Pre-lockdown Period Research Articles

The Effect of COVID-19 Lockdown Among Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis.

The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes. A comprehensive search of literature was performed in PubMed, Scopus, Web of Science, and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore, HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown, lockdown, and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I2 statistic. Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI, 153.78, 180.02) from 205.793 mg/dL (95% CI, 188.412, 223.173) during the pre-lockdown period, then it increased to 204.23 mg/dL (95% CI, 186.17, 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However, it was not statistically significant, possibly due to the small number of studies that reported data from all three periods. Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes, this was not statistically significant in the pooled analysis.

The impact of social restrictions on the incidence and microbiology of severe acute tonsillitis.

We aimed to explore the impact of social distancing on the incidence, severity and microbiology of patients with acute tonsillitis (AT). In this single-centre study, we retrospectively included all patients with AT referred to the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark, in the two years preceding versus the two years after the COVID-19 lockdown in Denmark (11 March 2020). In total, 425 patients were included. The incidence of AT was significantly lower in the post-lockdown period (n = 128) than in the pre-lockdown period (n = 297) (p less-than 0.001). Reduced incidence was observed across all age groups. No significant differences were found in patient characteristics between periods. The proportion of hospitalised patients was significantly lower in the post- than in the pre-lockdown period (36% versus 25%, p = 0.032). Prevalent culture findings were Streptococcus pyogenes (15%), S. anginosus group (11%) and Fusobacterium necrophorum (5%). No statistically significant differences in the relative prevalence of individual bacteria were found between periods. The incidence of patients with AT referred to hospital decreased by 57% in the two-year period after the COVID-19 lockdown compared with the period leading up to the lockdown. Our findings suggest that this decrease mirrored a general decline in AT incidence rather than altered referral patterns. None. The study was approved by the Danish Data Protection Agency (#1-16-02-134-23) and the Danish Patient Safety Authority (#1-45-70-41-23).

Comparative Analysis of Aerosol Direct Radiative Forcing During COVID-19 Lockdown Period in Peninsular India

AbstractThe load of aerosols in the atmosphere has been increasing gradually due to industrialization and urbanization. This increase has contributed to change in the Earth’s radiation budget through the absorption or scattering of radiation. The aerosol direct radiative forcing (ADRF) is a measurement utilized to comprehend the impact of cooling or warming up of the atmosphere directly by aerosols. Our study examined the impact of aerosols during the COVID-19 pandemic by comparing them to the average from the preceding 5-year period (2015–2019) in peninsular India. The measure of aerosols deployed in this study is the Aerosol Optical Depth (AOD), and the study was carried out on three distinct time frames: prior to lockdown, during lockdown, and post lockdown. The study revealed that the ADRF increased during all the three time frames of 2020 compared to the average of 2015–2019, and the other time scales experienced an increase in ADRF as well. The most notable rise in ADRF and decrease in temperature occurred in the tropical savanna and warm semi-arid climate regions during the pre-lockdown period. During lockdown, the increase in ADRF was seen throughout the study area, and a decrease in temperature was observed only in the tropical monsoon region. In the post-lockdown period, the decline in ADRF was accompanied by a fall in temperature in the tropical savanna region. This study provides insights into the effect of aerosols on ADRF in peninsular India and highlights the importance of monitoring and regulating aerosol emissions to mitigate the changes in temperature.

COVID-19 lockdowns and children's access to justice: An interrupted time series analysis of Moroccan court filings

Morocco's national lockdown was enforced between March 21st and June 10th 2020 in response to the spread of coronavirus. Restriction of civil space was not fully extended to the judiciary which had to transition to virtual sessions. To prepare for future pandemics and disasters, it is crucial to understand how well court systems across jurisdictions especially in low- and middle-income countries managed to function and protect children's access to justice under the constraints of stay-at-home orders. To investigate the effect of the national lockdown on children's access to justice in Morocco, this study employed interrupted time series analysis of publicly available court filings (N = 77,335) pertaining to child protection from January 1st to December 31st 2020 spanning the pre-lockdown, lockdown, and post-lockdown periods. Results showed that lockdown measures hampered children's access to justice and is associated with statistically significant and substantial deceases in the number of cases heard by the courts across all filing types. The interrupted time series model estimates that average cases per week dropped by 199.5 for penal filings, 1180.3 for civil filings, 942.5 for complaint filings, and 358.1 for report fillings during the lockdown relative to the pre-lockdown period. While the percentage of cases with recorded delays mostly increased, the average case length decreased except for civil filings which saw a significant increase. The substantial susceptibility of civil cases to lockdowns might be precipitated by the need of individuals to petition the court for a hearing. Evidence suggests that the courts adjudicating child protection cases struggled to maintain operations during the national lockdown, and indicates the need for stronger disaster preparedness and an integrated child protection system to increase the judiciaries' resilience and children's access to justice in future emergency and disaster events.

Recent decline in carbon monoxide levels observed at an urban site in Ahmedabad, India.

Carbon monoxide (CO) is a prominent air pollutant in cities, with far-reaching implications for both local air quality and global atmospheric chemistry. The long-term change in atmospheric CO levels at a specific location is influenced by a complex interplay of local emissions, atmospheric transport, and photochemical processes, making it a subject of considerable interest. This study presents an 8-year analysis (2014-2021) of in situ CO observations using a cutting-edge laser-based analyzer at an urban site in Ahmedabad, western India. The long-term observations reveal a subtle trend in CO levels, masked by contrasting year-to-year variations, particular after 2018, across distinct diurnal time windows. Mid-afternoon (12:00-16:00h) CO levels, reflecting background and regional conditions, remained relatively stable over the study period. In contrast, evening (18:00-21:00h) CO levels, influenced by local emissions, exhibited substantial inter-annual variability without discernible trends from 2014 to 2018. However, post-2018, evening CO levels showed a consistent decline, predating COVID-19 lockdown measures. This decline coincided with the nationwide adoption of Bharat stage IV emission standards and other measures aimed at reducing vehicular emissions. The COVID-19 lockdown in 2020 further resulted in a noteworthy 29% reduction in evening CO levels compared to the pre-lockdown (2014-2019) period, highlighting the potential for substantial CO reduction through stringent vehicular emission controls. The observed long-term changes in CO levels do not align with the decreasing emission estimated by various inventories from 2014 to 2018, suggesting a need for improved emission statistics in Indian urban regions. This study underscores the importance of ongoing continuous CO measurements in urban areas to inform policy efforts aimed at controlling atmospheric pollutants.

Institutional Deliveries at Public and Private Health Institutions in Punjab: A Comparative Study of Pre-Lockdown, Lockdown and Post-Lockdown Periods in Selected Districts

From 25 March 2020, there was a complete lockdown in Punjab till 31 May 2020 in four different phases affecting almost all types of services except delivery of essential services. Further, lockdown restrictions continued for night movement in the State in various phases. Out-patient (OPD) services were closed and entry to medical institutions was restricted to emergency services. Since institutional deliveries constitute an important ingredient of maternal and child health care facilities, it is important to study and examine the impact on institutional births in Punjab in the context of lockdown. The main objectives of the research paper are to find out the patterns of actual institutional deliveries in the selected districts of Punjab; to study the variations in three-distinct phases such as pre-lockdown (before March 2020), lockdown (March-July 2020) and the post-lockdown (after July 2020). Further, all deliveries have been classified in different categories-normal, caesarean, public, private, core and periphery, etc. Among various things, paper finds there was an edge of government sector in both the selected districts during pre-lockdown period which started intermingling during the lockdown period and completely reversed in favour of private sector during the post- lockdown period.

Ebola incidence and mortality before and during a lockdown: The 2022 epidemic in Uganda.

On September 20, 2022, an Ebola Disease (EBOD) outbreak was declared in Mubende district, Central Uganda. Following a rapid surge in the number of cases and mortality, the Government of Uganda imposed a lockdown in the two most affected districts, Mubende and Kassanda. We describe the trends in EBOD incidence and mortality nationally and in the two districts before and during the lockdown and the lessons learned during the epidemic response. We retrieved data from the Ministry of Health situation reports from September 20, 2022, when the EBOD outbreak was declared until November 26, 2022, when the lockdown ended. We graphed trends in EBOD morbidity and mortality during a 3-week and 6-week lockdown, computed the EBOD case fatality rate, and summarized the major lessons learned during the epidemic response. We found case fatality rate during the pre-lockdown, 3-week lockdown, and 6-week lockdown period was 37.9% (22/58), 39.3% (53/135), and 38.7% (55/142), respectively. In the early weeks of the lockdown, EBOD incidence and mortality increased nationally and in Kassanda district while Mubende district registered a decline in incidence and stagnation in mortality. With the extension of the lockdown to six weeks, the EBOD incidence and mortality during the 4-6-week lockdown declined compared to the pre-lockdown period. In conclusion, the EBOD incidence and mortality remained higher in the early weeks of the lockdown than during the pre-lockdown period nationally and in one of the two districts. With extended lockdown, incidence and mortality dropped in the 4-6-week period than the pre-lockdown period. Therefore, reliance on known public health measures to control an EBOD outbreak is important.

A mixed method evaluation of a theory based intervention to reduce sedentary behaviour in contact centres- the stand up for health stepped wedge feasibility study

Introduction Contact centres have higher levels of sedentary behaviour than other office-based workplaces. Stand Up for Health (SUH) is a theory-based intervention developed using the 6SQuID framework to reduce sedentary behaviour in contact centre workers. The aim of this study was to test acceptability and feasibility of implementing SUH in UK contact centres. Methods The study was conducted in 2020–2022 (pre COVID and during lockdown) and used a stepped-wedge cluster randomised trial design including a process evaluation. The intervention included working with contact centre managers to develop and implement a customised action plan aligning with SUH’s theory of change. Workplace sedentary time, measured using activPAL™ devices, was the primary outcome. Secondary outcomes included productivity, mental wellbeing, musculoskeletal health and physical activity. Empirical estimates of between-centre standard deviation and within-centre standard deviation of outcomes from pre-lockdown data were calculated to inform sample size calculations for future trials. The process evaluation adopted the RE-AIM framework to understand acceptability and feasibility of implementing the intervention. Interviews and focus groups were conducted with contact centre employees and managers, and activity preferences were collected using a questionnaire. Results A total of 11 contact centres participated: 155 employees from 6 centres in the pre-lockdown data collection, and 54 employees from 5 centres post-lockdown. Interviews and focus groups were conducted with 33 employees and managers, and 96 participants completed an intervention activity preference questionnaire. Overall, the intervention was perceived as acceptable and feasible to deliver. Most centres implemented several intervention activities aligned with SUH’s theory of change and over 50% of staff participated in at least one activity (pre-lockdown period). Perceived benefits including reduced sedentary behaviour, increased physical activity, and improved staff morale and mood were reported by contact centre employees and managers. Conclusions SUH demonstrates potential as an appealing and acceptable intervention, impacting several wellbeing outcomes. Trial registration The trial has been registered on the ISRCTNdatabase: http://www.isrctn.com/ISRCTN11580369.

Impacts of irregular and strategic lockdown on air quality over Indo-Pak Subcontinent: Pre-to-post COVID-19 analysis

The COVID-19 pandemic has received enormous attention worldwide due to its environmental, and societal impacts. After the discovery of this novel virus in December 2019, the governmental bodies have suspended the social and economic activities and declare an unprecedented lockdown emergency. The present work sought to investigate the impact of COVID-19 containment measures on air quality in the region of Indo-Pak subcontinent (IPS). The satellite retrievals of aerosol optical depth (AOD), sulfur dioxide (SO2), nitrogen dioxide (NO2), and Ozone (O3) was used to estimate the spatial-temporal extent of major air pollutants in the region during lock down period (March–May 2020) in comparison to the pre-lockdown period (March–May 2015–2019) and post-lockdown (March–May 2021) across the IPS. From the results, a considerable reduction in air pollutants concentration has been observed during the lockdown phase that in turns significantly improved the regional air quality. Moreover, we have also done comparative analysis among meteorological parameters and ambient air pollutants and observed that meteorological factors were not the main reason for the dramatic reductions of pollutants in the atmosphere. In addition, backward trajectory analysis has been done through the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model to find the path and direction of air particles parcels as large-scale atmospheric circulation is a critical factor in driving pollutant. Following the implementation of strict lockdown, reduction in anthropogenic activities led to a substantial decline in AOD, SO2 and NO2 whereas, a considerable increase in tropospheric O3 has been observed and well supported by other regional studies. Overall, the findings of this study are believed to be a useful addition to the regulatory authorities and will help the policymakers to formulate the air pollution mitigation strategies in a long-term perspective.

Status of SWL Indicated Patients with Urolithiasis during the Era of SARS-Cov-2 Pandemia

Purpose: It was aimed to investigate the effects of the SARS-CoV-2 pandemic period on SWL indicated patients with urolithiasis. Method: Medical records of SWL indicated patients with urolithiasis were obtained before and after the SARS-CoV-2 outbreak, covering the period between January 2019 and December 2021. The study was divided into two time periods as the pre-lockdown and the post-lockdown periods due to quarantine curfew. The data regarding the patient and stone characteristics were obtained from the records and compared between the time periods. Results: A sum of 286 patients who underwent SWL treatment due to urolithiasis between January 2019 and December 2021 were included into the study. 45% of these patients were treated with SWL in pre-lockdown period and 55% were treated with SWL in post-lockdown period. The mean size of SWL indicated stones were 10.84 ± 4.82mm. While the pre-lockdown mean size was 9.76 ± 4.31mm, the post-lockdown mean size was 11.71 ± 5.04mm (p=0.001) and there was a tendency to increase in stone size after the lockdown. A tendency to increase in stone firmness and radiodensity was observed after the lockdown. While there were recurrent stones in 43% of pre-lockdown patients, new stone formation occurred in 19% of post-lockdown patients that this finding might be interpreted as an increase in stone count. Conclusion: According to these results, the stone characteristics of SWL indicated patients are directly affected as a result of lockdown due to the SARS-CoV-2 pandemic.

Psychoactive substance intoxication leading to general hospital admission in young and middle-aged people during and after the first lockdown

Incidence of hospitalisations related to psychoactive substance (H-PS) intoxication has been strongly decreased during the coronavirus disease 2019 (COVID-19) pandemic especially in young adult and French region of Nouvelle-Aquitaine was mostly concerned. This study aimed to describe (i) the incidence of H-PS in Bordeaux teaching hospital during and after the first 2020 lockdown in adults aged 18-29 years or 30+ then (ii) their characteristics specifically associated with the pandemic period by comparing 2020 with 2017-2019 baseline period. This historical cohort study was conducted in adults admitted to the Bordeaux teaching hospital with main or associated diagnosis codes of intoxication with benzodiazepine, methadone, buprenorphine, codeine, morphine, heroin, cocaine, ecstasy and alcohol. Data were collected locally through the discharge database. Incidence and characteristics of H-PS were described according to patients' age, in 2020 before (01/01-16/03), during (17/03-10/05), and after the first lockdown (11/05-31/07). Among the 5,824 stays included over the study period, PS most involved were alcohol and benzodiazepines. Compared to baseline, the decrease in H-PS's incidence was more important in young adults (-40%; nbaseline=450) in comparison to those aged 30+ (-18%; nbaseline=1,101) during the pandemic period, especially during the lockdown compared to 2017 (-59%; n2017=145 vs. -35%; n2017=166) with far decrease in alcohol and ecstasy intoxications. Seriousness of hospitalisation indications was increased regardless of age during the pandemic. Particularly in young adults, the proportion of suicides attempts increased during lockdown compared to the baseline period (almost 50% vs. 29%) and the period after lockdown was associated with 1.7 more-time road accident increased and 3 more-time fights compared with pre-lockdown period. The period following lockdown should be considered at risk H-PS due to accident. Recreational use of alcohol and ecstasy could be a target for minimize serious consequences associated to PS use in young adult.

Spatio-temporal analysis of air pollution dynamics over Bangalore city during second wave of COVID-19

The country wide lockdown implemented during 27th April to 14th June 2021 in order to prevent the spread of COVID-19 during the second wave in India. Effect of the restricted lockdown resulted in improved air quality. This study focuses on analyzing the spatio-temporal distribution analysis of major air pollutant concentration over Bangalore city in India. The inverse distance weighting (IDW) method is implemented for the spatial analysis in order to quantify the distribution of the pollutant concentrations at each location in the Urban city of Bangalore. The research considers the distinct periods of pre-lockdown and lockdown during the second wave of COVID-19 pandemic in 2021 to investigate the impact of reduced human activities on air quality over the city. The study mainly utilizes the air pollution data collected from Central Pollution Control Board (CPCB) monitoring stations across Bangalore, including measurements of pollutants such as PM2.5, PM10, O3, NO2, SO2, and CO. The IDW method is implemented to create the high-resolution pollution concentration maps for both the pre-lockdown and lockdown periods. This spatial distribution provides valuable insights into the variations in the pollution levels though out the Bangalore city. The comparative analysis of the concentration maps reveals significant changes in air pollution levels between the two periods; similarly, the temporal weekly average analysis also witnessed negative anomalies during the lockdown weeks. The results indicate substantial reductions in pollutant concentrations during the second wave COVID-19 lockdown, attributed to decreased vehicular emissions, industrial activities, and construction operations. The pre-lockdown period serves as a baseline for assessing the improvements in air quality during the lockdown. The spatio-temporal modeling approach enhances our understanding of the distribution patterns of air pollutants across the Bangalore metropolitan city. The findings underscore the potential benefits of implementing sustainable strategies to maintain improved air quality even after the pandemic subsides.

Impact of COVID-19 Lockdown on Metabolic/Inflammatory Profile in Adolescents: Cellular Studies and Predictive Biomarkers.

The COVID-19 pandemic and its lockdown restrictions changed people's lifestyles with potential negative impact on health. This longitudinal study aimed to assess the COVID-19 lockdown influence on the adherence to the Mediterranean Diet (MD) pattern and its effects on the metabolic inflammatory profile in a cohort of healthy adolescents. We analyzed anthropometric measurements, body composition, and MD adherence along with serum metabolic and inflammatory profile in 77 healthy adolescents from Southern Italy before and after the COVID-19 pandemic lockdown. Additionally, we evaluated the biological properties of pre- and post-lockdown serum on human HepG2 and HuH-7 hepatic cells. We didn't observe any significant differences in anthropometric and body composition parameters as well as in MD adherence score in adolescents between pre- and post-lockdown COVID-19. Intriguingly, despite the metabolic profile of adolescents in post-lockdown was within the normal range, we evidenced increased levels of fasting glucose, triglycerides, Total Cholesterol and LDL along with a reduction in HDL, in post- compared to pre-lockdown adolescent serum. In addition, elevated levels of TNF-α, IL-1β and ferritin were found in post-lockdown adolescents when compared to their pre-lockdown counterparts. Consistent with biochemical parameters, were observed in HepG2 and HuH-7 cells treated with pooled serum from post- respect to pre-lockdown period enhanced lipid accumulation with altered mitochondrial functions and increased reactive oxygen species production. Receiver operator characteristic curve analysis identified Total C Cholesterol, LDL, HDL, TNF-α and ferritin as predictive serum markers for metabolic and inflammatory profiling after lockdown period. Our findings highlight that the COVID-19 lockdown, forcing sedentary behavior, had a negative impact on adolescents' metabolic and inflammatory profile which may result in long-term unhealth outcomes.

A CNN-SVR model for NO2 profile prediction based on MAX-DOAS observations: The influence of Chinese New Year overlapping the 2020 COVID-19 lockdown on vertical distributions of tropospheric NO2 in Nanjing, China

In this study, a hybrid model, the convolutional neural network-support vector regression model, was adopted to achieve prediction of the NO2 profile in Nanjing from January 2019 to March 2021. Given the sudden decline in NO2 in February 2020, the contribution of the Coronavirus Disease-19 (COVID-19) lockdown, Chinese New Year (CNY), and meteorological conditions to the reduction of NO2 was evaluated. NO2 vertical column densities (VCDs) from January to March 2020 decreased by 59.05% and 32.81%, relative to the same period in 2019 and 2021, respectively. During the period of 2020 COVID-19, the average NO2 VCDs were 50.50% and 29.96% lower than those during the pre-lockdown and post-lockdown periods, respectively. The NO2 volume mixing ratios (VMRs) during the 2020 COVID-19 lockdown significantly decreased below 400 m. The NO2 VMRs under the different wind fields were significantly lower during the lockdown period than during the pre-lockdown period. This phenomenon could be attributed to the 2020 COVID-19 lockdown. The NO2 VMRs before and after the CNY were significantly lower in 2020 than in 2019 and 2021 in the same period, which further proves that the decrease in NO2 in February 2020 was attributed to the COVID-19 lockdown. Pollution source analysis of an NO2 pollution episode during the lockdown period showed that the polluted air mass in the Beijing-Tianjin-Hebei was transported southwards under the action of the north wind, and the subsequent unfavorable meteorological conditions (local wind speed of < 2.0 m/sec) resulted in the accumulation of pollutants.

O.2.3-1 Stand Up for Health: process evaluation of an intervention to reduce sedentary behaviour in contact centres

Abstract Purpose Contact centres have been identified as high-pressured workplaces where staff are sedentary, and one in four experience musculoskeletal problems. Stand Up for Health (SUH) is an intervention developed using the 6SQuID intervention development framework to target sedentary behaviour in contact centres. It is an adaptive intervention based on the Social Cognitive Theory and the Social Ecological Model. The aim of this study was to test the acceptability and feasibility of implementing SUH in contact centres. Methods The study used a stepped-wedge cluster randomised trial design and included eleven UK-based contact centres. Intervention implementation involved working with contact centre stakeholders to develop a customised action plan that aligned with SUH’s theory of change. This was operationalised to include two workshops, creating a SUH committee, and loaning equipment (desk-risers, exercise equipment) to each centre. During the pandemic, online staff consults replaced these activities. The process evaluation adopted the RE-AIM framework to understand acceptability and feasibility of implementing the SUH intervention. Interviews and focus groups were conducted with 33 staff members and stakeholders, and 96 participants completed an activity preference questionnaire. Qualitative data were analysed using a codebook thematic analysis approach and descriptive statistics were used to describe activity preferences. Results The intervention was acceptable and feasible to deliver, and most contact centres implemented several activities aligned with each level of the programme’s theory of change. All centres reported that more than 50% of staff participated in at least one SUH activity (during the pre-lockdown period). Perceived benefits such as reduced sedentary behaviour, increased physical activity, and improved staff morale and mood were reported by contact centre staff and stakeholders. Participants felt that SUH was particularly significant because it increased awareness of sedentary behaviour, encouraged movement, and helped staff manage stress. Conclusions SUH is an adaptive multicomponent programme that considers the culture and contexts of contact centres. The programme shows potential as an appealing and acceptable intervention, impacting several wellbeing outcomes. Next steps include adapting the intervention for the post-pandemic work context, and further pilot testing before large scale evaluation. Funding Source National Institute for Health Research (NIHR) [PHR project grant: 17/149/19]

Investigating changes in atmospheric aerosols properties over the Indo-Gangetic Plain during different phases of COVID-19-induced lockdowns.

Impact of COrona VIrus Diseases 2019 (COVID-19) restrictive measures on aerosol optical depth (AOD) and black carbon (BC) concentration is investigated for the western, central, and eastern Indo-Gangetic Plain (IGP) using satellite-based observations. Due to COVID-19-induced lockdown measures, a noticeable decline in AOD and BC concentrations was observed across the IGP when compared to pre-lockdown period of 2020 and the lockdown concurrent period of 2015-2019. During the total lockdown period, a maximum drop in AOD and BC was observed in the central IGP (26.5 % and 10.1 %), followed by western IGP (24.9% and 5.2%) and eastern IGP (23.2 % and 4.9 %) with respect to the same period of 2015-2019. We have removed seasonal influences on aerosol properties during the COVID-19 lockdown, by taking average seasonal variations during the period of 2015-2019 as reference and projecting the hypothetical AOD and BC for the lockdown period under normal scenario. The difference between the hypothetical AOD and BC (under normal scenario) and the retrieved AOD and BC for the lockdown period is the absolute percentage change in AOD and BC concentration due to the lockdown alone. This elimination of seasonal influence is a novel approach. Central IGP showed an absolute decrease in AOD and BC of 38.5% and 18.2% during the lockdown period followed by western IGP (34.6% and 7.7%) and eastern IGP (25.9% and 11.5%). The observed absolute reduction in AOD, 26-39 %, is significantly higher than the global average reduction in AOD of 2-5%. CALIPSO-derived aerosol sub-types over major location of the western, central, and eastern IGP suggests prevalence of anthropogenic activities during pre- and post-lockdown periods. During the lockdown, IGP was influenced by aerosols from natural sources, with mineral dust and polluted dust in the western and central IGP, and aerosols from marine regions in the eastern IGP. Replenishment of aerosols within the boundary layer were far quicker when compared to total column during post-lockdown. Overall, the study reveals a reduction in anthropogenic emissions during the COVID-19-induced lockdowns, leading to temporary improvements in air quality over the IGP. Our study presents a comprehensive analysis of COVID-19 lockdown impact on aerosols properties over the IGP and highlights unprecedented reductions in AOD (~ 40 %) and BC (~ 20 %), due to imposition of lockdown and subsequent cessation of aerosol sources, by removing seasonal influences.

The impact of COVID-19 on health care accessibility and financial risk protection in Sri Lanka.

The COVID-19 pandemic negatively impacted the global economy, disrupted essential health services, and distorted social determinants of health, reducing healthcare accessibility and increasing financial risk. we aimed to assess the impact of COVID-19 on healthcare accessibility and financial risk protection in Sri Lanka. We conducted a cross-sectional study on a representative sample (multi-stage sampling process) of 3151 households in 105 clusters representing all the districts of Sri Lanka. The data collection was conducted using an interviewer-administered questionnaire in early November 2021. This was important to classify three periods of interest, namely: (1) the pre-lockdown period (2) the nationwide lockdown period, and (3) the new normal period. (After Oct 1 to early November 2021). Among 11,463 household occupants, 12.6% reported having chronic diseases, with 76.5% diagnosed prior to six months. The majority had heart disease, high blood pressure, or diabetes. Of them, 53.7% have been followed up during the lockdown, increasing to 80.8% in the new normal period. Provincial variations in expenses were observed, with the highest food expenses in the Western Province. Catastrophic health expenditures affected 9.5% and 3.4% of households at 10% and 25%, respectively. A considerable proportion of those having heart disease, high blood pressure, high blood sugar or diabetes mellitus were not followed up in the lockdown period and the first month of the new normal period. Antenatal care and family planning were the least affected. Participants had incurred high out-of-pocket expenditures for healthcare during the entire period.

Alcohol-Related Hospitalizations During the Initial COVID-19 Lockdown in Massachusetts: An Interrupted Time-Series Analysis.

The effect of initial COVID-19 pandemic-associated lockdowns on alcohol-related hospitalizations remains uncertain. This study compares alcohol-related hospitalizations at a US Department of Veterans Affairs (VA) system in Massachusetts before, during, and after the initial COVID-19 lockdown. This study is an interrupted time-series analysis at the VA Boston Healthcare System. Participants included all patients hospitalized on the medical, psychiatry, and neurology services at VA Boston Healthcare System from January 1, 2017, to December 31, 2020, excluding those under observation status. The period January 1, 2017, to March 9, 2020, was defined as prelockdown (the reference group); March 10, 2020, to May 18, 2020, was lockdown; and May 19, 2020, to December 31, 2020, was postlockdown. Alcohol-related hospitalizations were determined using International Statistical Classification of Diseases, Tenth Revision primary diagnosis codes. We identified 27,508 hospitalizations during the study periods. There were 72 alcohol-related hospitalizations per 100,000 patient-months during the prelockdown period, 10 per 100,000 patient-months during the lockdown, and 46 per 100,000 patient-months in the postlockdown period. Compared with the prelockdown period, the adjusted rate ratio for daily alcohol-related hospitalizations during lockdown was 0.20 (95% CI, 0.10-0.39) vs 0.72 (95% CI, 0.57-0.92) after the lockdown. A similar pattern was observed for all-cause hospitalizations. Our results suggest that COVID-19 pandemic lockdown measures were associated with fewer alcohol-related hospitalizations. Proactive outreach for vulnerable populations during lockdowns is needed.

Impact of COVID-19 Pandemic on the Exacerbation Rates in COPD Patients in Southern India - A Potential Role for Community Mitigations Measures.

The impact of the coronavirus 2 (SARS-CoV-2) pandemic and the effect of preventive health strategies on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are largely unknown. The public health model imposed during the pandemic and the lessons learnt have implications on recommending future preventive strategies for COPD care in general and exacerbations in particular. This study endeavors to assess the role of preventive strategies of COVID-19 on exacerbation rates of COPD during the lockdown period compared to similar periods the previous year and assess the compliance to preventive strategies for COVID-19 among COPD patients. This is a hospital-based descriptive cross-sectional study at a tertiary care center. AECOPD in patients during a period spanning five months in the pre-lockdown days was compared with exacerbation rates for a similar period during the national lockdown. Sixty-eight patients were recruited (mean age: 67.38) among whom 47 were males and 21 were females. There were only 7 (10.3%) reported admissions during the lockdown period of 5 months compared to 50 (73.5%) during the corresponding period pre-lockdown. Mild exacerbations reported during the lockdown period were also significantly less with only 17 (25%) against 58 (85.3%) during the pre-lockdown period. Adherence to measures such as donning of masks, hand hygiene, and social distancing was observed among COPD patients with good compliance to the health practices promulgated in the pandemic. A significant reduction in exacerbation rates among AECOPD patients during the period of lockdown was observed compared to a similar period the year prior. Noticeable were the findings that both community-based milder exacerbations and severe exacerbations necessitating hospitalizations showed a reduction during the period of lockdown. Adaptability, compliance and acceptance to usage of masks, hand hygiene measures, and norms such as physical distancing were observed in the majority of COPD patients.

The acute care burden of asthma in children was profoundly reduced during the COVID-19 pandemic: A multi-centre Canadian retrospective study.

Asthma is a chronic lung condition that can be exacerbated when triggered by viruses. Pandemic public health restrictions aimed to reduce COVID-19 transmission indirectly effected other circulating viruses. This study assessed the impact of the pandemic and associated public health measures on acute paediatric asthma across four tertiary sites in three Canadian provinces. We queried whether pandemic-related changes would impair preventive care and delay presentation to care, increasing asthma exacerbation severity. This retrospective study compared the frequency of acute care access and severity of presentation to emergency departments (ED) for acute asthma to four tertiary care children's hospitals during the COVID-19 pandemic (from March 17, 2020 to June 30, 2021) to a pre-lockdown control period (July 1, 2018 to March 16, 2020). Data was subjected to interrupted time series and Chi-square analysis. Our study included 26,316 acute asthma visits to ED. Sites experienced a 63% to 89% reduction in acute asthma visits during the pandemic, compared with pre-lockdown controls, and a 17% to 85% reduction in asthma, that is out of proportion as a fraction of all-cause ED visits. For asthma, there was no difference in severity measured by rate of ward admission or rate of Paediatric Intensive Care Unit (PICU) admission. Public health measures appear to have resulted in a specific protective association on acute asthma with reduced acute care utilization over and above the reduction in all-cause presentations, without an increase in severity upon presentation. Our study indicates an importance to antiviral public health and engineering strategies to reduce viral transmission and thereby asthma morbidity.