COVID-19 Lockdown Research Articles

The effect of COVID-19 lockdown on admission rates in Maternity Hospital.

The COVID-19 pandemic had adverse health outcomes on individuals and communities. In this cross-sectional study we evaluated the admission rates in a tertiary-level hospital during the first wave of the pandemic (March 22, 2020 to August 31, 2020). We compared the indications for admission during the first wave of the pandemic to a control period prior to the lockdown (November 9, 2019 to March 22, 2020). Most hospital admissions during the curfew period were obstetric emergencies (46.88%), which were significantly higher than the control group (38.19%) p ≤ 0.0001. Among the obstetric emergencies, cases in active labor (65.63%) were dominant. Significant rises in car deliveries (2.46%, p ≤ 0.0001) and admissions during the second stage of labor (6.43%, p ≤ 0.001) were noted. There was also an increased rate of admissions for early pregnancy complications, induction of labor, elective obstetric cases, and medical obstetric cases. This study demonstrates that lockdown precautions implemented had a significant impact on the rate of admissions to Maternity Hospital. The data obtained may be a used to aid in designing robust policies for future pandemics to avoid adverse health outcomes.

Does air pollution impact myocardial infarction incidence even in a city with fair air quality? Results from the EPIC-MI (Environmental Pollution and IncidenCe of Myocardial Infarction) Study

Abstract Background In light of recent research highlighting the potential association between air pollution and cardiovascular diseases, there remains a gap in data, particularly in cities characterized by relatively low pollution levels. The EPIC-MI Study endeavors to explore whether, even in a city boasting fair air quality such as our city, there exists a discernible impact of air pollution on the risk of cardiovascular events within an urban setting. Methods We analyzed all consecutive acute myocardial infarction (MI) patients admitted to our city heart center from March 2013 to December 2022. Air pollution data were meticulously gathered from 5 strategically positioned monitoring stations. Utilizing Poisson regression, the associations between these pollutants and the incidence of MI was analyzed. We also investigated the impact of pollution exceedance days and COVID-19 lockdown periods on MI incidence. Results Over nearly a decade, 18.798 MI cases were analyzed. The Poisson regression model revealed a significant independent association between the monthly average MI incidence and pollutant concentrations within the same month. Statistically significant independent effects were observed for CO (p<0.01), O₃ (p=0.03), SO₂ (p<0.01), and relative humidity (p<0.01) on MI incidence (Figure 1). Exceedance days were associated with a significant upswing in daily MI incidence. The MI incidence increased by 3.3% when PM10 exceeded 25 µg/m³ on the same day (5.19 ± 2.49 vs. 5.36 ± 2.50, p=0.03) and remained elevated over three days (5.19 ± 1.42 vs. 5.34 ± 1.46, p<0.01). For PM2.5, there was a 4.2% increase when exceeding 20 µg/m³ on the same day (5.20 ± 2.49 vs. 5.42 ± 2.52, p=0.02) and still elevated over three days (5.20 ± 1.42 vs. 5.40 ± 1.47, p<0.01). During the COVID-19 lockdown periods, a significant decrease was observed in air pollutant levels compared to non-lockdown years within the same timeframe (Figure 2). PM2.5 (9.89 µg/m³ vs. 12.76 µg/m³, p=0.02), PM10 (15.26 µg/m³ vs. 18.7 µg/m³, p<0.01), SO2 (1.16 µg/m³ vs. 1.77 µg/m³, p<0.01), and NO2 (14.42 µg/m³ vs. 19.53 µg/m³, p<0.01) exhibited significant reductions. Concurrently, a 22.5% reduction in daily MI incidence was observed compared to non-lockdown years within the same timeframe (4.16 vs. 5.37, p<0.01). Conclusion The study demonstrates an enduring influence of air pollutants on cardiovascular events, even in a city with fair air quality, such as our city. Elevated concentrations of air pollutants, especially on days with excessive levels, were significantly associated with an increased incidence of MI. The reduction in MI cases observed during the COVID-19 lockdown period underscores the potential cardiovascular benefits associated with improved air quality. These findings emphasize the importance of sustained efforts to mitigate air pollution for the enhancement of cardiovascular health in urban environments.

Living the first years in a pandemic: children's linguistic development and related factors in and out of the COVID-19 lockdowns.

This retrospective study provides insights on linguistic development in exceptional circumstances assessing 378 children (between 2;6 and 3;6) who lived their first years during the COVID-19 pandemic and comparing it with normative data collected before this period (CDI-III-PT; Cadime et al., 2021). It investigates the extent to which linguistic development was modulated by a complex set of factors, including sex, maternal education, book reading, language-promoting practices, COVID-19 infection, parental stress and sleeping problems, considering three periods (during lockdowns, out of lockdowns and at present). The results show a substantial negative effect of the pandemic on both lexical and syntactic development. Considering individual variation, structural equation modelling unveiled a complex scenario in which age, sex, book reading, language-promoting practices, sleeping problems and COVID-19 infection showed a direct effect on linguistic development. Maternal education and parental stress had an indirect effect on children's language, mediated by book reading and sleeping problems, respectively.

Changes in health, lifestyle, and wellbeing of children with type 1 diabetes and their parents during the pandemic

ObjectiveThe COVID-19 pandemic restrictions have substantially affected people’s health and rapidly changed their daily routines. This is a prospective study that investigated the impact of the pandemic on primary school children with Type 1 diabetes and their parents during the first lockdown in Kuwait.MethodsA questionnaire battery related to mental health, well-being, and lifestyle was administered at baseline in Summer 2019 (face-to-face, at a diabetes outpatient clinic) and at follow-up during lockdown in Summer 2020 (via telephone, in adherence with COVID-19 restrictions). Data were collected for 70 dyads with children aged 9–12 years.ResultsSignificant differences were found in most scores for both children and parents. Their mental health worsened to a higher level of depression, anxiety, stress, and a poor level of wellbeing. The average scores on the follow-up tests fell within a clinical range on these measures. Significant differences in their lifestyle, compared to before the lockdown, included decreased levels of physical activity and lower healthy core nutritional intake.ConclusionsOur findings indicate that the COVID-19 lockdown has had a significant psychological and possibly physiological impact on children with Type 1 diabetes and their parents. We conclude that there is a need for mental health support services focusing on these groups. Although full lockdown restrictions will have stopped in the past year, post-pandemic stressors may be expected to continue to adversely affect this cohort.

Ganga, GAP, and lockdown: potential threats to the biodiversity of the river

ABSTRACT The Ganges River holds a vital status within India as a cornerstone of the nation's ecological and socio-economic fabric. Flowing through diverse terrains like the Himalayas, Gangetic plains, and coastal regions, it fosters an incredibly rich biodiversity, supporting a myriad of life forms ranging from microorganisms to mammals. Beyond its ecological significance, the river sustains the livelihoods of millions, contributing significantly to the economy of northern India. However, rampant human development over recent decades has posed grave threats to its well-being. Pollution from sewage and industrial waste has tainted its waters with heavy metals, posing risks of bioaccumulation and magnification within aquatic life. Infrastructure projects like dams and bridges disrupt natural habitats and impede the migration of aquatic species, further jeopardising the river's ecological balance. Despite these challenges, there have been glimmers of hope, particularly noted during the COVID-19 lockdown when industrial activities ceased, offering the river a temporary reprieve. Moving forward, effective measures are imperative, including reducing industrial and domestic effluent discharge, scrutinising sources of heavy metal contamination, and prioritising the restoration of the river's natural flow. Preserving the Ganges’ ecological integrity is paramount, necessitating concerted efforts to ensure its health and vitality for future generations.

Enhancing Space-Based Tracking of Fossil Fuel CO2 Emissions via Synergistic Integration of OCO-2, OCO-3, and TROPOMI Measurements.

Top-down estimates of fossil fuel CO2 (FFCO2) emissions are crucial for tracking emissions and evaluating mitigation strategies. However, their practical application is hindered by limited data coverage and overreliance on NOx-to-CO2 emission ratios from emission inventories. We developed the Machine Learning-Driven Mapping Satellite-based XCO2en (ML-MSXE) model using the column-averaged dry-air mole fraction of CO2 enhancement (XCO2en) derived from OCO-2 and OCO-3 measurements to reconstruct the XCO2en distribution for monitoring FFCO2 emissions. Compared to the previous Machine Learning-Driven Deriving XCO2en from Mapped XCO2 (ML-DXEMX) model, ML-MSXE enhances the utilization of TROPOMI NO2 measurements, increasing their relative contribution from 4.3 to 21.7%, thereby improving XCO2en reconstruction accuracy and enhancing the ability to track emissions. Despite the COVID-19 lockdown, XCO2en levels in China rose from 1.33 ± 1.06 in 2019 to 1.39 ± 1.01 ppm in 2021. In February 2020, while the national average rate of XCO2en decline (16.3%) aligned with the reduction in FFCO2 emissions estimated by inventories, XCO2en further revealed varying rates of decline between cities. Furthermore, the spatial distribution of XCO2en identified hotspots where FFCO2 emissions might be underestimated by inventories. This study presents a space-based approach for monitoring FFCO2 emissions, offering valuable insights for assessing carbon neutrality progress and informing policy.

The Impact of Lockdown in Cyberbullying in Primary Education: Transitions of Cyberbullying and Bullying.

The COVID-19 pandemic triggered a worldwide socio-sanitary crisis, continuing to impact societies worldwide. With many school systems shifted to online education, the current study presents a unique opportunity to investigate relevant phenomena related to serious health issues during the schooling and later in life, cyberbullying and bullying. This study began just before the COVID-19 lockdown was declared and resumed 5 months later allowing to explore 2 main objectives: first, to explore whether cyberbullying increased during the lockdown, and second, to analyze transitions from to time of bullying and cyberbullying. The participants included 792 students from sixth and seventh years of Primary Education (Meanage = 10.81, SD = 0.85) in Ecuador. This is a quantitative longitudinal study. Cyberbullying and bullying scales were used for data collection before the lockdown in January and February 2020 (T1), and after 5 months of lockdown, at the end of the same academic year in July 2020 (T2). Descriptive, comparative and predictive analyses, a latent transition analysis was used to identify latent status of cyberbullying and bullying behavior at T1 and T2. The results revealed a significant increase of cyberbullying after 5 months of the lockdown. Interestingly, only a small percentage of students who were uninvolved in cyberbullying and bullying in T1 remained uninvolved in T2. The discussion explores the dynamics of cyberbullying involvement and examines changes in the roles and groups of bullying and cyberbullying after 5 months of lockdown. The political- and school-related implications of these findings are thoroughly discussed.

Dietary changes during the COVID-19 lockdown in Iranian households: are we witnessing a secular trend? A narrative review

BackgroundThe COVID-19 pandemic, which emerged in late 2019, influenced nearly all aspects of human life, including food choices and dietary habits.MethodologyA web-based search was conducted from March to April 2024 in MEDLINE/PubMed, CINAHL, Embase, and the Cochrane Library for published reports of large-scale surveys of dietary changes during or shortly after the coronavirus pandemic lockdown in Iran. The keywords used were coronavirus OR COVID-19, diet OR nutrition, household, and Iran. Studies that focused on specific areas, subgroups (such as students), or just one city or province were not included. To monitor dietary changes from the years before the lockdown, we used and plotted data from the Household Income and Expenditure Survey (HIES), as provided by the Statistical Center of Iran.ResultsThe overall results of the nationwide studies conducted during the lockdown period in Iran revealed that a significant proportion of the households reduced their consumption of milk, yogurt, cheese, red meat, white meat, eggs, and rice/bread. In approximately 47% of the households where weekly consumption of animal protein sources decreased, the consumption of rice and bread increased. Accordingly, 35 and 44% of households reported a decrease in the consumption frequency of fruits and snacks, respectively. Additionally, 21% of those who reduced their fruit consumption completely removed fruits from their food basket. Meanwhile, the use of dietary supplements, especially vitamin D, vitamin C, zinc, and multivitamins, had increased in households, particularly among those with higher incomes. Decreased income was a common reason for all of these dietary changes, which can have major health consequences in the long term.ConclusionThis review provides evidence that the observed changes had already begun years before the pandemic and presumably have not yet returned to the pre-pandemic situation. Finally, we suggest some strategies for policymakers to overcome the crisis and enhance community the nutrition and health of general population.

Food purchase and consumption behavior during the COVID-19 pandemic lockdown in Bangladesh: association between sociodemographic composition

BackgroundBangladesh suffered a severe COVID-19 wave from June to August 2021, which forced the government to impose emergency nationwide lockdown measures for three months with discontinuities. The sudden lockdown strongly affected the dietary preferences, financial circumstances, and social interactions of citizens.MethodsIn this comprehensive study, we collected sociodemographic information as well as data on food purchase and consumption behaviors from 1,350 adults in Bangladesh during the weeks of enforced confinement. The association between the sociodemographic factors (viz., gender, age, education status, income, occupation, and household size) and food purchase and consumption behaviors were determined by conducting bivariate and multivariate logistic regression models reporting as odds ratios.ResultsThe descriptive result reveals that 49.63% of the participants experienced wage reductions, with many people enduring reductions of up to 75%; 12.22% lost their jobs. Besides, a decline in the frequency of shopping was observed by 35.04%; and 24.52% avoided outdoor shopping during the pandemic period. Additionally, 28.74% of participants purchased less overall, while 19.48% purchased significantly fewer items per trip compared to the pre-pandemic period. The multivariate analysis shows a prominent increase in online grocery shopping (OR: 4.03, 95% CI: 2.38–6.83, p < 0.001) and meal delivery services (OR = 5.19, 95% CI = 3.21–7.17, p < 0.001) among higher educated individuals compared to the individuals having no institutional education. The personnel having formal jobs purchased 2.34 times more from online grocery sites (95% CI = 0.34–4.08, p = 0.003) compared to the unemployed one. In contrast, a notable increase in panic buying and stockpiling was observed, driven by scarcity and escalating prices of essential food items. The frequency of meals with families, active engagement in meal preparation, and the exploration of novel recipes also increased notably.ConclusionsThe consumption of takeaway food and inter-meal snacks increased significantly with the education level of individuals. These findings highlighted that a prolonged pandemic could magnify economic vulnerability in Bangladesh.

From public health to political repression: COVID-19 lockdown measure in Hong Kong's opposition districts

Repression comes with costs, such as reducing regime legitimacy and citizen conformity. The COVID-19 pandemic was an opportunity and a pretext for authoritarian regimes to repress their populations at a low cost. This paper examines the case of Hong Kong, where restriction-testing declarations (RTDs) were used as a lockdown measure to facilitate mandatory testing for the virus from January 2021 to September 2022. Despite the government's claim that RTDs were implemented for public health reasons, statistical analyses showed that Hong Kong districts that opposed the regime or those with a mobilization legacy were more likely to be subject to RTDs, with the opposition district effect present only when COVID-19 infections were low. These RTDs highlight the authoritarian regime's tradeoff in using a nonpolitical measure to achieve its political aims and illustrates the enduring impact of past election and mobilization activities on the choice of selective repression sites in Hong Kong.

Chlorophyll-a Concentrations analysis During COVID-19 Lockdown Period in Northern Egyptian coastal Area of Mediterranean Sea Using Google Earth Engine

Chlorophyll-a Concentrations analysis During COVID-19 Lockdown Period in Northern Egyptian coastal Area of Mediterranean Sea Using Google Earth Engine

Eating disorder debut cases during COVID-19 lockdown in adults. Exploring differences in treatment outcome contrasting with pre-pandemic onset cases.

Despite an increase in eating disorder (ED) cases during the COVID-19 pandemic, there are limited longitudinal studies exploring treatment outcomes. The aims of the present study were: (1) to compare the clinical features of patients with EDs whose onset was during the COVID-19 lockdown (pandemic cohort) against patients with EDs whose onset was prior to the pandemic (pre-pandemic cohort) and, (2) to compare therapy responses between the cohorts. The sample consisted of 115 adult women with an ED. N=37 new ED cases (pandemic cohort) were diagnosed and included in the study during the pandemic (May 2020-May 2021); these patients did not have any previous history of an ED. We also included N=78 ED cases (pre-pandemic cohort) diagnosed prior to the COVID-19 pandemic breakout (prior to March 2020). All ED subtypes were considered in both groups and several clinical variables were assessed. At baseline, pandemic cohort reported lower levels of impulsivity and higher emotional regulation capacities than the pre-pandemic cohort; however, no differences were found in aspects of general psychopathology and ED related severity. Following treatment, the pandemic cohort showed higher rates of good outcome and lower rates of dropouts than the pre-pandemic cohort. Although both cohorts showed similar ED-related symptoms and general psychopathology scores, treatment outcomes were more favourable in the pandemic cohort.

Support Carbon Neutral Goal with a High-resolution Carbon Monitoring System in Beijing

Abstract China has committed to peak its carbon emissions before 2030 and achieve carbon neutrality before 2060, known as the Dual Carbon Goals (DCG). To support the DCG, monitoring and assessment of progresses in emissions reduction have become a central research focus. Here we describe the Beijing-Tianjin-Hebei (JJJ) Carbon Monitoring System, established over the last six years through a collaborative effort of 16 research institutions and universities. The monitoring capability includes ground-based high-precision reference stations, a dense network of medium-accuracy low-cost sensors, carbon satellites, vertical profile samplers, and mobile platforms. Observations using the network have shown CO2 variations from diurnal, synoptic to seasonal-interannual timescales, as well as dramatic on-road changes during the COVID-19 lockdown. High-resolution modeling and data assimilation at km-scale reveal major deficiencies in global carbon emissions datasets at regional/city scale. The inversion found the total fossil fuel CO2 emissions of the City of Beijing to be 117 megatonne (Mt), but much lower than the national-data-based inventories (152 MtCO2). The results have been used in emissions assessment by national and local environmental protection agencies. Similar systems are now being developed in other Chinese cities.

E-learning Supporting Infrastructure Investment in South Africa: Perspective of a Developing Economy

South Africa is one of the developing economies. Most of its provinces are in rural areas and have poor or lack of reliable critical infrastructure to enable development as in the case of urban areas. Infrastructure refers to physical structures that serve as the underlying foundation for the functioning of an economy. It includes physical facilities such as communication systems (telephone lines, broadband), and power supply systems (electrical grids, dams, etc.). The focus of the study is on information communication technological infrastructure (ICT) such as telephone and broadband networks and electricity infrastructure that support the adoption of e-learning. Many schools in South Africa are in rural areas and are attended by the majority of learners. These learners should perform the same way as learners in urban schools. Urban schools have better access to ICT infrastructure. Due to a lack of equitable ICT infrastructure, many education institutions back-tracked from the hybrid teaching mode implemented during the coronavirus (COVID-19) lockdown to the traditional class/lecture-room mode of teaching. It is revealed in the study that South Africa struggles in the area of infrastructure development. These affect the achievement of sustainable development goals (SDGs) which are heavily dependent on infrastructure, including education. E-learning offers a better advantage compared to traditional class/lecture-room-based education. ICT infrastructure that supports the provision of e-learning is not equitably distributed, and those that are available are not enough and reliable. South Africa is reported to need R4.8 trillion to achieve its critical infrastructure goals, indicating a dire need for infrastructure investment. Under-investment in infrastructure affects all sectors of the economy, including the education sector.

Teaching Online in a Developing Country Context

This study explored lecturer perceptions of their use of a Learning Management System (LMS) at a rural university in the Eastern Cape Province of South Africa. The study took place just prior to the COVID-19 lockdown and provides a brief insight into the thoughts of lecturers at this time. A sample of 141 lecturers from six faculties at the rural university completed an online questionnaire. A factor analysis (using principal component analysis and varimax rotation) of 46 items on lecturers’ perceptions of the LMS yielded six factors: their perceptions of usefulness, performance expectancy, self-efficacy, technical support, effort, and institutional support using the LMS. The reliability of factors was confirmed, while group differences were determined with independent sample t-tests and ANOVAs. The results indicate that although lecturers found the LMS to be beneficial, they were reluctant to use it when teaching face-to-face. There was a large discrepancy between the perceived usefulness and their actual use of the LMS. They perceived the LMS to be very useful but found technical- and institutional support to be low, which in turn strongly influenced their low self-efficacy (confidence) to use it. It emerged that increased training and support for lecturers would address both work performance and the confidence of lecturers using the platform. It was also evident that each academic department requires a dedicated teaching and learning consultant and that a centralized teaching and learning division may not be the answer. The one academic department with their own dedicated consultant was the best prepared for the demands of online teaching when the need arose.

Touching Technology-Parents' Experiences of Remote Consultations for Children With Severe Congenital Cardiac Conditions: Quasi-Experimental Cohort Study.

Remote consultations (RCs) using videoconferencing was recommended by the General Medical Council as the method for clinicians to provide patient consultations during the COVID-19 pandemic. Facilitating this while providing high-quality care depends on the usability and acceptability of the technology. This project aimed to investigate parents' experiences of using videoconferencing technology for real-time RCs with children who had congenital heart defects during the COVID-19 pandemic lockdown. This study's design was quasi-experimental and was underpinned by the Unified Theory of Acceptance and Use of Technology model that seeks to explain and predict an individual's intention to use a technology. Parents were informed of this study by the medical team, posters were made available in the wards and clinics, and leaflets were left for browsing. Clinician screening of potential participants led to the identification of 33 children and parents who were enrolled on this study. The intervention was a web-based RC by medical staff using a secure, interactive videoconferencing platform (Pexip). Each child and their mother or father received 8 RCs with the same specialist doctor or nurse. Measurements were taken using web-based questionnaires pre and post consultation at the first, middle, and last events; questions were focused on the acceptability, usability, and clinical applicability of RCs. Parents' experiences were explored using recorded interviews and analyzed thematically. In total, 29 children aged 4-1052 (mean 95, SD 191.14) days completed the project, receiving a total of 189 RCs as part of their routine care. Parents' prior experience of consultation via videoconference was low; however, as time progressed, their use and acceptance of the technology increased. The intervention was warmly received by all parents who found the face-to-face component particularly useful for discussion with their child's medical team. Furthermore, parents noted the savings on time, money, and childcare. While in-person consultations are considered the gold standard of patient care, increasing pressures on health services and staff reduce availability. Given the ease of access and additional benefits experienced by parents and their children, it is proposed that hybrid models of consultation and care provision are equal, if not superior, to in-person consultations in the management of children with severe congenital heart defects while reducing costs and pressure on the health service and parents.

‘We’ve Done Our Bit’: Post-COVID Experiences of Precarious Privilege Among Western International School Teachers in Shanghai

In this article, we consider how the COVID-19 pandemic has affected migration experiences and decisions among transnationally mobile Western international school teachers in China. International school teachers are among the most numerous groups of Western ‘expats’ in the country, arriving from the beginning of China’s ‘Reform period’. Drawing on exploratory interviews with international school teachers, we examine experiences of precarious privilege against the backdrop of COVID-19 lockdowns. We analyse our participants’ decisions about onward migration or permanence in China. In spite of evidence showing erosion of privilege during the pandemic, international school teachers remain largely insulated from its impact due to the privileged nature of their employment. Of greater significance was the impact of the Shanghai lockdown on the participants’ mobility and emotions, which proved the catalyst for two of the three participants to return to the UK.

Narratives of Personhood and Caregiving in Ontario Long-Term Care Homes During COVID-19

Drawing on narratives recorded from family members of residents in long-term care homes in Ontario, Canada, during the 2020 COVID-19 lockdown, in this paper, I present a two-pronged argument. First, following Taylor (2008) and Seaman (2018, 2020) I suggest that family caregiving for residents of long-term care homes helps to sustain residents’ personhood: the recognition of their identity as an ongoing participant in their social universe. The second part of my argument is that caregiving is a multifaceted and paradoxical endeavour. While caregiving can be a transformative and reciprocal practice of self-actualization (cf. Kleinman 2012; Kleinman and van der Geest 2009), at times it can also be troubled, ambivalent, and stressful (Cook and Trumble 2020). At its best, caregiving is a two-way street, enabling the maintenance of personhood for the care recipient, and validating the caregiver’s sense of ‘moral agency,’ or what medical anthropologist Neely Myers (2015, 13) defines as the capacity to be recognized in one’s local sphere as a good person who can make intimate connections to others. When caregiving goes awry, however, it leads to frustration, despair, and a sense of moral failure for the caregiver. For the care recipient, non-recognition and the loss of personhood can lead to social death and may also hasten physical decline. I conclude that for both professional and family caregivers of long-term care residents, systemic improvement of social and material support is needed to mitigate the challenges inherent in the recognition of personhood in caregiving relationships.

The Effects of the COVID-19 Pandemic on Pediatric Orthopedic Injuries: A Single-Center Retrospective Study.

The COVID-19 pandemic has had a profound effect on the pediatric population worldwide. The consequences of the lockdown and the reallocation of hospital resources have caused notable changes in the presentation of pediatric orthopedic injuries. Through our use of patient records, we were able to display the epidemiological trends, as well as analyze the changes in the type and mechanism of various injuries. Our purpose is to further understand the considerable effects of the COVID-19 pandemic on pediatric orthopedic trauma and help guide the allocation of future healthcare resources. We conducted a retrospective cohort study on pediatric patients admitted for any orthopedic injury over a 3-year period (September 2018 to August 2021) at a Midwest level 1 trauma center. Cases were stratified into two groups based on the United States' COVID-19 lockdown (19 March 2020): Pre-COVID-19 cases were any cases prior to the lockdown and Intra-COVID-19 which are cases following the lockdown. Numerical data and categorical variables were summarized and differences between the case groups were examined using either two-Proportion Z-Test, Independent Two-Sample t-test, Pearson's chi-squared, or Fisher's exact tests. A total of 3179 pediatric orthopedic referrals occurred between the Pre-COVID-19 and Intra-COVID-19 study periods. We observed a general decrease in orthopedic injuries following the COVID-19 lockdowns with 1235 injuries compared to 1606 Pre-COVID-19. Patterns in the locations of injuries changed; notably, fractures of the humerus, tibia, and fibula decreased significantly (p < 0.05). Several mechanisms of injuries decreased significantly following the onset of COVID-19 including injuries caused by monkey bars, basketball, and automobiles (p < 0.01). There was a significant increase in the overall injury severity during the Intra-COVID-19 period (p < 0.05). Although there was a reduction in acute orthopedic trauma referrals, many injury mechanisms displayed similar trends regardless of restrictions. We clinically observed an overall increase in the severity of pediatric orthopedic injuries during the COVID-19 pandemic.

Efficacy of community groups as a social prescription for senior health-insights from a natural experiment during the COVID-19 lockdown.

Loneliness and associated physical and cognitive health decline among the aging population is an important medical concern, exacerbated in times of abnormal isolation like the 2020-2021 Covid-19 pandemic lockdown. In this backdrop, recent "social prescribing" based health policy initiatives such as community groups as a support structure for the aging population assumes great importance. In this paper, we evaluate and quantify the impact of such social prescribing policies in combatting loneliness and related health degeneration of the aging population in times of abnormal isolation. To this end, we conduct a natural experiment across a sample of 618 individuals aged 65 and over with varying access to community groups during the Covid-19 lockdown period. Using a random-effects, probit model to compare the differences in health outcomes of participants with access to community groups (target) with those without access (control), we find that the target group was 2.65 times less likely to suffer from loneliness as compared to the control group, along with lower incidences of reported cardiovascular and cognitive health decline. These initial findings provide preliminary support in favor of the interventional power of social prescription tools in mitigating loneliness and its consequent negative health impact on the aging population.