Non-essential Business Closures Research Articles

Nonpharmaceutical public health interventions to curb the COVID-19 pandemic: a narrative review.

Nonpharmaceutical Interventions (NPI) consist of compulsory (isolation, quarantine, stay-at-home orders, banning public gatherings, nonessential business closures, school closures), and voluntary (social distancing, handwashing, respiratory etiquette, and universal mask wearing) measures. The aim of this narrative review is to evaluate the different forms of NPI and their effectiveness in combating the pandemic. Isolation can be indicated for symptomatic and asymptomatic infected people at home or at hospitals depending on the patient's clinical picture. Quarantine is a social distancing intervention in asymptomatic uninfected people who had contact with SARS-CoV-2 infected individuals. Stay-at-home orders refer to statewide mandates imposing nonessential business closures, prohibition of public events and gatherings, and travel restrictions. Studies have suggested that stay-at-home orders may be associated with a reduction in the incidence of COVID-19 in some countries. Mask wearing decreases the risk of COVID-19 in the community, especially when the surgical masks are used for vulnerable people. N-95 respirators protect health workers from COVID-19. NPI may be helpful to curb the COVID-19 pandemic while mass vaccination worldwide is not attainable, and the threat of SARS-COV-2 variants remain on the horizon.

The efficiency of COVID cases to COVID policies: a robust conditional approach.

This paper examines the efficiency of four major COVID-19 social distancing policies: (i) shelter-in-place orders (SIPO), (ii) non-essential business closures, (iii) mandatory quarantine for travelers, and (iv) bans on large gatherings. Results suggest that the average US state is highly inefficient in producing the fraction of the population that does not have COVID-19 without social distancing policies put in place. We find that having any of the four major social distancing policies increases conditional efficiency by 9.7 (9.5) percentage points in the first 100 days (full sample). This corresponds to 57 (172) fewer total COVID-19 cases per 100,000 population in the first 100 days (full sample). We also find that population density accounts for a majority of unconditional state inefficiency. Evidence suggests considerable heterogeneity in conditional efficiency improvement, indicating that no uniform national social distancing policy would have been more effective; more effective strategies would have been to target more densely populated areas. Conditional efficiency regressions suggest that bans on large gatherings were the most effective policies, with SIPOs and non-essential business closures having smaller impacts. States that implemented social distancing policies except mandatory quarantine for traveler policies were highly effective for the first 100 days, but had less effectiveness over the full sample. There is also preliminary evidence that premature revocations of social distancing policies reduced conditional efficiency, leading to COVID-19 case spikes.

Effect of Quarantine and Reopening Measures on Pediatric Trauma Admissions During the 2019 SARS-CoV2 Virus Pandemic.

Several studies have reported decreased trauma admissions and increased physical abuse in children resulting from stay-at-home measures. However, these studies have focused on a limited period after the implementation of lockdown policies. The purpose of this study was to examine the effect of quarantine and reopening initiatives on admissions for varying types of injuries in pediatric patients. Registry data for an urban Level I pediatric trauma center were evaluated from April 1, 2018, to March 30, 2021. A timeline of local shutdown and reopening measures was established and used to partition the data into 6-month intervals. Data about demographics and injury characteristics were compared with similar intervals in 2018 and 2019 using appropriate statistical methodology for categorical, parametric, and nonparametric data. A total of 3,110 patients met criteria for inclusion. A total of 1,106 patients were admitted the year after the closure of schools and nonessential businesses. Decreases in overall admissions and evaluations for suspected child abuse noted early in the pandemic were not sustained during shutdown or reopening periods. However, we observed a 77% increase in all-terrain vehicle injuries, along with a 59% reduction in sports injuries (chi-square [8, N = 3,110] = 49.7; p < 0.001). Significant shifts in demographic and payor status were also noted. This is the first study to comprehensively examine the effects of quarantine and reopening policies on admission patterns for a pediatric trauma center in a metropolitan area. Total admissions and child abuse evaluations were not impacted. If shutdown measures are re-instituted, preventative efforts should be directed towards ATV use and recreational activities.

Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap.

The purpose of this study was to capture the perceptions of COVID-19 mitigations’ efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies’ effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community’s perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

Restaurant dining during the COVID-19 pandemic among adults with low-income in the United States

The COVID-19 pandemic caused widespread non-essential business closures in the U.S., which may have disproportionately impacted food consumption in lower-income communities, in part due to reduced access to healthy and affordable foods, as well as occupations that may have required working outside the home. The aims of this study were to examine restaurant dining behaviors (including drive-through, takeout, and delivery) at fast-food and non-fast-food (i.e., fast casual and full-service [‘other’]) restaurants and the impact on diet quality among racially/ethnically diverse low-income adults during the early months of the pandemic. Participants completed an online survey using CloudResearch regarding restaurant dining behaviors in the past week (during June 2020) and during a typical week prior to the pandemic. Diet quality was measured using the Prime Diet Quality Score (PDQS). Surveys from 1,756 low-income adults (incomes <250% of the Federal Poverty Level) were analyzed using chi-squared tests to examine differences in demographic characteristics among those dining at restaurants during the pandemic, as well as to examine differences in dining frequency compared with prior to COVID-19. Negative binomial regressions were used to examine the mean frequency of eating food from fast-food and other restaurants, adjusted for socio-demographic characteristics. This study found reductions in fast-food and other restaurant dining compared with prior to COVID-19, although overall restaurant consumption remained high with over half of participants reporting fast-food consumption in the week prior (average consumption of twice per week). Greater fast-food consumption was associated with poorer diet quality. In conclusion, while fast-food consumption was slightly lower during the pandemic, the overall high levels observed among socioeconomically disadvantaged adults remains concerning, highlighting the continued need for initiatives and policies to encourage greater access to and consumption of affordable and healthier foods.

The Impact of COVID-19 Vaccination on the Italian Healthcare System: A Scenario Analysis.

Background and ObjectiveDuring 2020, the only instruments for fighting against the pandemic peaks were lockdowns, physical distancing, closure of schools and non-essential businesses, and travel restrictions. The new vaccination strategy adopted in Italy in 2021 represented a new perspective for policymakers.ObjectiveThe aim of this study was to estimate the effects of the national immunisation strategy for coronavirus disease 2019 (COVID-19) in Italy on the national healthcare system.MethodsAn epidemiological scenario analysis was developed in order to simulate the impact of the COVID-19 pandemic on the Italian national healthcare system in 2021. Hospitalisations, intensive care unit (ICU) admissions and death rates were modelled based on 2020 data. Costs were estimated using hospital admissions from the Policlinico of Tor Vergata Hospital in Rome. Two scenarios were tested, one with vaccination and the second without.ResultsThe roll-out of vaccinations to protect against COVID-19 was estimated to prevent 52,115 deaths in 2021, 45.2% less than what was expected in the absence of immunisation. Based on the assumptions underlying the two epidemiological scenarios, our model predicted an overall reduction of 2.4 million hospital admissions and 259,000 ICU admissions (74.9% and 71.3% less, respectively, than the world without vaccinations between June and December 2021). Overall, in Italy, the model estimated over €3.0 billion costs of hospitalisations due to COVID-19 in 2020. In 2021, vaccines prevented around 36% of the overall costs.ConclusionsThis is the first study highlighting the effect of vaccines on the Italian healthcare system in terms of avoided cases, hospitalisations and costs. Our results have the potential to inform policymakers and the general population on the benefits of vaccinations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40261-022-01127-9.

COVID-19 and gender-based violence service provision in the United States.

IntroductionGender-based violence (GBV) policies and services in the United States (U.S.) have historically been underfunded and siloed from other health services. Soon after the onset of the COVID-19 pandemic, reports emerged noting increases in GBV and disruption of health services but few studies have empirically investigated these impacts. This study examines how the existing GBV funding and policy landscape, COVID-19, and resulting state policies in the first six months of the pandemic affect GBV health service provision in the U.S.MethodsThis is a mixed method study consisting of 1) an analysis of state-by-state emergency response policies review; 2) a quantitative analysis of a survey of U.S.-based GBV service providers (N = 77); and 3) a qualitative analysis of in-depth interviews with U.S.-based GBV service providers (N = 11). Respondents spanned a range of organization types, populations served, and states.ResultsTwenty-one states enacted protections for GBV survivors and five states included explicit exemptions from non-essential business closures for GBV service providers. Through the surveys and interviews, GBV service providers note three major themes on COVID-19’s impact on GBV services: reductions in GBV service provision and quality and increased workload, shifts in service utilization, and funding impacts. Findings also indicate GBV inequities were exacerbated for historically underserved groups.DiscussionThe noted disruptions on GBV services from the COVID-19 pandemic overlaid long-term policy and funding limitations that left service providers unprepared for the challenges posed by the pandemic. Future policies, in emergency and non-emergency contexts, should recognize GBV as essential care and ensure comprehensive services for clients, particularly members of historically underserved groups.

Hit Hard but Recover Slowly: The Asymmetric Effects of Social Distancing Policies on the US Labor Market

This study employs a difference-in-differences approach to examine the US labor market response to two widely used social distancing policies, stay-at-home (SAH) order and non-essential business closure, with special attention paid to the asymmetric effect of the policies’ imposition and lifting. Exploiting the variation across states and time, we find that state employment rates declined by 4.3% and 1.9% for the two policies respectively, within one month of the enaction of social distancing policies, but the recovery was slower after the policies were removed. We also highlight that the low-income group suffered the highest employment rate drop from the SAH enaction while presenting the mildest rebound. Self-employed workers were more affected by the policy impositions but recovered slightly faster than wage earners. Our results suggest persistent efforts must be made after the pandemic, especially for more vulnerable groups in the labor market.

Structural modeling of COVID-19 spread in relation to human mobility

Human mobility is considered as one of the prominent non-pharmaceutical interventions to control the spread of the pandemic (positive effect from mobility to infection). Conversely, the spread of the pandemic triggered massive changes to people’s daily schedules by limiting their movement (negative effect from infection to mobility). The purpose of this study is to investigate this bi-directional relationship between human mobility and COVID-19 spread across U.S. counties during the early phase of the pandemic when infection rates were stabilizing and activity-travel behavior reflected a fairly steady return to normal following the drastic changes observed during the pandemic’s initial shock. In particular, we applied Structural Regression (SR) model to investigate a bi-directional relationship between COVID-19 infection rate and the degree of human mobility in a county in association with socio-demographic and location characteristics of that county, and state-wide COVID-19 policies. Combining U.S. county-level cross-sectional data from multiple sources, our model results suggested that during the study period, human mobility and infection rate in a county both influenced each other, but in an opposite direction. Metropolitan counties experienced higher infection and lower mobility than non-metropolitan counties in the early stage of the pandemic. Counties with highly infected neighboring counties and more external trips had a higher infection rate. During the study period, community mitigation strategies, such as stay at home order, emergency declaration, and non-essential business closure significantly reduced mobility whereas public mask mandate significantly reduced infection rates. The findings of this study will provide important insights to policy makers in understanding the two-way relationship between human mobility and COVID-19 spread and to derive mobility-driven policy actions accordingly.

COVID-19: Socio-Economic Consequences on the Hospitality Industry in Malaysia

The novel Coronavirus disease (COVID-19) first appeared in December 2019 in Wuhan, Hubei Province China before emerging in neighbouring countries in early 2020. The World Health Organization (WHO) declared COVID-19 a pandemic when the spreading of the virus started accelerating in many parts of the world and killing thousands of people. As of 22nd May 2021, there were more than 166 million confirmed cases with more than 147 million recovered and nearly 3.5 million deaths (Worldometers, n.d.). According to the WHO (2020) and Centers for Disease Control and Prevention (2020), the virus easily spreads through coughing and sneezing. Therefore, many countries implemented social distancing between individuals and various other restriction orders or recommendations (e.g., stay-at-home policies, closure of non-essential businesses) to help curb virus spread. How governments in each country reacted to control the spread of the virus appeared crucial to mitigate public health and economic impacts. Keywords: Foodservice, Hospitality, Hotel, Malaysia, Pandemic

6.10 Impact of the COVID-19 Pandemic on Prescribing for Youth With Autism Spectrum Disorder: A Review of the Literature

Measures were implemented by governments around the world to limit the spread of the novel COVID-19 pandemic in 2020. These measures included quarantines, social distancing, and the closure of schools and nonessential businesses. It has been reported that there has been a negative impact on the mental health of the general population, although the full extent or long-term impact is not known. The authors reviewed the literature regarding the mental health/behavioral impact of the pandemic on youth with autism spectrum disorder (ASD), including any changes to psychotropic medication prescribing rates.

Association of Jail Decarceration and Anticontagion Policies With COVID-19 Case Growth Rates in US Counties

Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety. To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. This cohort study used county-level data from January to November 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population. Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. Daily COVID-19 case growth rates. In the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%- 7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). Although many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial detention policies are likely to be important for improving US public health, biosecurity, and pandemic preparedness.

42 First Year of COVID-19: Stay at Home Decreased Accidents, but Increased Assaults

Early articles published during the first few months of the COVID-19 pandemic indicated declines in traumatic injuries in the U.S. and internationally. Throughout 2020, there were numerous governmental stay-home orders and policies, health care responses, and COVID-19 vaccine development; all of which may have had unintended consequences beyond illness prevention. Here we investigate the longer-term impact over the first year of the pandemic on the incidence of traumatic injuries. This retrospective analysis was performed with all records of trauma activations from an urban level 1 trauma center’s trauma registry. Mean weekly, monthly, and total yearly patient counts from 2017-2019 and total from 2020 were compared using independent samples t-test or Mann-Whitney U test. Shapiro-Wilk and Levene’s tests were used to assess normality and variances, respectively. Differences were considered significant when two-sided p-value < 0.05. Of 4157 trauma patients in 2020, 73% were male and average age was 39 years old. There were more trauma patients in 2020 than the 2017-2019 average (n = 3869). No demographic differences were present comparing patients seen in 2020 and those of previous years. In 2020, there were significantly higher weekly counts of penetrating injuries versus the 2017-2019 average (mean [SD]) (22.5 [7.2] vs 17.5 [3.1], p > 0.000), specifically gunshot wounds (GSWs) (15.8 [6.0] vs. 11.3 [2.7], p > 0.0000) and more assaults (23.3 [6.7] vs 19.4 [3.2], p > 0.0003). In 2020, fewer falls (11.9 [4.3] vs. 13.4 [2.5], p > 0.03), pedestrian/bicycle accidents (5.5 [3.1] vs 7.5 [2.1], p > 0.0002) and accidents in general (45.9 [17.1] vs 50.9 [5.6], p > 0.0003) presented to our hospital compared to 2017-2019 average. Monthly totals in 2020 were higher than average in every month except those with strictest stay home mandates in place (March-May). Overall, weekly totals were higher than average in 2020 (79 vs 73) and decreased during the strictest shut-downs from March 18 through the beginning of June (Fig. 1A & B). A decreased number of traumatic injuries presented to our level 1 trauma center during the first six weeks of the pandemic, which coincided with closure of most non-essential businesses and the strictest government-instituted stay home orders. The week that our state and city moved into re-opening of businesses to 50% capacity and opened bars, there were more traumatic injuries than previous years on average. After that initial week of increased patient volume, weekly counts of trauma patients were above average in most (25 / 31, 80%) weeks through the end of the year. Increased GSWs and assaults this year may suggest increased interpersonal conflict due to external stressors caused by the pandemic. Conversely, decreased falls, pedestrian/bike accidents and other causes of accidents may suggest that staying at home decreases activities and associated accident risk.

A disproportionate epidemic: COVID-19 cases and deaths among essential workers in Toronto, Canada

Shelter-in-place mandates and closure of nonessential businesses have been central to COVID19 response strategies including in Toronto, Canada. Approximately half of the working population in Canada are employed in occupations that do not allow for remote work suggesting potentially limited impact of some of the strategies proposed to mitigate COVID-19 acquisition and onward transmission risks and associated morbidity and mortality. We compared per-capita rates of COVID-19 cases and deaths from January 23, 2020 to January 24, 2021, across neighborhoods in Toronto by proportion of the population working in essential services. We used person-level data on laboratory-confirmed COVID-19 community cases and deaths, and census data for neighborhood-level attributes. Cumulative per-capita rates of COVID-19 cases and deaths were 3.3-fold and 2.5-fold higher, respectively, in neighborhoods with the highest versus lowest concentration of essential workers. Findings suggest that the population who continued to serve the essential needs of society throughout COVID-19 shouldered a disproportionate burden of transmission and deaths. Taken together, results signal the need for active intervention strategies to complement restrictive measures to optimize both the equity and effectiveness of COVID-19 responses.

Impact of non-pharmaceutical interventions against COVID-19 in Europe in 2020: a quasi-experimental non-equivalent group and time series design study

IntroductionThe current pandemic of coronavirus disease (COVID-19) is unparalleled in recent history as are the social distancing interventions that have led to a considerable halt on the economic and social life of so many countries.AimWe aimed to generate empirical evidence about which social distancing measures had the most impact in reducing case counts and mortality.MethodsWe report a quasi-experimental (observational) study of the impact of various interventions for control of the outbreak through 24 April 2020. Chronological data on case numbers and deaths were taken from the daily published figures by the European Centre for Disease Prevention and Control and dates of initiation of various control strategies from the Institute of Health Metrics and Evaluation website and published sources. Our complementary analyses were modelled in R using Bayesian generalised additive mixed models and in STATA using multilevel mixed-effects regression models.ResultsFrom both sets of modelling, we found that closure of education facilities, prohibiting mass gatherings and closure of some non-essential businesses were associated with reduced incidence whereas stay-at-home orders and closure of additional non-essential businesses was not associated with any independent additional impact.ConclusionsOur findings are that schools and some non-essential businesses operating ‘as normal’ as well as allowing mass gatherings were incompatible with suppressing disease spread. Closure of all businesses and stay at home orders are less likely to be required to keep disease incidence low. Our results help identify what were the most effective non-pharmaceutical interventions in this period.

State variation in effects of state social distancing policies on COVID-19 cases

BackgroundThe novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021. Our objective was to describe state variation in the effect of initial social distancing policies and non-essential business (NEB) closure on infection rates early in 2020.MethodsWe used an interrupted time series study design to estimate the total effect of all state social distancing orders, including NEB closure, shelter-in-place, and stay-at-home orders, on cumulative COVID-19 cases for each state. Data included the daily number of COVID-19 cases and deaths for all 50 states and Washington, DC from the New York Times database (January 21 to May 7, 2020). We predicted cumulative daily cases and deaths using a generalized linear model with a negative binomial distribution and a log link for two models.ResultsSocial distancing was associated with a 15.4% daily reduction (Relative Risk = 0.846; Confidence Interval [CI] = 0.832, 0.859) in COVID-19 cases. After 3 weeks, social distancing prevented nearly 33 million cases nationwide, with about half (16.5 million) of those prevented cases among residents of the Mid-Atlantic census division (New York, New Jersey, Pennsylvania). Eleven states prevented more than 10,000 cases per 100,000 residents within 3 weeks.ConclusionsThe effect of social distancing on the infection rate of COVID-19 in the US varied substantially across states, and effects were largest in states with highest community spread.

The benefits of coronavirus suppression: A cost-benefit analysis of the response to the first wave of COVID-19 in the United States.

This paper estimates the benefits and costs of state suppression policies to “bend the curve” during the initial outbreak of COVID-19 in the United States. We employ an approach that values benefits and costs in terms of additions or subtractions to total production. Relative to a baseline in which only the infected and at-risk populations mitigate the spread of coronavirus, we estimate that total benefits of suppression policies to economic output are between $632.5 billion and $765.0 billion from early March 2020 to August 1, 2020. Relative to private mitigation, output lost due to suppression policies is estimated to be between $214.2 billion and $331.5 billion. The cost estimate is based on the duration of nonessential business closures and stay-at-home orders, which were enforced between 42 and 65 days. Our results indicate that the net benefits of suppression policies to slow the spread of COVID-19 are positive and may be substantial. We discuss uncertainty surrounding several parameters and employ alternative methods for valuing mortality benefits, which also suggest that suppression measures had positive net benefits.

Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

BackgroundThe widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.MethodsBased on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between Rt and NPIs through a generalized linear model (GLM).ResultsDifferent NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46–57%), wearing (face) masks 29% (15–42%), gathering ban (more than 10 people) 19% (14–24%), non-essential business closure 16% (10–21%), declaration of emergency 13% (8–17%), interstate travel restriction 11% (5–16%), school closure 10% (7–14%), initial business closure 10% (6–14%), and gathering ban (more than 50 people) 7% (2–11%).ConclusionsThis retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

The Economic Effect of the CVOID-19 Lockdown in the United States: Was the Cure Worse than the Disease?

COVID-19 is an ongoing global outbreak of coronavirus disease 2019, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern on January 30, 2020; and a pandemic on March 11, 2020.Several mitigation measures have been used in attempts to limit the spread of the virus, including mandatory wearing of masks in public; bans on unnecessary travel; and the closure of non-essential businesses. This paper defines a lockdown as the closure of non-essential businesses combined with requirements that all citizens stay at home except for grocery shopping, trips to a pharmacy, and medical appointments.The effectiveness of lockdowns is controversial. Proponents tend to argue that lockdowns would have been more effective if enforcement had been increased and if lockdowns had been extended for a longer period of time. Opponents have argued that lockdowns hurt the economy, hurt children, and have had little positive effect on public health.The paper addresses the economic effect of COVID-19 lockdowns in the United States using a Benefit/Cost Analysis (BCA) framework. Two separate analyses are provided: a traditional BCA analysis, which assumes that the value of life is constant regardless of age; and a Preferred Analysis, which adjusts the number of deaths, and values the economic cost of the deaths based on the age of the deceased.

Psychosocial impact of Covid-19 outbreak on Italian asthmatic children and their mothers in a post lockdown scenario

Italy was the first European country to fight the Covid-19 outbreak. To limit the transmission of the virus, the Italian Government imposed strict domestic quarantine policies and temporary closure of non-essential businesses and schools from March 10th,2020. Although more and more literature is exploring the impact of the pandemic on non-referred children and families, only a few studies are focused on the psychosocial impact of Covid-19 in chronically ill children and their caregivers. The present study investigates asthma control and children and mothers’ psychological functioning (i.e.: psychological well-being, fear of contagion, and mothers’ Covid-19 related fears) in 45 asthmatic children aged 7-to-14, compared to a control sample. The subjects were administered an online survey after the lockdown (from 28th May to 23rd August 2020). The analysis shows that asthmatic children presented higher concern in relation to contagion, however, no difference in psychological functioning was displayed between the two cohorts. Mothers reported more Covid-19 related fears, and greater worries according to the resumption of their children’s activities. Moreover, they indicated a global worsening of their psychological well-being during the lockdown. Furthermore, regarding the clinical sample, the multivariate regression model showed that a worsening of mothers' psychological and children’s physical well-being was associated with a worsening of children’s psychological well-being during the lockdown. The results of this study indicate that mothers of asthmatic children can be more prone to experience psychological fatigue in a pandemic scenario. Special programs should be developed to support caregivers of chronically ill children.