Public Health Restrictions Research Articles

Determinants and Variations of COVID-19 Vaccine Uptake and Responses Among Minority Ethnic Groups in Amsterdam, the Netherlands.

The outbreak of the deadly novel coronavirus disease (COVID-19) has disrupted life worldwide in an unprecedented manner. Over the period, scientific breakthroughs have resulted in the rollout of many vaccination programmes to protect against the disease, reduce the fear and ease public health restrictions for lives to return to some normalcy. The aim of this study was to identify the factors responsible for COVID-19 vaccine acceptance or vaccine hesitancy and to develop a framework to improve vaccine uptake in the Ghanaian-Dutch, Afro and Hindustani Surinamese-Dutch communities in Amsterdam. Using a mixed method approach, this community-based cross-sectional survey recruited 160 respondents consisting of 57 Ghanaian-Dutch, 54 Afro Surinamese-Dutch and 49 Hindustani-Dutch residents in Amsterdam. Our findings showed that the choice of a vaccine as well as the likelihood of self-reported willingness to receive a vaccine is highly dependent on vaccine efficacy and safety. Available evidence of high vaccine effectiveness and safety could encourage about 41.3% of the respondents to accept the vaccine. Additionally, 69.6% of the respondents indicated their willingness to accept the vaccine when vaccine passports are made mandatory by the government. Other major factors that could drive the likelihood of accepting the COVID-19 vaccine include travel requirement for vaccination (28.3%), the safety/probability of only minor side effects (26.1%) and recommendation by family and friends (15.2%). The study therefore provides systematic evidence of factors associated with individual preferences toward COVID-19 vaccination. It demonstrates that the needs of each community are unique and specific interventional efforts are urgently needed to address concerns likely to be associated with vaccine hesitancy.

At odds? How European governments decided on public health restrictions during COVID-19

ObjectivesThis study aimed to understand how politics, economics, and public health restrictions affected each other during the COVID-19 pandemic. MethodsWe use seemingly unrelated regressions on a monthly data set of government approval ratings, the stringency index, the time-dependent reproduction number (R), and unemployment, allowing the residuals in each regression to be correlated with each other. We also conduct sensitivity tests using weekly data and the growth in polls. ResultsThe study covers 27 European countries from April 2020 to April 2021. A unit increase in the R and COVID-19 cases per million increases the stringency index by 23.742 and 4.207, respectively; a unit increase in stringency boosts the incumbent’s popularity by 0.384; the poll positively affects the stringency index; stringency has negative effects on the R; and the poll and stringency index have opposite effects on unemployment. ConclusionPolitical and economic pressures did not hinder the government from introducing stronger measures.

The impact of the COVID-19 pandemic on frozen shoulder incidence rates and severity.

BackgroundAlthough there is evidence that the COVID-19 pandemic had profound physiological and psychological effects, there is no research aimed at understanding if the pandemic has had an impact on the incidence or severity of frozen shoulder (FS). The aim of this study was to compare the incidence and severity of idiopathic FS before and during the pandemic.MethodsA retrospective cohort study was performed to establish the incidence of FS during the pandemic, from March 2020 to January 2021 (pandemic study period), compared to the same time period 1 year earlier, before the pandemic (control group). All patients who were diagnosed with idiopathic FS were included. To assess the severity of the condition, visual analog scale (VAS) for pain score and Subjective Shoulder Value (SSV) on presentation were recorded and the patients were categorized into 5 different treatment groups (0 injections, 1 injection, 2 injections, 3 injections, or capsular release). As the pandemic and public health restrictions could have influenced the availability of appointments, the waiting time between referral and first appointment was calculated as a possible confounding factor. Statistical analysis was performed using the chi-square and Student t test for categorical and continuous variables, respectively.ResultsThere were 847 new patient consultations during the pandemic study period; of these, 232 were for idiopathic FS. One year earlier, there were 898 initial consultations for a new shoulder problem; of these, 176 were for idiopathic FS. This represents a relative increase of 39.8% (P < .001) in the incidence of patients with FS. The mean SSV in the control group was 50% ± 20% vs. 45% ± 18% in the pandemic group—statistically significant (P = .013) but unlikely to be clinically significant. The VAS pain score was similar in both groups: mean 6 ± 2 and 7 ± 2, respectively (P = .06). There was no significant difference between the control and the pandemic group in the distribution of patients per treatment group (P = .94). The mean waiting time from referral to appointment was not significantly different between the control and the pandemic group: 58 ± 30 days vs. 55 ± 27 days (P = .30).ConclusionDuring the COVID-19 pandemic, there was a significant increase in the incidence of patients with FS. No significant difference in severity was observed. Further research is needed to evaluate a causal relationship between the COVID-19 pandemic and FS.

A qualitative 5-country comparison of the perceived impacts of COVID-19 on people living with dementia and unpaid carers

BackgroundEmerging evidence shows an impact of the COVID-19 pandemic on people living with dementia and informal carers, without any evidence-based global comparison to date. The aim of this international study was to explore and compare the perceived impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries.MethodsInformal carers and people living with dementia who were residing in the community in the UK, Australia, Italy, India, and Poland were interviewed remotely between April and December 2020. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using inductive thematic analysis.ResultsFifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and issues accessing remote support; (3) Emotional impact; and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly affected people with dementia and carers across all five countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were very limited in benefit and usability for those with dementia. As a result, carers appeared to notice reduced cognitive and physical health in people with dementia. Particular differences were noted between India and Poland vs. the UK, Italy, and Australia, with less impact on care provision in the former due to limited uptake of support services pre-pandemic based on cultural settings.ConclusionsThe pandemic has amplified dementia as a global public health problem, and people affected by the condition need support to better access vital support services to live well.

Occupational disruption during the COVID-19 pandemic: Exploring changes to daily routines and their potential impact on mental health

ABSTRACT The COVID-19 pandemic has had far-reaching consequences for health, in part due to the numerous changes to daily routines that arose due to public health measures and restrictions. The aim of this study was to examine the experience of occupational disruption during pandemic and the consequences for mental health among women living in Croatia. In May 2020, 661 women completed an online questionnaire exploring changes to time spent engaged in various occupations, changes to the quality of occupational participation, and psychological health. While most participants experienced changes to daily occupations, these changes were not universal across occupational domains or for all participants. Cluster analysis revealed three unique groups: participants who reported poorer quality of participation in all domains; those who reported reduced quality in most domains, but stable or improved quality in leisure and outdoor occupations; and those who reported stable or improved quality in most domains. Participants in the first cluster exhibited significantly greater levels of anxiety, depression, and stress compared to the other two clusters, suggesting that greater occupational disruption was related to poorer mental health. This study is among the first to demonstrate the way in which the pandemic and measures used to restrict the spread of the virus have contributed to occupational disruption. Findings indicating the varying degrees to which this disruption was perceived and experienced by participants shed new light on factors that influence potential vulnerability or resilience to the effects of occupational disruption. Findings are consistent with existing work demonstrating the role of participation in maintaining health and emphasize the importance of preserving daily routines during pandemic.

Great Expectations of COVID-19 Herd Immunity.

ABSTRACTThere is a common preconception that reaching an estimated herd immunity threshold through vaccination will end the COVID-19 pandemic. However, the mathematical models underpinning this estimate make numerous assumptions that may not be met in the real world. The protection afforded by vaccines is imperfect, particularly against asymptomatic infection, which can still result in transmission and propagate pandemic viral spread. Immune responses wane and SARS-COV-2 has the capacity to mutate over time to become more infectious and resistant to vaccine elicited immunity. Human behavior and public health restrictions also vary over time and among different populations, impacting the transmissibility of infection. These ever-changing factors modify the number of secondary cases produced by an infected individual, thereby necessitating constant revision of the herd immunity threshold. Even so, vaccination remains a powerful strategy to slow down the pandemic, save lives, and alleviate the burden on limited health care resources.

Same Pandemic Yet Different COVID-19 Vaccination Roll-Out Rates in Two Small European Islands: A Comparison between Cyprus and Malta.

A mass vaccination strategy is estimated to be the long-term solution to control COVID-19. Different European countries have committed to vaccination strategies with variable population inoculation rates. We sought to investigate the extent to which the COVID-19 vaccination strategies, inoculation rate, and COVID-19 outcome differ between Cyprus and Malta. Data were obtained from the Ministry of Health websites and COVID-19 dashboards, while vaccination data were obtained from the European Centre for Disease Prevention and Control until mid-June, 2021. Comparative assessments were performed between the two countries using Microsoft® Excel for Mac, Version 16.54. Both islands took part in the European Union’s advanced purchase agreement and received their first batch of vaccines on 27 December 2020. The positivity rate and mortality between December and June differs between the two countries (average positivity rate Cyprus 1.34, Malta 3.37 p ≤ 0.01; average mortality Cyprus 7.29, Malta 9.68 p ≤ 0.01). Both the positivity rate and mortality for Cyprus declined due to strict public health measures and vaccination roll-out in early January (positivity rate by 95% and mortality by 58%). In contrast, for Malta, there was a sharp increase (64% p ≤ 0.01) with almost no public health restrictions in place and soaring cases during the Christmas and Carnival period until March, when lockdown measures were re-introduced. A distinctive difference between Cyprus and Malta in positivity rate (14 per 100,000 population; p ≤ 0.01) can also be observed between January and mid-April 2021. However, from April onwards it is evident that the positivity rate and mortality decline (positivity rate Cyprus by 82%, Malta by 95%; mortality Cyprus by 90%, Malta by 95%, p ≤ 0.01, respectively) in both countries as the vaccination roll-outs progressed, covering about 58.93% of the Maltese population, while Cyprus had fully inoculated about 38.03% of its population. The vaccine strategies and vaccination rates were similar for both countries; yet Malta had the fastest vaccine roll-out. Reluctancy to get vaccinated, significant differences in the vaccination appointment scheduling system, and the freedom of vaccination choice for the citizens in Cyprus may have contributed to a delayed vaccination roll-out. These potential contributing factors should be acknowledged and considered for future vaccination programs and potential COVID-19 boosters.

Academic Conferencing Reimagined in the COVID-19 Era: The Vision Health Research Network Experience

The Coronavirus disease 2019 pandemic has reshaped academic conferencing and the experience for many research students and trainees. Scientific associations have adapted to new public health restrictions by adopting virtual conferences to maintain the dissemination of knowledge. The Vision Health Research Network (VHRN) has brought its annual meeting online in 2021. The virtual conference format reduces its associated carbon footprint and encourages increased participation by eliminating barriers to access such as transportation, accommodation fees and scheduling conflicts. The annual meeting has been divided into several smaller themed days to increase participation throughout the year. The use of novel online platforms for information sharing such as FOURWAVES and Zoom has enabled an ease of interaction but has brought unique challenges as well. The technical learning curve and functionality of these programs may initially impact accessibility. Leveraging deliberate usage of social media to promote conference events and highlighting projects are also avenues to be further explored.

A Latent Class Analysis of Mental Health Severity and Alcohol Consumption: Associations with COVID-19-Related Quarantining, Isolation, Suicidal Ideations, and Physical Activity.

The present study examined latent class cluster group patterns based on measures of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Hypothesized correlates with latent class cluster groups including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week) were examined. The delimited participant sample consisted of 606 university young adults 18 to 25 years of age (M = 21.24 ± 1.62). Latent cluster analysis (LCA) modeled patterns of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Between group analysis and multinomial logistic regression analysis were used to examine relationships between latent class clusters and correlates including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week). LCA results showed that six latent cluster groups provided optimal model-to-date fit based on mental health symptom severity and alcohol consumption (L2 = 56.31, BIC = 5012.79, AIC = 4849.74, and the bootstrap L2 p-value = .88; Entropy R2 = .89). Identified latent class clusters were as follows: cluster one = moderate anxiety and depression severity and moderate alcohol consumption (n = 156; 25.7%); cluster two = high mental health severity and alcohol consumption (n = 133; 21.9%); cluster three = low mental health symptoms and moderate alcohol consumption (n = 105; 17.3%); cluster four = lowest mental health severity and alcohol consumption (n = 95; 15.7%); cluster five = moderate depression severity, low anxiety severity, and low alcohol consumptions (n = 74; 12.2%); and cluster six = moderate anxiety severity, low depression severity, and low alcohol consumption (n = 43; 7.1%). Multinomial logistic regression analysis results found that quarantining, self-isolation, suicidal ideations, sedentary behavior, and physical activity were differentially associated with cluster group membership. Findings from this study demonstrate associations between COVID-19 public health restrictions, suicidal ideations, and declines in mental health and increases in alcohol consumption among young adult university students.

Summer crowds: An analysis of USFS campground reservations during the COVID-19 pandemic.

During the COVID-19 pandemic, US public land managers faced the challenge of catering to large increases in camping demand, while maintaining social distancing guidelines. In this paper, we use multivariate linear regression to analyze weekly changes in reservations to US Forest Service (USFS) campgrounds between 2019 and 2020. The regression models estimate the impact of local COVID infection rates, public health restrictions, and spatial spillovers from proximity to National Parks (NPs), metropolitan areas and wildfire on camping demand. Our sample includes 1,688 individual USFS campgrounds from across the contiguous US. The results illustrate the dramatic increases in camping on USFS land that occurred in the summer of 2020 and demonstrate that increases in local infection rates led to significant increases in camping nights reserved in the summer. The results also illustrate that the increase in camping nights reserved at USFS campgrounds was particularly dramatic for campgrounds located near large metropolitan areas and near NPs that saw increases in overall recreational visits. These results point to the important role that public lands played during the pandemic and can help guide public land resource allocations for campground maintenance and operation.

Impact of COVID-19 public health restrictions on hospital admissions for young infants in Victoria, Australia.

Strict public health measures during the COVID-19 pandemic led to less support for infants and their parents. We aimed to characterise the frequency and nature of infant admissions to the Royal Children's Hospital (RCH), Melbourne in 2020, compared to the previous year. A retrospective review of medical records identified infants ≤3months admitted to the general medicine unit, RCH from March to September in 2019 and 2020. Diagnoses potentially related to the impact of public health measures and reduced family and community supports were identified and compared to all infant diagnoses across both years. Clinical characteristics and need for referral for additional supports or mental health services were also ascertained. There were fewer admissions for infants ≤3 months in 2020 (n= 411) compared to 2019 (n= 678), with a threefold increase in admissions with a primary or secondary diagnosis of feeding difficulties, growth disturbance, infant irritability or maternal mental health concerns (191/411; 46% vs. 97/678; 14%). There were more infants of first-time parents (112/191; 59% vs. 44/97; 45%) and a reduction in the number of admissions due to infection (145/411; 35%; vs. 467/678; 69%). During the COVID-19 pandemic, there was a threefold increase in admissions for infants ≤3months due to poor growth, feeding difficulties, irritability and maternal mental health concerns in 2020 compared to 2019. These findings may inform future pandemic planning and policy development to ensure maintenance of community supports such as maternal child health nurse (MCHN) service delivery for young infants.

The Simplification of Procedures in Portuguese Administrative Law

The present paper intends to provide an overview and a critical assessment of the administrative simplification policies implemented in Portugal over the past 20+ years. Throughout these decades, the major instruments for administrative simplification have been: (i) Decree-Law n. 135/99, of 22 April; (ii) the Simplex programme; (iii) the 2015 new Code of Administrative Procedure and its 2021 amendment; and (iv) the COVID-19 legislation. Although Decree-Law n. 135/99 (i) was the first attempt to specifically address simplification, it was a very thin one. The Simplex programme (ii), created in 2006, was the first cross-sectoral robust policy of simplification; its motto is “the simpler the better” and it encompassed reforms in all government areas aiming at cutting red tape, promoting administrative efficiency, and making the citizens’ and the corporations’ lives easier when dealing with State. The new Code of Administrative Procedure (iii), approved in 2015, brought about specific normative solutions to simplify procedures, namely, prior communications, administrative assistance, procedural conferences, and the electronic one-stop shop. Finally, the COVID-19 legislation (iv) was made necessary by the COVID-19 pandemic and by the fact that public health restrictions made it impossible for citizens to establish personal contact with the administration in many cases.

The moderating role of social distancing in mobile commerce adoption.

The Covid-19 pandemic has pressured marketers and consumers adapt their purchasing habits. Known literature on mobile commerce (MC) highlights its advantage on convenience, which now is accompanied by health safety. Although MC has been outgrowing other online sectors, the early stages of the pandemic provided a new scenario. We study the relationship between consumer’s attitudes about Covid-19 public health restrictions and the behavioral intention for MC adoption. Previous research on technology acceptance of online and mobile shopping have focused on aspects like safety and behavioral intention as key factors. Thus, we examine how attitude towards social distancing practices during the pandemic has affected consumers intentions to adopt of mobile commerce. We aim to study the degree on which this attitude affects previous intentions on purchasing or subscribing to services via mobile devices. For this, we present a Theory of Planned Behavior (TPB) model of consumer MC adoption using social distance as a moderator. An empirical analysis using a survey of attitude and beliefs over mobile commerce and social distancing is presented, confirming the factors underlying using structural equation modeling. Results show that the attitudes toward social distancing are a significant moderator of purchasing through mobile devices; indicating that an individual’s adherence to recommended practices during the pandemic does positively influence the adoption. MC is known for being a potential advantage to facilitate customer experience. According to our results, we believe marketers should reconsider or further develop MC infrastructure, highlighting its convenience and health safety role.

COVID-19 and Public Health Restrictions Disproportionately Affected the Vulnerable: A Population Study in Sydney, Australia

COVID-19 and Public Health Restrictions Disproportionately Affected the Vulnerable: A Population Study in Sydney, Australia

Scaling out a palliative compassionate community innovation: Nav-CARE.

Background:There is an urgent need for community-based interventions that can be scaled up to meet the growing demand for palliative care. The purpose of this study was to scale out a volunteer navigation intervention called Nav-CARE by replicating the program in multiple contexts and evaluating feasibility, acceptability, sustainability, and impact.Methods:This was a scale-out implementation and mixed-method evaluation study. Nav-CARE was implemented in 12 hospice and 3 nonhospice community-based organizations spanning five provinces in Canada. Volunteers visited clients in the home approximately every 2 weeks for 1 year with some modifications required by the COVID-19 public health restrictions. Qualitative evaluation data were collected from key informants (n = 26), clients/family caregivers (n = 57), and volunteers (n = 86) using semistructured interviews. Quantitative evaluation data included volunteer self-efficacy, satisfaction, and quality of life, and client engagement and quality of life.Findings:Successful implementation was influenced by organizational capacity, stable and engaged leadership, a targeted client population, and skillful messaging. Recruitment of clients was the most significant barrier to implementation. Clients reported statistically significant improvements in feeling they had someone to turn to, knowing the services available to help them in their community, being involved in things that were important to them, and having confidence in taking care of their illness. Improvements in clients’ quality of life were reported in the qualitative data, although no statistically significant gains were reported on the quality of life measure. Volunteers reported good self-efficacy and satisfaction in their role.Conclusion:The feasibility, acceptability, and sustainability of the program were largely dependent on strong intraorganizational leadership. Volunteers reported that their involvement in Nav-CARE enabled them to engage in ongoing learning and have a meaningful and relational role with clients. Clients and families described the positive impact of a volunteer on their engagement and quality of life.

Qualitative Research Studies Online: Using Prompted Weekly Journal Entries During the COVID-19 Pandemic.

Solicited journal entries are a qualitative research method with a fairly strong tradition in sociological research and particularly in qualitative health research. However, the practices and strengths associated with solicited journal entries have not been explored as frequently or comprehensively as more conventional qualitative research methods, such as interviews. During the COVID-19 pandemic we carried out two online studies employing solicited written journal entries and photos. One study focused on pregnancy and health care experiences during the pandemic and the other on everyday life while working from home due to public health restrictions. Here, we discuss solicited online journal entries as a qualitative method and reflect on the strengths and challenges we encountered, including those related to using the online survey tool LimeSurvey for a qualitative diary-based study. The richness of data and the ability to solicit participants’ contemporaneous reflections over the course of a set length of time, the ability to reach people across time zones and in multiple places, and the ability to adapt prompts in a quickly changing research context are major strengths of online journaling. The level of commitment required by participants, the potential for attrition, the need for literacy and technology access, and the large amount of data from each participant are potential limitations for researchers to consider.

Impact of the COVID-19 pandemic on children and adolescents with autism spectrum disorder and their families: a mixed-methods study protocol

BackgroundThe COVID-19 pandemic is a challenge for everyone, particularly for children and adolescents with autism spectrum disorder (ASD). ASD is a developmental disorder characterised by limitations in social communication, repetitive...

COVID-19 and Public Health Restrictions Disproportionately Affected the Vulnerable: A Population Study in Sydney, Australia

COVID-19 and Public Health Restrictions Disproportionately Affected the Vulnerable: A Population Study in Sydney, Australia

The Lived Experience of Older Adults Transferring Between Long-Term Care Facilities During the COVID-19 Pandemic.

Long-term care facility (LTCF) residents have been disproportionately affected by coronavirus disease 2019 (COVID-19), from increased mortality and restrictive public health measures. The current study aims to describe the experiences of residents relocating between LTCFs at the onset of the COVID-19 pandemic. Emphasis was placed on residents' sense of home and how the pandemic and ensuing isolation affected their transition. This qualitative study follows the principles of constructivist grounded theory. Seven of 10 residents interviewed had cognitive impairment (mean age = 84 years). Four primary themes were elicited from the interviews focusing on residents' perceptions of their environment and highlights the value placed on privacy and control, the multifaceted feeling of loss during the pandemic, the importance of relationships as a source of comfort and pleasure, and resilience shown by residents in times of hardship. Our study indicates that residents experienced dichotomy and paradox during the pandemic, attempting to strike a balance between isolation and camaraderie, infection risk and mental health, and loss and resilience. The need for familial contact and socialization must be balanced against infection control measures. [Journal of Gerontological Nursing, 48(1), 29-33.].

A Narrative Review of COVID-19 Vaccines.

The COVID-19 pandemic has shaken the world since early 2020 and its health, social, economic, and societal negative impacts at the global scale have been catastrophic. Since the early days of the pandemic, development of safe and effective vaccines was judged to be the best possible tool to minimize the effects of this pandemic. Drastic public health measures were put into place to stop the spread of the virus, with the hope that vaccines would be available soon. Thanks to the extraordinary commitments of many organizations and individuals from around the globe and the collaborative effort of many international scientists, vaccines against COVID-19 received regulatory approval for emergency human use in many jurisdictions in less than a year after the identification of the viral sequence. Several of these vaccines have been in use for some time; however, the pandemic is still ongoing and likely to persist for the foreseeable future. This is due to many reasons including reduced compliance with public health restrictions, limited vaccine manufacturing/distribution capacity, high rates of vaccine hesitancy, and the emergence of new variants with the capacity to spread more easily and to evade current vaccines. Here we discuss the discovery and availability of COVID-19 vaccines and evolving issues around mass vaccination programs.