Pandemic Emergency Research Articles

Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders

BackgroundLow population density, geographic spread, limited infrastructure and higher costs are unique challenges in the delivery of healthcare in rural areas. During the COVID-19 pandemic, emergency powers adopted globally to slow the spread of transmission of the virus included population-wide lockdowns and restrictions upon movement, testing, contact tracing and vaccination programs. The aim of this research was to document the experiences of rural health service leaders as they prepared for the emergency pandemic response, and to derive from this the lessons learned for workforce preparedness to inform recommendations for future policy and emergency planning. Methodology and methodsInterviews were conducted with leaders from two rural public health services in Australia, one small (500 staff) and one large (3000 staff). Data were inductively coded and analysed thematically. ParticipantsThirty-three participants included health service leaders in executive, clinical, and administrative roles. FindingsSix major themes were identified: Working towards a common goal, Delivery of care, Education and training, Organizational governance and leadership, Personal and psychological impacts, and Working with the Local Community. Findings informed the development of a applied framework. ConclusionThe study findings emphasise the critical importance of leadership, teamwork and community engagement in preparing the emergency pandemic response in rural areas. Informed by this research, recommendations were made to guide future rural pandemic emergency responses or health crises around the world.

Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.

The emergence of the COVID-19 pandemic has served as a call for enhanced global cooperation and a more robust pandemic preparedness and response framework. As a result of this pressing demand, dialogues were initiated to establish a pandemic treaty designed to foster a synchronized global strategy for addressing forthcoming health emergencies. In this review, we discussed the main obstacles to this treaty. Among several challenges facing the pandemic treaty, we highlighted (1) global cooperation and political will, (2) equity in access to resources and treatments, (3) sustainable financing, (4) compliance and enforcement mechanisms, (5) sovereignty concerns, and (6) data sharing and transparency. Navigating the hurdles facing the development of the pandemic treaty requires concerted efforts, diplomatic finesse, and a shared commitment to global solidarity. Addressing challenges in global cooperation, equitable access, transparency, compliance, financing, and sovereignty is essential for forging a comprehensive and effective framework for pandemic preparedness and response on the global stage.

Hospital-admitted drowning in Victoria, Australia, before and after the emergence of the COVID-19 pandemic

ObjectivesTo examine trends in hospitalisation following drowning in Victoria, Australia, before and after the emergence of the COVID-19 pandemic.DesignRetrospective analysis of administrative hospital admission records.SettingHospital admissions recorded in the Victorian...

Urban biodiversity and design in time of (post)pandemics: research perspectives from URBIO international network

Reflecting on the insights from research development within Urban Biodiversity and Design Network (URBIO), this paper attempts to link the consequences of current global changes (ongoing urbanization, biodiversity loss, land-use changes, globalization, etc.) to the emergence and outbreaks of the COVID-19 pandemic. It analyses the main outcomes of the URBIO webinar (December 2021) and the URBIO conference (November 2022) and the results of the questionnaire survey among the URBIO experts on the impact of COVID-19 on the biodiversity, design and society in their local contexts as well as on the ongoing and future URBIO research directions. The survey also enabled to explore and assess a wide diversity of human-nature interactions as well as the novel actions and adaptation strategies established to have positive outcomes for both humans and nature. The results revealed the following aspects associated with the COVID-19 pandemic: silence, social distancing, isolation, conflict ideologies, and declined recreational and other human activities. Experts noticed the increase of urban green space visitation and interest in nature. The majority of the experts confirmed the impact (both positive and negative) of the COVID-19 on biodiversity and environment. General positive aspects refer to the value/significance of nature and biodiversity/wildlife and especially the contact with nature (“time outdoor”, “time spent with family”, “inspiration from nature” and “enjoying nature”). The positive consequence of the COVID-19 measures was also the improvement of wildlife habitats and the increase of spontaneous flora as well as fauna species. Experts confirmed the lower/decreased level of pollution, noise, traffic, light, anthropogenic pressure/impact, number of tourists, vehicles as well as less garbage. The analysis of leading research themes among the URBIO conference participants confirmed that the biggest number of presenters and participants were on the topic of biodiversity integration in urban planning, green infrastructure, and landscape design projects. Another popular theme was ecological restoration and urban wildlife and plant biodiversity. One particular research direction that emerged recently and clearly pronounced at URBIO 2022 was urban biodiversity in times of climate change and post-pandemics.

Impact of home quarantine on physical fitness of school-aged children in Xi’an during COVID-19 lockdown: a cross-sectional study

BackgroundThe emergence of the COVID-19 pandemic has sparked unprecedented global challenges. This study intends to investigate changes in the physical fitness of students aged 6–22 during the COVID-19 pandemic and to assess how the pandemic lockdown period affected these markers.MethodsAccording to the National Student Physical Health Standard, a stratified cluster sampling method was used to evaluate the body shape, body function, and physical fitness of children and adolescents (n = 8092) in Xi’an from 2019 to 2021. This study uses SPSS 26.0 (IBM, Chicago, IL, USA) for data statistics and analysis. The connection between physical fitness and years was measured using the one-variable analysis in the general linear model (GLM). Independent t-tests were used to determine the sex (male/female) and area (urban/rural) differences.ResultsDuring the lockdown period, Body Mass Index (BMI) and flexibility showed an upward trend, while aerobic, strength, speed, and endurance showed a downward trend. In addition to the BMI of middle and high school students, almost all indicators show significant sex differences. There are urban-rural differences in some indicators, such as chin-ups.ConclusionDuring the pandemic of COVID-19, the physical fitness of children and adolescents in Xi’an did not change significantly, and there were slight differences among different grades. During the pandemic lockdown period, lifestyle changes and reduced outdoor activities for children and adolescents may be the reasons for the changing trend of various indicators.

Mucormycosis in the time of COVID-19: risks and challenges

The first patients positive for SARS-CoV-2 were registered in December 2019. In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic, the beginning of a worldwide health crisis that revealed numerous medical challenges for healthcare systems and pandemic emergency strategies.Among these challenges, mucormycosis, a typically rare fungal infection, gained global attention. With an average global incidence of about 2 per 1 million people, mucormycosis is considered a very rare disease, an opportunistic infection mostly affecting the lungs or skin and soft tissues in immunocompromised patients. Poorly controlled diabetes mellitus is one of the leading risk factors for rhino-orbital mucormycosis. Countries with a high prevalence of diabetes and limited healthcare resources have higher mucormycosis rates, with India and Pakistan being among the nations with particularly high incidences.During the second wave of the COVID-19 pandemic in India, mucormycosis rates surged dramatically within a few weeks, with over 47,500 cases of COVID-19-associated mucormycosis (CAM) reported between May and August 2021. Mucormycosis is characterized by a high mortality rate of up to 90%, especially when the diagnosis is delayed, and treatment commences late. There were concerns about a potentially global threat.In this article, we explore the risk factors and mechanisms leading to this viral-fungal coinfection. We present global distribution patterns, clinical presentation, and challenges in the diagnosis and treatment of COVID-19-associated mucormycosis.

Perceptions on violence against women and its impacts on mental health and response mechanisms among community-based stakeholders: a qualitative study from Nepal

BackgroundViolence against women (VAW) is a significant public health problem. With the emergence of the COVID-19 pandemic, the frequency and severity of VAW has escalated globally. Approximately one in four women in Nepal have been exposed to either physical, psychological, and/or sexual violence in their lifetime, with husbands or male partners being the perpetrators in most cases. VAW prevention has been under-researched in low- and middle-income countries, including Nepal. This study aims to explore the perspectives of local stakeholders, including healthcare providers and survivors of violence in Madhesh Province. The overarching goal is to provide insights for designing prevention and support programs that are acceptable to communities and cater to the needs of survivors.MethodsAn explorative qualitative study was conducted in Madhesh Province, southern Nepal. A total of 21 interviews, including 15 in-depth interviews (IDIs) with health care providers, three IDIs with women seeking general or maternal and child health services at health care centres, three key informant interviews with the local stakeholders working in the field of VAW, and one focus group discussion with violence survivors, were conducted in Nepali by trained field interviewers. Interviews were recorded, transcribed, translated into English, and analysed using content analysis.ResultsVAW, particularly physical violence, was a common experience in the study area. Sociocultural traditions such as dowry, child marriages and son preference were identifiable triggers for VAW, causing significant physical injuries and mental health problems, including suicide. Health care providers reported that violence survivors often hide their experiences of violence and do not seek any kind of help. Women feared that violence would increase in frequency and intensity if their perpetrators found out that they had disclosed their experiences of violence to health care providers. Local stakeholders emphasized the importance of engaging community leaders and garnering support from both women and men in interventions designed to reduce VAW and its impacts on mental health.ConclusionsParticipants reported that verbal and physical violence is often perceived as a normal part of women’s lives. Women should be made aware of available support services and empowered and supported to increase access and uptake of these services. Additionally, more individual-based counselling sessions that encourage women to escape violence and its mental health consequences while maintaining privacy and confidentiality are recommended.

The Impact of Assisted Living Organizational Structure and Process Characteristics on Staff Absence During COVID-19

ABSTRACT Quality of care in assisted living communities (ALCs) is important to consumers. The coronavirus disease of 2019 (COVID-19) pandemic and associated emergency policies have posed major challenges on staff recruitment and retention. This study aimed to examine the relationship between organizational characteristics of ALCs in Florida and challenges with staff absence during COVID-19 (N = 129 ALCs). Results indicated that structures (provision of memory care services), processes of care (challenges hiring new staff, staff sent home to comply with precautions, and staff anxiety), and local COVID-19 positivity rate were significantly associated with staff absence due to fear of infection, sickness, or family responsibilities. ALC providers and state regulatory agencies should develop policies and procedures that take these issues into consideration to prepare for future emergencies and disasters. Infection control policies should reflect whether an ALC provides memory care services and inform ways to overcome potential challenges with protocols. Efforts to reduce staff anxiety and disaster-related concerns should also be considered to ensure quality of care during emergencies.

Knowledge, attitudes and practices in biosafety and biosecurity in medical biology laboratories in Togo, 2021

IntroductionFaced with the emergence of pandemics and the omnipresence of gaps in the process of controlling elements likely to impact the implementation of biosafety and biosecurity measures, the evaluation of the related determinants becomes an urgent necessity.MethodsThe subject addressed in this study was primarily aimed at exploring the current situation of knowledge, attitudes and practices of biosafety and biosecurity as well as the associated factors in medical biology laboratories in Togo in 2021. A cross-sectional study with an analytical focus among laboratory professionals was conducted using a structured questionnaire. Statistical tests were performed using Epi Info 7.2.3.0 (2019) and Stata 13 (2013) software.ResultsOf the 322 participants, 49.1% had good knowledge while 62.4% and 77.6% had good attitudes and practices respectively. In 23.4% (25/107) of the laboratories, the staff surveyed ate their meals in the manipulation room, of which 80.0% (20/25) were in the public sector. Although the results showed that respondents who had received prior training in this area had higher score on the knowledge component (p = 0.03), this intervention had no direct effect on the attitude (p = 0.91) or practice (p = 0.84) scores. Trained participants were significantly more likely to have good knowledge. Regional disparity was noted on the knowledge and practice components and several gaps were identified.DiscussionBiosafety and biosecurity remain a challenge in medical biology laboratories in Togo. Based on the gaps identified, training, substantial improvement of the working environment, and provision of resources to achieve optimal and sustainable biosafety and biosecurity practices in Togo are required.

Mapping economic and social effects of Covid-19 in ASEAN economies

The emergence of the Covid-19 pandemic has created a perfect storm of crises in ASEAN member countries (AMCs). Before the Covid-19 crisis, economic inequalities were prevalent all across AMCs at domestic and regional levels and the majority of the population was confined to surviving on low and insecure incomes. The main objective of this study is to explore the economic and social effects among AMCs and how Covid-19 interacted with these effects. Our study indicates that stark and myriad economic inequalities persist among low-income and rural poor societies of high-income countries in the ASEAN ranging from wealth, access to healthcare and education services, gender-based inequalities, deprivation of basic resources and services, and asymmetry in employment and migration opportunities for certain groups. We predict that Covid-19 will exacerbate these inequalities consequently pushing marginalised and vulnerable people into extreme poverty and may further escalate health and economic risks. AMCs governments need to focus on developing an inclusive economic recovery process to strengthen the poorly protected social safety nets, address the gender-based issues and consider the inclusion of marginalised and vulnerable communities while developing health and economic recovery policies to mitigate Covid-19 impacts. Our findings provide a roadmap to the governments and policymakers scrambling for resources to combat the Covid-19 social and economic impacts.

Factors Influencing the Use of E-Assessment in Engineering Education During Emergency Remote Teaching: A Qualitative Approach

The study aims to investigate engineering education instructors' observations and experiences with e-assessment challenges during the COVID-19 pandemic's Emergency Remote Teaching (ERT) period. The study employed a focus group discussion method with a criterion sample of seven instructors from engineering education in a higher education institution. The data gathered was transcribed and analyzed using thematic analysis, which revealed four major themes: benefits, challenges, different types of remote assessment, and recommendations and guidelines for future better practice. The study's findings offer insights into the challenges faced by engineering education instructors during the ERT period, as well as recommendations for future better e-assessment practices.

Risk and Protective Factors of Stress Level in COVID-19 Survivors

Aim: The level of mental emotional disorders in community has increased since the emergence of the COVID-19 pandemic. This study aimed to determine the risk factors and protective factors of the stress level of COVID-19 survivors. Subjects and Methods: This study used a descriptive analytic design with a cross sectional approach. A total of 66 respondents were involved in this study. Data were collected using a questionnaire consisting of: 1) Sociodemographic factors (age, sex, education level, COVID-19 wave and long COVID); 2) Risk factors (previous mental disorders, economic problems, substance use, loneliness, conflict in relationships and loss of important people); 3) Protective factors (spirituality, healthy eating patterns, physical activity, good sleep patterns and good personal relationships. Stress levels were measured using the Hopkins Symptom Checklist - 25 (HSCL - 25), where if the total score/ number of items ≥ 1.75 then categorized as experiencing stress disorder. For data analysis, SPSS Windows 25 was used. Results: The results of the descriptive analysis show that COVID-19 survivors were of the average age of 18-40 years old (78.8 %), female (80.3 %), had undergraduate education level (75.8 %), affected in wave II (45.5 %), felt loneliness (51.5 %), had conflict in their relationships (56.1 %), experienced continued effect of COVID (81.8 %), experienced anxiety (53 %), depression (56.1 %) and stress (57.6 %). The most influential factor on the stress level of COVID-19 survivors was sex (p = 0.032; OR: 0.189). Conclusion: There is no relationship between risk factors and protective factors on the stress level of COVID survivors. The most influential factor is the socio-demographic factor of sex.

Staff Opinions on the Most Positive and Negative Changes in Mental Health Services During the 2 Years of the Pandemic Emergency in Italy

AbstractThis mixed-methods study investigated healthcare staff members’ opinions on the most positive and negative changes in mental health services (MHSs) during the 2-year COVID-19 pandemic emergency in Italy, and whether those changes differed by professional role and type of service. At the end of the national health emergency (March–April 2022), staff members from 17 MHSs completed the MHS Transformations Questionnaire, which includes a quantitative section with 30 multiple-choice items addressing positive changes and a qualitative section with two open-ended items on the most positive and negative changes. The 714 participants who responded to at least one open-ended item in the qualitative section formed the sample. Qualitative responses were categorised according to the textual content of the response and the themes of the quantitative section. Flexibility and Ability to Reinvent the Service was the subscale with the highest mean score. The most positive and negative changes fell into the following categories: practices (49.1 and 39%), organisation (34.5 and 36.9%), teamwork values (45.0 and 34.5%), and relationships with users and their families (31.9 and 40.6%). The most positive changes differed by type of service (i.e. in the relationship with users and their families category) and by professional role (i.e. in the practices and relationship with users and their families categories), whereas the most negative changes differed by type of service (i.e. in the practices category). The results may elucidate the complex experiences with the COVID-19 pandemic in MHSs and reveal lessons to be considered in post-pandemic service planning.

Promoting Science Communication for the Purpose of Pandemic Preparedness and Response: An Assessment of the Relevance of Pre-COVID Pandemic “early warnings”

Abstract Given the abrupt global disruption caused by SARS-CoV-2, one might think that the COVID pandemic was an unpredictable event. But in the years leading up to the emergence of the COVID pandemic, several documents had already been warning of the increasing occurrences of new disease outbreaks with pandemic potential and lack of corresponding policies to promote pandemic preparedness and response. In this article, we call these documents “early warnings”. We argue that a survey of early warnings can help science communicators to promote the public understanding of evidence-based pandemic preparedness and response policies at local or international level. Our proposal differs from other approaches to pandemic preparedness and response in that it highlights the relevance of documents published before the COVID outbreak. We show that the early warnings did not become outdated after the COVID outbreak, but, rather, that they are even more pressing now.

Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level.

The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic. This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level. Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25th 64.0; 75th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25th 13.0, 75th 22.0), fear of danger (median score 17.0; IQR 25th 14.0, 75th 20.0) and contamination fears (median score 16.0; IQR 25th 12.0, 75th 19.0). Lower household income was associated with higher stress level (p = 0.006). Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.

Federal Retail Pharmacy Program Contributions to Bivalent mRNA COVID-19 Vaccinations Across Sociodemographic Characteristics - United States, September 1, 2022-September 30, 2023.

The Federal Retail Pharmacy Program (FRPP) facilitated integration of pharmacies as partners in national efforts to scale up vaccination capacity during the COVID-19 pandemic emergency response. To evaluate FRPP's contribution to vaccination efforts across various sociodemographic groups, data on COVID-19 bivalent mRNA vaccine doses administered during September 1, 2022-September 30, 2023, were evaluated from two sources: 1) FRPP data reported directly to CDC and 2) jurisdictional immunization information systems data reported to CDC from all 50 states, the District of Columbia, U.S. territories, and freely associated states. Among 59.8 million COVID-19 bivalent vaccine doses administered in the United States during this period, 40.5 million (67.7%) were administered by FRPP partners. The proportion of COVID-19 bivalent doses administered by FRPP partners ranged from 5.9% among children aged 6 months-4 years to 70.6% among adults aged 18-49 years. Among some racial and ethnic minority groups (e.g., Hispanic or Latino, non-Hispanic Black or African American, non-Hispanic Native Hawaiian or other Pacific Islander, and non-Hispanic Asian persons), ≥45% of COVID-19 bivalent vaccine doses were administered by FRPP partners. Further, in urban and rural areas, FRPP partners administered 81.6% and 60.0% of bivalent vaccine doses, respectively. The FRPP partnership administered approximately two thirds of all bivalent COVID-19 vaccine doses in the United States and provided vaccine access for persons across a wide range of sociodemographic groups, demonstrating that this program could serve as a model to address vaccination services needs for routine vaccines and to provide health services in other public health emergencies.

Sound contexts of cultural heritage tourism in the Iberian Peninsula

ABSTRACT Podcasting has emerged as an important tool for interpretive communication of heritage and promotion and marketing of tourism organizations. The integration of podcasting in these organizations’ digital models and strategies became even more evident with the emergence of the Covid-19 pandemic, setting an alternative and enriching medium for citizens to experience heritage. Thus, the aim of the paper is to explore the use of cultural heritage, tourism-related podcasts in the context of the Iberian Peninsula, a territory with deep geographical and intercultural relationships, with capacity for developing integrated tourism strategies and products, but also with dissimilarities in the tourism and media area. Through qualitative methodology, the cultural heritage, tourism-related podcasts available in Portugal and Spain in 2022 were mapped, an observation grid was built, and a content analysis was carried out, identifying the themes, the origin, the structure, sound expressiveness and narrative techniques used in podcasts. Thus, this paper contributes to a greater understanding of how podcasts are used in the tourism sector, highlighting the good practices existing in both countries, the advantages and potential of podcasts and pointing out new paths that could constitute innovative uses in communication in tourism.

An Analysis of the Great Disruption of COVID-19 Pandemic

The emergence of the COVID-19 pandemic in late 2019 led to a global crisis of unprecedented scale and complexity that disrupted almost every aspect of human life. The pandemic has taken people, institutions and governments by surprise, so the impact of the virus has been profound and far-reaching. The rapid and relentless spread of the pandemic has challenged global health systems, strained economies, altered daily routines in educational settings and at work, and tested the resilience of communities worldwide. Different studies have identified vulnerabilities in the world’s ability to respond to health emergencies at the individual and societal levels. This study presents a systematic literature review and theoretical analysis of the disruptions caused by COVID-19 to help formulate strategies that encourage flexibility and resilience in the face of such complex and interconnected disruptions. The article analyzes the consequences of the COVID-19 pandemic through the prism of two main theories: the theory of situational crisis communications (type of crisis, its history, responsibility, perceived seriousness, predictable probability, crisis communications strategies, post-crisis reputation), as well as the theory of social learning (learning through observation, modeling and imitation, positive and negative reinforcement in the formation of behavior). In addition, the nature of society’s adaptation to the challenges of the COVID-19 pandemic is also considered through the prism of the theory of subversive innovations (progress in communication technologies, new methods of remote work and education, the entry of social networks into the business world, the introduction of asynchronous communication). The article summarizes the scientific progress on the following main consequences of the COVID-19 pandemic in the workplace, healthcare system, and education. The study provides recommendations on the steps that individuals, institutions and governments can take to increase readiness and ability to adapt to the next crisis (interdisciplinary cooperation, analysis of communication strategies, system analysis). The analysis conducted in the article also made it possible to outline the most promising directions for further qualitative intervention studies (in-depth case studies taking into account the specific context of regions, organizations or communities to identify effective and ineffective policies and practices; qualitative interviews with key stakeholders to understand the intricacies of decision-making in the context of the pandemic crisis); qualitative action studies (building community resilience, collaborative research efforts involving policymakers, health experts and community representatives to develop crisis response policies jointly) and quantitative studies (analysis of pandemic spread, impact of vaccination on disease control, analysis of the economic effects of the pandemic, etc.).

Innovations in Global Health: Leveraging Technology for Disease Surveillance and Pandemic Preparedness

The emergence of infectious diseases and global pandemics necessitates continuous advancements in health surveillance and preparedness strategies. This article explores the innovations in global health that leverage technology to enhance disease surveillance and improve pandemic preparedness. The study investigates the role of various technological solutions, including artificial intelligence, data analytics, mobile applications, and digital communication platforms, in strengthening global health systems. The article reviews recent case studies and initiatives where technology has been successfully employed for disease surveillance, early detection of outbreaks, and rapid response to emerging health threats. It examines how digital tools facilitate real-time data collection, analysis, and dissemination, enabling more effective monitoring of infectious diseases globally. Additionally, the article discusses the integration of wearable devices, telemedicine, and other remote health technologies in enhancing the resilience of health systems during pandemics. Furthermore, the challenges and ethical considerations associated with the implementation of technological innovations in global health are critically assessed. Privacy concerns, data security, and the need for global collaboration are addressed to ensure the responsible and ethical use of technology in disease surveillance. The article concludes by highlighting the potential of technology to revolutionize global health practices, emphasizing the importance of collaborative efforts among governments, international organizations, and the private sector. As the world faces ongoing and emerging health threats, the adoption of innovative technological solutions becomes paramount for building robust disease surveillance systems and improving overall pandemic preparedness on a global scale.

Shifts in Reduction Mammaplasty Surgical Volumes With the Emergence of a Global Pandemic.

The onset of the COVID-19 pandemic resulted in significant changes to the surgical caseload for various surgery departments across the United States. As medical institutions prioritized resources for the expected increase in patient volumes due to the SARS-CoV-2 viral infection, surgical departments saw a decrease in nonemergent and elective surgical procedures. Reduction mammoplasties, which are largely covered by insurance, are among the elective procedures that provide significant revenue to the hospital. This expected decline in procedures suggests a potential decline in revenue provided by the plastic surgery department of a hospital. The purpose of this study was to analyze the loss of revenue experienced by a single academic medical institution due to changes in breast reduction mammoplasty volumes during the COVID-19 pandemic. Upon institutional review board approval, using the Augusta University Medical Center's Financial Billing Data, 373 patients who underwent bilateral reduction mammoplasty were queried. A time horizon of March 2019 to February 2022 was used to determine the pre- and post-COVID case load and charges that were incurred. Statistical analysis to compare the prior 12 months and after 24 months of COVID was conducted using 2 samples of equal variance t test and F test confirming equal variance. There was a statistically significant increase in the number of reduction mammoplasties performed per month from the year before the onset of COVID-19 (March 2020) to the 2 years after (6.6-11.4 per month, P = 0.0024). There was a statistically significant increase in the per-month charges from the AU Health system for reduction mammoplasties for the same period ($31,780.92-$52,113.34 per month, P = 0.0054). Although there was an increase in per-month revenue from reduction mammoplasties, this increase failed to reach statistical significance ($7,059.95-$10,423.51 per month, P = 0.064). The plastic surgery department saw a statistically significant increase in reduction mammoplasty cases and subsequent charges in the post-COVID cohort. These findings suggest that the emergence of a nationwide pandemic did not necessarily lead to a decrease in the volume of nonemergent surgical cases despite an expected decrease in caseload due to the need to reallocate hospital resources. On the contrary, there was an increase in caseload suggesting that there may be other factors contributing to patients' pursuance of reduction mammoplasty post-COVID including convenience, resulting from time off due to pandemic, meeting insurance-covered reduction criteria, and projected recovery time.