we aim to assess the population interest in telemedicine services across India during the COVID-19 pandemic. We measured national-level public interest in "telemedicine" using terms related to telemedicine in Google Trends during the years 2019 and 2020. The relationship between population search volume for telemedicine (composite score) and the number of COVID-19 cases during the early phase of COVID-19 was analyzed. The literacy rate and relative interest in telemedicine in the states were analyzed to assess the impact of education on telemedicine interest. The interest in telemedicine in the year 2020 is higher compared to the year 2019 (U = 269.5, z = -7.043, p&lt;0.001). The search trends for telemedicine increased consistently during the early phase of the COVID-19 pandemic. The greatest search volume was seen in Andhra Pradesh. There was a strong correlation (r = 0.65, p &lt; 0.001) between the initial increase in the number of COVID-19 cases and population-level interest in telemedicine over time. The relative interest in telemedicine for the year 2019 showed a significant direct relationship with the literacy rate (r = 0.47, p = 0.04). However, the relative interest in telemedicine for the year 2020 showed no relationship with the state's literacy rate signifying the spread of telemedicine across literacy barriers. Population interest in telemedicine was higher in the year 2020 compared to the previous year and remained high even after the easing of lockdown. The COVID-19 pandemic has played an important role in increasing the Indian public's interest in telemedicine.

A multi-perspective qualitative exploration of the reasons for changes in the physical activity among 10–11-year-old children following the easing of the COVID-19 lockdown in the UK in 2021

BackgroundActive-6 is exploring how the COVID-19 pandemic has impacted physical activity behaviour among Year 6 children (aged 10–11 years) and their parents in Southwest England. Initial findings from the Active-6 project have shown a 7–8 min decrease in moderate-to-vigorous physical activity and an increase in sedentary behaviour among children following the easing of restrictions in the UK in latter half of 2021. This finding suggests that the pandemic has had a persistent impact on child physical activity behaviour. This paper explored the possible mechanisms behind these changes.MethodsInterviews with parents (n = 21), members of school staff (n = 9) and focus groups with children aged 10–11 years (n = 47) were conducted between August and December 2021 to discuss the impact of the pandemic on child physical activity behaviour. The framework method was used for analysis.ResultsFive themes spanning two key stages of the pandemic were described. Three themes related to the period of lockdowns and fluctuating restrictions (March 2020 – April 2021). These included: Theme 1) Lockdown: A short-lived adventure; Theme 2) Access to facilities during restrictions; and Theme 3) The importance of the parent. A further two themes were identified related to the period following the gradual easing of restrictions in April 2021. These included: Theme 4) An overwhelming return to normal; and Theme 5) Reopening fatigue.ConclusionsThe analysis suggested that feelings of novelty experienced during the initial stages of lockdown waned as restrictions were prolonged, creating an increasingly challenging period for parents and their children. However, during periods of restrictions, the importance of parental encouragement and access to appropriate facilities in the local and home environment helped facilitate physical activity. Following the easing of COVID-19 restrictions, emotional overwhelm and physical fatigue among children, stemming from a sedentary and socially isolated life in lockdown and other restrictions, were key contributors to the decreased moderate to vigorous physical activity and increased sedentary behaviour that was observed in a related quantitative study.

Mental health and wellbeing among people with informal caring responsibilities across different time points during the COVID-19 pandemic: a population-based propensity score matching analysis.

Due to a prolonged period of national and regional lockdown measures during the coronavirus (COVID-19) pandemic, there has been an increase reliance on informal care for informal carers. In light of this, the current study compared the experiences of carers and non-carers on various mental health and wellbeing measures across six key time points during the pandemic. Data analysed were from the University College London (UCL) COVID -19 Social Study. Our study focused on six time points in England: (1) the first national lockdown (March-April 2020); (2) the beginning of first lockdown rules easing (May 2020); (3) the second national lockdown (November 2020); (4) the third national lockdown (January 2021); (5) the easing of the third lockdown (March 2021); and (6) the end of restrictions (July-August 2021). We considered five mental health and wellbeing measures: depressive symptoms, anxiety symptoms, loneliness, life satisfaction, and sense of being worthwhile. Propensity score matching was applied for the analyses. We found that informal carers experienced higher levels of depressive and anxiety symptoms than non-carers across much of the pandemic. During the first national lockdown, carers also experienced a higher sense of life being worthwhile. No association was found between informal caring responsibilities and levels of loneliness and life satisfaction. Given that carers are an essential national healthcare support, especially during a pandemic, it is crucial to integrate carers' needs into healthcare planning and delivery. These results highlight that there is a pressing need to provide adequate and targeted mental health support for carers during and following this pandemic.

Economic Recovery Post Covid-19: Centralised vs Decentralised Lockdown

To arrest the spread of COVID-19, most countries have imposed some form of lockdown to ensure social distancing. For India, the lockdown was over four phases and over two months. While, the effectiveness of such a stringent measure is yet to be established, some estimates of the economic distress is available. It is therefore important for India to plan the unlock down phase well. In this paper, we develop a theoretical framework to address how un lockdown must be planned and discuss the respective roles of the states and the centre. The model is set against the backdrop where a large part of the migrant labours has also been forced to return to their home States. We find that the easing of lockdown levels in the poorer (richer) State will be lower (higher) when the decision is Centralised vis a vis when it is decided by the poor State. We recommend that the role of the Centre in easing of lockdown must be limited to two things. One, support the States with more investments in health infrastructure that will help them reduce lockdown intensities. Two, compensate the expected shortfall in wage income through a Direct Benefit Transfer to the labour in the two States.

Work in pandemic times: Exploring precarious continuities in paid domestic work in India.

Research on crisis have brought to fore the necessity of studying the gendered impact of such events. Covid‐19 too has shown how gender relations play a role in the political economy of crisis, relief and response as well as recovery. This article focusses on the experiences of paid domestic workers in India who are among the most invisible and marginalized of India's informal workers and largely excluded from labor discourse and employment legislation. With Covid‐19, the precariousness characterizing the sector has also been further exposed and exacerbated, with vast numbers of workers now facing significant challenges to livelihood, as well as several new/additional pressures and risks, both at work and at home. In this article, we examine these Covid‐related challenges, drawing on interviews conducted with domestic workers, NGO practitioners, and labor rights' activists in Delhi and Kolkata between April and August 2020. We show how, during the national lockdown, many domestic workers in these cities experienced increased insecurity related to jobs and housing, as well as an increased control and surveillance at home. Furthermore, with the partial easing of lockdown and the associated ‘return’ to work, many experienced reduced bargaining power at work, increasingly blurred roles, and heavier workloads. Workers also experienced more overt forms of avoidance behavior, linked to ideas of caste/class and more recent notions of ‘hygiene’/‘distancing’. In detailing these experiences and contextualizing them within a much longer history of invisibilization and marginalization facing workers engaged in social reproduction, we draw attention to what we call the ‘precarious continuities’ in paid domestic work. We argue that the crisis allows for a lens to widen the theoretical understanding around social reproduction as a form of underpaid and devalued labor.

Increasing hip fracture volume following repeated lockdowns: an Irish multicentre study of periods pre-Covid, during Covid lockdown and following vaccination

BackgroundOlder age groups were identified as a high-risk cohort for Covid-19 and thus were a focus of lockdown measures enacted internationally. Resultant decreased social mobility and physical activity levels are associated with sarcopenia, which may lead to increased risk of hip fracture upon resuming social integration and physical activities after easing of lockdown restrictions.AimsOur aim was to compare the incidence of hip fractures during the period following vaccination with subsequent relaxation of restrictions, to those prior to and during the Covid pandemic.MethodsA multicentre retrospective cohort study was performed consisting of all patients presenting with a “hip” fracture to 3 regional trauma units over the relevant time periods in 2019, 2020 and 2021. Tallaght, Galway and Waterford University Hospitals are large academic teaching hospitals with a combined mixed urban and rural catchment of over 1 million people.FindingsFour-hundred-fourteen patients in total were included in the final analysis, with 133 eligible hip fractures observed proceeding to operative treatment across the study period in 2019, 132 in 2020 and 149 in 2021, representing a 12.88% increase. Demographic data revealed similar patient cohorts with respect to age and gender, fracture pattern and treatment.ConclusionsAn increase in hip fracture volume was observed during the period post vaccination with subsequent relaxation of restrictions and increased social mobility, compared to those prior to and during the Covid pandemic. These findings have implications for hospital planning and orthopaedic resourcing as we navigate our way forward past the Covid-19 Pandemic.

Business strategies for small- and medium-sized tourism enterprises during COVID-19: a developing country case

PurposeIn this paper, the authors set out to explore how small- and medium-sized tourism enterprises (SMTEs) in a developing country (Turkey) are coping with economic and financial consequences of coronavirus disease 2019 (COVID-19) pandemic. It is also crucial to understand what kind of policymaking solutions will help them to successfully overcome it.Design/methodology/approachTo gather data, the authors interviewed SMTEs in the Bodrum area – one of the most elite and exciting destinations for foreign travelers in Turkey. Semi-structured interview method was used, and questions for data collection focused on three key areas: (1) impact of COVID-19 on SMTEs, especially in terms of cash flow and other problems, (2) government incentives and (3) business strategies to cope with the crisis.Findings(1) Even a year and a half into the pandemic, despite government relief efforts, vaccination programs, the easing of lockdown and travel restrictions, survival is still the main concern for SMTEs. (2) Although they do not have enough resources, these entrepreneurs have energy and motivation, are optimistic about the future and are investigating new opportunities by capitalizing on their “strategic flexibility”, an intrinsic strength of SMEs. (3) Recovery is going to take a long time, and government support, however crucial in the interim, cannot replace the pre-crisis conditions that are anxiously awaited by these businesses.Research limitations/implicationsOne of the main limitations of this study is that the gathered research data are localized to one destination in Turkey, the Bodrum area. In that respect, it is difficult to hypothesize the degree to which the resulting data can be generalized to other areas of Turkey and the rest of the world. Future work is required to provide greater insight into how to be prepared effectively for this type of crisis. Therefore, further research should be undertaken to investigate tourism and hospitality industry in the whole country and to compare findings to those of other cities and regions. An especially important issue for future research that would yield insight and practical implications worldwide is comparison of findings across countries.Practical implicationsThe impact of COVID-19 is challenging all SMTEs’ conventional business models. Each business needs to evaluate its own internal and external conditions, secure required financial resources necessary for survival and sustainable business strategies for post-COVID-19 era. Besides short-term survival thinking, they also look for long-term business strategies both saving, investing, innovation and diversification. They are also on the look-out to seize any new opportunities presenting themselves as well as for any additional governmental support.Originality/valueThis paper offers a systematic approach toward understanding the realities of SMTEs in the midst of crisis by focusing on their short-term survival and long-term sustainability responses against COVID-19. It also brings practical experiences of industry participants and opinions of industry experts to academicians, practitioners and policymakers, shedding light on challenges faced by SMTEs.

SaliVISION: a rapid saliva-based COVID-19 screening and diagnostic test with high sensitivity and specificity

The Coronavirus disease 2019 (COVID-19) pandemic-caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)– has posed a global threat and presented with it a multitude of economic and public-health challenges. Establishing a reliable means of readily available, rapid diagnostic testing is of paramount importance in halting the spread of COVID-19, as governments continue to ease lockdown restrictions. The current standard for laboratory testing utilizes reverse transcription quantitative polymerase chain reaction (RT-qPCR); however, this method presents clear limitations in requiring a longer run-time as well as reduced on-site testing capability. Therefore, we investigated the feasibility of a reverse transcription looped-mediated isothermal amplification (RT-LAMP)-based model of rapid COVID-19 diagnostic testing which allows for less invasive sample collection, named SaliVISION. This novel, two-step, RT-LAMP assay utilizes a customized multiplex primer set specifically targeting SARS-CoV-2 and a visual report system that is ready to interpret within 40 min from the start of sample processing and does not require a BSL-2 level testing environment or special laboratory equipment. When compared to the SalivaDirect and Thermo Fisher Scientific TaqPath RT-qPCR testing platforms, the respective sensitivities of the SaliVISION assay are 94.29% and 98.28% while assay specificity was 100% when compared to either testing platform. Our data illustrate a robust, rapid diagnostic assay in our novel RT-LAMP test design, with potential for greater testing throughput than is currently available through laboratory testing and increased on-site testing capability.

The trajectories of anxiety and depression during the COVID-19 pandemic and the protective role of psychological flexibility: A four-wave longitudinal study

BackgroundPublished reports on the adverse mental health impacts of the initial phase of the COVID-19 pandemic suggest an emerging global mental health crisis. However, the trajectories of these mental health impacts over multiple COVID-19 peaks and corresponding lockdowns are unknown. This study explored the trajectories of anxiety and depression over two consecutive lockdowns during the first nine months of the pandemic in Europe (April 2020–January 2021) and examined whether they varied as a function of different psychological flexibility and inflexibility profiles. MethodsA total of 569 Italians completed online surveys at four assessment points. Trajectories of anxiety and depression were examined with latent growth modeling and according to different psychological flexibility and inflexibility profiles. ResultsAnxiety increased linearly throughout the study period, whereas depression displayed a quadratic trajectory evidencing a decrease with the easing of the first lockdown followed by an increase during the second lockdown. Furthermore, two profiles were identified that displayed different anxiety and depression trajectories. Compared to the psychologically flexible profile, the psychologically inflexible profile reported significantly higher anxiety and depression which remained higher across the study period. LimitationsA reliance on self-report measures and convenience sampling constitute key study limitations. ConclusionsResults suggest that high psychological inflexibility is a risk factor for prolonged elevated anxiety and depression during the COVID-19 pandemic, whereas high psychological flexibility is a protective factor. Psychological flexibility and inflexibility should be targeted by preventive public health interventions that harness evidence-based strategies shown to effectively target these factors.