Post-lockdown Period Research Articles

Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Background: The COVID-19 pandemic had a significant effect on the mental health of human beingsworld wide. There is a lack of information pertaining to the mental wellness of students and faculty in dental institutions in India. This study aimed to assess the overall mental well being of students and faculty of dental institution after return to normalcy post-lockdown period during COVID-19. Material & Methods: A self reporting online questionnaire was designed by the authors after speaking with various therapists and mental health coaches. This questionnaire was anonymously filled out by 492 participants which included under graduate students, post graduate students, academic staff, paramedical and clerical staff in a dental institution. Results: Majority of the subjects felt the need for counseling in their work place (53.4%). A greater number felt they were getting insufficient sleep (48.3%) and (31.5%) of the participants experienced depression and anxiety which further affected their emotional well being and their day to day activities. One-fifth (16.8%) of the participants perceived that mental health affected their relationships and 20.1% observed that physical health restricted their day to day activities. Mental wellness of females was significantly more affected than males. Additionally marital status also influenced the mental wellness of the subjects. Conclusion: Literary evidence suggests that mental wellness is not given enough importance in our country in general. This study only proved the ramifications of COVID-19 on mental wellness and suggested the provision of counselling which could’ve protected the participants from slipping into a negative frame of mind.

The Impact of Increased Access to Telemedicine

Abstract We estimate the impact of increased access to telemedicine following widespread adoption during the March–April 2020 COVID-19 lockdown period. We focus on the post-lockdown period, which was characterized by near-complete reopening. Using a difference-in-differences framework, we compare primary care episodes before and after the lockdown between patients with high and low access to telemedicine, as defined by their primary care physician adoption. Our results show that access to telemedicine leads to slightly more primary care visits but lower spending. Visits involve fewer prescriptions and more follow-ups, but we find no evidence of missed diagnoses or adverse outcomes. Results suggest that telemedicine does not compromise care quality or raise costs.

Influence of COVID-19 lockdown on river water quality and assessment of environmental health in an industrialized belt of southern Western Ghats, India.

The COVID-19 pandemic and sudden lockdown have severely hampered the country's economic growth and socio-cultural activities while imparting a positive effect on the overall fitness of the environment especially air and water resources. Increased urbanization and rapid industrialization have led to rising pollution and deterioration of rivers and associated sectors such as agriculture, domestic and commercial needs. However, various available studies in different parts of the country indicate that the COVID-19 pandemic has changed the entire ecosystem. But it is noted that studies are lacking in the southern Western Ghats region of India. Therefore, the present study attempts to investigate how the continuous lockdowns affect the River Water Quality (RWQ) during lockdown (October 2020) and post-lockdown (January 2021) periods in the lower catchments (Eloor-Edayar industrialized belt) of Periyar river, Kerala state, South India. A total of thirty samples (15 samples each) were analyzed based on drinking water quality, irrigational suitability, and multivariate statistical methods to evaluate the physical and chemical status of RWQ. The results of theWater Quality Index (WQI) for assessing the drinking water suitability showed a total of 93% of samples in the excellent and good category during the lockdown, while only 47% of samples were found fit for drinking during the post-lockdown period. Irrigational suitability indices like Mg hazard, KR, PI, SAR, and Wilcox diagram revealed lockdown period samples as more suitable for irrigational activities compared to post-lockdown samples with site-specific changes. Spearman rank correlation analysis indicated EC and TDS with a strong positive correlation to Ca2+, Mg2+, Na+, K+, TH, SO42-, and Cl- during both periods as well as strong positive correlations within the alkaline earth elements (Ca2+ and Mg 2+) and alkalis (Na+ and K+). Three significant components were extracted from principal component analysis (PCA), explaining 88.89% and 96.03% of the total variance for lockdown and post-lockdown periods, respectively. Variables like DO, BOD, Ca2+, NO3-, and Cl- remained in the same component loading during both periods elucidating their natural origin in the basin. The results of health risk assessment based on US EPA represented hazard quotient and hazard index values below the acceptable limit signifying no potential noncarcinogenic risk via oral exposure except As, suggesting children as more vulnerable to the negative effects than adults. Furthermore, this study also shows rejuvenation of river health during lockdown offers ample scope to policymakers, administrators and environmentalists for deriving appropriate plans for the restoration of river health from anthropogenic stress.

Housing conditions and changes in professional activity during lockdown and the risk of prevalent and incident depression: Findings from the CONSTANCES cohort

BackgroundMaterial conditions of lockdown and changes in regular functioning may have played a role on depressive manifestations. We aimed to examine the association between housing conditions and changes in professional activity and depression during the first COVID-19 outbreak in France. MethodParticipants of the CONSTANCES cohort were followed online. A first questionnaire covered the lockdown period (assessing housing conditions and changes in professional activity), and a second the post-lockdown period (assessing depression using the Center of Epidemiologic Studies Depression-Scale (CES-D)). Incident depression was also estimated (with a previous CES-D measure). Logistic regression models were applied. Results22,042 participants (median age 46 years, 53.2 % women) were included and 20,534 had a previous CES-D measure. Depression was associated with female gender, lower household income and past history of depression. A negative gradient between the number of rooms and the likelihood of depression was consistently observed (OR = 1.55 95 % [1.19–2.00] for one room, OR = 0.76 [0.65–0.88] for seven rooms), while a U-shape relationship was observed with the number of people living together (OR = 1.62 [1.42–1.84] for living alone, OR = 1.44 [1.07–1.92] for six persons). These associations were also observed with incident depression. Changes in professional activity were associated with depression (Started distance working (OR = 1.33 [1.17–1.50]). Starting distance working was also associated with incident depression (OR = 1.27 [1.08–1.48]). LimitationA cross-sectional design was used. ConclusionThe consequences of lockdown on depression may vary depending on living conditions and changes in professional activity, including distance working. These results could help to better identify vulnerable people to promote mental health.

Comparative analysis of the pattern of intimate partner violence against women admitted to a tertiary hospital in Sri Lanka during and after the periods of COVID-19 lockdown.

Lockdown measures during the COVID-19 pandemic resulted in restrictions on people's ability to move, allowing more time for intimate partners-this increased opportunities for intimate partner violence (IPV), especially against women. The study aimed to evaluate the characteristics of IPV against women during and after the lockdown period.A prospective, descriptive study on female victims of IPV presented from March 2020 to February 2022 to a leading teaching hospital in Sri Lanka.Out of the 876 patients admitted during the period, details could be obtained from 300 victims. Ninety-four (31%) were during the lockdown, while 206 (69%) were post-lockdown admissions. The mean age of the victim in both groups was 33.5years. Even though physical abuse was high throughout, the prevalence of sexual abuse was significantly higher (p < 0.0001) during the lockdown period (31.9%) than during the post-lockdown period (3.4%). Financial problems (46.6%), followed by substance abuse (35%), were the most common risk factors during the post-lockdown period, while morbid jealousy (34%) was the most common risk factor, followed by extramarital relationships (33%) during the lockdown. Psychological consequences due to IPV were observed in 76.5% of victims during the lockdown period and only 11.2% during the post-lockdown period.The prolonged lockdown has significantly influenced mental and sexual health, changing the pattern of IPV against women. The need to have services to ensure the mental and sexual well-being of the community was highlighted.

Ground-Based MAX-DOAS Observation of Trace Gases from 2019 to 2021 in Huaibei, China

With the spread of the COVID-19 pandemic and the implementation of closure measures in 2020, population mobility and human activities have decreased, which has seriously impacted atmospheric quality. Huaibei City is an important coal and chemical production base in East China, which faces increasing environmental problems. The impact of anthropogenic activities on air quality in this area was investigated by comparing the COVID-19 lockdown in 2020 with the normal situation in 2021. Tropospheric NO2, HCHO and SO2 column densities were observed by ground-based multiple axis differential optical absorption spectroscopy (MAX-DOAS). In situ measurements for PM2.5, NO2, SO2 and O3 were also taken. The observation period was divided into four phases, the pre-lockdown period, phase 1 lockdown, phase 2 lockdown and the post-lockdown period. Ground-based MAX-DOAS results showed that tropospheric NO2, HCHO and SO2 column densities increased by 41, 14 and 14%, respectively, during phase 1 in 2021 vs. 2020. In situ results showed that NO2 and SO2 increased by 59 and 11%, respectively, during phase 1 in 2021 vs. 2020, but PM2.5 and O3 decreased by 15 and 17%, respectively. In the phase 2 period, due to the partial lifting of control measures, the concentration of pollutants did not significantly change. The weekly MAX-DOAS results showed that there was no obvious weekend effect of pollutants in the Huaibei area, and NO2, HCHO and SO2 had obvious diurnal variation characteristics. In addition, the relationship between the column densities and wind speed and direction in 2020 and 2021 was studied. The results showed that, in the absence of traffic control in 2021, elevated sources in the Eastern part of the city emitted large amounts of NO2. The observed ratios of HCHO to NO2 suggested that tropospheric ozone production involved NOX-limited scenarios. The correlation analysis between HCHO and different gases showed that HCHO mainly originated from primary emission sources related to SO2.

Environmental factors are associated to hospital outcomes in COVID-19 patients during lockdown and post-lockdown in 2020: A nationwide study

ObjectiveThis study analyzed, at a postcode detailed level, the relation-ship between short-term exposure to environmental factors and hospital ad-missions, in-hospital mortality, ICU admission, and ICU mortality due to COVID-19 during the lockdown and post-lockdown 2020 period in Spain. MethodsWe performed a nationwide population-based retrospective study on 208,744 patients admitted to Spanish hospitals due to COVID-19 based on the Minimum Basic Data Set (MBDS) during the first two waves of the pandemic in 2020. Environmental data were obtained from Copernicus Atmosphere Monitoring Service. The association was assessed by a generalized additive model. ResultsPM2.5 was the most critical environmental factor related to hospital admissions and hospital mortality due to COVID-19 during the lockdown in Spain, PM10, NO2, and SO2and also showed associations. The effect was considerably reduced during the post-lockdown period. ICU admissions in COVID-19 patients were mainly associated with PM2.5, PM10, NO2, and SO2 during the lockdown as well. During the lockdown, exposure to PM2.5 and PM10 were the most critical environmental factors related to ICU mortality in COVID-19. ConclusionShort-term exposure to air pollutants impacts COVID-19 out-comes during the lockdown, especially PM2.5, PM10, NO2, and SO2. These pollutants are associated with hospital admission, hospital mortality and ICU admission, while ICU mortality is mainly associated with PM2.5 and PM10. Our findings reveal the importance of monitoring air pollutants in respiratory infectious diseases.

The detrimental consequences of two consecutive disasters impacting cytopathology in Ukraine: COVID followed by thewar.

The Covid-19 pandemic and ongoing war in Ukraine caused unprecedented disruption in healthcare, including cytopathology activities. This paper elucidates the effect of two consecutive disasters-the COVID-19 pandemic followed by the war-on cytopathology practice in Ukraine through a single-centre retrospective study. Total testing volumes, geographic distribution, and indicators of laboratory operations were assessed during three periods of 3 months each: the first 3 months of the acute phase of the war (March-May 2022, period 1); summer (June-August 2022, period 2); and the fall (September-November 2022, period 3, associated with massive attacks on the energy infrastructure in Ukraine). These data were compared with the corresponding periods in 2020, during the COVID-19 pandemic, and in 2021, the post-lockdown period. The ongoing war in Ukraine has caused a dramatic disruption in routine health maintenance and cytological practice. A net decline in both PAP testing and non-gynaecological pathology was associated with a geographic redistribution of cytopathological testing, and an increase in the rate of abnormal sample reporting. Despite these challenges, cytopathology practice in Ukraine demonstrates resilience, allowing for maintaining the healthcare system and addressing the needs of the civil population during the war. The ongoing war in Ukraine heavily affected cytological practice. The decline in PAP testing during the early period of the war was associated with an increase in the abnormal sample rate. Further study of the war's impact on the cervical pathology rate and the health of the population in the next decades is needed.

The impact of SARS-CoV-2 pandemic on patients who attend a pediatric emergency department for mental health issues

To compare the reasons for consultation, diagnoses at discharge, and admission and re-consultation rates of pediatric patients attending the Emergency Department due to mental health disorders before and after the SARS-CoV-2 pandemic lockdown. Retrospective, descriptive study. Patients under 16 years of age consulting due to mental health-related disorders during the pre- (07/01/2018-07/01/2019) and post-lockdown (07/01/2020-07/01/2021) periods were included. The frequency of mental health diagnoses, need for drug administration, hospitalization, and reconsultations were compared. 760 patients were included, 399 pre-lockdown and 361 postlockdown. After the lockdown, there was a 45.7% increase in the frequency of mental health-related consultations with respect to the total number of emergency consultations. Behavioral alterations were the most frequent reason for consultation in both groups (34.3% vs. 36.6%, p = 0.54). In the post-lockdown period, consultations related to self-harm attempts (16.3% vs. 24.4%, p < 0.01) and the diagnosis of depression (7.5% vs. 18.5%, p < 0.01) increased significantly. There was an increase of 58.8% in patients who were hospitalized with respect to the total number of ED patients (0.17% vs. 0.27%, p = 0.003) and in the number of re-consultations (12% vs. 17.8%, p = 0.026). No differences were observed in days of hospitalization (7 days [IQR 4-13] vs. 9 days [IQR 9-14], p0.45). In the post-lockdown period, the proportion of pediatric patients presenting to the ED with mental health disturbances increased.

COVID-19 pandemic changes the recreational use of Moscow parks in space and time: Outcomes from crowd-sourcing and machine learning

The limited access to urban green spaces during the COVID-19 pandemic had a negative impact on the human-nature interaction in cities and human well-being. Number of visitors to green areas, initially declined due to imposed restrictions, was restored after they were lifted as established by several studies across the globe However, little is still known about changes in behavior and preferences of park visitors in the post-COVID time. In this study, we investigated spatial-temporal patterns of recreational activities in the three urban parks in Moscow (Russia) prior, during and after the COVID-19 lockdown (in 2019 and 2020). The selected parks represent two different types: a centrally located park with much infrastructure and open landscapes (Gorky Park) and parks located at the outskirts of the city center with a more forested landscape and little infrastructure (Timiryazevski and Sokolniki parks). Recreational activities were identified based on the analysis of social media photos using machine-learning algorithms. As expected, park closures during lockdown resulted in overall decrease in the number of taken photos. After the parks were re-opened, however, the number of photos did not grow immediately. The number of photos only restored after almost three months, and the visiting peak shifted to autumn. Differences between parks were related to the type of the park and its landscape structure. The lowest decrease in the number of photos was observed for the Timiryazevsky park – a semi-natural green area, while the centrally located Gorky Park was the most affected, likely due to the strictest control measures. In comparison to 2019, photos in 2020 were more evenly distributed across the area in all the three parks. Besides, ‘natural’ areas became the main attractors for the visitors - photos under ‘nature observation’ category became the most popular. Spatial distribution of the recreational activities in post-lockdown period was characterized by larger distances between photos, likely corresponding to the social distancing. COVID-19 pandemic highlighted the value of green areas for citizens, but also changed their recreational preferences and overall behavior in parks. The observed shift from high density of visitors around entertainments and attractions in 2019 to a more homogeneous and less dense distribution along the natural zones in 2020 reveals a new pattern in visitors behavior and preference, which shall be considered in spatial planning of the parks. Increasing availability of natural green areas and their integration in urban green infrastructures can become the most relevant policy to consider the crucial role of urban nature as a source of resilience in turbulent times.

‘Back to the past’: The decline and rebound in traffic accident numbers in Catalonia in the context of COVID-19 lockdown and post-lockdown

ABSTRACT This article analyses the impact of the COVID-19 lockdown and mobility restrictions on interurban traffic accidents in Catalonia, Spain, and how accident numbers and their spatiality changed during the post-lockdown and beginning of the ‘new normal’ period. The authors compared the number of interurban traffic accidents in 2020 with those in the four previous years for the entire period (1 January – 30 September 2020) and for three different subperiods: pre-lockdown, lockdown, and post-lockdown. The results indicate a reduction of almost two-thirds for the entire lockdown period but of more than three-quarters for the hard-lockdown period (first seven weeks). There was an evident rebound in the number of accidents, starting before the end of the lockdown, within a context of flexibilization of mobility restrictions. In September 2020, the number of traffic accidents was the same as in September in the years 2016–2019. The authors conclude that several short-term benefits related to mobility restrictions following the COVID-19 outbreak were lost rapidly in the ‘new normal’ period. They also conclude that the results indicate that some tourist and rural areas have suffered a particular rebound in numbers of accidents during the post-lockdown period.

A longitudinal analysis of revenue management strategies and measures implemented in the hospitality industry during the COVID-19 crisis

PurposeThis research aims to answer two major research questions related to the COVID-19 crisis from a longitudinal approach: What is the revenue management (RM) role during the different periods subject to analysis? What are the RM strategies and measures implemented during this crisis in contrast with a non-crisis context? It also aims to propose an RM implementation model that provides a contingency plan to face future crises.Design/methodology/approachThis qualitative study, following a longitudinal approach, analyses three round-table discussions with 11 internationally renowned experts during three key scenarios of the COVID-19 crisis: the lockdown period (from March to June 2020) and the following two summer seasons (the post-lockdown period): Post-lockdown I (the summer campaign, 2020) and Post-lockdown II (the summer campaign, 2021). Based on a deductive approach, thematic analysis is conducted using NVivo.FindingsFurther professionalisation of revenue managers, which has enabled the correct application of strategies and measures, highlighting the importance of not lowering prices, the flexibility of booking conditions, the development of other sources of income and the increase in the value of services, amongst others, are key factors in managing this crisis. The longitudinal analysis carried out in three different periods of this crisis shows how these measures have evolved and the contrast with RM application in a non-crisis context. The revenue manager's leadership and proactivity, the holistic organisation of RM marketing, commercial and sales departments and the quick adaptation of RM systems (RMSs) by modifying their algorithms are essential to reducing the impact of COVID-19 on the hospitality industry. This crisis has led the industry to rethink processes and strategies and to increase digitalisation. The proposed model, which considers the various RM strategies and measures implemented during COVID-19 in contrast to a non-crisis context, is the cornerstone for developing a graded contingency plan to face future crises. This research sheds light on the widely discussed role of RM during this crisis.Research limitations/implicationsThis study has various limitations. First, the three round-table discussions were held online due to the health crisis, and the chosen webinar format may have biased the participants' answers due to its public nature. Second, the survey was carried out in Spanish. Despite the strong international profiles of the participants, cultural distortion may appear, suggesting that the research should possibly be extended to other cultural contexts in the future. Third, some of the participants were unable to attend all the round-table discussions due to their professional duties, so people with similar profiles were invited to the rest of the sessions.Practical implicationsThe revenue manager's leadership and proactivity, the holistic organisation of RM marketing, commercial and sales departments and the quick adaptation of RMSs by modifying their algorithms are essential to reducing the impact of COVID-19 on the hospitality industry. This crisis has led the industry to rethink processes and strategies and to increase digitalisation. The proposed model, which considers the various RM strategies and measures implemented during COVID-19 in contrast to a non-crisis context, is the cornerstone for developing a graded contingency plan to face future crises. This research sheds light on the widely discussed role of RM during this crisis.Originality/valueThis work contributes to the literature by providing a model that considers the various RM strategies and measures implemented during COVID-19 in contrast to a non-crisis context. The novelty of this research is mainly found in the conducting of a deductive and longitudinal study considering previous research focussed on RM strategies applied during the COVID-19 crisis and supplementing it with new measures by applying qualitative techniques.

Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown.

In order to reduce transmission of COVID-19, in March 2020 the UK national and devolved governments imposed restrictions including spatial distancing, stay-at-home orders, and travel restrictions. The aim of this study is to compare the characteristics of cases referred to the Coronial system for autopsy in the months before and during the lockdown period. In all, 580 autopsy cases, performed in the London area between January and June 2020 were included in the study. In the postlockdown period, there was an increase in the proportion of black individuals referred for autopsy, which just attained statistical significance (p = 0.047). The proportion of decomposed bodies submitted for examination was significantly increased (p = 0.011). The study did not show a significant increase in the proportion of out-of-hospital (community) deaths, traumatic deaths, or deaths due to alcohol or drug abuse or overdose. The study shows no evidence that COVID-19 preventative measures led to a change in the causes of death referred to the Coroner, except, of course, for COVID-related deaths. The proportion of black people among subjects for autopsy increased, probably because of a relatively higher incidence of COVID deaths among this group. Decomposed subjects were more common, probably due to social isolation.

Impact of the COVID-19 lockdown on routine childhood vaccination coverage rates in Catalonia (Spain): a public health register–based study

ObjectiveThe aim of this study was to determine the impact of the lockdown measures adopted during the COVID-19 pandemic on routine childhood vaccination coverage rates in Catalonia (Spain) and to estimate its recovery once the progressive return to ‘normalcy’ had begun. Study designWe conducted a public health register–based study. MethodsRoutine childhood vaccination coverage rates were analysed in three periods: a first pre-lockdown period (from January 2019 to February 2020), a second lockdown period with full restrictions (from March 2020 to June 2020), and, finally, a third post-lockdown period with partial restrictions (from July 2020 to December 2021). ResultsDuring the lockdown period, most of the coverage rates remained stable, concerning the pre-lockdown period; however, when comparing the vaccination coverage rates in the post-lockdown period to the pre-lockdown period, we observed decreases in all types of vaccines and doses analysed, except for coverage with the PCV13 vaccine in 2-year-olds, which experienced an increase. The most relevant reductions were observed in measles-mumps-rubella and diphtheria-tetanus-acellular pertussis vaccination coverage rates. ConclusionsSince the beginning of the COVID-19 pandemic, there has been an overall decline in routine childhood vaccine coverage rates, and the pre-pandemic rates have not yet been recovered. Immediate and long-term support strategies must be maintained and strengthened to restore and sustain routine childhood vaccination.

Study of PM2.5-bound polycyclic aromatic hydrocarbons and anhydro-sugars in ambient air near two Spanish oil refineries: Covid-19 effects

We report the results from a 12 month-long study of the organic compounds associated to PM2.5 samples collected around two petroleum refineries (4 samples/month/site) in two complex industrial zones reporting atmospheric pollution issues in the past (Estuary of Huelva and Bay of Algeciras, Spain). Sampling campaign was done from March 2020 when a Covid-19 lockdown was established at Spain to March 2021. Concentrations of fine particulate polycyclic aromatic hydrocarbons (PAHs) and anhydrosugars were separately measured using gas chromatography-mass spectrometry (GC-MS) and ion chromatography-amperometric detection (IC-PAD). The annual average abundances of PM2.5-bound benzo[a]pyrene (BaP) are 0.024 and 0.013 ng˖m−3 at La Rábida and Puente Mayorga monitoring stations, while both sites have annual average concentrations of levoglucosan in PM2.5 of 14.98 and 9.78 ng˖m−3, respectively. Seasonal variations are observed for concentrations of ƩPAHs and total anhydrosugars in both sampling sites. For PAHs, the highest concentrations averaging c. a. 0.400 (La Rábida) and 0.350 ng m−3 (Puente Mayorga) are reported in cold months during December 2020-Febraury 2021 (post-lockdown period), compared to the lowest levels averaging 0.111 and 0.211 ng˖m−3, respectively, in temperate months from mid-March 2020 to early June 2020 (0.284 and 0.321 ng m−3 on average annually), coinciding with the confinement and relaxation periods in Spain. Similarly, total anhydrosugars show the highest values of 81.80 ng˖m−3 (La Rábida) and 53.52 ng˖m−3 (Puente Mayorga) in winter and lowest values of 2.71 ng˖m−3 and 3.30 ng˖m−3 into the lockdown period (22.51 and 14.09 ng˖m−3 on average annually). Except phenanthrene, PAHs are present in PM2.5 principally as result of motor vehicle exhausts. Levoglucosan, a tracer for biomass burning, peaked in December 2020 and January 2021, during the high residential wood-burning season. In addition, multivariate analysis was used to assess the origin of organic components of PM2.5 samples. The two principal components are characterized by the grouping of heavy PAHs associated to vehicular traffic, and anhydrosugars indicating biomass burning emissions, respectively.

Impact of the SARS-CoV-2 pandemic on the diagnostic delay of oral carcinoma: a retrospective analysis.

The aim of the present study was to investigate how the organisation of healthcare activity during the first wave of the SARS-CoV-2 pandemic affected the timing of diagnosis of oral carcinoma in the Functional Head and Neck Department of Padua (Italy). This study gives an effective temporal dimension of the diagnostic delay that occurred during the pandemic, compared with data from the literature. A retrospective analysis of the diagnostic path of a patient affected by oral cancer during COVID-19 pandemic was performed. The time elapsed from the patient's awareness of the problem to the first curative surgical intervention was considered both during the blockage of elective care activities and in the period immediately following. The results were compared to a group of patients treated in the same period of the year 2019. The territorial time was 53.9% longer in the post-lockdown period than in the lockdown period (39.6 days) while the hospital time was 56.6% shorter than in the post-lockdown period (56 days). The response time of territorial medicine has been longer during the pandemic peak. The unintentional creation of exclusive pathways for oncological patients speeded up the diagnostic process. The organization and accessibility of operating theatres can become particularly problematic during the acute phases of a pandemic.

The 10-month mortality rate among older patients treated for digestive system cancer during the first wave of the COVID-19 pandemic: The CADIGCOVAGE multicentre cohort study

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and care pathways. Here, we assessed the mid-term impact of the COVID-19 pandemic on older adults with cancer before, during and after the lockdown period in 2020. Materials and MethodsWe performed a retrospective, observational, multicentre cohort study of prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer in our institution between January 2018 until August 2020 were enrolled. ResultsData on 7,881 patients were analyzed. Although the overall 10-month mortality rate was similar in 2020 vs. 2018–2019, the mortality rate among for patients newly treated in the 2020 post-lockdown period was (after four months of follow-up) significantly higher. A subgroup analysis revealed higher mortality rates for (i) patients diagnosed in the emergency department during the pre-lockdown period, (ii) patients with small intestine cancer newly treated during the post-lockdown period, and (iii) patients having undergone surgery with curative intent during the post-lockdown period. However, when considering individuals newly treated during the lockdown period, we observed lower mortality rates for (i) patients aged 80 and over, (ii) patients with a biliary or pancreatic cancer, and (iii) patients diagnosed in the emergency department. DiscussionThere was no overall increase in mortality among patients newly treated in 2020 vs. 2018–2019. Longer follow-up is needed to assess the consequences of the pandemic. A subgroup analysis revealed significant intergroup differences in mortality.

Progression of Diabetic Retinopathy during COVID-19 Pandemic: A Retrospective Study

Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) infection during 2020 forced the Government to issue countrywide lockdown from March 2020. Diabetic Retinopathy (DR) is one of the debilitating diseases of the eye which requires regular follow-ups and timely intervention to prevent permanent vision loss. The impact of countrywide lockdown on prevalence and progression of DR needs to be evaluated. Aim: To assess the effect of COVID-19 pandemic situation on the prevalence and progression of DR and analyse the possible risk factors for progression of DR in the ongoing pandemic period by comparing retrospective data from immediate prepandemic quarter with post lockdown quarter. Materials and Methods: This retrospective study was conducted in the Department of Opthalmology at Regional Institute of Ophthalmology, Kolkata, West Bengal, India. The study was done during the prepandemic period, from November 2019 to February 2020. In the present study, a cohort of 83 diabetic patients with pre-existing DR was selected from past medical records and compared with post lockdown period during November 2020 to February 2021. Data regarding prevalence of various types of DR, mean Central Macular Thickness (CMT), mean Visual Acuity (VA), proportion of patients requiring &gt;3 doses of monthly anti-Vascular Endothelial Growth Factors (VEGF) and additional laser therapy or vitrectomy, VA improvement and reduction of mean CMT were gathered and compared between those two quarters. The data was analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Results: The prevalence of moderate Non Proliferative Diabetic Retinopathy (NPDR) (13% vs 25%), severe NPDR (19% vs 8%), Proliferative DR (PDR) (18% vs 7%), Advanced Diabetic Eye Disease (ADED) (4.8% vs 1%) and Diabetic Macular Oedema (DME) (62% vs 28%) increased several folds during post lockdown quarter in comparison to prepandemic quarter. There was a statistically significant difference (p-value&lt;0.05) in baseline mean LogMar Best Corrected Visual Acuity (BCVA) (0.4±0.08 vs 0.9±0.07), mean CMT (386.4±26.8 to 421.8±21.6) positive correlations of some of the possible risk factors for poor visual outcome among the same cohort of patients in the post lockdown period: poor socioeconomic status (35%; Odds Ratio (OR):3.59, Relative Risk (RR):2.68), irregular diabetic medication (52%; OR:3.56, RR:2.23), residence more than 100 km from the hospital (38%; OR:3.03, RR:2.26). Conclusion: The present study, concludes that, the status of DR stage among study subjects in the post lockdown period has deteriorated when compared with the prepandemic period.

COVID-19 lockdown has indirect, non-equivalent effects on activity patterns of Reeves’s Pheasant (Syrmaticus reevesii) and sympatric species

The outbreak of the COVID-19 pandemic has brought massive shifts in human activities through a global blockade, directly affecting wildlife survival. However, the indirect impacts of changes in human activities are often easily overlooked. We conducted surveys of Reeves’s Pheasant (Syrmaticus reevesii) and its sympatric species by camera traps in forest-type nature reserves in three different scenarios: pre-lockdown, lockdown and post-lockdown. An increase in livestock activities observed during the lockdown and post-lockdown period in our study area provided us an opportunity to investigate the indirect impact of the lockdown on wildlife. The pre-lockdown period was used as a baseline to compare any changes in trends of relative abundance index, activity patterns and temporal spacing of targeted species and livestock. During the lockdown period, the relative abundance index of livestock increased by 50% and there was an increase in daytime activity. Reeves's Pheasant showed avoidance responses to almost all sympatric species and livestock in three different periods, and the livestock avoidance level of Reeves's Pheasant during the lockdown period was significantly and positively correlated with the relative abundance index of livestock. Species-specific changes in activity patterns of study species were observed, with reduced daytime activities of Hog Badger and Raccoon Dog during and after the confinement periods. This study highlights the effect of the COVID-19 lockdown on the responses of wildlife by considering the changes in their temporal and spatial use before, during and after lockdown. The knowledge gained on wildlife during reduced human mobility because of the pandemic aids in understanding the effect of human disturbances and developing future conservation strategies in the shared space, to manage both wildlife and livestock.

Medicolegal Aspects during Mass Casualty Due to Road Traffic Accidents in the Era of Covid: A Tertiary Care Institutional Experience

Background: In March 2020, the world health organization declared COVID-19 a world wide pandemic.Countries introduced public health measures to contain and reduce its spread. The effect of mandated societallockdown to reduce the transmission of corona virus disease 2019 (COVID-19) on road traffic accidents is notknown. For this we performed an in-depth analysis singdata of emergency and trauma centre UPUMS, Saifai.As most of the manpower was involved in managing Covid patients directly or indirectly, it was a challenge tomanage these mass casualty patients who require intensive care as well as Medicolegal documentation , recordkeeping , Consent for life saving procedures in absence of Relatives.Materials and Methods: We reviewed data on total 2876 road traffic accident records in UPUMS, Saifai fromJanuary 1, 2020 through September 30, 2020. We treated March 20th as the first day of mandated societal lock downand 1st July as the first day of re-opening.Results: We have found that the reis increase in road traffic accidents resulting in serious or fatal injuries duringlockdown and post-lockdown period. There was increased Medicolegal burden in spite of the decreased medicalresources, manpower as most of manpower and resources were being utilized for covid patients.Conclusion: Road traffic accidents are a prominent contributor to hospitalization and may negatively impact theexisting hospital resources directed towards COVID-19.