First Wave Of Coronavirus Disease Research Articles

Mental Health of Teachers during the First Wave of COVID-19 in Daegu, Korea: Challenges in Reopening Schools

This study conducted an in-depth analysis of the psychological states of teachers during the first outbreak of coronavirus disease 2019 (COVID-19) using data on school mental health projects related to COVID-19 in Daegu from May to June 2020. The participants comprised 811 (34.9%) male and 1,511 (65.1%) female teachers in 1,041 (44.8%) middle and 1,281 (55.2%) high schools. After schools reopened, the most common causes of unbearable stress were unusual experiences, fear of infection, and negative emotions. Moreover, 41.5%/40.4% reported experiencing anxiety/depression, out of which 25.1%/23.6%, 10.0%/14.0%, and 6.4%/2.8% exhibited mild, moderate, and severe levels, respectively. The study identified the following influencing factors of anxiety: being female (OR: 1.52), years of employment (≤5 and <15; OR: 1.36; reference: <5), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.69], 5,000,000 ≤ [OR: 0.67]; reference ≤1,000,000 and <3,000,000 won), depression (OR: 19.14), posttraumatic stress symptoms (OR: 11.65), job stress (OR: 9.13), resilience (OR: 0.37), and subjective well-being (OR: 0.45). We identified the following factors for depression: being female (OR: 1.51), aged 40s (OR: 1.70; reference: 20s), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.75], ≤5,000,000 [OR: 0.66]; reference: ≤1,000,000 and <3,000,000 won), anxiety (OR: 19.14), posttraumatic stress symptoms (OR: 4.03), job stress (OR: 14.04), resilience (OR: 0.29), and subjective well-being (OR: 0.33). The findings suggest a necessity for specific, systematic measures and psychological support to teachers vulnerable to the impact of disasters, such as the COVID-19 pandemic, to cope with disasters and improve school adaptation.

The impact and management of internet-based public opinion dissemination during emergencies: A case study of Baidu News during the first wave of coronavirus disease 2019 (COVID-19).

The coronavirus disease 2019 (COVID-19) public health emergency has had a huge impact worldwide. We analyzed news headlines and keywords from the initial period of COVID-19, and explored the dissemination timeline of news related to the epidemic, and the impact of Internet-based media on the public using lifecycle theory and agenda-setting theory. We aimed to explore the impact of Baidu news headlines on public attention during the first wave of COVID-19, as well as the management mechanism of regulatory departments for social public opinion. We searched Baidu News using the keywords "Novel Coronavirus" and "COVID-19" from 8 January to 21 February 2020, a total of 45 days, and used Python V3.6 to extract news samples during the first wave of the epidemic. We used text analysis software to structurally process captured news topics and content summaries, applied VOSviewer V6.19 and Ucinet V6.0 to examine key aspects of the data. We analyzed the impact of Baidu News headlines on social opinion during the first wave of COVID-19 in the budding, spread, and outbreak stage of the information lifecycle. From clustering visualization and social network analysis perspectives, we explored the characteristics of Baidu News during the initial stage of the COVID-19. The results indicated that agenda-setting coverage through online media helped to mitigate the negative impact of COVID-19. The findings revealed that news reporting generated a high level of public attention toward a specific emergency event. The public requires accurate and objective information on the progress of COVID-19 through Baidu News headlines to inform their planning for the epidemic. Meanwhile, government can enhance the management mechanism of news dissemination, correct false and inaccurate news, and guide public opinion in a positive direction. In addition, timely official announcements on the progress of the COVID-19 outbreak and responses to matters of public concern can help calm tensions and maintain social stability.

Mask-Wearing Behavior Among Individuals Newly Diagnosed With Type 2 Diabetes: Insights From Community Health Screenings During the COVID-19 Pandemic in Indonesia

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on people with type 2 diabete (T2D) and their health behaviors. This study investigated the associations between T2D status and mask-wearing behaviors in public settings during the first wave of COVID-19 among community residents in Yogyakarta, Indonesia. Outreach health checkups and self-report questionnaires were cross-sectionally conducted to measure for mask-wearing behavior, T2D status, and sociodemographic characteristics. Chi-square tests, bivariate, and multivariate logistic regression were performed for data analysis. Out of 254 total participants, nearly one forth (24%) of them were newly diagnosed with T2D, while 15% of them reported that they had ever been diagnosed as T2D before. There were no statistically significant associations between mask-wearing behavior and T2D status in bivariate and multivariate logistic regression models. However, Chi-square test results showed significant differences (P=0.02) in percentages of inconsistent mask-wearing behavior among those who were newly diagnosed as T2D (19.4%), those who had known as T2D (7.9%), and those who had no T2D (7.1%). This discrepancy in the results suggests the need for further investigations using larger sample size and more representative community samples to examine the associations between mask-wearing behaviors and T2D. Early diagnostic services and the awareness education for T2D is imperative to reduce the disease severity and mortality for future pandemic particularly among undiagnosed individuals who are unaware of their T2D status,

COVID-19 Stroke Apical Lung Examination Study 2: a national prospective CTA biomarker study of the lung apices, in patients presenting with suspected acute stroke (COVID SALES 2)

BackgroundApical ground-glass opacification (GGO) identified on CT angiography (CTA) performed for suspected acute stroke was developed in 2020 as a coronavirus-disease-2019 (COVID-19) diagnostic and prognostic biomarker in a retrospective study during the first wave of COVID-19. ObjectiveTo prospectively validate whether GGO on CTA performed for suspected acute stroke is a reliable COVID-19 diagnostic and prognostic biomarker and whether it is reliable for COVID-19 vaccinated patients. MethodsIn this prospective, pragmatic, national, multi-center validation study performed at 13 sites, we captured study data consecutively in patients undergoing CTA for suspected acute stroke from January-March 2021. Demographic and clinical features associated with stroke and COVID-19 were incorporated. The primary outcome was the likelihood of reverse-transcriptase-polymerase-chain-reaction swab-test-confirmed COVID-19 using the GGO biomarker. Secondary outcomes investigated were functional status at discharge and survival analyses at 30 and 90 days. Univariate and multivariable statistical analyses were employed. ResultsCTAs from 1,111 patients were analyzed, with apical GGO identified in 8.5 % during a period of high COVID-19 prevalence. GGO showed good inter-rater reliability (Fleiss κ = 0.77); and high COVID-19 specificity (93.7 %, 91.8–95.2) and negative predictive value (NPV; 97.8 %, 96.5–98.6). In subgroup analysis of vaccinated patients, GGO remained a good diagnostic biomarker (specificity 93.1 %, 89.8–95.5; NPV 99.7 %, 98.3–100.0). Patients with COVID-19 were more likely to have higher stroke score (NIHSS (mean +/- SD) 6.9 +/- 6.9, COVID-19 negative, 9.7 +/- 9.0, COVID-19 positive; p = 0.01), carotid occlusions (6.2 % negative, 14.9 % positive; p = 0.02), and larger infarcts on presentation CT (ASPECTS 9.4 +/- 1.5, COVID-19 negative, 8.6 +/- 2.4, COVID-19 positive; p = 0.00). After multivariable logistic regression, GGO (odds ratio 15.7, 6.2–40.1), myalgia (8.9, 2.1–38.2) and higher core body temperature (1.9, 1.1–3.2) were independent COVID-19 predictors. GGO was associated with worse functional outcome on discharge and worse survival after univariate analysis. However, after adjustment for factors including stroke severity, GGO was not independently predictive of functional outcome or mortality. ConclusionApical GGO on CTA performed for patients with suspected acute stroke is a reliable diagnostic biomarker for COVID-19, which in combination with clinical features may be useful in COVID-19 triage.

Comparison of Chest Computed Tomography (CT) Imaging Patterns and Severity among COVID-19 Patients during the First and Fourth Waves in Addis Ababa, Ethiopia

Background. Studies done globally had shown that chest imaging patterns of Corona virus disease 2019 (COVID-19) infection varied depending on the strains of the virus and the waves of the pandemic. There is no published literature done in Ethiopia to examine whether there is any difference in chest computed tomography (CT) findings of COVID-19 patients during the first and fourth waves. Thus, this study tries to fill the gap of knowledge in that regard. Objective. To describe and compare chest CT scan imaging pattern and assess the predictors of chest CT severity of the first and fourth wave of COVID-19 infection. Methods. An institution-based cross-sectional study was conducted on 200 polymerase chain reaction test confirmed COVID-19 patients who underwent chest CT scan imaging in two diagnostic centers in Addis Ababa city. Pioneer and Wudassie diagnostic centers were selected due to the high case load and availability of well-experienced cardiothoracic radiologists. Data were collected from July 1 to August 3, 2022, using a structured Google form sheet questionnaire. Binary logistic regression was performed, and statistical significance was assessed at a level of significance α = 0.05. Results. Comparatively higher proportion of patients from the first wave had positive chest CT finding than fourth wave (99% vs. 69%). Bilateral lung involvement and lower lobe predilection were seen for both waves of COVID-19. Ground glass opacity and consolidation were the most common CT features for both waves. Delayed chest CT features such as traction bronchiectasis were primarily seen among first-wave patients. Mean global CT severity score was higher for the first-wave patients (13.18 vs. 8.31), and the mean difference is statistically significant ( p < 0.001). Duration of symptoms was a statistically significant predictor of CT severity during the first wave of COVID-19, and patients that presented later than 14 days had 4.12 times higher odds of being in the severe CT score category than those that presented less than 7 days (AOR = 4.12, p = 0.011). There was no statistically significant predictor of CT severity for the fourth wave in this study. Conclusion. Chest CT positivity was comparatively higher for first wave patients. Common features included bilateral involvement, lower lobe involvement, ground glass opacity, and consolidation. Mean chest CT severity was comparatively higher for the first wave than the fourth wave, and the duration of symptoms was a statistically significant predictor of the CT severity for first wave.

Examining the Qualitative Experiences of Latinx Nurses During the First Wave of COVID-19.

Introduction: The world has been impacted by the coronavirus disease 2019 (COVID-19) pandemic since March of 2020. Latinx nurses have been some of the most underrepresented in being studied during this time and have been greatly affected by it. To the best of our knowledge, there are no published studies that focus on the qualitative experiences of Latinx nurses during the first wave of the pandemic. Methods: Data analysis included thematic analysis to identify main themes experienced by Latinx nurses. A qualitative descriptive study design was employed to conduct a parent study with 100 nurses across the United States reflecting on their experiences during the first wave of the COVID-19 pandemic, data collected from May to September 2020. Formal coding of the interview data was conducted utilizing Dedoose cloud-based software. Results: Five main themes emerged, including (1) connection to patients' personal touch and empathy, (2) connection to Latinx nurses, (3) connection to family and friends, (4) connection to food as care, and (5) coping. Within the theme of coping, subthemes of (5.1) faith, (5.2) maladaptive behaviors, and (5.3) self-care activities emerged. Conclusion: These experiences can help shape the pathway to be better prepared for any emergency or future pandemic.

The unequal effects of the health-economy trade-off during the COVID-19 pandemic.

Despite the global impact of the coronavirus disease 2019 pandemic, the question of whether mandated interventions have similar economic and public health effects as spontaneous behavioural change remains unresolved. Addressing this question, and understanding differential effects across socioeconomic groups, requires building quantitative and fine-grained mechanistic models. Here we introduce a data-driven, granular, agent-based model that simulates epidemic and economic outcomes across industries, occupations and income levels. We validate the model by reproducing key outcomes of the first wave of coronavirus disease 2019 in the New York metropolitan area. The key mechanism coupling the epidemic and economic modules is the reduction in consumption due to fear of infection. In counterfactual experiments, we show that a similar trade-off between epidemic and economic outcomes exists both when individuals change their behaviour due to fear of infection and when non-pharmaceutical interventions are imposed. Low-income workers, who perform in-person occupations in customer-facing industries, face the strongest trade-off.

Using financial resilience to grow business amidst adversities

PurposeThis paper investigates financial resilience within selected micro small and medium enterprises (MSMEs) and how it is used as a growth tool amidst coronavirus disease 2019 (COVID-19) threats.Design/methodology/approachAn appreciative inquiry qualitative approach using a positive orientation with a case study design instead of the conventional problem-oriented approach was used. It focuses on successful MSMEs that experienced growth amidst the first wave of COVID-19 despite the large number of MSMEs that were affected negatively by the pandemic.FindingsThe results indicate that the MSMEs that were growing at an epic rate during COVID-19 exhibited financial resilience due to savings, innovative leadership, financial knowledge, experience and social capital. These businesses maintained client relationships and accessed financial capital.Research limitations/implicationsThe study was qualitative based on a few cases.Practical implicationsBusiness owners/managers should learn financial literacy, entrepreneurial skills and leadership skills and build social capital which are tenets of financial resilience during turbulent times.Originality/valueThe study contributes to the continuity of MSMEs in developing economies during times of uncertainty.

Impact of 2020 COVID-19 lockdowns on particulate air pollution across Europe

Abstract. To fight against the first wave of coronavirus disease 2019 (COVID-19) in 2020, lockdown measures were implemented in most European countries. These lockdowns had well-documented effects on human mobility. We assessed the impact of the lockdown implementation and relaxation on air pollution by comparing daily particulate matter (PM), nitrogen dioxide (NO2) and ozone (O3) concentrations, as well as particle number size distributions (PNSDs) and particle light absorption coefficient in situ measurement data, with values that would have been expected if no COVID-19 epidemic had occurred at 28 sites across Europe for the period 17 February–31 May 2020. Expected PM, NO2 and O3 concentrations were calculated from the 2020 Copernicus Atmosphere Monitoring Service (CAMS) ensemble forecasts, combined with 2019 CAMS ensemble forecasts and measurement data. On average, lockdown implementations did not lead to a decrease in PM2.5 mass concentrations at urban sites, while relaxations resulted in a +26 ± 21 % rebound. The impacts of lockdown implementation and relaxation on NO2 concentrations were more consistent (−29 ± 17 and +31 ± 30 %, respectively). The implementation of the lockdown measures also induced statistically significant increases in O3 concentrations at half of all sites (+13 % on average). An enhanced oxidising capacity of the atmosphere could have boosted the production of secondary aerosol at those places. By comparison with 2017–2019 measurement data, a significant change in the relative contributions of wood and fossil fuel burning to the concentration of black carbon during the lockdown was detected at 7 out of 14 sites. The contribution of particles smaller than 70 nm to the total number of particles significantly also changed at most of the urban sites, with a mean decrease of −7 ± 5 % coinciding with the lockdown implementation. Our study shows that the response of PM2.5 and PM10 mass concentrations to lockdown measures was not systematic at various sites across Europe for multiple reasons, the relationship between road traffic intensity and particulate air pollution being more complex than expected.

Progress of ulcerative colitis patients during the COVID-19 pandemic.

We have previously demonstrated that the first wave of the coronavirus disease 2019 (COVID-19) pandemic caused exacerbations in ulcerative colitis (UC) patients, probably through psychological and physical stress. However, successive waves of the COVID-19 pandemic continuously followed the first. The effects of this chronic stress on the disease condition in UC patients are of interest. To clarify the effect of chronic stress from COVID-19 on disease condition in patients aggravated after the first wave. Our previous study investigated 289 consecutive UC outpatients treated in one center during March and April 2020, the period of the first wave of the COVID-19 pandemic. In this study, an identical group of 289 UC patients was evaluated using UC-disease activity index (UC-DAI), endoscopic mucosal appearance score, and Matts pathological grade scoring. Of the 289 UC patients included in the study in 2020, 10 patients dropped out as of 2021 and another 11 patients dropped out as of 2022, making three groups for 2020, 2021 and 2022. No significant differences in characteristics were found among the three groups. UC-DAI scores had aggravated during the period of the first wave of the COVID-19 pandemic, but significantly recovered in 2021 and remained stable in 2022. Matts grade scores significantly recovered in 2021 from those in 2020 and remained stable in 2022. Disease activity of UC patients recovered in 2021 and remained stable in 2022, aggravated by the stress of the first wave of COVID-19 in 2020 despite persistence of the pandemic.

Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study.

Mortality amongst nursing home (NH) residents increased by 43% during the first wave of coronavirus disease 2019 (COVID-19). We estimated the 'contextual effect' on mortality, tried to explain it by NH characteristics and identified resident- and NH-level risk factors for mortality. The contextual effect was measured for two cohorts of NH residents managed by the general scheme in metropolitan France (RESIDESMS data from 03/01/2020 to 05/31/2020 and 03/01/2019 to 05/31/2019) by the intraclass correlation coefficient (ICC) estimated from mixed-effects logistic regression. Amongst 385,300 residents (5,339 NHs) included in 2020 (median age 89years, 25% men), 9.1% died, versus 6.7% of 379,926 residents (5,270 NHs) in 2019. In the empty model, the ICC was 9.3% in 2020 and 1.5% in 2019. Only the geographic location partially explained the heterogeneity observed in 2020 (ICC: 6.5% after adjustment). Associations with mortality were stronger in 2020 than in 2019 for male sex and diabetes and weaker for heart disease, chronic respiratory disease and residence <6months. Mortality was higher in 2020 (15.1%) than 2019 (6.3%) in NHs with at least one death with a mention of COVID-19 and more heterogeneous (ICC: 8.0%) than in the others (mortality: 6.7% in both years; ICC: 1.1%). Our results suggest that the COVID-19 crisis had a heterogeneous impact on mortality in NH residents and that geographic location explain a part of the contextual effect, which appears to have had little influence on mortality in NHs not being affected by the virus.

Impact of the first wave of COVID-19 on Crohn's disease after the end of "zero-COVID" policy in China.

The incidence and severity of coronavirus disease 2019 (COVID-19) among Crohn's disease (CD) patients are unknown in China. This study aimed to clarify the clinical courses and outcomes of CD patients in the first COVID-19 wave after the end of "zero-COVID" policy in China. Clinical characteristics, including vaccination doses and medications of 880 CD patients from a prospective cohort were collected for analysis. Of the enrolled patients (n = 880) who underwent nucleic acid or antigen testing for COVID-19 from Dec 7, 2022, to Jan 7, 2023, 779 (88.5%) were infected with COVID-19. Among the infected patients, 755 (96.9%) were mild, 14 (1.8%) were moderate, one patient with leukemia died of cerebral hemorrhage (mortality, 0.1%) and only 9 (1.2%) were asymptomatic. Fever, cough, headache and appetite loss were the most frequently observed symptoms in general, respiratory, neurological and gastrointestinal manifestations, respectively. The age and disease duration were significantly higher (40/32, 5.6/3.6, all p < 0.05) in moderate patients than those in mild patients. All other clinical characteristics, including CD activity and medication exposure, showed no significant differences between the above two groups. Furthermore, no significant difference in vaccination or comorbidities was observed between the two groups. Most CD patients contracted the Omicron infection and experienced mild disease courses in the first COVID-19 wave attack after China ended the "zero-COVID" policy irrespective of vaccination dose or comorbidities.

The Assessment of the Spectrum of Preventive Measures Taken by Healthcare Providers During the COVID-19 Pandemic in India: A Survey-Based Study.

The first wave of the coronavirus disease 2019 (COVID-19) pandemic createdhavoc and confusion in choosing appropriate treatment, as well as prophylaxis, due to its rapid surge, disease novelty, and lack of evidence-based literature. It was even more concerning amongthe healthcare workers (HCWs), who had to take care of patients, themselves, and their own families. This online survey-based study targeted finding the various options for COVID-19 precautionary or prophylactic measures opted for by HCWs. This was an observational study based on a predesigned questionnaire, which was floated online for three months after institutional ethical approval, just after the first wave of COVID-19 in 2021, targetingHCWs of different cadres (doctors, nurses, paramedics/laboratory technicians, etc.), ages, and sexesand HCWs hailing from across the country. Questions were focused on HCW's adopted measures, the order of preference and its reasons, and concerns related to safety and efficacy. Data was collected through Google Forms (Google, Inc., Mountain View, CA) into an Excel spreadsheet (Microsoft® Corp., Redmond, WA) and analyzed by the latest Statistical Package for Social Sciences (SPSS)software (IBM SPSS Statistics, Armonk, NY) using appropriate statistics. The routine practice of standard precautionary measures (face mask, hand hygiene, and social distancing) and wearing a personal protective equipment (PPE) kit during the care of COVID-19-positive or COVID-19-suspected patients was adopted by themajority of HCWs, i.e., 306/312 (>98%) irrespective of cadre (p = 0.001). After the "routine measures," the most adopted measure by participant HCWs irrespective of profession, age, and gender was the consumption of allopathic drugs (n = 188; 60.26%). Anti-COVID-19 measures in the category of drugs used by healthcare providers (HCPs) were prophylactic allopathic drugs (60.26%), homeopathic drugs (11.86%), and other Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH)/traditional medical system drugs (11.86%). Vitamin C was the most consumed among all of the drugs for COVID-19 prophylaxis purposes. Non-drug measures espoused by the HCPs were physical exercises (46.47%), increased sleepduration (35.89%), change in dietary habits (42.62%), and spiritual measures (19.23%). The fear of COVID-19 imposed on the HCPs the obligation to use all the available preventive measures in spite of the lack of evidence on actual benefits. After the routine infection preventive measures, the most adopted measure by participant HCWs irrespective of profession, age, and gender was the consumption of prophylactic allopathic drugs (>60%), and the most non-drug preventive measures were the initiation of physical exercises and change in dietary habits. Adapting some form of physical exercise was more noted with males than females (p = 0.001), and it significantly increased with HCPs of higher age of >25 and >40 years than younger HCPs (58.6% versus29.3%; p = 0.016). Females preferred more dietary and nutritional modifications.

Risk Perception, Behavior Change and Perceived Impact due to COVID-19 Pandemic among General Population in Tamil Nadu, India: A Cross-Sectional Study

Background: Coronavirus disease 2019 (COVID-19) has affected countries all over the world. Assessment of risk perception and scaling up appropriate behavioral practices are of utmost importance for its prevention and control. The objectives of this study were identifying risk perception, behavioral changes and perceived impact as a result of COVID-19 and its associated factors among general population.&#x0D; Methods: A cross-sectional study was done during the first wave of COVID-19 among general population in Tamil Nadu, India. A semi-structured questionnaire was prepared in Google forms and circulated using whatsapp during April and June 2020. The sample size was calculated at 384. Data were analyzed using SPSS software version 21.0. Association between the variables was analyzed using Chi-square test. P-value &lt;0.05 was considered significant. &#x0D; Results: Mean age was 38.4 ±13.8, and 52.1% of the participants were females. Almost 2/3rdhad perceived risk of catching COVID-19, which was more among respondents aged 20-39 and residing in urban area. Among the behavior change measures, wearing mask in public places was practiced by 95%, followed by hand washing (90.4%) and social distancing (80%). More than 50% had some form of psychological stress that included inability to perform their daily routines, anxiously browsing media for information about COVID-19, not going to work .etc.&#x0D; Conclusion: General public staying in rural areas have not completed secondary school education, and the elderly have to be targeted to provide appropriate information about COVID-19 and its preventive measures.

Physical Disability, Psychological Resilience, and COVID-Related Changes in Depressive Symptoms Among U.S. OlderAdults.

This study pursued 3 goals: (1) to determine how depressive symptoms among U.S.older adults changed in 2018-2020, a period transitioning to the first wave of coronavirus disease (COVID) pandemic, compared to in prepandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018-2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018-2020. Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before-after design and latent change score model to examine whether depressive symptoms change in 2018-2020 represents a continuation or departure from the overall trend of between-wave changes in 2010-2018. We also used physical disability in 2018 and psychological resilience in 2016-2018 to predict depressive symptoms change score in 2018-2020. In contrast to the relatively stable between-wave change trend in 2010-2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018-2020, which was primarily driven by increased affective symptoms (e.g., depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018-2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant. Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms.

The First Effect of COVID-19 Pandemic on Starting Biological Disease Modifying Anti-Rheumatic Drugs: Outcomes from the TReasure Real-Life Database.

The coronavirus disease 2019 pandemic has been resulting in increased hospital occupancy rates. Rheumatic patients cannot still reach to hospitals, or they hesitate about going to a hospital even they are able to reach. We aimed to show the effect of the first wave of coronavirus disease 2019 pandemic on the treatment of biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis or spondyloarthritis. Patients were divided into three groups as follows: pre-pandemic (Pre-p: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within 6 months before March 11, 2020); post-pandemic A (Post-p A: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the first 6 months after March 11, 2020); post-pandemic B (Post-p B: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the second 6 months). The number of rheumatoid arthritis patients in the Post-p A and B groups decreased by 51% and 48%, respectively, as compared to the Pre-p group similar rates of reduction were also determined in the number of spondyloarthritis patients. The rates of tofacitinib and abatacept use increased in rheumatoid arthritis patients in Post-p period. The number of rheumatoid arthritis and spondyloarthritis patients starting on biological disease-modifying anti-rheumatic drugs for the first time decreased during the first year of the coronavirus disease 2019 pandemic.

Change in substance use patterns and behaviors due to COVID-19 and related restrictions among patients seeking treatment for substance use

Background: Coronavirus disease 2019 (COVID-19) and related restrictions have affected individuals with opioid use disorders who are on treatment by affecting the opioid agonist treatment services worldwide. The study aimed to assess the changes in substance use patterns and associated behaviors among the patients on buprenorphine maintenance treatment (BMT) due to the first wave of COVID-19 in India (March–September 2020). Materials and Methods: The cross-sectional observational study was conducted in a community-based drug treatment center situated in northern India serving a slum population. Male opioid-dependent patients (n = 94), maintained on BMT for at least a year before the start of the COVID-related restrictions in India, were assessed for use of illicit opioids, diverted opioid agonist medications and other psychoactive substances, lapses, compliance to BMT, high-risk behaviors, socio-occupational and mental health, and impact of COVID-19 by comparing it with the immediate pre-COVID period (September 2019–February 2020). Result: There was no significant increase in the use of illicit opioid use, spending on illicit opioids, and lapse rate. Though treatment break was seen in 39.4% of subjects at the start of the COVID-19 restrictions, the proportion of those abstinent from illicit opioids remained constant. No significant increase in the use of illegally diverted buprenorphine and other substance use was noted. More than half (56.4%) of the patients abstained from all substances (excluding tobacco). However, a significantly higher proportion of participants reported financial loss, unemployment, and frequent anxiety and depressive symptoms during the COVID period. Conclusion: The study demonstrated that despite the restrictions, continuing treatment service can help retain patients, keep them abstinent, prevent other high-risk behaviors, and help them tide over economic hardships.

Equity, Public Health Messaging, and Traditional Māori Knowledge: The Te Ranga Tupua COVID-19 Response

Throughout the coronavirus disease 2019 (COVID-19) pandemic, the Māori, Indigenous people of New Zealand, public health response has been guided by the collaborative and relationship-centered principles of te ao Māori, the Māori world. This article presents the communications response to COVID-19 by Iwi, tribes, within Te Ranga Tupua (TRT), a collective of Iwi from the South Taranaki/Whanganui/Rangitīkei/Ruapehu regions of Aotearoa, New Zealand. This research uses a qualitative design based on a Kaupapa Māori approach. The research presented here focuses on the intersect between COVID-19-related public health messaging, and the application of Māori knowledge and worldviews to establish equitable protection for Māori. By prioritizing equity, self-determination, and adopting a holistic approach to well-being, TRT have been able to re-frame public health messaging in accordance with our tikanga, customs, and notions of Māori public health. We provide a snapshot of how a unique tribal collective deployed its resource to provide culturally appropriate information and communication responses to the first wave of COVID-19 in 2020, and then built on this knowledge and experience providing a modified and more strategic response to the pandemic in 2021.

PP10 Impact Of COVID-19 On The Management Of Breast Cancer In Italy: The Perspectives Of Patients And Coordinators

IntroductionBreast Units (BU) represent an opportunity to adequately manage and improve quality of care for patients with breast cancer. The presence of specific national guidelines should promote safe and good quality, integrated care. In fact, the presence of a multidisciplinary team of specialists whose workflows follow specific guidelines, set to the highest European standards, should ensure that patients in Breast Units receive appropriate care at diagnosis and throughout the course of the disease.MethodsTwo surveys were developed and administered to Breast Unit coordinators and patients throughout Italy. The surveys investigated the provision of healthcare services and the implementation of a new organizational model over two time periods: the first wave of the coronavirus disease 2019 (COVID-19) pandemic from March 2020 to August 2020 and the second wave from September 2020 to December 2020. The surveys aimed to assess the continuity of care during the pandemic from the clinician and patient perspective.ResultsPatients observed a reduction in the postponement of care between the first wave of COVID-19 and the second wave. Some services were delayed, particularly in the second wave where a large number of services were not rescheduled. Management of the COVID-19 pandemic resulted in many healthcare professionals being reallocated to other duties and hospital departments. The effect of this was particularly relevant for both patients and clinicians, with few healthcare professionals having the capacity to focus on conditions other than COVID-19. In the first wave of the pandemic 42 percent of professionals were redeployed, compared with 27 percent in the second wave.ConclusionsThis study demonstrates how COVID-19 affected the care of patients with breast cancer in Italy. Patients and coordinators from Breast Units across the country highlighted many important aspects that should be considered when assessing the effects of the COVID-19 pandemic on the entire healthcare system in order to be better prepared for future pandemics.

Loneliness and resilience are associated with nutrition risk after the first wave of COVID-19 in community-dwelling older Canadians.

Nutrition risk is linked to hospitalization, frailty, depression, and death. Loneliness during the coronavirus disease 2019 (COVID-19) pandemic may have heightened nutrition risk. We sought to determine prevalence of high nutrition risk and whether loneliness, mental health, and assistance with meal preparation/delivery were associated with risk in community-dwelling older adults (65+years) after the first wave of COVID-19 in association analyses and when adjusting for meaningful covariates. Data were collected from 12 May 2020 to 19 August 2020. Descriptive statistics, association analyses, and linear regression analyses were conducted. For our total sample of 272 participants (78 ± 7.3 years old, 70% female), the median Seniors in the Community: Risk evaluation for Eating and Nutrition (SCREEN-8) score (nutrition risk) was 35 [1st quartile, 3rd quartile: 29, 40], and 64% were at high risk (SCREEN-8 < 38). Fifteen percent felt lonely two or more days a week. Loneliness and meal assistance were associated with high nutrition risk in association analyses. In multivariable analyses adjusting for other lifestyle factors, loneliness was negatively associated with SCREEN-8 scores (-2.92, 95% confidence interval [-5.51, -0.34]), as was smoking (-3.63, [-7.07, -0.19]). Higher SCREEN-8 scores were associated with higher education (2.71, [0.76, 4.66]), living with others (3.17, [1.35, 4.99]), higher self-reported health (0.11, [0.05, 0.16]), and resilience (1.28, [0.04, 2.52]). Loneliness, but not mental health and meal assistance, was associated with nutrition risk in older adults after the first wave of COVID-19. Future research should consider longitudinal associations among loneliness, resilience, and nutrition.