Initial Lockdown Research Articles

Valuing COVID-19 as an opportunity to understand teacher agency

AbstractThis paper seeks to better understand how unanticipated disruption influences teacher agency and professionalism. Drawing on a conceptual model of teacher agency the paper examines data from teacher focus groups conducted in one Australian K-12 school to understand the lived experience of teachers (n = 50) during an initial COVID-19 lockdown period, particularly how they successfully navigated the transition to online teaching, and subsequent changes in practice and pedagogy. A grounded theory approach to data analysis revealed five conditions shaped teacher experience and a sense of personal achievement during this disruption: (1) an open individual mindset; (2) permission to be flexible and respond in appropriate ways; (3) reduced complexity; (4) effective relationships with leadership, colleagues, students, and parents; and (5) parental support. Temporal and affective dimensions of teacher agency (iterational—past; projective—future, and practical-evaluative—present) were used to explore the relationship between the five conditions and action for change. Findings suggest teacher agency was enhanced by focused school-based support which enabled teachers to deal with rapid change. Such support effectively facilitated reduction in complexity, provided structural and systemic assistance, valued and respected teachers as the professionals best placed to manage the shift to online learning, provided teachers with permission to try and fail, and enabled collegial support through a variety of communities of practice and structural support. Implications and future areas of research presented.

Consumer Anxiety and Coping in COVID Times: Towards a Sociological Understanding of Consumer Resilience

This article develops a sociological understanding of consumer resilience across three national contexts during a prolonged, global health crisis – COVID-19. We asked 112 individuals from the UK, China and Malaysia to diarise their consumption during the initial lockdowns of 2020. We found that when social subjects were confronted with material, socio-relational and symbolic restrictions, two types of anxieties emerged – health, safety and wellbeing and social alienation – along with three coping-response strategies, consumer purification, consumer policing and consumer sociality. At this anxiety–coping interface, we identify reflexive, emotive and transformative narratives that are productive of consumer resilience. In this era of ‘Permacrisis’ relating to war, health, climate and cost-of-living, it is essential to examine consumer behaviour under conditions of deep uncertainty to comprehend how (resilient) social subjects use the (non-)market domain to cope with anxieties caused by multifaceted restrictions placed on everyday life.

SP6.5 Outcomes in Oesophagogastric Cancer up to 18 months following the COVID-19 pandemic

Abstract Aims COVID-19 has negatively influenced oesophago-gastric (OG) cancer prognosis with stage migration described during the first six months of the pandemic. This study investigated the medium term effect of the national lockdown on diagnosis, management and outcomes. Methods A retrospective cohort study of all newly diagnosed OG cancers in a single regional MDT between 1 October 2019 and 30 September 2021. Patients were divided into four 6-month period based upon date of first MDT discussion in relation to the first UK national lockdown: pre-lockdown, 0-6, 6-12 and 12-18 months post-lockdown. Electronic health records were reviewed and results compared. Result 664 patients with OG cancers were included. Median age was 71 years (62-77) and 445 (67%) were male. 502 (76%) had adenocarcinoma. Compared with pre-lockdown, patients in the 0-6-months group were significantly older (p<0.05), symptomatic (p<0.05), and had stage migration with increased metastatic disease (p<0.05), palliative treatment intent (p<0.001) and reduced survival (p<0.05). Compared with pre-lockdown, there was no difference in patients presenting in the 12-18 months group in terms of age (p=0.927), sex (p=0.461), performance status (p=0.666), presence of metastatic disease (p=0.971) and treatment intent (p=0.123). However, more patients in this group were symptomatic (p=0.025), presented as emergencies (p=0.032) and had a poorer overall survival (p<0.05). Conclusion Patients presenting 12-18 months after the initial lockdown are still experiencing poorer overall survival than those pre-pandemic. Identification and addressment of the factors contributing to the continued poor outcomes following COVID-19 is urgently required to return overall patient survival to the pre-pandemic level.

COVID-19 infections, hospitalizations, and mortality in Navarre (Spain) between February 2020 and September 2022

Between February 2020 and September 2022, SARS-CoV-2 has circulated uninterruptedly throughout Spain. This study analyses COVID-19 infections, hospitalizations, and deaths in Navarre. Enhanced epidemiological surveillance and results of seroepidemiological surveys were used to analyze COVID-19 infections, hospitalizations, and deaths, based on the vaccination coverage and other preventive measures applied from February 2020 to September 2022. A total of 295,424 COVID-19 cases were confirmed (45% of the population in Navarre); 8,594 required hospital admission (1.3%), 832 were admitted to intensive care units (1.3‰) and 1,725 died (2.6‰). Over the first wave of the pandemic, there were 1,934 hospitalizations and 529 deaths from confirmed COVID-19 cases over a few weeks; these figures dropped rapidly following lockdown. Until October 2021, SARS-CoV-2 circulation was modulated by non-pharmacological preventive measures. The subsequent relaxation of these measures led to a wide circulation of the omicron variant, increasing the number of cases by three-fold. The high vaccination coverage against COVID-19 introduced decisive changes in the epidemiology of the disease, reducing to less than 2%, 0.1%, and 0.5% the cases requiring hospitalization, intensive care unit admission, or that died, respectively. Initial lockdown and non-pharmacological preventive measures helped control SARS-CoV-2 transmission until vaccination was extended. Vaccination achieved a decisive reduction of the COVID-19 severity and lethality.

Refuge or retreat: resilience and the mediatization of Scotland’s island space

ABSTRACT Islands are significantly on the agenda in Scotland. Media accounts – news, features, and other creative narratives – textually frame the representational terrains of island policy, agency and community. Such mediatization informs and responds to certain ideas and discourses of our island geographies. It typically includes what could be considered good islandness: that is, islands as good lifestyle havens, sites of social resilience and adaptive social renewal. During the COVID-19 pandemic, certain spaces and geographies were notably re-evaluated. Sites of ‘isolation’, ‘remoteness’ and places considered ‘far from’ occupied a heightened position of desirability and potential refuge. A purposive sample of stories and features is presented here to capture case exemplars of how Scotland’s island space and place geographies were variously textually framed by media news across the initial lockdown and subsequent significant travel restriction phases (March 2020 to October 2020). The discussion explores how a short-view media framing of Scotland’s island spaces specifically during the COVID-19 pandemic spoke to aspects of islandness as refuge and as resilience. The paper offers a longer-view perspective whereby the complexities and complicities of media framing of Scottish rural and island spaces as resilient is considered more broadly.

Alcohol-Related Hospitalizations During the Initial COVID-19 Lockdown in Massachusetts: An Interrupted Time-Series Analysis.

The effect of initial COVID-19 pandemic-associated lockdowns on alcohol-related hospitalizations remains uncertain. This study compares alcohol-related hospitalizations at a US Department of Veterans Affairs (VA) system in Massachusetts before, during, and after the initial COVID-19 lockdown. This study is an interrupted time-series analysis at the VA Boston Healthcare System. Participants included all patients hospitalized on the medical, psychiatry, and neurology services at VA Boston Healthcare System from January 1, 2017, to December 31, 2020, excluding those under observation status. The period January 1, 2017, to March 9, 2020, was defined as prelockdown (the reference group); March 10, 2020, to May 18, 2020, was lockdown; and May 19, 2020, to December 31, 2020, was postlockdown. Alcohol-related hospitalizations were determined using International Statistical Classification of Diseases, Tenth Revision primary diagnosis codes. We identified 27,508 hospitalizations during the study periods. There were 72 alcohol-related hospitalizations per 100,000 patient-months during the prelockdown period, 10 per 100,000 patient-months during the lockdown, and 46 per 100,000 patient-months in the postlockdown period. Compared with the prelockdown period, the adjusted rate ratio for daily alcohol-related hospitalizations during lockdown was 0.20 (95% CI, 0.10-0.39) vs 0.72 (95% CI, 0.57-0.92) after the lockdown. A similar pattern was observed for all-cause hospitalizations. Our results suggest that COVID-19 pandemic lockdown measures were associated with fewer alcohol-related hospitalizations. Proactive outreach for vulnerable populations during lockdowns is needed.

Rapid Expansion of a Teledermatology Web Application for Digital Dermatology Assessment Necessitated by the COVID-19 Pandemic: Retrospective Evaluation.

The COVID-19 pandemic necessitated a change in the provision of outpatient care in dermatology. A novel, asynchronous, digital consultation platform was codeveloped with 2 National Health Service dermatology teams to improve access and enhance choice in outpatient care. The rollout of the platform was accelerated during the initial COVID-19 lockdown, and its wider use across 2 Scottish health boards was retrospectively evaluated. Integrated with the hospital booking system and electronic patient record, the platform provides an alternative to face-to-face consultations, using information and images submitted by the patients. In total, 297 new patient consultations and 108 return patient consultations were assessed, and 80% (324/405) of the images submitted were of satisfactory quality. The consultations were, on average, 3 minutes shorter than equivalent face-to-face interactions, and a total of 5758 km of patient travel was avoided. Outcomes included web-based reviews (66/405, 16.3%), face-to-face reviews (190/405, 46.9%), biopsies (46/405, 11.4%), discharge (89/405, 22%), and other treatments or investigations (14/405, 3.5%). High levels of patient satisfaction (92/112, 82.1%) were reported. Digital dermatology assessments are now included in the choices for consultation types that are available to patients, helping to augment service capacity during pandemic recovery.

Impact of COVID-19 control on lung, breast, and colorectal pathological cancer diagnoses. A comparison between the Netherlands, Aotearoa New Zealand, and Northern Ireland

BackgroundThe COVID-19 pandemic was managed in Aotearoa New Zealand (NZ) by a COVID-19 elimination policy, involving border closure and an initial national lockdown. This was different to most other countries including Northern Ireland (NI) and the Netherlands (NED). We quantify the effect of these policies on the diagnosis of three major cancers, comparing NZ with these two European countries.MethodData from NED, NZ and NI population-based cancer registries were used to assess trends in all pathologically diagnosed (PD) lung, breast, and colorectal cancers from March to December 2020 (pandemic period) and compared to the similar pre-pandemic period (2017–2019). Trend data were also collated on COVID-19 cases and deaths per 100,000 in each population.ResultsComparing the pre-pandemic period to the pandemic period there were statistically significant reductions in numbers of lung (↓23%) and colorectal (↓15%) PD cancers in NI and numbers of breast (↓18%) and colorectal cancer (↓18.5%) diagnosed in the NED. In NZ there was no significant change in the number of lung (↑10%) or breast cancers (↑0.2%) but a statistically significant increase in numbers of colorectal cancer diagnosed (↑5%).ConclusionThe impact of COVID-19 on cancer services was mitigated in NZ as services continued as usual reflecting minimal healthcare disruption and protected cancer services linked with the elimination approach adopted. The reduction in PD cases diagnosed in NED and NI were linked with higher COVID-19 rates and reflect societal restrictions which resulted in delayed patient presentation to primary and secondary care, disruption to screening and healthcare services as a result of COVID-19 infections on staff and the need to shift intensive care to COVID-19 patients. Reductions in PD cancers in NI and the NED and in particularly lung cancers in NI, highlight the need for targeted public health campaigns to identify and treat ‘missing’ patients. Protecting cancer services should be a priority in any future pandemic or systemic healthcare system disruption.

COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?

Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs. Using daily case data for 84 days (9 March-31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, -15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, -204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.

Families in quarantine: COVID‐19 pandemic effects on the work and home lives of women and their daughters

AbstractThe onset of the COVID‐19 pandemic in March 2020 disrupted the lives of millions of US families, with rising unemployment and initial lockdowns forcing nationwide school and daycare closures. These abrupt changes impacted women in particular, shifting how families navigated roles. Even pre‐pandemic, US women were responsible for the majority of household labor and childcare, and daughters bore greater chore responsibility than sons. We surveyed 280 families early in the pandemic (Spring 2020) and another 199 families more than a year later (Summer 2021) about pre‐pandemic versus current work‐family conflict (WFC), division of labor and schooling, and children's daily activities. Early on, mothers reported increased WFC (especially family impacting work), mothers assumed primary responsibility for children's education at home, and daughters spent more time doing chores and educating siblings. One year in, WFC remained high but mother's stress was lower, parents reported working less from home, and children largely returned to face‐to‐face schooling. Yet, children, especially daughters, actually spent more time caring for siblings than early in the pandemic, though less time on chores overall. We conclude that policies that support families such as paid family leave and subsidized childcare are needed to right the gender inequalities exacerbated by the pandemic.

Changes in environmental stress over COVID-19 pandemic likely contributed to failure to replicate adiposity phenotype associated with Krtcap3.

We previously identified keratinocyte-associated protein 3, Krtcap3, as an obesity-related gene in female rats where a whole body Krtcap3 knockout (KO) led to increased adiposity compared to wild-type (WT) controls when fed a high-fat diet (HFD). We sought to replicate this work to better understand the function of Krtcap3 but were unable to reproduce the adiposity phenotype. In the current work, WT female rats ate more compared to WT in the prior study, with corresponding increases in body weight and fat mass, while there were no changes in these measures in KO females between the studies. The prior study was conducted before the COVID-19 pandemic, while the current study started after initial lockdown orders and was completed during the pandemic in a generally less stressful environment. We hypothesize that the environmental changes impacted stress levels and may explain the failure to replicate our results. Analysis of corticosterone (CORT) at euthanasia showed a significant study-by-genotype interaction where WT had significantly higher CORT relative to KO in study 1, with no differences in study 2. These data suggest that decreasing Krtcap3 expression may alter the environmental stress response to influence adiposity. We also found that KO rats in both studies, but not WT, experienced a dramatic increase in CORT after their cage mate was removed, suggesting a separate connection to social behavioral stress. Future work is necessary to confirm and elucidate the finer mechanisms of these relationships, but these data indicate the possibility of Krtcap3 as a novel stress gene.NEW & NOTEWORTHY Obesity is linked to both genetics and environmental factors such as stress. Krtcap3 has previously been identified as a gene associated with adiposity, and our work here demonstrates that environmental stress may influence the role of Krtcap3 on both food intake and adiposity. Obesity is strongly influenced by stress in humans, so the identification of novel genes that link stress and obesity will greatly advance our understanding of the disease.

Does Online Social Support Uniquely Buffer Effects of Stress During the COVID-19 Pandemic?: A Natural Experiment.

In-person sources of social support buffer effects of stress on mental health. However, online social support inconsistently demonstrates stress-buffering effects. Highly stressful circumstances, such as the first month of COVID-19 lockdown, may be necessary to benefit from support received from online networks. We investigated whether online support demonstrated an increased stress-buffering effect on depressive symptoms during the first month of COVID-19 lockdown. We collected cross-sectional data on three distinct groups of participants from February to April 2020-preceding lockdown (pre-COVID; n = 53), up to four weeks following university closures (initial lockdown; n = 136), and the final weeks of the semester (later lockdown; n = 127). Initial lockdown participants reported significantly more stress than pre-COVID but not later lockdown participants. The online social support by stress by COVID phase interaction was only significant for the initial versus later lockdown comparison. Online support buffered stress during initial lockdown but not later lockdown. Stress-buffering effects of offline support were observed and did not depend on COVID phase. Online support may only buffer stress when stress is heightened and offline support is less available.

Perceived social support attenuates increased hostile reactions to traumatic threat.

Extant literature has seldom examined the naturalistic role of reaction to threat on downstream emotional distress while also considering buffers, such as perceived social support, to acute negative mental health outcomes. The present study examined how trauma symptoms, in reaction to a global stressor, predicted increased psychological distress via elevated emotional hostility and whether perceived social support modified such effects. We predicted a priori that increased exposure to trauma would be associated with increased hostility and global psychological distress, but that this path would be attenuated by greater levels of perceived social support, as individuals who report greater support exhibit greater emotional coping. We recruited 408 adults from a large university in the Midwestern United States to participate in a survey assessing past-week trauma, hostility, distress, and perceived social support following the initial COVID-19 lockdown. The survey was conducted in March 2020, directly after strict shelter-in-place orders were locally mandated. To test our hypotheses, we employed a moderated mediation analysis approach. Results demonstrate that higher trauma predicted increased hostility, which in turn predicted increased distress, and trauma predicted distress via hostility (an indirect effect). As hypothesized, higher perceived social support attenuated the association between trauma and hostility. Results support a hostile emotional pathway that may increase distress in the context of increased traumatic impact; however, social support likely buffers these effects, particularly in the face of new or novel threats and stressors. Findings suggest broad application for understanding the relation between the introduction of stressors, psychological distress, and social support.

An experience-sampling study of the content and outcomes of socially oriented task-unrelated thoughts during a COVID-19 lockdown

ABSTRACT There is evidence to support a role for intentional and unintentional task-unrelated thoughts (TUTs) in social cognition and emotional regulation. Individual differences in personality impact the regulation and functionality of these thoughts. This study examined how intention and trait loneliness and schizotypy relate to the content and emotional outcomes of socially-oriented TUTs recalled in daily life. The study took place during initial COVID-19 lockdown measures in Australia, providing insights into TUTs during times of uncertainty and social isolation. A total of 129 undergraduate students (118 female) completed a 7-day experience-sampling assessment following measures of schizotypy, loneliness, and trait-level mind wandering. Results revealed that intentional social TUTs had more constructive content and socio-emotional outcomes compared to unintentional TUTs. However, dimensions of schizotypy and loneliness were associated with less constructive thought patterns. Findings are discussed with reference to the content-regulation and current concerns hypotheses, and the potential impact of lockdown measures.

Was access to video consultations with GPs in England equitable during the early COVID-19 lockdown period?

The COVID-19 pandemic compelled clinicians to change access to primary health care as face-to-face consultations were a risk to patients and staff. Video consultations (VCs) were frequently substituted as a proxy for a clinical examination. We were interested in finding out whether people from lower socioeconomic backgrounds in England had equitable video access to their GPs during the initial COVID-19 lockdown period. There are various VC applications available to GPs. We used publicly available data from one supplier in this study. Data were available for the number of VCs that GP practices from each clinical commissioning group (CCG) in England completed during March 2020. We ranked CCGs and their socioeconomic backgrounds by using Indices of Multiple Deprivation (IMD) data added from GOV.UK resources. In March, there were 77 834 VCs recorded for England, with a range of 4.3 to 45.4 VCs per GP practice per month (interquartile range 13.7-24.3). There was a negative correlation between consultation rate and deprivation (IMD) (Pearson -0.276, P = 0.04), suggesting a nearly 60% difference in VC rate between most and least deprived CCGs, with the least affluent CCGs having fewest VCs. While video use overall was low, patients from lower socioeconomic backgrounds had less access to VCs with their GPs in the initial lockdown, which may have had negative impacts on health. The pandemic was an unprecedented event, and primary care rapidly pivoted to online care. However, to mitigate health inequalities, primary care must implement methods to cater for all patients and minimise the risk of digital health exclusion.

Rates of STEMI Lab Activations and One-year Outcomes Pre COVID-19 and During Initial COVID-19 Lockdown

Rates of STEMI Lab Activations and One-year Outcomes Pre COVID-19 and During Initial COVID-19 Lockdown

COVID-19’s Psychosocial Impact on American and Canadian Dental Students

Introduction: The COVID-19 pandemic has significantly affected dental education, contributing to adverse psychological outcomes, especially among dental students. In this cross-sectional study, the psychosocial state of American and Canadian dental students was explored, with special emphasis on affective, behavioral, and cognitive well-being, during and after the initial lockdown. Methods: Dental students were invited to participate in an online survey. The questions evaluated the pandemic’s effect on affective, behavioral, and cognitive responses, and learning experiences. Results: A total of 287 dental students completed the online survey. Sadness and anticipation were the strongest emotions experienced during and following the lockdown. Student worries were classified into external and internal stressors. Females demonstrated higher fear, students from larger dental schools held higher emotions of anticipation and disgust. American students held higher anticipation scores both during and following the lockdown. Canadian, third and fourth years, and students from small dental schools were more aware of which authority to contact if their patient, who presented for care, was suspected of COVID-19 infection which emphasizes the need for a preparedness protocol. Conclusions: More studies that explore the broader scope of psychological aspects are necessary. Monitoring and developing treatment strategies for emergent mental conditions among dental students is extremely important in pandemic crisis management. The study highlights the need for development of standardized protocols and pandemic related health education topics as well as psychological interventions to better prepare dental students globally during the time of crisis.

Gambling advertising on Twitter before, during and after the initial Australian COVID-19 lockdown.

COVID-19 resulted in the shutdown of almost all sporting competitions and most venue-based gambling opportunities. This study examines how wagering operators in Australia responded, by examining their advertising. The study compared Twitter activity during lockdown (March-May 2020) to the previous year for four major wagering operators. Wagering operators continued to advertise in earnest, changing their marketing mix to include more race betting content, as races continued to operate. Most also promoted the only sports available, such as table tennis or esports. When sports resumed, sports betting advertising quickly returned to normal, or exceeded previous levels. Despite more content being available in the case of two operators, engagement from the public during lockdown was similar to or lower than previously. These results indicate that gambling operators can adjust quickly to major changes. These shifts appear to have been successful, with the increase in race betting during this period almost completely offsetting the decreases in sports betting. This is likely due in part to changes in advertising, which have been associated with increased betting activity, particularly amongst vulnerable people. Responsible gambling messages were virtually non-existent on Twitter, which contrasts with mandatory requirements in other media. The study highlights that regulatory changes to advertising, e.g., banning some content, are likely to be met with substitution of content, rather than reduction, unless advertising volume is also capped. The study also highlights the adaptive capacity of the gambling industry in the face of major disruption to supply.

Australian community pharmacists' experiences during the COVID-19 pandemic.

Community pharmacists have played an important role in providing services for their community during the COVID-19 pandemic. In this study, the purpose is to present the attitudes and experiences of Australian pharmacists regarding the COVID-19 pandemic. A qualitative semi-structured interview explored community pharmacist experiences during the initial COVID-19 lockdown. Thematic analysis of transcribed interviews was conducted to investigate the experiences of pharmacists. Interviews were conducted with 15 pharmacists from different regional areas and states of Australia. In the study, five main themes were developed: COVID-19 practice complications; pharmacy practice changes; difficult patient interactions; worsened mental well-being and coping strategies; and career dissatisfaction. Pharmacists stated that an increase in workload, shortage of supplies and frequent COVID-19 management updates increased pressure on their duties. The negative customer interactions during COVID-19 lockdown adversely affected some pharmacists' mental health and career satisfaction. Community pharmacists are subject to multiple factors affecting their practice, impairing their mental well-being and triggering them to reconsider their career choice. It is important to provide support to community pharmacists to help improve their well-being and workplace satisfaction.

The antenatal psychological experiences of women during two phases of the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis.

Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of women during different phases of pandemic-related lockdown restrictions in the UK. Semi-structured interviews were held with 24 women about their antenatal experiences: twelve were interviewed after the initial lockdown restrictions (Timepoint 1; T1), and a separate twelve women were interviewed after the subsequent lifting of those restrictions (Timepoint 2; T2). Interviews were transcribed and a recurrent, cross-sectional thematic analysis was conducted. Two themes were identified for each timepoint, and each theme contained sub-themes. T1 themes were: 'A Mindful Pregnancy' and 'It's a Grieving Process', and T2 themes were: 'Coping with Lockdown Restrictions' and 'Robbed of Our Pregnancy'. COVID-19 related social distancing restrictions had an adverse effect on women's mental health during the antenatal period. Feeling trapped, anxious, and abandoned were common at both timepoints. Actively encouraging conversations about mental wellbeing during routine care and adopting a prevention opposed to cure attitude toward implementing additional support provisions may serve to improve antenatal psychological wellbeing during health crises.