Restrictive Lockdown Research Articles

Resilience during lockdown: a longitudinal study investigating changes in behaviour and attitudes among older females during COVID-19 lockdown in the UK

In order to slow the spread of COVID-19, on March 23, 2020, a strict lockdown was implemented in the UK. This was followed by alternating periods of less restrictive lockdowns until most public health restrictions were lifted in the summer of 2021. While these measures were necessary, they significantly affected people’s daily activities, lifestyles, and mental well-being.This paper presents a longitudinal research study that focused on females aged 55 + in the UK, aiming to understand how COVID-19 and the subsequent 15-month period of lockdowns affected their lifestyles and emotions. The study collected data through online surveys, where respondents reported the frequency and mode of access to activities, and their positive and negative emotional experiences during distinct study phases that encompassed both lockdown and less strict periods.In contrast to previous studies highlighting vulnerabilities for females and the elderly during lockdowns, this research found that the studied group maintained an overall positive outlook throughout the study period and successfully adapted to the lockdowns by increasing their engagement in certain activities, in particular, activities like ‘getting active’. In addition, our findings indicate rapid adaptive behaviour change towards many online activities, such as cultural activities. However, the study also revealed negative emotions and a decrease in some activities during the second lockdown in 2020 and the subsequent lockdowns in 2021, underscoring the challenges inherent in prolonged periods of confinement. In addition, the study found negative affect associated with some activities, including working and studying from home.The findings provide valuable insights into how females aged over 55 coped with stressful circumstances, which can inform the development of resilient and mental health-conscious public health policies and responses in preparation for future pandemics or other hazards.

Changes in systemic cancer therapy in Australia during the Delta and Omicron waves of the COVID-19 pandemic (2021-2022): a controlled interrupted time series analysis.

Australian lockdowns in response to the initial coronavirus disease 2019 (COVID-19) outbreak in 2020 were associated with small and transient changes in the use of systemic cancer therapy. We aimed to investigate the impacts of the longer and more restrictive lockdowns in the Australian states of New South Wales (NSW) and Victoria during both the Delta subvariant lockdowns in mid-2021 and the Omicron subvariant outbreak in late 2021/early 2022. Population-based, controlled interrupted time series analysis. We conducted a national observational study using de-identified records of government-subsidised cancer medicines dispensed to a random 10% sample of Australians between July 2018 and July 2022. We used controlled interrupted time series analysis to investigate changes in the dispensing, initiation and discontinuation of all cancer medicines dispensed to residents of NSW and Victoria, using the rest of Australia as a control series. We used quasi-Poisson regression to model weekly counts and estimate incidence rate ratios (IRRs) for the effect of (each) the Delta phase lockdown and the Omicron outbreak on our systemic cancer therapy outcomes. Between July 2018 and July 2022, cancer medicines were dispensed 592 141 times to 33 198 people in NSW and Victoria. Overall, there were no changes to the rates of dispensing, initiation or discontinuation of antineoplastics during the Delta phase lockdowns. In both states during the Omicron outbreak, there were significant decreases in the dispensing of antineoplastics (NSW IRR 0.89; 95% confidence interval [CI] 0.84, 0.93. Victoria IRR 0.92; 95% CI 0.88, 0.96) and in the initiation of endocrine therapy (NSW IRR 0.85; 95% CI 0.74, 0.99. Victoria IRR 0.78; 95% CI 0.65, 0.94), and no changes in the discontinuation of any systemic cancer therapy. The 2021 lockdowns and 2021/2022 Omicron outbreaks in NSW and Victoria had significant impacts on the dispensing, initiation and discontinuation of systemic cancer therapies, however, the overall effects were minimal. The impacts of lockdowns were less significant than the Omicron outbreaks, suggesting COVID-19 infection, health system capacity, and patient and community concerns were important factors for treatment changes.

COVID-19 vaccine refusal as unfair free-riding

Contributions to COVID-19 vaccination programmes promise valuable collective goods. They can support public and individual health by creating herd immunity and taking the pressure off overwhelmed public health services; support freedom of movement by enabling governments to remove restrictive lockdown policies; and improve economic and social well-being by allowing businesses, schools, and other essential public services to re-open. The vaccinated can contribute to the production of these goods. The unvaccinated, who benefit from, but who do not contribute to these goods can be morally criticised as free-riders. In this paper defends the claim that in the case of COVID-19, the unvaccinated are unfair free-riders. I defend the claim against two objections. First, that they are not unfair free-riders because they lack the subjective attitudes and intentions of free-riders; second, that although the unvaccinated may be free-riders, their free-riding is not unfair.

The Covid-19 pandemic in Ghana: exploring the discourse strategies in president Nana Addo’s speeches

Communication during a crisis can affect crisis management and health outcomes. Only a few studies in Africa have examined political leaders’ speeches on Covid-19 pandemic preventive and restrictive lockdown measures. The purpose of this study is to examine the discourse strategies employed in President Nana Addo’s speeches delivered to Ghanaians on the measures taken to combat the coronavirus. The first ten speeches of Nana Addo since the inception of Covid-19 were selected, coded, and examined using content thematic analysis. The analysis of these speeches identified five main themes to capture the discourse strategies which President Nana Addo used. The strategies captured in the thematic analysis included framing Covid-19 as a war, encouraging nationalism and patriotism, showing appreciation and gratitude, threatening sanctions, and using religious values. These strategies were reinforced by using religious, moralizing, and national identity legitimation discourses to justify measures the government had put in place to minimize the impact of Covid-19 and improve healthcare response. Also, the historical, social, and political contexts of Ghana and elsewhere were invoked in Nana Addo’s speeches to legitimize the government’s response to Covid-19. In conclusion, we highlight the implications of these strategies on crisis communication and management.

How has the strict lockdown during the SARS-COV-2 outbreak changed the diet of Spaniards?

PurposeWe investigate the impact of a specific macroeconomic shock that occurred as a response to the SARS-COV-2 outbreak, namely the strict lockdown imposed in Spain on the March 14, 2020. MethodsWe use fortnightly purchase data relating to over 50,000 households from a supermarket chain in Catalonia from March to June in 2019 and 2020. Using a panel data approach, we analyse the impact of the lockdown on the caloric content, sugar composition, and alcohol content in beverages and food purchases bought before and after lockdown. We corrected our results to take into account the likelihood of stockpiling. ResultsThe lockdown is related to an increase in unhealthy beverage and food purchases. We find heterogeneous effects across groups of the sample based on cardholder characteristics. Families with children or babies and those in the upper two income quintiles had the unhealthiest changes. As the lockdown went through phases of relaxation, households made better food decisions but maintained unhealthy beverage choices. ConclusionsThe very restrictive lockdown negatively impacted the characteristics of food and beverage purchases made by Spaniards. However, we are unsure whether there was substitution to restaurant and bar visits. Additional work to find out whether there were permanent changes in purchasing behaviour after lockdown ended is needed in the future.

Civil Liberties in a Lockdown: The Case of COVID-19.

In response to the spread of COVID-19, governments across the world, with very few exceptions, have enacted sweeping restrictive lockdown policies that impede citizens' freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support worldwide should be justified by uncontroversial moral principles. We argue that the virtually unanimous support in favor of restrictive lockdowns is not adequately justified by the arguments given in favor of them. Importantly, this is not to say that states ought not impose restrictive lockdown measures, but rather that the extent of the acceptance of these measures is not proportionate to the strength of the arguments for lockdowns.

Community Perceptions and Experiences of the South African Government’s Response to the First Wave of the COVID-19 Pandemic in Johannesburg, South Africa

In response to the COVID-19 pandemic, governments in low- and middle-income countries largely followed the strategy of national lockdowns adopted by high-income countries. The South African government imposed some the most restrictive policies in the world. In this article, we examine the perceptions and lived experiences of South Africans in Johannesburg in relation to this initial response to the pandemic. In-depth interviews were conducted with a diverse group of 38 South African adults in Johannesburg, South Africa. The analysis followed an inductive approach. The data revealed that the majority of participants had a positive view of the strong response to the first wave of the pandemic by the South African government, including the restrictive lockdown measures. However, concerns regarding the government’s response included worries about the economy and livelihoods of poor people under lockdown, divisions in compliance between townships and wealthier communities, poor funding in the healthcare sector, corruption and nepotism in the distribution of government aid, and the lack of cultural adaptation of awareness-raising campaigns about COVID-19. The ability of governments to gauge how populations perceive the effectiveness of public health measures is essential for identifying obstacles to disease-control objectives.

The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study

The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

The Impact of COVID-19 Lockdown on Parents and Young People With Autism Spectrum Disorder (ASD)

ABSTRACT The spread of COVID-19 resulted in restrictive lockdowns. For families supporting young people with autism spectrum disorder (ASD), the service system was stripped away. The aim of this study was to explore the impact of this challenging situation on a group of Australian carers and parents of children and young people with ASD, with an intention to inform policy and practice based on the lived experiences of these families. A survey of parents of children and young people with ASD in Australia returned 117 responses, of which 86 responded to open-ended questions about COVID-19 lockdowns. Twelve parents responded to the invitation to be interviewed. Interview and survey data were analysed thematically. Five themes emerged: accessing support services, receiving support services online, changes in behaviour, higher levels of conflict, and impact on health and relationships. The experience of lockdowns under COVID-19 undermined informal and formal support systems, and had a particularly strong negative impact on the experiences of children with ASD and their families. These findings also provide support for understanding the social model of disability as a mainstay in the lives of children with disabilities and their carers. IMPLICATIONS The social model of disability was dismantled for children and young people and their carers during the COVID crisis. This unacceptable attack on the human rights of disabled people (people with a disability) needs future planning to ensure that it does not occur again. Future crises require more nuanced policy and practice responses that do not close off all child and family supports to children with ASD and their carers.

Students' views and experiences of blended learning and employability in a post-pandemic context

Existing research has investigated university students' experiences of learning during restrictive lockdowns (e.g. Ela et al., 2021; Khan, 2021) as well as their perceptions of their own employability (Haekal et al., 2021; Plakhotnik et al., 2021). This study addresses a research gap, by exploring these topics from a post-pandemic perspective. Our research collected data with a cohort of university students at a UK institution, otherwise known as ‘NorthSea’, in relation to their views and experiences of both ‘blended learning’ (BL) and employability. The study had a multi-method design comprising of an online focus group (OFG) with n.18 respondents, n.10 semi structured interviews (SSI) and anecdotal data collected from n.6 students. Students were generally supportive of the continuation of BL due to its flexibility. Anecdotal data, collected six months after the original research study, noted further support for BL due to financial concerns about the cost of living crisis. Although other respondents preferred face to face teaching as they observed a disconnect between lectures being delivered online and in person. In terms of employability, respondents were complimentary of the support provided by the Employability Service, (ES), although mature did not always avail themselves of this support, and international students did not perceive that the service was available to them. Respondents also talked of wanting tailored information, advice and guidance (IAG) that considered their degree subject. Recommendations included further research in the shape of an action research project that focused on tailored IAG and included student unions, and for ES to take proactive steps such faculty endorsements, peer ambassadors (who have successfully used the employability service) and a university incentive scheme.

Spatiotemporal Analysis of Black Carbon Sources: Case of Santiago, Chile, under SARS-CoV-2 Lockdowns.

The SARS-CoV-2 pandemic has temporarily decreased black carbon emissions worldwide. The use of multi-wavelength aethalometers provides a quantitative apportionment of black carbon (BC) from fossil fuels (BCff) and wood-burning sources (BCwb). However, this apportionment is aggregated: local and non-local BC sources are lumped together in the aethalometer results. We propose a spatiotemporal analysis of BC results along with meteorological data, using a fuzzy clustering approach, to resolve local and non-local BC contributions. We apply this methodology to BC measurements taken at an urban site in Santiago, Chile, from March through December 2020, including lockdown periods of different intensities. BCff accounts for 85% of total BC; there was up to an 80% reduction in total BC during the most restrictive lockdowns (April-June); the reduction was 40-50% in periods with less restrictive lockdowns. The new methodology can apportion BCff and BCwb into local and non-local contributions; local traffic (wood burning) sources account for 66% (86%) of BCff (BCwb). The intensive lockdowns brought down ambient BC across the city. The proposed fuzzy clustering methodology can resolve local and non-local contributions to BC in urban zones.

When Two Coincidences are a Clue: A Retrospective Cohort Study Regarding the Incidence of Ruptured Tubal Pregnancies in a Northern Italy Hospital During the COVID-19 Pandemic

Background: Undiagnosed ectopic pregnancies are among the main gynecological emergencies, and hemorrhage from an ectopic pregnancy is still the leading cause of maternal mortality in the first trimester. During the first lockdown period in Italy (March–April 2020) and in March 2021 restrictive measures were issued by the Italian government, but their impact on the incidence of ruptured tubal pregnancies remains unknown. Methods: The purpose of this study was to evaluate the impact of restrictive measures for the COVID-19 outbreak on the incidence of ruptured tubal pregnancies at our referral center for endoscopic gynecologic surgery. In particular, the primary outcome was the comparison of the incidence of ruptured tubal pregnancies between the lockdown phases and the other months of the pandemic. For this retrospective cohort study we considered all women examined for tubal ectopic pregnancy at our emergency unit from 1 January 2019 to 30 April 2021. We divided patients into three groups according to the period they were referred to our center: 10 March 2019–10 March 2020 (Pre-Covid period); 11 March–4 May 2020 and 6 March–30 April 2021 (Lockdown periods); 5 May 2020–5 March 2021 (COVID-19 pandemic period without restrictive policies). We compared data acquired during the lockdown phases with data collected both before the COVID-19 pandemic and during the restriction-free COVID-19 period. Results: 31 of 85 women were diagnosed with a ruptured tubal pregnancy. The proportion of ruptured ectopic pregnancies was higher during the lockdown period than the other two periods combined (62.5% vs 30.4%, p = 0.016). Mean gestational age and beta-HCG levels showed the same tendency (7.31 ± 1.25 weeks vs 5.99 ± 1.28 weeks, p < 0.0001; 7392.56 ± 4337.50 mUI/mL vs 4188.36 ± 3235.95 mUI/mL, p = 0.001). There were no differences between the proportion of ruptured pregnancies during the whole COVID-19 pandemic and the months preceding it (45.7% vs 25.6%, p = 0.07). Conclusions: Our study demonstrated that restrictive lockdown policies for the containment of the COVID-19 outbreak are associated with an increased rate of ruptured extrauterine tubal pregnancies.

Mental health consequences of COVID-19 suppression strategies in Victoria, Australia: a narrative review.

The COVID-19 pandemic has imposed significant mental health burdens upon the general population worldwide, either directly owing to the disease or indirectly through aggressive public health measures to control spread of the virus that causes COVID-19. In this narrative review, we used a systematic approach to summarize the impact of restrictive lockdown measures on the general mental health of people living in Victoria, Australia during 2020 and to identify the groups with an increased risk of adverse mental health outcomes. A systematic database search (Ovid Medline, PsycINFO, Embase) for articles examining the mental health of Victorians in the context of the COVID-19 pandemic during 2020 yielded 88 articles, of which 15 articles were finally included in this review. We found that the general mental health of Victorians was negatively affected by COVID-19 restrictions during 2020. Although studies reported heterogeneous mental health outcomes, we found that the general population consistently used coping strategies and demonstrated mental health help-seeking behaviors in response to the restrictions. Women, children, young people, carers, people who became unemployed owing to the pandemic, and those with pre-existing psychiatric conditions had a higher risk of adverse mental health consequences during the COVID-19 pandemic in 2020.

Infant HIV Testing Amid the COVID-19 Pandemic and Evolving PMTCT Guidelines in Johannesburg, South Africa.

Background: The COVID-19 pandemic impacted HIV programmes with the diversion of resources and lockdown measures. We assessed the impact of COVID-19 on infant HIV diagnosis in the context of updated 2019 prevention of mother-to-child transmission of HIV (PMTCT) guidelines in Johannesburg, South Africa. Methods: HIV PCR data for children <2 years were extracted from the National Health Laboratory Service database from October 2018 to September 2021, inclusive. Trends in the total number of tests performed and the total number of children with HIV diagnosed, stratified by age, were determined to assess the effect of different COVID-19 lockdown levels and updated guidelines. Results: When comparing three 12-month periods ending September 2019–2021, respectively, the total number of HIV PCR tests performed increased (from 41 879 to 47 265 to 56 813), and the total number of children with HIV decreased (from 659 to 640 to 620), year-on-year. There was a substantial increase in 6-month testing in response to updated guidelines. Excluding 6-month testing, the year-on-year increase in total tests was maintained with birth and 10-week testing closely approximating total live births to women living with HIV. A decrease in the total number of children with HIV diagnosed was noted in Q2 2020, coinciding with the most restrictive lockdown, followed by a rebound in cases. Conclusions: Despite the restrictions and diversion of resources associated with COVID-19, there was a successful implementation of PMTCT guideline updates and minimal disruption to infant HIV testing. However, much work remains in order to achieve the elimination of mother-to-child transmission of HIV.

Factors associated with insomnia symptoms: A cross-sectional study during a Covid-19 fully restrictive lockdown.

Insomnia is the most frequent sleep disorder and a public health concern that increased during the Covid 19 pandemic. Fully restrictive lockdowns during Covid are interesting periods to examine the impact of environmental and behavioural changes on the emergence of insomnia symptoms. In this cross-sectional study we aimed to (1) determine the main factors associated with insomnia symptoms during a Covid-19 fully restrictive lockdown examining the associated daily life alterations and (2) create a predictive model of insomnia symptoms. We used the data drawn from the "Covid-RythmE" study that reached volunteers from the general French population through an online survey during the last 2 weeks of the 2 month full lockdown. Associations with insomnia symptoms were tested and significant associations were entered in a Backward Stepwise Logistic Regression (BSLR) to assess the best combination to classify individuals with or without insomnia symptoms. From the 1624 participants, 50.64% suffered from mild to severe insomnia symptoms as assessed by the ISI. The best combination for explaining insomnia symptoms with 74.26% of accuracy included: age (OR=1.15), females (OR=1.26), smaller home sizes (OR=0.77), environmental noises (OR=1.59), anxiety symptoms (OR=1.24), depressive symptoms (OR=1.15), regularity of sleep-wake schedules (OR=1.25), exposure to screen during the morning (OR=1.13), and LED light during the evening (OR=1.17). Thus, lifestyle schedule and exposure to natural synchronizers such as light, are primordial in considering in insomnia physiopathology, prevention and treatment, as well as the associated mental health status.

Emotional eating and depression during the pandemic: QuarantEat, an Italian nationwide survey

ObjectivesThis study aimed to explore the consequences of the pandemic lockdown among the Italian general population by focusing on depression and emotional overeating (EO). MethodsQuarantEat was an Italian, nationwide, cross-sectional study conducted using a computer-assisted web interview method (May 6-31, 2020). The 40-item questionnaire included the five-item World Health Organization Wellbeing Index and EO Questionnaire-5. Multivariable logistic regressions were performed. ResultsA total of 1865 adults participated in the study. Depression and EO were reported by 57.6% and 49.3%, respectively, of the sample. When considering multivariable models, women, students, participants who smoked more/equal during lockdown, and individuals with EO were more likely to report depression. Following a healthier diet or exercising during lockdown reduced the probability of depression. The likelihood of EO was higher for participants who were female, consumed more food, had a less healthy diet, were overweight and obese, consumed more chocolate, consumed more snacks between meals or before going to sleep/during the night, and were at risk for depression. Increasing age, having a relationship, and not having increased television/computer watching time while eating reduced the odds of EO. ConclusionsQuarantEat highlighted high levels of depression and EO right after the end of pandemic lockdown measures, and outlined the importance of the relationships between mental health and health risk behaviors, such as smoking, exercise, diet, and changes in eating behaviors due to the pandemic lockdown. Planning interventions using a holistic approach and reaching every individual to overcome the limits caused by the restrictive lockdown measures is essential.

Child, adolescent, and caregiver mental health difficulties and associated risk factors early in the COVID-19 pandemic in South Africa

At the onset of the COVID-19 pandemic in early 2020 in South Africa, many safety measures were implemented to protect the lives of the population. Ironically, these same safety measures have negatively impacted on the lives of children and their caregivers resulting in increased mental health problems. This study forms part of the multicountry Co-SPACE (COVID-19: Supporting Parents, Adolescents and Children during Epidemics) study that explores how families are coping during the COVID-19 pandemic, and what caregivers can do to help support their children’s mental health. This paper aims to gain a better understanding of the mental health status of families specifically in South Africa in the early onset of the pandemic during restrictive lockdown measures, and identify certain risk factors that might contribute towards deteriorating mental health. Two hundred and fifty-four South African parents and carers of children and adolescents completed an online survey about their child’s mental health as well as their own mental health during and post- hard lockdown in South Africa. Data collection took place over the period of the first and second waves of the COVID-19 pandemic in South Africa. Results showed that children experienced significantly higher mental health problems than adolescents (p = 0.016). Younger children were particularly negatively affected by lockdown and had more mental health problems than adolescents (p = 0.023); including emotional problems (p = 0.017), misconduct (p = 0.030), and hyperactivity (p = 0.001). Additionally, the presence of special educational needs/neurodevelopmental disorders (SEN/ND) was associated with more mental health problems (p = 0.001). Surprisingly, single parent households, which is another well-known risk factor showed no differences in mental health problems compared to nuclear families. There was also a reciprocal relationship between parental/carer mental health and child/adolescent mental health, with higher level of endorsement of mental health problems in children by parents/caregivers who themselves associated with higher levels of depression, anxiety and stress (all p’s < 0.001). These results highlight the dramatic impact that COVID-19 had on children, adolescents and parents in South Africa early in the pandemic, and emphasises the need for specific support structures to be implemented within the SEN/ND community, as well as for younger children and single parent households.

Implementation of emergency general practitioner management of patients during the complete lockdown consequent to the COVID-19 Omicron outbreak in Shanghai.

The outbreak of the Omicron strain of COVID-19 led to the most restrictive lockdowns ever implemented in Shanghai.

Analytic modeling and risk assessment of aerial transmission of SARS-CoV-2 virus through vaping expirations in shared micro-environments

It is well known that airborne transmission of COVID-19 in indoor spaces occurs through various respiratory activities: breathing, vocalizing, coughing, and sneezing. However, there is a complete lack of knowledge of its possible transmission through exhalations of e-cigarette aerosol (ECA), which is also a respiratory activity. E-cigarettes have become widely popular among smokers seeking a much safer way of nicotine consumption than smoking. Due to restrictive lockdown measures taken during the COVID-19 pandemic, many smokers and vapers (e-cigarette users) were confined to shared indoor spaces, making it necessary to assess the risk of SARS-CoV-2 virus aerial transmission through their exhalations. We summarize inferred knowledge of respiratory particles emission and transport through ECA, as well as a theoretical framework for explaining the visibility of exhaled ECA, which has safety implications and is absent in other respiratory activities (apart from smoking). We also summarize and briefly discuss the effects of new SARS-CoV-2 variants, vaccination rates, and environmental factors that may influence the spread of COVID-19. To estimate the risk of SARS-CoV-2 virus aerial transmission associated with vaping exhalations, we adapt a theoretical risk model that has been used to analyze the risks associated with other respiratory activities in shared indoor spaces. We consider home and restaurant scenarios, with natural and mechanical ventilation, with occupants wearing and not wearing face masks. We consider as “control case” or baseline risk scenario an indoor space (home and restaurant) where respiratory droplets and droplet nuclei are uniformly distributed and aerial contagion risk might originate exclusively from occupants exclusively rest breathing, assuming this to be the only (unavoidable) respiratory activity they all carry on. If an infected occupant uses an e-cigarette in a home or restaurant scenarios, bystanders not wearing face masks exposed to the resulting ECA expirations face a 1,% increase of risk of contagion with respect the control case. This relative added risk with respect to the control case becomes 5-17 % for high-intensity vaping, 44-176 %, and over 260 % for speaking for various periods or coughing (all without vaping). Infectious emissions are significantly modified by mechanical ventilation, face mask usage, vaccination, and environmental factors, but given the lack of empiric evidence, we assume as a working hypothesis that all basic parameters of respiratory activities are equally (or roughly equally) affected by these factors. Hence, the relative risk percentages with respect to the control state should remain roughly the same under a wide range of varying conditions. By avoiding direct exposure to the visible exhaled vaping jet, wearers of commonly used face masks are well protected from respiratory droplets and droplet nuclei directly emitted by mask-less vapers. Compared to the control case of an already existing (unavoidable) risk from continuous breathing, vaping emissions in shared indoor spaces pose just a negligible additional risk of COVID-19 contagion. We consider that it is not necessary to take additional preventive measures beyond those already prescribed (1.5 m separation and wearing face masks) in order to protect bystanders from this contagion.

TANKS Tangible Game Facilitators Lived Experiences: Roles, Competencies, and Challenges

TANKS is a tangible coding game that introduced coding to South African 10–14-year-old learners. It is aimed to initiate and stimulate learning using facilitators. Facilitators use untraditional teaching methods because they are influential on training success. Also, facilitators undertook face-to-face contact sessions, since TANKS requires the use of a smartphone and tokens. A phenomenological qualitative study design approach of six facilitators of a face-to-face interview using an adapted semi-structured questionnaire was used. All interviews were audio-taped, transcribed verbatim, and thematically analyzed using an explanation-building strategy applied. Results identified themes where each theme was further explained in the study. Limitations included small interviewee numbers because of a nationwide COVID-19 restrictive lockdown. The feed-forward learning flow model concluded that supportive school leadership by principals or teachers creates an academic coding culture. This culture will necessitate learners’ competitive behavior by adopting a performance-based appraisal practice, to improve the coding interest and TANKS performance by learners.