Phase Of Pandemic Research Articles

Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19.

The timely management of rapidly evolving epidemiological scenarios caused by disease outbreaks is crucial to prevent devastating consequences. However, delayed laboratory diagnostics can hamper swift health policy and epidemic response, especially in remote regions such as the western Brazilian Amazon. The aim of the article is to analyze the impact of the COVID-19 pandemic on the volume and characteristics of emergency medical services (EMS) in Manaus, focusing on how the pandemic affected sensitive indicators such as response time and the use of advanced life support ambulances. Additionally, the study seeks to understand how changes in prehospital EMS patterns, triggered by the pandemic, could be utilized as health surveillance tools, enabling a more rapid response in epidemic scenarios. This retrospective, descriptive study included data from the SAMU (Serviço de Atendimento Móvel de Urgência) medical records between January and June 2020. A total of 45,581 calls resulted in mobile units being dispatched during this period. These patients were predominantly male (28,227, 61.9%), with a median age of 47 years (IQR 30-67). The median response time significantly increased during the pandemic, reaching a median of 45.9 min (IQR 30.6-67.7) (p < 0.001). EMS calls were reduced for trauma patients and increased for other medical emergencies, especially respiratory conditions, concomitantly to an escalation in the number of deaths caused by SARS and COVID-19 (p < 0.001). The employment of advanced life support ambulances was higher during the pandemic phase (p = 0.0007). The COVID-19 pandemic resulted in a temporary disorder in the volume and reason for EMS calls in Manaus. Consequently, sensitive indicators like the response time and the employment of advanced life support ambulances were negatively affected. Sudden prehospital EMS pattern changes could play an important role in health surveillance systems, allowing for earlier establishment of countermeasures in epidemics. The impact of the COVID-19 pandemic on prehospital EMS and its role in health surveillance should be further explored.

Prediction of the effects of the top 10 synonymous mutations from 26645 SARS-CoV-2 genomes of early pandemic phase

Background The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had led to a global pandemic since December 2019. SARS-CoV-2 is a single-stranded RNA virus, which mutates at a higher rate. Multiple works had been done to study nonsynonymous mutations, which change protein sequences. However, there is little study on the effects of SARS-CoV-2 synonymous mutations, which may affect viral fitness. This study aims to predict the effect of synonymous mutations on the SARS-CoV-2 genome. Methods A total of 26645 SARS-CoV-2 genomic sequences retrieved from Global Initiative on Sharing all Influenza Data (GISAID) database were aligned using MAFFT. Then, the mutations and their respective frequency were identified. Multiple RNA secondary structures prediction tools, namely RNAfold, IPknot++ and MXfold2 were applied to predict the effect of the mutations on RNA secondary structure and their base pair probabilities was estimated using MutaRNA. Relative synonymous codon usage (RSCU) analysis was also performed to measure the codon usage bias (CUB) of SARS-CoV-2. Results A total of 150 synonymous mutations were identified. The synonymous mutation identified with the highest frequency is C3037U mutation in the nsp3 of ORF1a. Of these top 10 highest frequency synonymous mutations, C913U, C3037U, U16176C and C18877U mutants show pronounced changes between wild type and mutant in all 3 RNA secondary structure prediction tools, suggesting these mutations may have some biological impact on viral fitness. These four mutations show changes in base pair probabilities. All mutations except U16176C change the codon to a more preferred codon, which may result in higher translation efficiency. Conclusion Synonymous mutations in SARS-CoV-2 genome may affect RNA secondary structure, changing base pair probabilities and possibly resulting in a higher translation rate. However, lab experiments are required to validate the results obtained from prediction analysis.

Geographical Mapping of COVID-19 Testing Rates in St. Louis: Influence of the Socioeconomic Index and Race on Testing in the Early Phase and Peak of the COVID-19 Pandemic

Purpose: This study aimed to explore how race and the socioeconomic index (SES) of residential zip codes influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City, including 16,915 tests from 30 residential zip codes. Geographical mapping identified areas lacking testing, descriptive statistics characterized testing rates by race and SES, and robust linear regression modeled the association between testing rates and race, controlling for SES. Results: The overall testing rate was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indians/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher rates were observed in low- and middle-SES zip codes compared with high-SES areas. Adjusted for SES, testing rates per 10,000 were higher by 125 (1.25%), 448 (4.48%), and 32 (0.32%) among Blacks, American Indians/Alaskan Natives, and Asians compared with Whites. Testing rates decreased by 56 (0.56%) per unit SES improvement. There was statistically significant SES finding and that of the difference between American Indians/Alaskan Natives and Whites. Geographical mapping showed higher rates in the inner core and lower rates in the periphery of St. Louis. Conclusions: Race and SES influence testing rates. Targeted interventions are needed in areas with low testing rates in St. Louis.

Birth rate decline in the later phase of the COVID-19 pandemic: the role of policy interventions, vaccination programmes and economic uncertainty

Abstract STUDY QUESTION What are the factors influencing the decline in the birth rates observed in higher-income countries in the later phase of the COVID-19 pandemic? SUMMARY ANSWER Our results suggest that economic uncertainty, non-pharmaceutical policy interventions, and the first wave of the population-wide vaccination campaign were associated with the decline in birth rates during 2022. WHAT IS KNOWN ALREADY During the COVID-19 pandemic, birth rates in most higher-income countries first briefly declined and then shortly recovered, showing no common trends afterwards until early 2022, when they unexpectedly dropped. STUDY DESIGN, SIZE, DURATION This study uses population-wide data on monthly total fertility rates adjusted for seasonality and calendar effects provided in the Human Fertility Database (HFD). Births taking place between November 2020 and October 2022 correspond to conceptions occurring between February 2020 and January 2022, ie, after the onset of the pandemic but prior to the Russian invasion of Ukraine. The data cover 26 countries, including 21 countries in Europe, the United States, Canada, Israel, Japan and the Republic of Korea. PARTICIPANTS/MATERIALS, SETTING, METHODS First, we provided a descriptive analysis of the monthly changes in the total fertility rate (TFR). Second, we employed linear fixed effects regression models to estimate the association of explanatory factors with the observed seasonally adjusted total fertility rates. Our analysis considered three broader sets of explanatory factors: economic uncertainty, policy interventions restricting mobility and social activities outside the home, and the progression of vaccination programmes. MAIN RESULTS AND THE ROLE OF CHANCE We found that birth trends during the COVID-19 pandemic were associated with economic uncertainty, as measured by increased inflation (p &amp;lt; 0.001), whereas unemployment did not show any link to births during the pandemic (p = 0.677). The stringency of pandemic policy interventions was linked to a postponement of births, but only in countries with lower institutional trust and only in the early phase of the pandemic (p = 0.003). In countries with higher trust, stricter containment measures were positively associated with birth rates, both for conceptions in the first year of the pandemic (p = 0.019) and, albeit only weakly significant, for conceptions later in the pandemic (p = 0.057). Furthermore, we found a negative association between the share of the population having received the first dose of the COVID-19 vaccination and total fertility rates (p &amp;lt; 0.001), whereas the share of the population having completed the primary vaccination course (usually consisting of two doses) was linked to a recovery of birth rates (p &amp;lt; 0.001). LARGE SCALE DATA N/A LIMITATIONS, REASONS FOR CAUTION Our research is restricted to higher-income countries with relatively strong social support policies provided by the government as well as wide access to modern contraception. Our data did not allow analyses of birth trends by key characteristics, such as age, birth order and social status. WIDER IMPLICATIONS OF THE FINDINGS This is the first multi-country study of the drivers of birth trends in the later phase of the COVID-19 pandemic. In the past, periods following epidemics and health crises were typically associated with a recovery in births. In contrast, our results show that the gradual phasing out of pandemic containment measures, allowing increased mobility and a return to more normal work and social life, contributed to declining birth rates in some countries. In addition, our analysis indicates that some women avoided pregnancy until completion of the primary vaccination protocol. STUDY FUNDING/COMPETING INTEREST(S) This study did not use any external funding. The authors acknowledge funding from their home institution, the Vienna Institute of Demography of the Austrian Academy of Sciences, and from the Open-Access Fund of the Austrian Academy of Sciences. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript versions arising from this submission. All authors declare that they have no conflicts of interest.

Characteristics and Rates of Preterm Births During the COVID-19 Pandemic in Germany

Population-based analyses provided divergent data on the changes in preterm birth rates during the COVID-19 pandemic, and there is a gap of knowledge on the variations in birth characteristics. To study changes in perinatal care, causes of preterm delivery, and very preterm (VPT; defined as <32 weeks' gestation) birth rates before and during the COVID-19 pandemic. This population-level cohort study used data from the quality assurance registry, which covers all births in Hesse, Germany. Deliveries during the COVID-19 pandemic (2020) were compared with the corresponding grouped prepandemic time intervals (2017 to 2019). Analyses were executed between August 2023 and July 2024. Analyses were directed to study differences in preterm births before and during 3 pandemic phases: first (March 14 to May 15, 2020) and second (October 19 to December 31, 2020) lockdowns and a period of less-vigorous restrictions between them (May 16 to October 18, 2020). Outcomes of interest were variations in preterm birth rates in the context of baseline characteristics and causes of preterm births during vs before the first year of the COVID-19 pandemic. From the total cohort of 184 827 births from 2017 to 2020, 719 stillbirths occurred and 184 108 infants were liveborn. Compared with the prepandemic period, medical care characteristics did not differ during the COVID-19 period. The odds of VPT births were lower during the pandemic period (odds ratio [OR], 0.87; 95% CI, 0.79-0.95) compared with the prepandemic period, with the greatest reduction observed during the second lockdown period (OR, 0.69; 95% CI, 0.55-0.84). Reduction in VPT births was attributed to fewer births in pregnancies among individuals with a history of serious disease (OR, 0.64; 95% CI, 0.50-0.83), pathologic cardiotocography (OR, 0.66; 95% CI, 0.53-0.82), and intrauterine infection (OR, 0.82; 95% CI, 0.72-0.92) while incidences of history of preterm birth, multiple pregnancies, serious or severe psychological distress, and preeclampsia, eclampsia, or hemolysis, elevated liver enzymes, and low platelet count syndrome as cause for preterm delivery remained unchanged. In this population-based cohort study on the COVID-19 pandemic and preterm birth rates, the duration of exposure to mitigation measures during pregnancy was associated with accelerated reductions in preterm births. The findings of lower rates of baseline risks and causes of preterm deliveries support efforts to intensify health care prevention programs during pregnancy to reduce the preterm birth burden. These findings of this study put particular focus on hygiene measures to reduce the rate of deliveries for intrauterine infection and highlight the potential of expanding strategies to the different risks and causes of preterm delivery.

A temporal dynamics framework and methodology for computationally intensive social media research

The growing availability of expansive social media trace data (SMTD) offers researchers promising opportunities to create rich depictions of societal and social phenomena. Despite this potential, research analysing such data often struggles to construct novel theoretical insight. This paper argues that holistically incorporating temporality enhances data collection and data analysis, subsequently facilitating process theory construction from SMTD. Recommendations to integrate temporality are outlined in the proposed Temporal Dynamics Framework and Methodology (TDFM). We apply the TDFM to investigate the temporal dynamics of mental health discourse on Twitter (now X) across different phases of the COVID-19 pandemic, theoretically framed in the context of innate psychological needs satisfaction. The findings reveal dynamic shifts in social media use, indicating that different phases of the pandemic triggered changes in the needs motivating, and being motivated by, social media use. This illustrative case reflectively evaluates the TDFM's usefulness in contextualising SMTD collection, analytical strategies, and process theory construction by incorporating a dynamic perspective on time.

SARS-COV-2 SEROSURVEY OF HEALTHY, PRIVATELY OWNED CATS PRESENTING TO A NEW YORK CITY ANIMAL HOSPITAL IN THE EARLY PHASE OF THE COVID-19 PANDEMIC (2020-2021).

SARS-CoV-2, the cause of the ongoing COVID-19 pandemic, not only infects humans but is also known to infect various species, including domestic and wild animals. While many species have been identified as susceptible to SARS-CoV-2, there are limited studies on the prevalence of SARS-CoV-2 in animals. Both domestic and non-domestic cats are now established to be susceptible to infection by SARS-CoV-2. While serious disease in cats may occur in some instances, the majority of infections appear to be subclinical. Differing prevalence data for SARS-CoV-2 infection of cats have been reported, and are highly context-dependent. Here, we report a retrospective serological survey of cats presented to an animal practice in New York City, located in close proximity to a large medical center that treated the first wave of COVID-19 patients in the U.S. in the Spring of 2020. We sampled 79, mostly indoor, cats between June 2020 to May 2021, the early part of which time the community was under a strict public health "lock-down". Using a highly sensitive and specific fluorescent bead-based multiplex assay, we found an overall prevalence of 13/79 (16%) serologically-positive animals for the study period; however, cats sampled in the Fall of 2020 had a confirmed positive prevalence of 44%. For SARS-CoV-2 seropositive cats, we performed viral neutralization test with live SARS-CoV-2 to additionally confirm presence of SARS-CoV-2 specific antibodies. Of the thirteen seropositive cats, 7/13 (54%) were also positive by virus neutralization, and two of seropositive cats had previously documented respiratory signs, with high neutralization titers of 1/1024 and 1/4096; overall however, there was no statistically significant association of SARS-CoV-2 seropositivity with respiratory signs, or with breed, sex or age of the animals. Follow up sampling of cats showed that positive serological titers were maintained over time. In comparison, we found an overall confirmed positive prevalence of 51% for feline coronavirus (FCoV), an endemic virus of cats, with 30% confirmed negative for FCoV. We demonstrate the impact of SARS-CoV-2 in a defined feline population during the first wave of SARS-CoV-2 infection of humans, and suggest that human-cat transmission was substantial in our study group. Our study provide a new context for SARS-CoV-2 transmission events across species.

Impact of the Early Phase of the COVID-19 Pandemic on the Quality of Care for Colorectal and Anal Cancers at Comprehensive Cancer Centers on Two Continents.

The early phase of the COVID-19 pandemic affected cancer care globally. Evaluating the impact of the pandemic on the quality of cancer care delivery is crucial for understanding how changes in care delivery may influence outcomes. Our study compared care delivered during the early phase of the pandemic with the same period in the previous year at two institutions across continents (Princess Margaret Cancer Center [PM] in Canada and A.C. Camargo Cancer Center [AC] in Brazil). Patients newly diagnosed with colorectal or anal cancer between February and December 2019 and the same period in 2020 were analyzed. Sociodemographic and clinical characteristics and performance of individual indicators within and between centers and between the peri-COVID-19 and control cohorts were tested using Cohen's h test to assess the standardized differences between the two groups. Among 925 patients, distinct effects of the early COVID-19 pandemic on oncology services were observed. AC experienced a 50% reduction in patient consultations (98 v 197) versus a 12.5% reduction at PM (294 v 336). Similarly, AC experienced a higher proportion of stage IV disease presentations (42.9% v 29.9%; P = .015) and an increase in treatment delay (61.9% v 9.7%; P < .001) compared with prepandemic. At PM, a 10% increase in treatment interruption (32.4% v 22.3%; P < .001) and a higher rate of discontinuation of radiotherapy (9.4% v 1.1%; P < .001) were observed during the pandemic. Postsurgical readmission rates increased in both AC (20.9% v 2.6%; P < .001) and PM (10.5% v 3.6%; P < .01). The early phase of the COVID-19 pandemic affected the quality of care delivery for colorectal and anal cancers at both centers. However, the magnitude of this impact was greater in Brazil.

Behind the screen: exploring the effects of home working on 999 telephone clinicians during the COVID-19 pandemic.

The COVID-19 pandemic has significantly stretched global healthcare provisions since its commencement in 2019. From the outset, ambulance services in the UK had to adapt and change their working practices to meet distancing requirements, to increase staff numbers and to ease the effects of staff becoming unavailable for work due to self-isolation and illness. One strategy was moving clinicians from emergency operation centres (EOCs) to working from home. Like many international services, UK ambulance services use paramedics and nurses to undertake telephone and video assessments of patients calling the 999 emergency services line in a model known as virtual care or remote clinical decision making. Virtual care is any interaction between a patient and a clinician or clinicians, occurring remotely via information technologies.Increasing evidence is becoming available to suggest that the pandemic caused harm to the well-being of healthcare workers, primarily due to the severe stress of regular exposure to death and human suffering. However, there remains a dearth of literature focusing on the well-being of remote and virtual clinicians, especially those who moved from working in EOCs to working at home during the COVID-19 pandemic. Therefore, this study reports the findings of a qualitative analysis of these effects from the clinician's perspective. The authors hope that the findings from this study will inform the operating, well-being and leadership practices of those delivering such services. A convenience sample of telephone nurses and paramedics from one UK ambulance service where home working had been implemented were contacted. Fifteen clinicians with recent home-working experience responded to the invitation to participate out of a possible 31 (48%). All participants had previously practised remote assessment from within an EOC. Semi-structured interviews took place via video-conferencing software and were recorded, transcribed and thematically analysed. An inductive approach was taken to generating codes, and both researchers separately read the transcripts before re-reading them, assigning initial themes and determining frequency. Five main themes were discovered, with further associated sub-themes. The main themes were: safety; financial implications; working relationships; home-working environment; and anxiety. Few studies explore remote clinicians' health and well-being. This study identified that home-working clinicians felt that there had been no detrimental impact on their health and well-being because of working from home during the initial phase of the COVID-19 pandemic. While some concerns were raised, these were mitigated through the support that clinicians received at home from family members, as well as from colleagues, some of whom had developed new working relationships. Financial implications appeared to have contributed to some concerns for participants initially, but these had been alleviated quickly despite requiring further exploration of the true financial impact of working from home.

Outpatient mental health care during high incidence phases of the COVID-19 pandemic in Germany - changes in utilization, challenges and post-COVID care.

As only a few studies have examined the impact of the COVID-19 pandemic on the mental health outpatient system so far, the aim of the COVID Ψ Outpatient Survey was to gain insight from outpatient providers in Germany regarding changes in utilization; associated problems and challenges; telemedicine services; interactions with inpatient and nursing home services; and experiences with post-COVID syndromes. Between July and September 2021, we invited 351 randomly selected outpatient mental health specialists to take part in the online survey via e-mail. Additionally, we extended an invitation to professional associations to encourage their members to participate. N = 105 physicians of most regions of Germany took part in the survey. Survey participants reported changes in utilization during the high incidence phases (HIP) of the pandemic using pre-formulated categories: For the first HIP in spring 2020, 31% of the survey participants reported a decrease > 20% and 5% an increase > 20% of patient contacts. For the third HIP in spring 2021, 4% reported a decrease > 20% of contacts, while 30% an increase > 20%. Participants chose "patient's fears of infection" and "providers protection measures" as reasons for decreases, and "pandemic related anxieties", "economic stressors", and "capacity reductions of the inpatient system" as reasons for increases of patient contact. Many providers introduced telemedicineservices. A majority reported consultations for post-COVID syndromes already in spring 2021. The survey hinted at changes in utilization, multiple problems but as well good-practice-solutions in the mental health outpatient system during the COVID-19 pandemic.

Impact of SARS-CoV-2 infection and vaccination on cesarean section outcomes: a retrospective analysis.

Pregnant individuals have faced unique challenges during the COVID-19 pandemic, necessitating a closer examination of maternal and fetal health outcomes. Investigate the morbidity and mortality associated with SARS-CoV-2 infection among pregnant individuals, considering vaccination status and variant strains. Retrospective cohort. Tertiary state hospital. Patients who underwent cesarean sections were categorized into three periods: pre-vaccination (before 31 August 2021), early post-vaccination (from September 2021), and late post-vaccination (aligned with 70% immunization coverage by 2 September 2021). Data collected included demographic information (age, gravidity, parity count, gestational age, newborn APGAR scores), cesarean section indications, chronic diseases, vaccination status, vaccine type and doses, SARS-CoV-2 variant status, ICU admission, and mortality due to COVID-19. ICU admission and mortality rates, focusing on the impact of SARS-CoV-2 infection and vaccination status. 297 COVID PCR-positive symptomatic patients who underwent cesarean sections. In the pre-vaccination group, there were 13 mortalities (8.1%) compared to 9 (6.6%) post-vaccination (P=.610). Maternal ARDS was seen in 46.2% of pre-vaccination mortalities versus 11.1% post-vaccination (P=.045). COVID-19 delta variant patients had higher ICU admission (80%) and mortality rates (40%). Rates of COVID-19 PCR-positive cesarean sections, ICU admissions, and mortality declined significantly in early (P=.021, P=.004, P=.009), respectively and late post-vaccination periods (P<.001, P<.001, P=.0019), respectively. Vaccinated patients had no ICU admissions or mortality. Vaccination against COVID-19 is crucial for pregnant individuals as it significantly reduces the risk of severe illness. While vaccines offer substantial protection, the pandemic's acute phase might be waning, yet COVID-19 remains a global threat, particularly in regions with limited vaccine access. Continued vigilance and proactive measures are essential to mitigate ongoing risks and the emergence of new variant strains. Retrospective observational design and the single-center setting, which may affect the generalizability of the findings.

Preserved prenatal lung growth assessed by fetal MRI in the omicron-dominated phase of the SARS-CoV-2 pandemic.

With SARS-CoV-2 evolving, disease severity and presentation have changed due to changes in mechanisms of entry and effector site as well as due to effects of vaccination- and/or infection-acquired immunity. We re-assessed fetal lung pathology in pregnancies with uncomplicated SARS-CoV-2 infections during the late, omicron-dominated pandemic phase to inform disease understanding and pregnancy consultation. In this case-control study, fetal lung volumes were assessed by fetal MRI in 24 pregnancies affected by mild maternal SARS-CoV-2 infection during the omicron-dominated pandemic phase with prevailing immunity through vaccination and/or prior SARS-CoV-2 infection. Fetal lung volumes (normalized to estimated fetal weight) in 24 pregnancies (GA 33.3 ± 3.8, 12 female fetuses) following mild, uncomplicated SARS-CoV-2 infection did not differ significantly from both, published reference values (96.3% ± 22.5% of 50th percentile reference values, p = 0.43), or fetal lung volumes of a site-specific, non-COVID control group (n = 15, 94.2% ± 18.5%, p = 0.76). Placental assessment revealed no group differences in thrombotic changes or placental heterogeneity (p > 0.05, respectively), and fetal lung volume did not correlate with placental heterogeneity when adjusting for gestational age at scan (p > 0.05). Assessment of fetal lung volume by MRI revealed unaffected lung growth in pregnancies affected by uncomplicated SARS-CoV-2 infection in the omicron-dominated pandemic phase in the presence of prevailing hybrid immunity. This finding contrasts sharply with the observed reduction in fetal lung volume following maternal alpha-variant infection in the pre-vaccination era and might reflect tropism- as well as immunity-related effects. Question: Is fetal lung development affected by mild maternal SARS-CoV-2 infection during the omicron-dominated phase of the pandemic? Fetal lung volume in 24 affected pregnancies did not differ significantly from published reference values or fetal lung volumes in 15 site-specific, non-COVID-affected control pregnancies. Preserved fetal lung volume following mild maternal SARS-CoV-2 infection during the omicron-dominated phase contrasts with previous findings of reduced volume in unvaccinated pregnancies during the alpha-dominated pandemic phase. These observations might reflect tropism- as well as immunity-related effects.

Alcohol purchases through online stores and mobile applications in the late phase of the COVID-19 pandemic in Poland.

Aim: Online alcohol sales have grown rapidly, but their impact on alcohol consumption and harms is not well understood. This study explores the association between online alcohol purchasing and drinking behaviours during the late phase of COVID-19 pandemic in Poland. Design: A nationally representative survey was conducted in May 2022 of 2000 Polish residents aged 18-50 years selected from a probability-based web panel. Measures included past-year alcohol purchasing through e-stores, food/delivery apps and retail apps. Alcohol consumption was quantified using the Beverage-Specific Quantity-Frequency method. Logistic regression was used to identify sociodemographic and behavioural correlates of online alcohol purchasing. Results: Of the study respondents, 19% purchased alcohol through e-stores, 17% via delivery apps and 15% with retail apps. Spirits were commonly purchased in e-stores (57%), while beer was purchased via apps (58%-60%). Most online buyers took advantage of price promotions (69%-75%) and reported some kind of age verification (67%-68%). Higher odds of online purchasing were found among men (adjusted odds ratio [aOR] 1.38-1.54), younger drinkers (aOR 1.65-2.04) and to some extent university graduates (aOR 1.75 for e-stores purchases). Compared to moderate drinkers, risky (aOR 2.32-3.02) and harmful drinkers (aOR 5.06-6.61) showed substantially increased odds of buying alcohol online. Conclusion: Results suggest online alcohol purchasing, especially through mobile apps, is linked to more excessive drinking. Apps enable easy access to alcohol anytime anywhere, circumventing policies restricting sales to minors and intoxicated persons. With youth drinking declining globally, online sales are an emerging issue for public health. Restricting mobile app-based alcohol delivery could be an important policy measure to curb excessive drinking enabled by digital sales.

A data science pipeline applied to Australia's 2022 COVID-19 Omicron waves

The field of software engineering is advancing at astonishing speed, with packages now available to support many stages of data science pipelines. These packages can support infectious disease modelling to be more robust, efficient and transparent, which has been particularly important during the COVID-19 pandemic. We developed a package for the construction of infectious disease models, integrated it with several open-source libraries and applied this composite pipeline to multiple data sources that provided insights into Australia's 2022 COVID-19 epidemic. We aimed to identify the key processes relevant to COVID-19 transmission dynamics and thereby develop a model that could quantify relevant epidemiological parameters.The pipeline's advantages include markedly increased speed, an expressive application programming interface, the transparency of open-source development, easy access to a broad range of calibration and optimisation tools and consideration of the full workflow from input manipulation through to algorithmic generation of the publication materials. Extending the base model to include mobility effects slightly improved model fit to data, with this approach selected as the model configuration for further epidemiological inference. Under our assumption of widespread immunity against severe outcomes from recent vaccination, incorporating an additional effect of the main vaccination programs rolled out during 2022 on transmission did not further improve model fit. Our simulations suggested that one in every two to six COVID-19 episodes were detected, subsequently emerging Omicron subvariants escaped 30–60% of recently acquired natural immunity and that natural immunity lasted only one to eight months on average. We documented our analyses algorithmically and present our methods in conjunction with interactive online code notebooks and plots.We demonstrate the feasibility of integrating a flexible domain-specific syntax library with state-of-the-art packages in high performance computing, calibration, optimisation and visualisation to create an end-to-end pipeline for infectious disease modelling. We used the resulting platform to demonstrate key epidemiological characteristics of the transition from the emergency to the endemic phase of the COVID-19 pandemic.

Analysis of the effect of Regional Stock Market on the Jakarta Composite Index using Markov Regime Switching Regression

Purpose: In the current era of information, global stock market interconnections significantly influence investment decisions. Changes in one market rapidly affect others. The co-movement of stock markets presents challenges and opportunities for investors, whereas volatility spillovers complicate risk management and investment strategies. Research Methodology: This study examines the influence of the Nikkei 225, Straits Times Index, and Shanghai Composite Index on the Jakarta Composite Index across the pre-pandemic, pandemic, and post-pandemic phases. Results: Utilizing the hidden Markov model with regime-switching regression, this study identifies changes in market behavior due to economic shifts during the pandemic, revealing two regimes: synchronization and desynchronization. Limitations: Pre-COVID-19, the Jakarta Composite Index shows strong synchronization with the Nikkei 225 and Straits Times Index, while the Shanghai Composite Index has an insignificant impact. During the COVID-19 pandemic, frequent desynchronization occurred due to high uncertainty and volatility, with only the Straits Times Index significantly influencing the Jakarta Composite Index. Post-pandemic, synchronization between the JCI and regional markets strengthened again. This study highlights the consistent influence of the Nikkei 225 and Straits Times Index, while the Shanghai Composite Index remains insignificant. Contributions: This study contributes significantly to the understanding of regional stock market relationships and offers valuable insights for academia and practice.

Closing the gap: addressing telehealth disparities across specialties in the sustained pandemic era

Missed appointments, or no-shows, disrupt healthcare delivery, exacerbating chronic disease management and leading to worse health outcomes. Telehealth has surged as a viable solution to reduce no-shows and improve healthcare accessibility, especially during the COVID-19 pandemic. However, telehealth disparities and its long-term efficacy across various medical specialties remain understudied. To address this, we performed a retrospective analysis of electronic health records from a heterogenous network of hospitals in Illinois, examining telehealth use and no-shows across among 444,752 adult patients with 1,973,098 outpatient encounters across nine specialties during the sustained pandemic phase (i.e., January 1, 2021 to July 1, 2022). Among them, 84,290 (4.27%) were no-shows, and telehealth constituted 202,933 (10.3%) of the total encounters. Telehealth use during the sustained phase varied significantly by specialty type. Overall, telehealth encounters were associated with reduced no-show odds compared to in-person encounters (OR, 0.28; 95% CI, 0.26–0.29). Black and Hispanic patients, as well as those with Medicaid, had higher no-show odds relative to their counterparts, even when using telehealth. Mental health specialty had the highest telehealth usage rate and the highest no-show odds (OR, 2.99; 95% CI, 2.84–3.14) relative to other specialties included in the study. Moreover, specialty type had differential effects on no-shows for telehealth. These results underscore the variability in telehealth use by specialty type and pervasive disparities telehealth use and no-shows. As we move beyond the pandemic, our findings can inform policymakers to tailor policies and incentives to reach different patient groups as well as specialties, with varying needs, to promote equitable telehealth utilization.

Understanding the role of mobility in the recorded levels of violent crimes during COVID-19 pandemic: a case study of Tamil Nadu, India

Purpose/GoalThis research investigates the potential link between mobility and violent crimes in Tamil Nadu, India, using an empirical study centred on the COVID-19 pandemic waves (2020–2022). The goal is to understand how these events influenced crime, employing a counterfactual approach.MethodsThe study employs the XGBoost algorithm to forecast counterfactual events across different timeframes with varying levels of mobility. The mobility data sources include historical bus and passenger records spanning a decade, along with Google Community Mobility Reports added during the pandemic phases. The foundation for crime analysis is built upon the univariate time series of violent crimes reported as First Information Reports from 2010 to 2022.FindingsResults indicate a significant correlation between mobility and violent crimes when mobility drops below a specific threshold. However, no such correlation is observed when mobility is above this threshold during the non-pandemic periods. The COVID-19 pandemic had a major impact on people’s and vehicular mobility, especially during the complete lockdown periods of the first two waves, and also affected crime rates.ConclusionsThe decrease in recorded incidents could also be attributed to fewer criminal opportunities. Additionally, this could be due to unfavourable situational factors, such as victims’ limited access to appropriate health and law enforcement agencies to report crimes. Furthermore, frontline services were busy with pandemic-related commitments, which could have contributed to a lack of crime registration even when crimes were committed.

Complex-Systems Analysis of the CSI 300 Index: Evolution, Resilience, and Prediction in Stock Correlation Network

With the outbreak and evolution of the pandemic worldwide, the financial market has experienced unprecedented shocks and adjustments, and the volatility and correlation of the stock market, as an important indicator of economic activities, have shown new features and trends during the pandemic. Based on the CSI 300 Index, we construct a three-stage sequential network representing the pre-pandemic, pandemic, and post-relaxation phases. We investigate the evolving dynamics and resilience of the network, forecasting potential future connections, thus offering fresh insights into comprehending market recovery. Our findings unveil that the market adapts dynamically to the pandemic’s progression, witnessing an overall augmentation in network interconnectedness. While the financial sector maintains its pivotal role, the influence of non-financial sectors experiences an upsurge. Despite the network demonstrating poor stability and heavy reliance on key nodes, there exists a positive recovery trajectory. Non-financial sectors such as energy and transportation emerge as pivotal catalysts for market rejuvenation. We provide suggestions for government regulators and investors, providing strong support for optimizing the market structure and promoting the long-term healthy development of the market.

Whole-genome demography of COVID-19 virus during its pandemic period and on “panvalent” vaccine design

With over 16 million submitted genomic sequences, the SARS-CoV-2 (SC2) virus, the cause of the most recent worldwide COVID-19 pandemic, has become the most sequenced genome of all known viruses, revealing, for example, a vast number of expanding viral lineages. Since the pandemic phase appears to be over, we performed a retrospective re-examination of the demographic grouping pattern and their genomic characteristics during the entire pandemic period up to the peak of the last pandemic wave. For our study, we extracted from the NCBI only unique viral sequences and converted each sequence data to a relational vector, indicating the presence/absence of each variational event compared to a “reference” sequence. Our study revealed several genomic features that are unexpected or different from those of previous studies. For example, approximately 44,000 variants with unique sequences emerged during the pandemic period; they group into only four major viral-genomic groups and each has a set of mostly unique highly-conserved variant-genotypes (HCVGs); and a small set from the first (“ancestral”) group was inherited by the three (“descendant”) groups, suggesting that HCVGs in the next group may be predictable from the current group(s). Such a concept may be potentially important in designing “panvalent” vaccines against the current and future waves of viral infections.

Malaysian homestay experience programme: A qualitative investigation on operator's crisis management practices and resiliency strategies

Understanding the specific crisis management practices and resilience strategies homestay operators adopt during a crisis is critical. Currently, it is an area that remains under-researched despite the growing importance of resilience in community-based tourism operations. As such, this study investigates the crisis management practices and strategies for resiliency that homestay operators adopt during a health crisis. This qualitative study has been conducted via semi-structured interviews among ten prominent homestay operators in Malaysia. The thematic data analysis using an inductive approach was employed to ensure the transferability of the findings. The study found that marketing initiatives, pandemic prevention measures, maintenance practices, and government assistance were the best crisis management practices homestay operators could implement during the pandemic phase. Homestay operators have adopted four resilience strategies to survive after the pandemic: for other creative business opportunities, government assistance, use of technology innovation, togetherness in mitigating the pandemic, and industry engagement and collaboration. The results provide comprehensive strategies to the policymakers and industry stakeholders to strengthen homestay businesses in the future. Such understanding enables government efforts to maintain CBT sustainability, which is in line with the National Tourism Policy (2020–2030) and Sustainable Development Goals (SDG) 1 (No Poverty), 8 (Decent Work and Economic Growth) and 11 (Sustainable Cities and Communities). The results are also expected to assist homestay operators in re-strategizing and striving toward recovery and resiliency after the crisis.