Post-lockdown Phase Research Articles

Impact of time and COVID-19 pandemic on GP mental health consultations in deprived neighborhoods

Abstract Background The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from deprived neighborhoods before and during COVID-19 pandemic, especially after the stringent lockdown in the Netherlands. Methods In an observational study (2018-2022), medical data of 360,645 patients were analyzed for the proportions of mental health consultations (segmented per month) by comparing the lockdown phase (March 2020-May 2020) and post-lockdown phase (June 2020-June 2022) with the pre-pandemic period the patients living in deprived and non-deprived neighborhoods. Results Analyzing a total of 759,863 mental health consultations showed that during the lockdown phase of COVID-19, less mental health problem consultations were observed than pre-pandemic. This decrease was not significant for patients from deprived neighborhoods, but the decrease was significant for patients from non-deprived neighborhoods, RR = 0.990; 95%CI=0.934-1.051 and RR = 0.918; 95%CI=0.885-0.953 respectively. Conversely, the number of post-lockdown phase consultations for patients in deprived neighborhoods was significantly increased compared to pre-pandemic levels (RR = 1.074;95%CI=1.002-1.152), but not for patients in non-deprived neighborhoods (RR = 1.000; 95%CI=0.959-1.043). This increase in post-lockdown phase consultations in deprived neighborhoods can be explained by the higher frequency of consultations per patient. Conclusions Consistently over time, demand for GP mental health care was and remains higher among patients from deprived neighborhoods, with an increase in post-lockdown consultations. Sufficient access to primary health care should be guaranteed to ensure treatment of mental health problems for social-economic disadvantaged groups. Key messages • Socioeconomic status has a negative sustainable impact on demand for mental health consultations in deprived neighbourhoods. • To ensure the treatment of mental health problems for social-economic disadvantaged groups, sufficient access to the primary health care should be guaranteed at all times.

The impact of the COVID-19 pandemic on the physical activity environment in English primary schools: a multi-perspective qualitative analysis.

The COVID-19 lockdowns and social distancing measures, including school closures, had a major impact on children's physical activity in England, with data showing an initial reduction in activity in the short-term post-lockdown phase of the pandemic followed by a recovery on average in the medium-term post-lockdown period. The school environment is an important context for child physical activity. The purpose of this study is to understand the changes that took place to school physical activity environments once schools reopened after lockdowns. This information will improve understanding of why changes to children's physical activity have occurred over the course of the pandemic and the implications for future promotion of physical activity in schools. Interviews with parents (n = 43), school staff (n = 18) and focus groups with 10- to 11-year-old children (participant n = 92) were conducted at two time points: between September-December 2021 and February-July 2022. Interview and focus group guides covered the impact of the pandemic on child physical activity and changes to this over time. The framework method was used for analysis. Three themes and three subthemes were generated: (1) the return to school; (2) over-pressured staff and environment and (3) the uneven impact of the pandemic. Theme 3 consists of three subthemes: (a) retained pandemic policies, (b) impact on physical activity culture and (c) different children need different things. Conducting this research in schools during ongoing COVID-19 disruptions was a challenge and may have limited school and participant participation, particularly school staff. The parent interview sample is predominantly female, active and of higher socioeconomic status, so the experiences of male, less active and lower socioeconomic parents are limited. This study suggests that the impact of COVID-19 on child physical activity is uneven, affecting some children more than others. Future work is therefore needed to explore the details of this potential diverging experience. The COVID-19 pandemic, school closures and post-lockdown school policies have impacted upon primary school physical activity environments. The post-lockdown school environment is highly pressured, impacting the extent to which schools can support and encourage child physical activity. Future research is needed to further explore the impact of post-lockdown changes on physical activity environments in schools, particularly over the longer term, as schools continue to adapt post lockdowns. Strategies required to support school physical activity environments must be context specific and sensitive to these changes, pressures and needs. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.

Green Business and Performance of Green Stock Indices in COVID-19 Impacted Indian Stock Market: A Study with Reference to BSE S&P GREENEX and CARBONEX

The Indian stock market and the investors’ confidence level was affected badly by COVID-19 crisis. World Business Council for Sustainable Development (2020) had stated that investor decision-making at the present time is influenced by the sustainability orientation of the companies. In the context of COVID-19 crisis, it is important to project investor behaviour in the post-lockdown phase to understand the stock market potential. This research has attempted to perceive the status of economic resurgence with respect to two Bombay Stock Exchange (BSE) green indices, that is, CARBONEX and GREENEX. A comparative analysis of such indices has been performed over the lockdown and unlockdown phases until 20 July 2021. This research attempted to find if the indices were significantly different in lockdown and unlockdown phases. A significant mean variance would indicate development in sustainable business operations since lockdown period and an increment in such values would draw better investment in Indian stock market in future, even amid further mild COVID waves with partial lockdowns. One-way between-the-groups ANOVA has been performed to see if the means of CARBONEX and GREENEX indices are significantly varying in the aforementioned phases. A significant variance will help the Indian investors to look forward to the post-COVID economic reinstatement.

Using smart card data to model public transport user profiles in light of the COVID-19 pandemic

The COVID-19 pandemic caused an unprecedented impact on public transport demand. Even though several studies have investigated the change in the use of public transport during the pandemic, most existing studies where large passive datasets have been considered focus on the drop in ridership at the aggregate level. To address this gap, this research aims to identify and model profiles of passengers considering their public transport recovery after the long-term lockdown in Santiago, Chile, during the early stage of the pandemic. The methodology proposed a three-stage approach associated with the analysis of smart card records. First, cardholder residential areas were identified to enrich the available data by integrating demographic information from the census. Then, a clustering analysis was applied to recognise distinctive classes of users based on their public transport usage change between the pre-pandemic and the post-lockdown phase. Finally, two different models were implemented to uncover the relationships between class membership and travellers’ characteristics (i.e. travel history and demographic characteristics of their residential area). Results revealed a heterogeneous recovery of public transport usage among passengers, summarising them into two recognisable classes: those who mainly returned to their pre-pandemic patterns and those who adapted their mobility profiles. A statistically significant association of travel history with the mobility adaptation profile was found, as well as with aggregate socio-demographic attributes. These insights about the extent of heterogeneity and its drivers can help in the formulation of specific policies associated with public transport supply in the post-pandemic era.

Impact of COVID-19 Pandemic on Routine Children Immunisation: Experience from a Tertiary Care Centre, in New Delhi, India

Introduction: Coronavirus Disease-2019 (COVID-19) pandemic was a global emergency in 2019 with multiphasic national lockdowns in most countries. Poor accessibility to travel and disease scare led to major fall in routine children vaccination. Aim: To study the impact of COVID-19 pandemic on routine children immunisation at a tertiary care centre in New Delhi, India. Materials and Methods: This retrospective cross-sectional study was carried out in May and June 2022, by collecting retrospective data from Immunisation Clinic of Paediatric Department of Dr. Ram Manohar Lohia hospital, a tertiary care public hospital from January 2018 to December 2021. The data of routine immunisation was further analysed to know the impact of the COVID-19 pandemic in children from birth to 5 years of age in 2019 i.e., before the lockdown versus the first and second major waves of COVID-19 in 2020 and 2021, respectively. The data was entered in an excel chart and statistical testing was conducted with Statistical Package for the Social Sciences (SPSS) version 27.0. Unpaired t-test of equal variance was used for data analysis and p <0.05 was considered as statistically significant. Results: There was a sharp fall in children receiving routine immunisation during COVID-19 pandemic in 2020(30.5%) and 2021 (24.9%) as compared to PreCOVID-19 period (2019). The overall vaccination coverage was significantly lower (p<0.001) in postlockdown-1 phase (July/Aug 2020; n=521) and postlockdown-2 phase (July/Aug 2021; n=735) in comparison to pre COVID-19 period (July/Aug 2019; n=899). Significant fall in vaccination (p<0.05) was seen in postlockdown phase 1 for birth dose vaccines, primary doses of combination vaccines, Measles-Rubella (MR-1) vaccine 1st dose, MR-2 and booster doses of Diphtheria, Pertussis, Tetanus (DPT) and for primary doses of combination vaccines, MR-1 vaccine 1st dose, MR-2 for postlockdown phase 2 (p<0.05). Conclusion: Routine immunisation for all vaccines had a major setback during unlockdown period in 2020 and 2021. There is an urge for national drive for routine Vaccine Preventable Diseases (VPD) to prevent their re-surgence.

Comparison of Burden of Injury at a Tertiary Care Centre of National Importance: Pre-COVID-19 and COVID-19 Era.

During the COVID-19 pandemic, precautionary guidelines to shut down non-essential services had an impact on the pattern of hospital trauma admissions. We compared the trauma cases handled in our hospital from 24th March 2020 to 30th November 2020 during the restricted movement period with statistics from 2019. The objectives of this study is to assess the prevalence of trauma during lockdown and restricted movement phase of COVID-19 pandemic and to analyze the epidemiology factor associated with trauma in pre COVID-19 and COVID-19 era in a tertiary care hospital of National importance in central India. This retrospective record-based study was done to analyze the profile of injured trauma patients presented to trauma and emergency center of tertiary care center of national importance from March 24 to June 30, 2020 (lockdown phase) and 1st July to 30th November (post-lockdown phase) of 2020. Results were compared with data from the year 2019. Total 621 trauma patients were managed during various restricted phases of the COVID-19 pandemic (March 2020 - November 2020). Out of which 128 admissions were in the strict lockdown phase (March-May 2020) while 493 presented after lockdown during the restricted movement phase. Both during and after a strict lockdown, road traffic accidents are significantly reduced. In contrast, assaults and household injuries were significantly higher. During the post-lockdown phase of 2020, self-falls increased significantly in both phases compared to the year 2019. There was a significant decrease in trauma admissions in lockdown phase due to decreased vehicular accident but increase in household injury due increased activities inside home. To determine the readiness to deal with future situations similar to these, we look at the behavioral changes in our patient population during the COVID-19 pandemic.

A centralized contact-tracing protocol for the COVID-19 pandemic

Digital contact tracing (DCT) is one of the weapons to be used against the COVID-19 pandemic, especially in a post-lockdown phase, to prevent or block foci of infection. As DCT systems can handle highly private information about people, great care must be taken to prevent misuse of the system and actions detrimental to people’s privacy, up to mass surveillance. This paper presents a new centralized DCT protocol, called ZE2-P3T (Zero Ephemeral Exchanging Privacy-Preserving Proximity Protocol), which relies on smartphone localization but does not give any information about the user’s location and identity to the server. Importantly, the fact that no exchange of ephemeral identities among users is required is the basis of the strong security of the protocol, which is proven to be more secure than the state-of-the-art protocol DP-3T/GAEN.

Effects of COVID-19 era on a subtropical river basin in Bangladesh: Heavy metal(loid)s distribution, sources and probable human health risks.

The COVID-19 era has profoundly affected everyday human life, the environment, and freshwater ecosystems worldwide. Despite the numerous influences, a strict COVID-19 lockdown might improve the surface water quality and thus provide an unprecedented opportunity to restore the degraded freshwater resource. Therefore, we intend to investigate the spatiotemporal water quality, sources, and preliminary health risks of heavy metal(loid)s in the Karatoya River basin (KRB), a tropical urban river in Bangladesh. Seventy water samples were collected from 35 stations in KRB in 2019 and 2022 during the dry season. The results showed that the concentrations of Ni, Cu, Zn, Pb, Cd, and Cr were significantly reduced by 89.3–99.7 % during the post-lockdown period (p < 0.05). However, pH, Fe, Mn, and As concentrations increased due to the rise of urban waste and the usage of disinfectants during the post-lockdown phase. In the post-lockdown phase, the heavy metal pollution index, heavy metal evaluation index, and Nemerow's pollution index values lessened by 8.58 %, 42.86 %, and 22.86 %, respectively. Besides, the irrigation water quality indices also improved by 59 %–62 %. The total hazard index values increased by 24 % (children) and 22 % (adults) due to the rise in Mn and As concentrations during the lockdown. In comparison, total carcinogenic risk values were reduced by 54 % (children) and 53 % (adults) in the post-lockdown. We found no significant changes in river flow, rainfall, or land cover near the river from the pre to post-lockdown phase. The results of semivariogram models have demonstrated that most attributes have weak spatial dependence, indicating restricted industrial and agricultural effluents during the lockdown, significantly improving river water quality. Our study confirms that the lockdown provides a unique opportunity for the remarkable improvement of degraded freshwater resources. Long-term management policies and regular monitoring should reduce river pollution and clean surface water.

Outcomes of Induction Therapy in Patients With Acute Myeloid Leukemia During the COVID-19 Pandemic: A Retrospective Study From a Tertiary Cancer Center

The induction outcomes of patients with acute myeloid leukemia (AML) in India are at par with western data. But we fear that the absence of a robust defense mechanism during the COVID-19 pandemic and the resultant social, financial, political, and medical disturbance might have influenced outcomes. Hence, this study was conducted to establish relationships between the coronavirus disease 2019 (COVID-19) lockdown and induction treatment outcomes in AML patients. To determine rates of induction remission, induction failure, and induction mortalities in patients with AML treated during the COVID-19 pandemic and compare those results between lockdown and post-lockdown periods in India. This retrospective, observational study includes data from patients with AML who were started on induction therapy between May 1, 2020, and December 31, 2020. A total of 53 AML patients' data was included in this study, divided into group 1 (n = 22) and group 2 (n = 31). Based on the COVID-19 pandemic-induced lockdown period in India, patients who were given induction therapy between May 1, 2020, and August 31, 2020, were included in Group 1 (Lockdown Phase group), and patients who were given induction therapy during the post-lockdown phase, i.e., September 1, 2020, to December 31, 2020, were included in Group 2 (Post-Lockdown Phase group). Data from AML patients of both sexes and all age groups were included. Data of patients who died before starting induction chemotherapy or patients who left the hospital before the completion of induction chemotherapy were excluded. Patients on induction therapy, be it intensive chemotherapy (ICT) or low dose chemotherapy (LCT), were included. Outcomes were analyzed after the first two induction cycles or 60 days of starting induction, whichever is earlier. The mean age of patients in Group 1 was 36.23±19.1 years and in Group 2 was 29±22.22 years; gender distribution was comparable in both groups. After the first induction, mortality in Group 1 was 36.36%, and in Group 2 was 45.16% (p = 0.036); partial remission in Group 1 and Group 2 was 50% and 29%, respectively (p = 0.036).Using survival analysis, death (event) after second induction was 149.77 days (111.1-188.5) in Group 1 and137.23 (111.4-163.1) days in Group 2, which was statistically insignificant. Remission was achieved faster in Group 2, achieving complete remission in the mean of 94.96 days (74.5-115.5), while in Group 1, the mean of 147.18 days (110.9-183.5) (p = 0.034). There was increased induction mortality and reduced complete remission (CR) during the post-lockdown phase despite the increased use of ICT, demonstrating an improvement in supportive care (availability of medicines, blood products). This shows that the improvement in supportive care did not show any change or improvement in the outcome for the patient. The mean days for remission were lower in the post-lockdown period compared to the lockdown phase, and patients who had achieved remission had a durable response.

Evaluation of the Impact of the First Wave of COVID-19 and Associated Lockdown Restrictions on Persons with Disabilities in 14 States of India.

Background: There is a paucity of data to assess the impact of the COVID-19 pandemic on persons with disabilities (PwDs) in India. About 27.4 million cases were reported as of 27 May 2021. The continuing pandemic in the form of subsequent waves is expected to have negative repercussions for the disabled globally, particularly in India, where access to health, rehabilitation, and social care services is very limited. Therefore, this study aimed to assess the impact of the COVID-19 pandemic and lockdown restrictions on PwDs in India. Objective: To determine the level of disruption due to COVID-19 and the associated countrywide lockdown restrictions on PwD in India during the first wave. Methods: Using a cross-sectional, mixed-methods approach, data were collected from a representative sample of 403 persons with disabilities in 14 states in India during the COVID-19 first wave at two different points in time (Lockdown and post-lockdown phase). Factors associated with the negative impact were examined using the Chi-square test for associations. The paired comparisons between ‘lockdown’ with the ‘post-lockdown’ phase are presented using McNemar’s test and the marginal homogeneity test to compare the proportions. Additionally, a subsample of the participants in the survey was identified to participate in in-depth interviews and focus group discussions to gain in-depth insights on the study question and substantiate the quantitative findings. The framework approach was used to conduct a thematic analysis of the qualitative data. Results: About 60% of the PwDs found it difficult to access emergency medical services during the lockdown, and 4.6% post lockdown (p < 0.001). Likewise, 12% found it difficult to access rehabilitation services during the lockdown, and 5% post lockdown (p = 0.03). About 76% of respondents were apprehensive of the risk of infection during the lockdown, and this increased to 92% post lockdown (p < 0.001). Parents with children were significantly impacted due to lockdown in the areas of Medical (p = 0.007), Rehabilitation (p = 0.001), and Mental health services (p = 0.001). The results from the qualitative study supported these quantitative findings. PWDs felt that the lockdown restrictions had negatively impacted their productivity, social participation, and overall engagement in everyday activities. Access to medicines and rehabilitation services was felt to be extremely difficult and detrimental to the therapeutic benefits that were gained by them during the pre-pandemic time. None of the pandemic mitigation plans and services was specific or inclusive of PWDs. Conclusions: COVID-19 and the associated lockdown restrictions have negatively impacted persons with disabilities during the first wave in India. It is critical to mainstream disability within the agenda for health and development with pragmatic, context-specific strategies and programs in the country.

Structural changes in intercity mobility networks of China during the COVID-19 outbreak: A weighted stochastic block modeling analysis

This study focuses on a mesoscale perspective to examine the structural and spatial changes in the intercity mobility networks of China from three phases of before, during and after the Wuhan lockdown due to the outbreak of COVID-19. Taking advantages of mobility big data from Baidu Maps, we introduce the weighted stochastic block model (WSBM) to measure and compare mesoscale structures in the three mobility networks. The results reveal significant changes to volume and structure of the intercity mobility networks. Particularly, WSBM results show that the intercity network transformed from a typical core-periphery structure in the normal phase, to a hybrid and asymmetric structure with mixing core-peripheries and local communities in the lockdown phase, and to a multi-community structure with nested core-peripheries during the post-lockdown phase. These changes suggest that the outbreak of COVID-19 and the travel restrictions deconstructed the original hierarchy of the intercity mobility network in China, making the network more locally or regionally fragmented, even at the recovery stage. This study provides new empirical and methodological insights into understanding mobility network dynamics under the impact of COVID-19, helping assess the emergency-induced impact as well as the recovery process of the mobility network.

Cancer care during the pandemic period: A hospital-based survey for future reference

Background: Worldwide pandemic due to the novel coronavirus, SARS COVID-19, forced the human race at a stake due to an unprecedented lockdown from March 23 to May 31, 2020. It jeopardized the normal quality of life to all population of India. Special sufferers were the infirmed people who need hospital-based management. Cancer patients were affected mostly as due to the fact that chemotherapy and radiotherapy are cycle specific and hospital specific as patients have to come to the hospital for getting radiation therapy. Objective: We aimed to assess how cancer patients were affected in a tertiary cancer care hospital. Methodology: During the lockdown period how much reduction of cancer service at different segments such as the outpatient department, indoor admission, teletherapy, and palliative care were influenced and were compared with the corresponding figures of the nonlockdown period of the previous 3 years were compared. Results and Conclusion: Around 30% reduction of hospital attendants in cancer follow-up clinics and new patient registration was attributed. More than 30% of patients failed to get radiotherapy compared to the previous years’ record. All these figures contributed adversely to upstage presentation in the postlockdown phase with obvious morbidity and mortality.

Public transportation and energy utilisation during Covid-19 pandemic in Nigeria

New public transport planning requirements are developed as many countries start to navigate their return to normality after the COVID-19 lockdown. This study combines key developments regarding public transportation and effect of the lockdown on energy utilization during the first and second wave of COVID-19 pandemic in Nigeria. Data were sourced from the National Bureau of Statistic and Nigerian National Petroleum Company (NNPC) on distribution of Fuel and gas energies which thematically analyzed the impact of COVID-19 on transportation systems in Lagos Nigeria. The decline in vehicular density on roads which leads to reduced fuel consumption coupled with infection risk in public transportation in the so-called post-lockdown phase. Domestic gas consumption and electricity generation were slightly affected during this period. Changes in travel demands; Financial sustainability; Increased cost of transportation and Loss of revenue were revealed as significant impact of the pandemic. Lastly, this study identifies maintenance of key principles in mitigating the spreading of the virus, probable energy utilization, policy recommendations and future management of resources that are most inclined to the development objectives of developing nations in the time of COVID-19 and beyond.

Air Quality Decrement After Lockdown in Major Cities of Rajasthan, India

The lockdown restrictions during the COVID-19 pandemic provided a 'path' of reinstatement of the air quality globally. Despite several financial challenges, air quality improvement positively impacted the environment due to lockdown in the worst pandemic situations. The present study assessed the air pollution scenario in the post lockdown phase in the seven major metropolises of Rajasthan, namely, Jodhpur, Alwar, Jaipur, Kota, Pali, Ajmer, and Udaipur, in the recent pandemic year 2020. The air pollution scenario is determined with the help of the Air Quality Index (AQI) and the concentration level of PM2.5, PM10, NO2, and SO2. This study reveals that most cities of Rajasthan are violating India's national ambient air quality standards (NAAQS). It is found that Jodhpur is on rank first in terms of pollution levels, followed by Alwar, Jaipur, Pali, and Udaipur. The pollution level was higher before the lockdown period then reduced to a certain level due to restricted activities in lockdown. The pollution level is not rapidly increased after lockdown due to rainfall from the southwest monsoon. Winter season consists of higher concentration levels of pollutant and higher than before lockdown period. The study shows the significant impact of lockdown in reducing air pollution levels in cities. But imposing lockdown in a city or country is not a permanent solution to curb air pollution. So, regulating agencies and stakeholders should implement better control and reduction technologies for Indian cities.

Effect of COVID-19 Pandemic on Hepatocellular Carcinoma Diagnosis: Results from a Tertiary Care Center in North-West Italy.

The COVID-19 pandemic has forced us to direct most of the available resources towards its management. This has led to the neglect of all other pathologies, including cancer. The aim of this study was to verify whether the difficulty in accessing the health system has led to a reduction in new diagnoses of hepatocellular carcinoma (HCC) and whether this has already been reflected in a more advanced stage of the cancer. A single-center, retrospective study including adult patients with a new diagnosis of HCC was performed. Patients were divided into three groups: the prelockdown phase (May 2019–February 2020), the lockdown phase (March 2020–December 2020), and the postlockdown phase (January 2021–October 2021); 247 patients were included. The number of patients diagnosed with HCC distinctly diminished in the periods March 2020–December 2020 (n = 69; −35%) and January 2021–October 2021 (n = 72; −32%) as compared to the period May 2019–February 2020 (n = 106). Noteworthy was the reduced surveillance in the period January 2021–October 2021 as compared to May 2019–February 2020 (22.9% vs. 36.6%, p = 0.056). No significant changes have yet been observed in tumor characteristics (BCLC staging distribution remained unvaried, p = 0.665). In conclusion, the number of new HCC diagnoses decreased sharply in the first 2 years of the pandemic, with no worsening of the stage. A more advanced stage of the disease could be expected in the next few years in patients who have escaped diagnosis.

Effect of COVID-19 driven lockdown on social contact pattern in Puducherry, India: A longitudinal study.

This study was undertaken to assess the change in social contact and transmission dynamics among adults in the Puducherry district during the different phases of country-wide lockdown. Adults aged 18-69 years in Puducherry were assessed for frequency and duration of contacts in the following time points: prior to lockdown (March 2020), during lockdown, immediate post-lockdown (April, June 2020), and seven months post-lockdown (February 2021). Adjusted incidence rate ratios (aIRR) were obtained using a generalized estimating equation. We also assessed the exponential trajectory of the time-varying reproduction number (Rt) during and after lockdown. Compared to pre-lockdown phase, frequency of social contacts during 1st week, 4th week of lockdown, and immediate post-lockdown were reduced by 89% (aIRR = 0.11; 95% CI: 0.09-0.13), 40% (aIRR = 0.60; 95% CI: 0.52-0.69) and 91% (aIRR = 0.09; 95% CI: 0.07-0.10) respectively. However, the decline was not statistically significant at seven months post-lockdown. Correspondingly, we observed an initial spike in Rt during the lockdown phase followed by a gradual decline during the immediate post-lockdown phase. However, seven months post-lockdown, Rt has increased again. The study showed high compliance to the lockdown measures in Puducherry during the lockdown and immediate post-lockdown periods. However, as the lockdown measures were relaxed, the contact rate returned to the pre-lockdown state.

Significant Changes in Urban Air Quality during Covid-19 Pandemic Lockdown in Rohtak City, India

The global spread of Covid-19 brought a dramatic decrease in vehicular activities, industrial activities and tourism for a limited period of time during the lockdown phase (Year 2020). The variations in ambient air quality were studied in Maharshi Dayanand University, Rohtak city (Haryana state, India) during the lockdown period and pollutants data were gathered from Haryana State Pollution Control Board (HSPCB). The study was conducted for 186 days in three periods; first pre-lockdown, second during the lockdown and third during post-lockdown phase (62 days each). The results showed a significantly decreased the levels of air pollutants through the lockdown season in comparison to pre and post-lockdown concentrations of air pollutants. Mean PM2.5 concentration was found to be higher than their standard limit for the episode of pre and post-lockdown and the mean value of PM2.5 was 2.3 and 2.8 times higher in pre and post-lockdown compared to during the lockdown period. The average air quality index (AQI) during lockdown has shown a 64.1% decrease as compared to pre-lockdown data and a 69.3% reduction from post-lockdown period. Based on one way Analysis of variance (ANOVA) results show ozone accepts the null hypothesis that lockdown had no effect on the atmospheric pollutant concentration due to the increasing pattern of ozone concentration because of a decrease in the concentration of NOx, which breakdown ozone.

Use of antidepressants during COVID19 outbreak: a real-world drug-utilization study

BackgroundLockdown measures implementation (LMI) to prevent COVID19 disease diffusion was associated to increased depression and anxiety cases. The main aim was to evaluate whether LMI affected prevalence and incidence of antidepressants (ADs) use, and ADs treatment interruption (TI) in the general population.MethodsAdults (≥18 years) with at least 1 dispensing of ADs between 01/01/2019-26/09/2020 were selected from a regional Italian healthcare administrative database. Patients presenting an AD dispensing in the year preceding the first observation were considered as prevalent otherwise as incident users. We divided the studied period into 3 parts: pre-lockdown (01/01/2019-08/03/2020), lockdown (09/03/2020-14/06/2020) and post-lockdown (15/06/2020-27/09/2020). The weekly prevalence (WP) and incidence (WI) per 10,000 inhabitants were compared among periods. Incidence of TI (no dispensing refill within 30 days of the end of its validity) was computed among prevalent AD users.ResultsThe WP (mean of 552.3 per 10,000 pre-lockdown vs 505.5 lockdown phase; relative change: -9%) and WI (5.2 vs 3.7; -29%) of ADs use decreased after LMI. During the post-lockdown phase WP (505.5 vs 495.9; -2%) decreased whereas the WI (3.7 vs 4.3; 16%) slightly increased in relation to the lockdown period, although differences were not statistically significant. Conversely, the incidence of TI increased during lockdown (344.7 vs 384.3; 12%) and post-lockdown (384.3 vs 394.2; 3%) periods, even not always statistically significant.ConclusionsOur analysis showed a reduction of ADs use during the early phase of lockdown. Several factors might have impacted on the observed phenomenon (i.e, patient reluctance to start new AD treatment). Considering the mutation of the virus and the potential waves that might occur in the next months, a continuous monitoring of the impact of COVID19 on mental diseases onset and treatment adherence are suggested.Key messages In Italy, the implementation of lockdown measures was followed by a reduction in antidepressants use, even though evidences are that diagnoses of psychiatric disorders increased.Future studies should monitor if these phenomena led to an increase in adverse events potentially correlated with inappropriate treatment of depression.

Preoperative anxiety among patients scheduled for elective surgical procedures during the COVID-19 pandemic - A cross-sectional study in a tertiary care teaching hospital in India.

Preoperative anxiety among patients scheduled for elective surgical procedures during the COVID-19 pandemic - A cross-sectional study in a tertiary care teaching hospital in India.

Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

AimsOur observational study aimed to evaluate the impact of the lockdown period due to 2019 Coronavirus disease pandemic on glycaemic control in a cohort of paediatric patients with type 1 diabetes (T1D). MethodsEighty-five patients with T1D aged 5–18 years using continuous glucose monitoring (CGM) systems were enrolled. Demographic and clinical data, including glucose metrics generated by CGM-specific web-based cloud platforms, were collected in three different periods (pre-lockdown phase, lockdown phase, and post-lockdown phase) of 90 days each and were statistically analysed. ResultsDuring the lockdown period, a clear improvement in almost all CGM metrics (time in range, time above range, coefficient of variation, and glucose management indicator) was observed in our study population, regardless of age and insulin type treatment. In the months following lockdown, maintaining satisfactory diabetes outcomes was confirmed only in younger patients (aged 5–9 years) and in those individuals on hybrid closed loop therapy. ConclusionsThe increasing use of innovative technological devices together with data sharing systems and interaction with multidisciplinary diabetes team through telemedicine allowed paediatric patients with T1D to improve glucose metrics during the lockdown period. However, our findings showed that the achievement of better glycaemic control was transient for most patients.