Pandemic Declaration Research Articles

Exploring the relationship between national governance indicators and speed of initial government response to COVID-19 in low- and middle-income countries

ObjectivesThis study aimed to explore the relationship between national governance and country response to the COVID-19 pandemic in low- and middle-income countries, to support preparedness for the next pandemic. We conducted a statistical analysis of 116 countries, examining the relationship between speed of initial response and measures of national governance. Study designObservational study, with individual countries as the unit of analysis. MethodsWe used logistic regression to look for associations between quicker initial government response and four national governance indicators: Government Effectiveness, Political Stability and Absence of Violence/Terrorism, Voice and Accountability, and Corruption Perceptions Index. ResultsA quicker initial government response was associated with countries with higher Government Effectiveness (OR 13.92 95% CI 3.69–52.48, p < 0.001) and lower Political Stability and Absence of Violence/Terrorism (OR 0.23, 95% CI 0.09–0.57, p = 0.002). There was no relationship observed between speed of initial government response and Voice and Accountability or Corruption Perceptions Index. Other factors associated with quicker initial response were small population size, experiencing first COVID-19 case after the pandemic declaration, not having previous experience with SARS-CoV1 or MERS and not being an island nation. ConclusionsThis study shows that having higher state policy and implementation capacity, and lower political stability was associated with a quicker initial pandemic response. Limitations of this study include the use of crude national level indicators and broad categorisations of countries into quicker and slower responders. Deeper enquiry into the early decision-making processes taken at the national executive level within individual countries may help clarify the observed associations further.

PANDEMIC: ADJUSTING SOCIAL WORK PRACTIUM. AN ISOLATED INDICENT OR AN ENTRY TO A LARGER DISCUSSION?

On March 13, 2020, Mount Royal University responded to the pandemic declaration of the World Health Organization (WHO) and local health directives by stopping all face-to-face learning, including practicums. This sudden cessation was done for reasons of safety and liability. Rapid shifts were required, presenting functional, ethical, and privacy challenges for students and faculty who recognized that practicums are vital for social work students preparing to enter practice. Using a theoretical framework of compounding complexity, the paper considers eight key learnings from the authors’ experiences managing a social work practicum program, contemplating implications for current and future crisis-oriented fieldwork. This paper goes further to challenge a re-evaluation of social work as a result of the pandemic, social movements including the Black Lives Matter movement, as well as the changing socio-economic factors that influence service users’ lives. These conversations have emerged within the pandemic context and afford a moment to reflect on the place and role of social work.

Impact of COVID-19 on morbidity, management, and course of acute appendicitisa retrospective cohort study

Acute appendicitis is one of the most common causes of abdominal pain requiring surgical intervention. This study aimed to assess the impact of the COVID-19 pandemic on the morbidity, therapeutic management, and course of acute appendicitis. This study retrospectively analyzed patients hospitalized at a general surgery department between 1 January 2019 and 19 March 2020 and compared them to patients hospitalized between 20 March 2020 (global pandemic declaration date) and 6 June 2021. Therefore, our analysis encompassed the period 443 days preceding the pandemic and 443 days after the start thereof. Other factors evaluated herein included sex, length of hospital stay, time from symptom onset, type of surgery, laboratory test results, histopathological diagnosis, and polymerase chain reaction test results for SARS-CoV-2 infection. Statistical analysis was conducted using statistical software IBM SPSS version 27. Significant differences in length of hospital stay, time from symptom onset to hospital admission, number of leukocytes, and type of surgical procedure were observed between groups of patients treated before and after the pandemic. Acute appendicitis remained one of the most commonly encountered diseases requiring surgical intervention during the COVID-19 pandemic. Overall, significant differences were observed between patients treated before and after COVID-19 had been declared a pandemic.

Physical Activity Dynamics During a Digital Messaging Intervention Changed After the Pandemic Declaration.

BackgroundThe COVID-19 pandemic adversely impacted physical activity, but little is known about how contextual changes following the pandemic declaration impacted either the dynamics of people’s physical activity or their responses to micro-interventions for promoting physical activity.PurposeThis paper explored the effect of the COVID-19 pandemic on the dynamics of physical activity responses to digital message interventions.MethodsInsufficiently-active young adults (18–29 years; N = 22) were recruited from November 2019 to January 2020 and wore a Fitbit smartwatch for 6 months. They received 0–6 messages/day via smartphone app notifications, timed and selected at random from three content libraries (Move More, Sit Less, and Inspirational Quotes). System identification techniques from control systems engineering were used to identify person-specific dynamical models of physical activity in response to messages before and after the pandemic declaration on March 13, 2020.ResultsDaily step counts decreased significantly following the pandemic declaration on weekdays (Cohen’s d = ‐1.40) but not on weekends (d = ‐0.26). The mean overall speed of the response describing physical activity (dominant pole magnitude) did not change significantly on either weekdays (d = ‐0.18) or weekends (d = ‐0.21). In contrast, there was limited rank-order consistency in specific features of intervention responses from before to after the pandemic declaration.ConclusionsGeneralizing models of behavioral dynamics across dramatically different environmental contexts (and participants) may lead to flawed decision rules for just-in-time physical activity interventions. Periodic model-based adaptations to person-specific decision rules (i.e., continuous tuning interventions) for digital messages are recommended when contexts change.

Enhancing Artificial Intelligence for Twitter-based Public Discourse on Food Security During the COVID-19 Pandemic.

Food security during public health emergencies relies on situational awareness of needs and resources. Artificial intelligence (AI) has revolutionized situational awareness during crises, allowing the allocation of resources to needs through machine learning algorithms. Limited research exists monitoring Twitter for changes in the food security-related public discourse during the COVID-19 pandemic. We aim to address that gap with AI by classifying food security topics on Twitter and showing topic frequency per day. Tweets were scraped from Twitter from January 2020 through December 2021 using food security keywords. Latent Dirichlet Allocation (LDA) topic modeling was performed, followed by time-series analyses on topic frequency per day. 237,107 tweets were scraped and classified into topics, including food needs and resources, emergency preparedness and response, and mental/physical health. After the WHO's pandemic declaration, there were relative increases in topic density per day regarding food pantries, food banks, economic and food security crises, essential services, and emergency preparedness advice. Threats to food security in Tigray emerged in 2021. AI is a powerful yet underused tool to monitor food insecurity on social media. Machine learning tools to improve emergency response should be prioritized, along with measurement of impact. Further food insecurity word patterns testing, as generated by this research, with supervised machine learning models can accelerate the uptake of these tools by policymakers and aid organizations.

Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors.

Mental health has become a growing concern in the wake of the COVID-19 pandemic. We sought to determine the prevalence of mental health symptoms 18 months after the pandemic's declaration. Our cross-sectional study conducted among 18- to 65-year-old adults (N = 33,454) in October 2021 using the Depression, Anxiety and Stress Scales (DASS-21) found a high prevalence of severe to extremely severe anxiety (49%), depression (47%) and stress (36%) symptoms in Malaysia, Indonesia, Thailand, and Singapore. Multiple logistic regression showed that female and non-binary genders were associated with increased odds of severe/extremely severe symptoms of anxiety (female: aOR 1.44 [95% CI 1.37–1.52]; non-binary aOR 1.46 [1.16–1.84]), depression (female: aOR 1.39 [1.32–1.47]; non-binary aOR 1.42 [1.13–1.79]), and stress (female: aOR 1.48 [CI 1.40–1.57]; non-binary aOR 1.42 [1.12–1.78]). In all three symptom domains, the odds of severe/extremely severe symptoms decreased across age groups. Middle- and high-income respondents had lower odds of reporting severe/extremely severe anxiety (middle-income: aOR 0.79 [0.75–0.84]; high-income aOR 0.77 [0.69–0.86]) and depression (middle-income: aOR 0.85 [0.80–0.90]; high-income aOR 0.84 [0.76–0.94]) symptoms compared to low-income respondents, while only middle-income respondents had lower odds of experiencing severe/extremely severe stress symptoms (aOR 0.89 [0.84–0.95]). Compared to residents of Malaysia, residents of Indonesia were more likely to experience severe/extremely severe anxiety symptoms (aOR 1.08 [1.03–1.15]) but less likely to experience depression (aOR 0.69 [0.65–0.73]) or stress symptoms (aOR 0.92 [0.87–0.97]). Respondents living in Singapore had increased odds of reporting severe/extremely severe depression symptoms (aOR 1.33 [1.16–1.52]), while respondents residing in Thailand were more likely to experience severe/extremely severe stress symptoms (aOR 1.46 [1.37–1.55]). This study provides insights into the impacts of the COVID-19 pandemic on the point prevalence of psychological distress in Southeast Asia one and a half years after the beginning of the pandemic.

Global monitoring of public interest in preventive measures against COVID-19 via analysis of Google Trends: an infodemiology and infoveillance study

ObjectivesThe COVID-19 pandemic has influenced people’s concerns regarding infectious diseases and their preventive measures. However, the magnitude of the impact and the difference between countries are unclear. This study aimed...

COVID-19’s Impact on Global Stock Market Movements and an Examination on Turkish Market

Finansal küreselleşme, 1980’li yıllarda gelişmiş ülkelerde ve 1990’lı yıllarda gelişmekte olan ülkelerde ortaya çıkan sermaye hareket serbestlikleri ile birlikte önemli bir aşamaya geçmiştir. Bu aşamada sistemik risk unsurları artmış, olumsuz gelişme ve beklentiler tüm piyasalara hızla yayılarak etki edebilir hale gelmiştir. Hisse senedi piyasaları özelinde bakıldığında çok sayıda ülke piyasasının “küresel” piyasaya hızlı bir şekilde entegre olduğu görülmüş ancak söz konusu entegrasyonun düzeyi, tüm ülke piyasalarının güçlü bir şekilde birlikte hareket edecekleri seviyelere ulaşmamıştır. Yaşanan krizler karşısında kısa dönemde benzer reaksiyonlar gözleniyor olsa da şoklar sonrası hareketlilikler önemli farklılıklar gösterebilmektedir. Bu çerçevede, COVID-19 hastalığının Dünya Sağlık Örgütü tarafından 11 Mart 2020 tarihinde küresel ölçekte salgın ilan edilmesi ile hisse senedi piyasalarının birlikte hareketlerinde bir değişim olup olmadığı, olduysa değişimin ne şekilde olduğu temel bileşenler analizi ve değişim noktası analizi ile araştırılmıştır. Analizde 31.12.2020 tarihine kadar gerçekleşen günlük endeks hareketleri kullanılmıştır ve Türkiye ile birlikte 20 ülke piyasası dâhil edilmiştir. Ayrıca Türkiye hisse senedi piyasasının, ülkede salgının seyrine ilişkin açıklanan sayı ve kısıtlamalardan ne düzeyde etkilendiği de incelenmiştir.

Unexpected Detection of Anti-SARS-CoV-2 Antibodies Before the Declaration of the COVID-19 Pandemic.

Background:Limited information is currently available regarding the global incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections prior to the declaration of the coronavirus disease 2019 (COVID-19) pandemic, which may result in improper conclusions regarding the timing of viral transmission.MethodsWe investigated the presence of specific antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 in archived serum samples that were collected from 478 healthy blood donors and patients in Madinah, Saudi Arabia, between October 2019 and January 2020. Enzyme-linked immunosorbent assay (ELISA) was performed to measure SARS-CoV-2 IgM and IgG antibodies. In addition, rheumatoid factor (RF) and urea dissociation tests were performed in all samples, which showed seropositivity for the SARS-CoV-2 IgM antibody. Additionally, Chemiluminescence immunoassays (CLIA) targeting the RBD of the SARS-CoV-2 spike (S) protein were performed to confirm the seropositivity of the samples.ResultsOverall, 20 (4.18%) serum samples were detected by ELISA to have SARS-CoV-2 IgG or IgM antibodies. Of these, 12 (2.51%) samples were positive for IgM antibody, and 8 (1.67%) were positive for IgG antibody. The 12 samples positive for SARS-CoV-2 IgM antibody were subjected to RF and urea dissociation tests, and all samples were RF-negative. The ELISA results were negative for 7 (58.33%) samples when subjected to urea dissociation prior to ELISA, whereas the other 5 (41.67%) samples remained positive. These 5 samples remained positive for the anti-S RBD IgG antibody in the CLIA. In addition, 3 of the 8 samples with IgG positivity according to the ELISA remained positive in the CLIA. After reviewing their data, we discovered that the 8 CLIA-confirmed positive samples were obtained from returned travellers who had visited China during the 4-week period immediately preceding blood donation.ConclusionIn conclusion, we found evidence to support the early circulation of SARS-CoV-2 among persons who visited China a few months prior to the pandemic declaration. These results can be used to better define the spread of SARS-CoV-2 infections before the COVID-19 pandemic declaration. The detection of SARS-CoV-2 antibodies in individuals before the pandemic was declared in China could rewrite the pre-pandemic timeline.

Beribadah di Tengah Wabak Covid-19: Analisis Terhadap Fatwa Majelis Ulama Indonesia No 14 Tahun 2020 Berasaskan Teori Maqāṣid al-Sharī‘ah al-Shāṭibī

The Indonesian Ulama Council (MUI) has issued fatwa number 14 of the year 2020 on the Maintenance of Prayer in the Situation of the COVID-19 Outbreak. Issues that were fatwaed such as not holding Friday prayers and replacing with noon prayers, not congregating in mosques, the ban on holding religious activities in public areas with high COVID-19 contagion and so on. Therefore, this article will analyze the fatwa based on the theory of maqāṣid al-sharī‘ah al-Shāṭibī. Using the literature review method, this article concludes that the MUI fatwa has resulted in a response to the COVID-19 pandemic declaration that spread to Indonesia as well as provide guidance to the community regarding permission to worship in the COVID-19 epidemic situation. Studies show that the members of the MUI Fatwa Commission take into account the aspect of maslahah in the determination of fatwas. The maslahah refers to the theory of maqāṣid al-sharī‘ah al-Shāṭibī, and covers all levels whether the levels of ḍarūriyyah, ḥājiyyah and taḥsīniyyah.

Myocarditis Following COVID-19 Vaccine Use: Can It Play a Role for Conditioning Immunization Schedules?

Myocarditis (MYO) is a relatively uncommon inflammatory disease that involves the heart muscle. It can be a very severe disease as it can lead to the development of acute or chronic heart failure and, in a not marginal number of cases, to death. Most of the cases are diagnosed in healthy people younger than 30 years of age. Moreover, males are affected about twice as much as females. Viruses are among the most common causes of MYO, but how viral infection can lead to MYO development is not precisely defined. After COVID-19 pandemic declaration, incidence rate of MYO has significantly increased worldwide because of the SARS-CoV-2 infection. After the introduction of anti-COVID-19 vaccines, reports of post-immunization MYO have emerged, suggesting that a further cause of MYO together with the SARS-CoV-2 infection could increase the risk of heart damage during pandemic. Main aim of this study is to discuss present knowledge regarding etiopathogenesis and clinical findings of MYO associated with COVID-19 vaccine administration and whether the risk of this adverse events can modify the initially suggested recommendation for the use of COVID-19 vaccines in pediatric age. Literature analysis showed that MYO is an adverse event that can follow the COVID-19 immunization with mRNA vaccines in few persons, particularly young adults, adolescents, and older children. It is generally a mild disease that should not modify the present recommendations for immunization with the authorized COVID-19 mRNA vaccines. Despite this, further studies are needed to evaluate presently undefined aspects of MYO development after COVID-19 vaccine administration and reduce the risk of development of this kind of vaccine complication. Together with a better definition of the true incidence of MYO and the exact role of the various factors in conditioning incidence variations, it is essential to establish long-term evolution of acute COVID-19 related MYO.

Impact of the COVID pandemic on emergency department CT utilization: where do we go from here?

PurposeTo analyze the impact of the coronavirus disease (COVID) pandemic on emergency department (ED) computed tomography (CT) utilization.MethodsA retrospective observational study was conducted assessing seven hospitals’ ED imaging volumes between Jan. 6, 2019, and Feb. 27, 2021. Weekly CT utilization is reported as CTs ordered per 100 ED visits. Utilization was ascertained in aggregate and by body area. Interrupted time series analysis was performed to assess significance of utilization change. Prespecified sensitivity analysis was performed for influenza-like or COVID-like illness (ILI/CLI).ResultsWeekly ED CT utilization increased from 35.9 CTs per 100 visits (95% confidence interval [95% CI] 35.8–36.1) to 41.8 per 100 visits (95% CI 41.7–42.0) in pre- and post-pandemic periods. Weekly ED CT chest utilization increased immediately following the pandemic declaration (+ 0.52 chest CTs per 100 ED visits, 95% CI 0.01–1.03, p < 0.05) and compared to pre-pandemic period (+ 0.02 per 100 ED visits, 95% CI 0.02–0.05, p < 0.02). For both CT abdomen/pelvis and CT head, there was neither an immediate effect (+ 0.34 CT-AP per 100 ED visits, 95% CI − 0.74 to 1.44, p = 0.89; − 0.42 CT-H per 100 ED visits, 95% CI − 1.53 to 0.70, p = 0.46) nor a change in weekly CT utilization (+ 0.03 CT-AP per 100 ED visits, 95% CI − 0.01 to 0.05, p = 0.09; + 0.03 CT-H per 100 ED visits, 95% CI − 0.01 to 0.06, p = 0.10). ConclusionThese data may help formulate future strategies for resource utilization and imaging operations as we envision a future with COVID and other federal mandates affecting imaging utilization and appropriateness.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10140-022-02071-z.

Global evidence on the rapid adoption of telemedicine in primary care during the first 2 years of the COVID-19 pandemic: a scoping review protocol

BackgroundBefore the declaration of the COVID-19 pandemic in March 2020, primary care in most countries relied on face-to-face consultations, with relatively limited use of telemedicine. Lockdowns and social distancing measures during the early stages of the pandemic led to rapid, widely spread telemedicine adoption in healthcare settings. The rapid uptake that occurred following the onset of these pandemic-induced measures in countries such as the UK, Canada and New Zealand prompts questions around the drivers, extent and sustainability of this transformation in clinical practice at the global level, as the research in this area is still emerging. The purpose of this scoping review is to explore the global evidence surrounding the rapid adoption of telemedicine in primary care settings during the first 2 years of the COVID-19 pandemic through three lenses: patient experience, health inequalities and patient-clinician trust, with the purpose of identifying elements contributing to the sustainability of this innovation.MethodsA draft protocol was tested through an initial search on Ovid Medline, Web of Science and Google Scholar with additional searches on the Cochrane Database. This informed the final selection of terms which will be used to search Ovid, Web of Science, Google Scholar, PROSPERO, Cochrane Library and others, filtering for studies from the pandemic declaration onwards. Additional grey literature reports will be sourced through simplified searches on Google in widely spoken languages. Duplicates will be removed by screening titles. s and grey literature text extracts will be screened based on pre-set eligibility criteria by two researchers. s (and extracts in the case of grey literature) will be mapped against the domains of the Non-adoption, Abandonment, and challenges to Scale-up, Spread and Sustainability (NASSS) framework by two researchers. Data will be presented in table format.DiscussionThis review will map the current literature to identify current gaps in evidence related to the adoption of telemedicine after the declaration of the pandemic in March 2020. The use of simplified searches in the several spoken languages in the world is aimed at capturing more immediate non-academic reflections and experiences on this major service change at a global level.Systematic review registrationThe study has been registered on Open Science Framework and can be accessed through the following URL: https://osf.io/4z5ut/

Changes in Positive Airway Pressure Use in Adults with Sleep-Related Breathing Disorder During the COVID-19 Pandemic: A Cross-Sectional National Community-Based Survey.

PurposeTo better understand: (i) a positive airway pressure (PAP) therapy use during the pandemic, (ii) how PAP use may relate to sleep, health, and COVID-19-related outcomes, and (iii) factors associated with PAP use during the pandemic.MethodsThis study is based on data collected between Apr 2020 and Jan 2021 as part of an online cross-sectional national community-based survey. The included participants were located in North America, 18 years and older, with self-reported sleep-related breathing disorder (SBD) and usage of a PAP device in the last month before the COVID-19 pandemic.ResultsOf all respondents, 7.2% (41/570) stopped using PAP during the pandemic over a median time since the pandemic declaration of 62.0 days (IQR = 8.0). There were no significant differences between individuals who continued and stopped using PAP in the time elapsed since the pandemic declaration, age, sex, education level, occupational status, family income, or the proportions of individuals endorsing symptoms that could be related to COVID-19. Compared to individuals who continued using PAP, those who stopped had significantly shorter sleep time, lower sleep efficiency, and poorer sleep quality. Higher stress levels and living with someone who experienced symptoms that could be attributable to COVID-19 were independently associated with stopping PAP use.ConclusionsIn this survey study, most individuals with SBD continued PAP therapy during the pandemic. However, even 7% of participants who stopped using PAP cannot be ignored. Identifying individuals at risk of discontinuing PAP treatment may help design targeted interventions for people with SBD and health professionals to improve PAP use.

COVID-19 and firm value drivers in the tourism industry

Using an international sample of 1315 observations for 194 listed tourism firms from 2012 to 2019, we investigate the impact on firm value of DuPont components, namely asset turnover and profit margin. Next, using an event study methodology, we analyze how these components are associated with the stock market reaction to the COVID-19 pandemic announcement. The results indicate that over 2012–2019, the association of performance with firm value is mostly driven by tourism companies' ability to become more efficient with their asset base, while both profitability and productivity levels are significant predictors of firm value one year ahead. Abnormal returns surrounding the pandemic announcement appear to be more negative for more productive firms, while the latter enjoyed a stronger recovery.

Impact of COVID-19 Lock-Downs on Nature Connection in Southern and Eastern Africa

The response of African countries immediately after the COVID-19 pandemic declaration was rapid and appropriate, with low infections and mortality rates until June 2020. Severe lock-down measures were effective in Africa; however, the reduction in the amount of natural experience influences the quality of life in modern society. This study is conducted as an international comparative study in five African countries on changes in the perception of health recovery and outdoor activities in urban forests during the COVID-19 pandemic. An online survey was conducted with 430 respondents to investigate the relationships between COVID-19 stress, indoor activity, appreciation of greenspaces, perception of health recovery, and use of greenspaces. A structural equation model was used for analysis. The visit frequency and staying time in urban forests after lock-down dramatically decreased, raising concerns about nature-deficit disorder across the target countries after the end of the pandemic. This study confirmed urban dwellers’ desire for natural experiences and health recovery during the pandemic and predicts an explosive increase in urban forest utilization after the pandemic has ended.

The impact of SARS-CoV-2 pandemic on suicidal ideation admissions: a single adolescent and young adult psychiatry center experience

IntroductionThe COVID-19 pandemic and the lockdown brought about a sense of fear and anxiety around the globe. This phenomenon led to both short and long term psychosocial and mental health implications for children and adolescents.ObjectivesTo evaluate the effect of COVID-19 pandemic on hospital admissions for suicidal ideation in a Portuguese adolescent and young adult psychiatry service.MethodsWe conducted a single-center, retrospective study including adolescent and young adult patients (15-25 years old) admitted to our service with suicidal ideation within a year before and a year after the declaration date of SARS-CoV-2 disease as a pandemic. Patients were divided in two groups: Group A - patients admitted before the pandemic (March 11, 2019 and March 11, 2020) and Group B – patients admitted after the pandemic declaration (March 12, 2020 and March 12, 2021). The groups characteristics and outcomes were assessed and compared.ResultsA total of 647 admissions were assessed (Group A, n= 372 and Group B, n=275). Demographic characteristics were similar between groups. 75 patients (vs 25 patients) were admitted with suicidal ideation in the year before the pandemic. There was a lower proportion of patients admitted with suicidal ideation during the year after the pandemic year - OR 0.374 (95% CI 0.228-0.614, P&lt;0.001).ConclusionsOur study showed a decrease in admissions for suicidal ideation in this service in the year after the pandemic. More studies are needed to understand the factors that may justify this decline and evaluate the longer effects of this pandemic in mental health.DisclosureNo significant relationships.

How the global airline industry behaved to restrictions on air travel to India? An event study analysis

We examine the impact of the recent restrictions/bans imposed by several nations on air travel to India in the light of the increasing number of infections amid the second wave of covid-19. We employ the standard event study method on a sample of 34 airline stocks across seven nations to find that the recent restrictions/bans on air travel significantly impact the global airline industry, although the country-specific impacts are not similar. We find that the post-event reaction in all nations has been different from those evidenced during the global pandemic declaration. We are the first to examine these impacts during the current wave of the pandemic. It contributes to the literature on the effects of the pandemic on the global airline industry. Further, it also provides practical explanations to the investors on how the airline stocks react to the persistence of the pandemic.

Trends in facility-level rates of Clostridioides difficile infections in US hospitals, 2019-2020.

The coronavirus disease 2019 pandemic caused substantial changes to healthcare delivery and antibiotic prescribing beginning in March 2020. To assess pandemic impact on Clostridioides difficile infection (CDI) rates, we described patients and trends in facility-level incidence, testing rates, and percent positivity during 2019-2020 in a large cohort of US hospitals. We estimated and compared rates of community-onset CDI (CO-CDI) per 10,000 discharges, hospital-onset CDI (HO-CDI) per 10,000 patient days, and C. difficile testing rates per 10,000 discharges in 2019 and 2020. We calculated percent positivity as the number of inpatients diagnosed with CDI over the total number of discharges with a test for C. difficile. We used an interrupted time series (ITS) design with negative binomial and logistic regression models to describe level and trend changes in rates and percent positivity before and after March 2020. In pairwise comparisons, overall CO-CDI rates decreased from 20.0 to 15.8 between 2019 and 2020 (P < .0001). HO-CDI rates did not change. Using ITS, we detected decreasing monthly trends in CO-CDI (-1% per month, P = .0036) and HO-CDI incidence (-1% per month, P < .0001) during the baseline period, prior to the COVID-19 pandemic declaration. We detected no change in monthly trends for CO-CDI or HO-CDI incidence or percent positivity after March 2020 compared with the baseline period. While there was a slight downward trajectory in CDI trends prior to March 2020, no significant change in CDI trends occurred during the COVID-19 pandemic despite changes in infection control practices, antibiotic use, and healthcare delivery.

Aging with Disability Symptoms and Ability to Participate in, and Satisfaction with, Social Participation among Persons Aged 45-64.

Pain, fatigue, and depression, considered aging with disability (AwD) symptoms, are known to be substantially higher among middle-aged adults with long-term disability compared to their age peers. Participation has been recognized as an important component of health. This cohort survey study reports findings on the relationship between AwD symptoms and ability to participate in, and satisfaction with participation in, social roles and activities using PROMIS measures. Data were collected at three time points from individuals aged 45–64 with an average of two decades of disability duration and primarily living in the state of Missouri, USA. This study reports on Time 1 (T1) and Time 3 (T3), pre- and post-COVID-19 pandemic declaration, respectively. Multiple regressions using both individual AwD symptoms and a composite measure demonstrated that having more pain, fatigue, and depression was associated with worse participation outcomes. Lower physical function scores were also related to lower participation scores, as was being female and living with others, and having more income reduced participation. Better physical health and identifying as African American/Black were associated with higher participation scores. Our findings suggest that AwD symptoms, along with other sociodemographic and health factors, play a substantial role in the social participation outcomes for persons aging with disability and remain consistent over time.