Quarantine Orders Research Articles

Nowhere to Go

This article examines epidemics and disease prevention within the War Relocation Authority camps for Japanese Americans during World War II. Although scholars and activists have noted the limits and inadequacies of medical care within the camps, little attention has been given to the actions of camp administrators in curtailing outbreaks of deadly diseases such as polio and tuberculosis, including universal vaccination requirements and the use of quarantine orders. Disease in the camps resulted in cases of social isolation and ostracization and further exacerbated the stresses of life among the confined. Meanwhile, this article explores the use of the camps as sites of scientific study. Administrators and anthropologists documented cases of camp epidemics and published their results in journals on public health.

“The police came in white protective suits and with batons, it was pure disaster” – a multi-stakeholder perspective on infection control in reception centers for asylum seekers during the COVID-19 pandemic in Germany

BackgroundThe COVID-19 pandemic presented unprecedented challenges, particularly for vulnerable populations residing in confined settings such as refugee shelters: Physical distancing measures were challenging to implement in shelters due to shared rooms or communal use of kitchens and sanitary facilities, which increased the risk of infections. Meanwhile, individuals’ capabilities for individual protection strategies were severely impaired by the structure of the shelters. Consequently, shelters had the duty to develop and implement strategies for the prevention and handling of SARS-CoV-2 infections. The aim of this study was to explore the perspectives of refugees, NGO employees, and shelter directors regarding COVID-19-related measures in German refugee shelters. The study aimed to identify challenges and conflicts arising from implemented measures, as well as expectations for improved support during the pandemic.MethodsSemi-structured and narrative interviews were conducted with 6 refugees, 6 facility managers, 12 NGO staff, and 2 social service agency staff from February to August 2022. Qualitative content analysis was employed to analyze the data, identifying overarching themes and codes.ResultsThe study uncovered challenges and conflicts resulting from pandemic measures, particularly mass quarantine orders, within refugee shelters. Lack of transparency and ineffective communication worsened tensions, with refugees feeling distressed and anxious. The quarantine experience had a negative impact on refugees’ mental health, which was exacerbated by limited social interaction and leisure-time activities. Shelter managers encountered administrative challenges when implementing measures due to facility constraints and limited resources, while NGO employees encountered obstacles in providing immediate assistance due to legal regulations and a lack of cooperation from shelter managers.ConclusionsThe study highlights that shelters are problematic institutions from a public health perspective. It shows the importance of implementing customized pandemic interventions in refugee shelters that take account of the diverse needs and experiences of both refugee and staff. To achieve this, we recommend to establish an ethics committee and involve various stakeholders in decision-making processes. Additionally, enhancing information dissemination to promote transparency and public understanding of measures is crucial. These insights can help develop comprehensive and effective pandemic plans for refugee shelters, ensuring better preparedness for future public health crises.

Quarantine Order Violators System using Face Recognition (FACID)

Face recognition technology is commonly utilized for user authentication and verification by analysing a digital image of a person's face and matching it against a database of faces for identification purposes. The COVID-19 pandemic has led to mandatory quarantines and the use of quarantine bracelets for some individuals, which can be time-consuming and require a lot of effort. Face recognition technology can help raise awareness about the current situation and alleviate some of the burden associated with quarantine measures. The aim of this research is to concentrate on the face recognition of individuals with a history of quarantine, as a measure to prevent the spread of COVID-19 in educational institutions like universities, colleges, and schools. This research study concentrates on individuals with a history of quarantine orders. The system will employ the Histograms of Oriented Gradients (HOG) algorithm for face detection. Additionally, the system will utilize the Face Landmark Algorithm to compare the 128-d vector with images stored locally. The system will make use of the Helen face collection dataset for its data requirements. The aim of this study is to explore and identify techniques for detecting individuals who violate quarantine measures and issuing notifications through the proposed system. By implementing this system, it could contribute to creating a more secure environment within the educational institution and potentially reduce the spread of the virus.

Explosive epidemic transitions induced by quarantine fatigue

Quarantine measures are one of the first lines of defense against the spread of infectious diseases. However, maintaining these measures over extended periods can be challenging due to a phenomenon known as quarantine fatigue. In this paper, we investigate the impact of quarantine fatigue on the spread of infectious diseases by using an epidemic model on random networks with cliques. In our model, susceptible individuals can be quarantined up to n times, after which they stop complying with quarantine orders due to fatigue. Our results show that quarantine fatigue may induce a regime in which increasing the probability of detecting and isolating infected individuals (along with their close contacts) could subsequently increase the expected number of cases at the end of an outbreak. Moreover, we observe that quarantine fatigue can trigger an abrupt phase transition at the critical reproduction number R0=1. Finally, we explore a scenario where a non-negligible number of individuals are infected at the beginning of an epidemic, and our results show that, depending on the value of n, an abrupt transition between a controlled epidemic and a large epidemic event can occur for R0<1.

COVID-19 isolation and quarantine orders in Berlin-Reinickendorf (Germany): How many, how long and to whom?

Isolating COVID-19 cases and quarantining their close contacts can prevent COVID-19 transmissions but also inflict harm. We analysed isolation and quarantine orders by the local public health agency in Berlin-Reinickendorf (Germany) and their dependence on the recommendations by the Robert Koch Institute, the national public health institute. Between 3 March 2020 and 18 December 2021 the local public health agency ordered 24 603 isolations (9.2 per 100 inhabitants) and 45 014 quarantines (17 per 100 inhabitants) in a population of 266 123. The mean contacts per case was 1.9. More days of quarantine per 100 inhabitants were ordered for children than for adults: 4.1 for children aged 0-6, 5.2 for children aged 7-17, 0.9 for adults aged 18-64 and 0.3 for senior citizens aged 65-110. The mean duration for isolation orders was 10.2 and for quarantine orders 8.2 days. We calculated a delay of 4 days between contact and quarantine order. 3484 contact persons were in quarantine when they developed an infection. This represents 8% of all individuals in quarantine and 14% of those in isolation. Our study quantifies isolation and quarantine orders, shows that children had been ordered to quarantine more than adults and that there were fewer school days lost to isolation or quarantine as compared to school closures. Our results indicate that the recommendations of the Robert Koch Institute had an influence on isolation and quarantine duration as well as contact identification and that the local public health agency was not able to provide rigorous contact tracing, as the mean number of contacts was lower than the mean number of contacts per person known from literature. Additionally, a considerable portion of the population underwent isolation or quarantine, with a notable number of cases emerging during the quarantine period.

Use of a digital contact tracing system in Singapore to mitigate COVID-19 spread

BackgroundContact tracing has been essential to reducing spread of COVID-19. Singapore leveraged technology to assist with contact tracing efforts using a Bluetooth-based app and token platform called ‘TraceTogether’.MethodsWe reviewed the impact of this system during the country’s Delta and Omicron waves (24 August 2021 to 17 February 2022) to identify differences in number of close contacts and time savings between full automation using TraceTogether alone as compared to manual contact tracing supplemented by TraceTogether. Characteristics of digital contact tracing app or token users were reviewed. Thereafter, the number of close contacts identified by manual and digital contact tracing methods, and the number of confirmed COVID-19 cases among contacts were analysed. The difference in time taken for identification of close contacts was also determined.FindingsAdoption rate for TraceTogether was high, with 93.3% of cases having a registered device. There was a 9.8 h (34.9%) reduction in time savings for close contacts to be informed using TraceTogether alone compared to manual contact tracing supplemented by TraceTogether. The proportion of close contacts automatically identified through TraceTogether alone and turned positive was 3.6%. For those identified through manual contact tracing supplemented by TraceTogether, this proportion was 12.5% and 6.2% for those served quarantine orders and health risk warnings respectively.InterpretationThe high adoption rate of ‘TraceTogether’ suggest that digital solutions remain a promising option to improve contact tracing in future epidemics. This may have been through its concurrent use with vaccine differentiated public health measures and policies which engender public trust. There is future potential for utilising such technology in managing communicable diseases to achieve good public health outcomes.

Lotnicze przewozy pasażerskie w okresie pandemii covid-19 w Polsce

Air transport development trends were disrupted as a result of the spread of the SARS-CoV-2 virus and the emergence of a global pandemic. During this difficult period, the largest drop in the number of air passengers in history occurred. For example, in 2020, compared to 2019, there was a global decrease in the number of passengers in air transport by 60% and in Poland by 70%. Temporary restrictions were introduced, related to, inter alia, the cancellation of flights from countries with a high incidence rate, a mandatory SARS-CoV-2 virus test or a quarantine order upon arrival. The main aim of the study was to present the impact of the COVID-19 pandemic on passenger traffic at Polish airports. Attempts were made to obtain answers to the following questions: (1) what were the changes in the number of passengers served in Poland before and during the COVID-19 pandemic; (2) what actions/restrictions were taken in the field of air transport in the face of an increased number of COVID-19 cases; and (3) how has the SARS-CoV-2 virus affected airports and air carriers in Poland. The research was based on the statistical data of: the Civil Aviation Authority (CAA), Eurostat, Eurocontrol, and the Polish Central Statistical Office. The study presents the situation as of the end of 2021.

Analysis and Research of COVID-19 as a Turning Point of Online/Offline Integration in the New Retail Industry

The impact of Covid-19 has changed people's lives dramatically. Health factors and government quarantine orders have limited industry-wide growth. In the retail industry, the change in the shopping environment has led to a change in consumer behavior. The flexibility and variety of products offered by online shopping are increasingly meeting the needs of most people. This paper will further discuss the possible convergence of the new retail industry by examining the consumer behavior during COVID-19 and thus analyze the further development of the new retail industry online and offline. This paper uses a survey method and functional analysis, and through the research, found that the consumer-focused digital transformation will continue after the end of Covid-19, and with it will come the question of how companies can maintain innovation and grow steadily.

Effects of the COVID-19 Pandemic on Humeral Shaft Fracture Management and Its Outcomes.

Background and objective The coronavirus disease 2019 (COVID-19) pandemic necessitated a sudden and drastic shift in patient management throughout the healthcare system,to curb the spread of the disease and deal with resource limitations. Many surgical cases were canceled or delayed with only the most urgent and emergent cases taken up for treatment. It is unknown if and how these alterations affected patient outcomes. The purpose of this study was to compare time to fracture care and outcomes between patients treated for humeral shaft fractures prior to the COVID-19 pandemic and those treated during the pandemic. We hypothesized that the pandemic cohort would have a prolonged time to fracture care and worse outcomes than the pre-pandemic cohort. Materials and methods This was a retrospective cohort study performed within a single healthcare system. All humeral shaft fractures treated from March to June 2019 (pre-pandemic cohort) and March to June 2020 (pandemic cohort) were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and ICD-10-CM codes as well as Current Procedural Terminology (CPT) codes. Data on demographics, fracture characteristics, treatment, and outcomes were collected via chart and radiograph review. Outcomes analyzed included time to being made weight-bearing as tolerated (WBAT), radiographic union, and final follow-up; range of motion (ROM) at radiographic union and final follow-up; and rate of complications. Results The pre-pandemic cohort (n=19) was significantly younger with a mean age of 29years than the pandemic cohort (n=17)with a mean age of 49years (p=0.010). Therewere no other significant differences in demographics, fracture characteristics, or treatment type between the groups. Time to fracture care was not significantly different in the pre-pandemic cohort (five days) versusthe pandemic cohort (four days). Time to being made WBAT, radiographic union, and final follow-up were not significantly different between thepre-pandemic(86, 113, and 98days) and the pandemic cohorts (77, 106, and 89.5 days). ROM measurements in abduction at radiographic union were significantly different between the cohorts: in the pre-pandemic cohort, 100% of patients reached greater than 160 degrees; in the pandemic cohort, only 16.7% of patients reached greater than 160 degrees (p=0.048). There was a non-significant decrease in the proportion of patients who achieved the maximal category of ROM measurements in forward elevation and extension at radiographic union and abduction, forward elevation, and extension at final follow-up, as well as a non-significant increase in visual analog scale (VAS) pain scores at final follow-up between cohorts. There were no significant differences in the rate of complications. Conclusions Despite limited resources, reduced operating room availability, and increased utilization of virtual visits due to the COVID-19 pandemic, patients with humeral shaft fractures may not have faced delays in fracture care or worse outcomes compared to the pre-pandemic period. The pandemic cohort may have experienced significantly decreased ROM compared to the pre-pandemic cohort, which may reflect the decreased availability of physical therapy services and overall decreased activity levels due to the quarantine orders. However, we could not identify any other significant differences in the type of treatment, pain, complications, or time to union.

Screening Hesitancy of a Universal Voluntary-based Rapid Antigen Test for coronavirus disease 2019 (COVID-19) During Omicron Wave in Hong Kong

BackgroundThe Hong Kong government distributed rapid antigen test (RAT) kits to households across the city and called for a universal voluntary testing exercise for three consecutive days during the Omicron wave to identify infected persons early for quarantine and disrupt transmission chains in the community. We conducted a survey to evaluate the participation rates and explore the determinants of voluntary RAT adoption and hesitancy. MethodsThis cross-sectional survey was conducted through computer-assisted telephone interviews from 19 May to 16 June 2022 using an overlapping dual-frame telephone number sampling design. Information on willingness to adopt voluntary RAT, four themes of personal qualities, attitudes toward the government’s health policies, incentives to motivate RAT adoption, and personal sociodemographic factors were collected. Logistic regression analysis was used to examine the factors associated with RAT adoption. ResultsOf the 1010 participants, 490 successfully responded to the fixed-line and 520 to the mobile phone survey, with response rates of 1.42% and 1.63% and screen hesitancy rates of 36.1% and 39.3%, respectively. Participants of adoption RAT were those aged 30–49 years, with high perceived COVID-19 infection severity, ≥ 3 doses of COVID-19 vaccination, and more agreement with the health policies on material resources and quarantine orders. Individuals who were less risk seeking and more altruistic reported a higher adoption of voluntary RAT. ConclusionsUnderstanding the willingness to participate in a voluntary universal testing programme might shed light on effective ways to minimise screening hesitancy in future public health strategies and campaigns.

Indonesian Travel Policy during the Outbreaks: Vaccination and Quarantine Legal Culture and Policy on Indonesian Air Transportation

During the pandemic, the Indonesian government implemented policies to protect citizens from the virus. One such policy mandated the use of the PeduliLindungi application for passengers traveling domestically or internationally by land, sea, or air. The application helps monitor and track the virus's spread, and provides vaccination information. This study examines the government's policies on PeduliLindungi's use and how the existing legal culture relates to vaccination and quarantine within the app. The research methodology employed a doctrinal approach, analyzing laws, concepts, interpretations, and cases. The study found that the PeduliLindungi application is mandatory for all travelers. It allows passengers to access their vaccination status and determines the required quarantine duration. Violating quarantine orders can result in imprisonment and fines, as per Judge Decision No. 21/Pid.S/2021/PN.Tng. However, limited smartphone ownership restricts public access to the app. Therefore, the government must formulate policies that accommodate individuals without smartphones, ensuring their safety while traveling. Public legal awareness and understanding of the PeduliLindungi app's importance are crucial for protecting public health. Strengthening the legal culture is necessary to promote compliance with health guidelines and informed decision-making. By fostering a robust legal culture, individuals will prioritize health measures, safeguarding their well-being and that of the community.

The Perceived Self-Efficacy of Teachers in the Use of Digital Tools during the COVID-19 Pandemic: A Comparative Study between Spain and the United States.

This study analyzed the use of fifteen groups of digital tools that 197 active teachers made during the sudden shift to remote instruction due to the COVID-19 quarantine orders placed by various health departments in Spain and the United States. The study also examined the impact that the use of digital tools had on teachers' perceived self-efficacy. A quantitative research design was used, supported by an exploratory descriptive approach that materializes in the application of an online questionnaire during the spring of 2020. The results indicate that perceived self-efficacy differs from country of origin and is conditioned by sociodemographic variables such as the training received and type of center. It is noted that teachers in Spain prefer the use of Moodle or Escholarium over that of teachers in the United States that opted for Google Classroom as a primary platform for teaching online, and the frequency of use of digital tools analyzed does not guarantee that their implementation is effective.

COVID-19 Close Contact Management: An Evolution of Operations Harnessing the Digital Edge

Singapore, like many other nations globally, had to contend with significant caseloads arising from the Coronavirus disease (COVID-19) pandemic. This paper focuses on using technology as an intervention for pandemic management. With scant scientific evidence on effective medications and vaccinations (i.e., pharmaceutical interventions) initially, disease containment strategies predominated during the early phases. Non-pharmaceutical interventions were critical in slowing disease transmission and preventing public healthcare institutions from being overwhelmed. Such interventions could be broadly divided into case-based interventions (e.g., contact tracing and quarantining of close contacts) and population-based measures (e.g., mask use and social distancing). The paper describes Singapore's experience in the operational implementation of contact-based interventions, and illustrates how harnessing the digital edge enabled fast, accurate, resource-efficient, and flexible execution of ground operations. Singapore applied digital technology and developed an integrated system to facilitate issuance and acknowledgement of quarantine orders, submission of COVID-19 test results, and collection of antigen rapid test kits at the population level. Data was obtained from this proprietary centralised, automated platform. The paper demonstrates how such simple, yet elegant systems could have a direct impact on disease transmission in an outbreak setting and on population health. Moving forward, it is recommended that technology and digital solutions feature prominently in work process designs beyond COVID-19 such as in the management of emerging infectious diseases and non-communicable diseases.

SG-APSIC1113: Descriptive study on COVID-19 exposures in Singapore General Hospital

Objectives: The highly transmissible SARS-CoV-2 has swept across the globe, causing large swaths of COVID-19, displacing medical resources and attention from patients with other life-threatening illnesses, and overwhelming healthcare institutions. Shifting toward endemicity, the Singapore Ministry of Health ceased issuing quarantine orders to close contacts of infected cases on October 11, 2021. However, contact tracing and exposure management within SGH continued with the same risk criteria. We have examined COVID-19 exposures in different hospital locations to determine the effectiveness of surveillance in breaking the chain of transmission. Methods: Contact tracing of COVID-19 exposures among Singapore General Hospital (SGH) staff and patients has been conducted since the first COVID-19 diagnosis in January 2020. The information collected is used to identify those at higher risk of infection for enhanced surveillance or isolation. The data analyzed in this study were collected during later periods of the SARS-CoV-2 δ (delta) pandemic wave between August 1, 2021, and December 31, 2021. Results: During the 4-month study period, there were 1,686 SARS-CoV-2 exposures in SGH. Among these 1,686 exposures, 1,157 (69%) were contacts with an infected patient. Among these infected source patients, 915 were emergency department patients, 210 were ward inpatients, and 32 were clinic outpatients. The remaining 524 exposure events (31%) were contacts with infected staff, of whom 441 were SGH employees and 83 were employees from other SingHealth institutions. The remaining 5 index cases were visitors to SGH. Of the 1,686 exposure events, 330 had associated at-risk contacts requiring exposure management. Among 330 patient index cases, 213 (64.5%) resulted in 699 exposed contacts (patients vs staff), whereas 117 staff index cases resulted in 435 exposed contacts (patients vs staff). For 434 exposed contacts who were staff, 204 (47%) of their exposures occurred in inpatient ward settings, followed by 153 (35.3%) that occurred in outpatient clinics, 36 (8%) that occurred common lounging areas, 16 (3.6%) that occurred in office sites, 15 (3.4%) that occurred in the community, 8 (1.8%) that occurred in occupation therapy, and 2 (0.5%) that occurred in the emergency department. For 688 exposed contacts who were patients, 579 (84.1%) exposures occurred in inpatient wards, 70 (10.2%) occurred in DEM, 19 (2.7%) occurred in other SingHealth institutions, 16 (2.3%) were exposures to roving porters, and 3 (0.4%) occurred in the community. During the study period, 3 hospital clusters were identified and investigated, one of which included secondary cases. Conclusions: Most SARS-CoV-2 exposures in SGH occurred in inpatient settings where patients were index cases. Despite intensive contact tracing and stringent surveillance and isolation measures, inpatient clusters could not be prevented.

“COVID gave him an opportunity to tighten the reins around my throat”: perceptions of COVID-19 movement restrictions among survivors of intimate partner violence

BackgroundIntimate Partner Violence (IPV) poses a serious public health threat globally and within the United States. Preliminary evidence highlighted surges in IPV during the COVID-19 pandemic. The pandemic offers a unique context, with many states and countries enacting movement-restrictions (i.e., shelter-in-place orders) that exacerbated IPV. Although these movement restrictions and other infection control methods (i.e., isolation, quarantine orders) have proven successful in reducing the spread of COVID-19, their impacts on IPV have not been thoroughly investigated. Specifically, public health measures restricting movement reinforce and socially legitimize isolation and coercive control tactics enacted by perpetrators of abuse. The purpose of this study was to understand the impacts of COVID-19, including the impacts of movement restrictions (i.e., shelter in place orders, quarantine, isolation orders) on experiences of IPV from the perspective of survivors.MethodsIn-depth interviews were conducted with ten survivors who presented at a large, public hospital or sought community IPV resources (i.e., domestic violence shelter, therapy services) in Atlanta, Georgia between March and December 2020. Thematic analysis was carried out to describe the impact of COVID-19 movement restrictions on IPV and help-seeking behaviors among survivors, in addition to identifying resources to improve IPV response during pandemics.ResultsThrough discussion of their experiences, survivors indicated how movement restrictions, social distancing measures, and the repercussions of the pandemic influenced their relationship challenges, including the occurrence of new or a higher frequency and/or severity of IPV episodes. Survivors cited relationship challenges that were amplified by either movement restrictions or consequences of COVID-19, including reinforced control tactics, and increased financial or life stressors resulting from the pandemic. COVID-19 movement restrictions catalyzed new relationships quickly and sparked new or intensified violence in existing relationships, revealing gaps in IPV support services.ConclusionThese findings suggest COVID-19 movement restrictions and social distancing measures amplify IPV and experiences of trauma due to new or exacerbated relationship challenges. Further, results highlight how partners cited COVID-19 movement restrictions to justify methods of coercive control. Public health professionals engaged in pandemic preparedness must give serious consideration to how social distancing measures may amplify trauma in those experiencing IPV.

Policing re-centralization or de-centralization? A study of state responses in England and Hong Kong during COVID-19

Abstract The persisting challenge of COVID-19 is urging states to respond with evolving strategies via policing systems. Policing systems are now mandated with new tasks beyond daily maintenance of law and order. First, states rely largely on empowering the public police officers as sovereign enforcers against COVID-19. Yet, the enforcement of COVID-19 displays considerable variation across nations, despite the existence of specific laws designed to curtail behaviour. This study seeks to analyse and explain the diverged pattern of policing during the pandemic via the experiences of Hong Kong and England. Different severity of quarantine, social distancing, and lockdown orders have been imposed in both Hong Kong and England since March 2020, but with different levels of engagement in pandemic policing. Our paper explains how and why England (de-centralized and comparatively light policing) and Hong Kong (aggressive, re-centralized policing response) have experienced such divergences in policing response.

Community policing and COVID-19 management: Household duties of street-level enforcers in Taiwan

Abstract Taiwan has been a few of the exceptions recording very low infection figures in the worldwide pandemic COVID-19 since early 2020. The island was regarded as ‘abnormally normal’ during the public health crisis. This study analysed the management of COVID-19 in two cities in Taiwan—Taipei City and New Taipei City, by exploring the roles of two groups of easily forgotten, street-level personnel who were indispensable—the village chiefs and police constables in field stations. We argued the effectiveness of infection control could partly be explained by the well-developed community policing practices. A close cooperation among public officers could be seen in the enforcement of home quarantine order for the Taiwan resident returnees in the early days of the anti-pandemic fight. This government–society collegiality in Taiwan is merely a continuation of the institutionalized practice of community policing evolving from the colonial and authoritarian regimes.

Reproducibility of Health Claims in Meta-Analysis Studies of COVID Quarantine (Stay-at-Home) Orders

The coronavirus pandemic (COVID) has been an extraordinary test of modern government scientific procedures that inform and shape policy. Many governments implemented COVID quarantine (stay-at-home) orders on the notion that this nonpharmaceutical intervention would delay and flatten the epidemic peak and largely benefit public health outcomes. The overall research capacity response to COVID since late 2019 has been massive. Given a lack of research transparency, only a small fraction of published research has been judged by others to be reproducible before COVID. Independent evaluation of published meta-analysis on a common research question can be used to assess the reproducibility of a claim coming from that field of research. We used a p-value plotting statistical method to independently evaluate reproducibility of specific research claims made in four meta-analysis studies related to benefits/harms of COVID quarantine orders. Research claims that these meta-analyses covered included: mortality, mental health symptoms, incidence of domestic violence, and suicidal ideation (thoughts of killing yourself). Three of the four meta-analysis studies that we evaluated (mortality, mental health symptoms, incidence of domestic violence) raise further questions about benefits/harms of this form of intervention. The fourth meta-analysis study (suicidal ideation) is judged to be unreliable. Given lack of research transparency and irreproducibility of published research, independent evaluation of meta-analysis studies using p-value plotting is offered as a way to strengthen or refute (falsify) claims made in COVID research.

Health-related quality of life of children and adolescents with type 1 diabetes during the COVID-19 pandemic in Kuwait.

With the rapid transmission of COVID-19 globally, countries have implemented strict governmental measures and social distancing rules that aimed to minimize the spread of the virus. School closures, quarantine orders, and social isolation, coupled with a surge in family stress and lack of peer interactions, are probable causes of mental health complications and psychological symptoms faced by children. This study aims at comparing the HRQoL of children and adolescents with type 1 diabetes (T1D) and affected by COVID-19 infection (personal or familial) and those who were not affected by COVID-19. A random sample was selected from children and adolescents diagnosed with T1D at the six major governmental diabetes centers in Kuwait. To measure HRQoL, parent-proxy and self-reports from the Pediatric Quality of Life Inventory (PedsQLTM) 3.0 Diabetes Module were used. A sample of 455 children and adolescents with T1D diabetes (44.6% male participants and 41.98% affected by COVID-19 infection) was studied. The total score of the HRQoL self-reports was significantly higher compared with parent-proxy reports (79.06 ± 15.19 vs. 73.79 ± 15.17, p < 0.01). Children reported significantly higher HRQoL scores in the "treatment I" domain and "worry" domain and lower scores in the "diabetes" symptoms domain, compared with their parents' reports (p < 0.01). In the COVID-19-affected group, a major difference was noticed between the total scores of children and parent-proxy reports (77.04 ± 15.81 vs. 72.80±14.90, p = 0.047). The affected children reported significantly lower scores in "diabetes" symptoms (59.50) (p < 0.01) and higher scores in the "treatment I" domain (81.43) than their parent-proxy reports (72.05) (p < 0.01). This is the first report on the health-related quality of life of children with T1D in Kuwait during the COVID-19 era. Parents' or caregivers' experience of caring for their children was negative, as they worried, and reported poorer HRQoL compared with their children's perceptions. There is a need to empower healthcare professionals to support parents and caregivers of children with chronic diseases such as T1D in promoting self-management, enhancing physical and psychological wellbeing, treatment adherence, and continuous health education during pandemics of any kind.

Psychological factors in adherence to COVID-19 public health restrictions in Italy: A path model testing depressed mood, anxiety, and co-rumination via cellphone.

During the COVID-19 pandemic, the success of major non-pharmaceutical interventions, such as quarantine orders, has depended upon robust rates of citizens' adherence to protocols. Thus, it is critical to public health for research to illuminate factors that affect compliance with contagion-mitigating practices. Previous research has examined sociodemographic factors and aspects of psychological distress as correlates of adherence to public health guidelines. The current study expanded this research to investigate the psychosocial process of co-rumination, which has been identified in previous research as a maladaptive type of social interaction that is associated with elevated levels of anxiety and depression. Data were collected from 932 Italian adults during the initial stages of the highly stressful COVID-19 pandemic and lockdown. A path model was tested to examine multivariate relationships among sociodemographic characteristics, symptoms of psychological distress (i.e., depression and anxiety), co-rumination via cellphone, and self-reported adherence to COVID-19-related public health restrictions. Results revealed that higher rates of co-rumination via cellphone were associated with lower levels of adherence to public health restrictions. Symptoms of depression and anxiety were differentially related to co-rumination processes and adherence to public health restrictions. Higher levels of depression symptoms were directly associated with poorer adherence to public health restrictions, and this path was mediated through higher levels of co-rumination via cellphone. On the contrary, higher levels of state anxiety were directly associated with greater adherence to public health guidelines. This path was also mediated through co-rumination via cellphone. Higher levels of anxiety were correlated with lower levels of co-rumination, which in turn were correlated with lower levels of adherence. These results suggest fruitful directions for future research examining co-rumination as a maladaptive coping behavior that may be addressed within public health interventions.