Social Distancing Recommendations Research Articles

People who have more science education rely less on misinformation—Even if they do not necessarily follow the health recommendations

AbstractRecent research has highlighted the role of science education in reducing beliefs in science‐related misinformation and stressed its potential positive impact on decision‐making and behavior. This study implemented the Elaboration Likelihood Model to explore how individuals' abilities and motivation interact with the type of processing of scientific information in the peripheral vs. central persuasion routes. A representative sample of adults (N = 500) completed an online questionnaire during the second wave of COVID‐19 (November 2020) focused on two COVID‐19‐related dilemmas involving social distancing recommendations. First, we examined whether relying on misinformation was associated with participants' stances and the complexity of their arguments and found that relying on misinformation was associated with the intention to reject social distancing recommendations and with the use of simple arguments. Second, we explored how motivation, operationalized as personal relevance, and abilities, operationalized as the highest level of science education, science knowledge, and strategies to identify misinformation, were associated with viewpoints and justifications. We found that personal relevance was associated with the intention to reject the recommendations but also with more complex arguments, suggesting that people did not intend to reject scientific knowledge but rather tended to contextualize it. Abilities were not associated with stance but were positively correlated with argument complexity. Finally, we examined whether motivation and abilities are associated with relying on scientific misinformation when making science‐related decisions. Respondents with higher levels of science education and motivation relied less on misinformation, even if they did not necessarily intend to follow the health recommendations. This implies that motivation directs people to greater usage of the central processing route, resulting in more deliberative use of information. Science education, it appears, impacts the information evaluation decision‐making process more than its outcome.

Quo Vadis, ECMO? Multidisciplinary Hybrid Extra Corporeal Membrane Oxygenation Rounds During the COVID-19 Pandemic

The complex care of patients on ECMO requires a high level of collaboration between multiple medical specialties and allied health professionals. Effective and timely communication between team members is imperative in ensuring patient safety. The COVID-19 pandemic posed unique challenges in the care of patients on ECMO. Communication between team members was complicated by social distancing recommendations, increased patient volume, and staff turnover. In this article, we describe a hybrid approach to rounds that allowed team members to attend virtually or in-person to improve team communication. Weekly hybrid ECMO rounds were held to discuss patient cases and work collectively to establish patient centered goals for the following week. Critical care and surgical consultants, RN ECMO specialists, RNs, perfusionists, respiratory therapists, physical and occupational therapists, pharmacists, ethics committee members, and patient family members were invited to attend hybrid ECMO rounds. After eight months of rounds, medical care team members were asked to provide feedback regarding the rounds format, strengths, and weaknesses. The most frequently identified strengths were improved multidisciplinary communication and continuity of care. This article demonstrates that hybrid virtual and in-person patient rounds are a feasible way for ECMO programs to improve team communication and overall patient care.

Association Between COVID-19 and Planned and Postponed Cancer Screenings Among American Indian Adults Residing in California and Oklahoma, March-December 2020.

Little is known about how the COVID-19 pandemic affected cancer screenings among American Indian people residing in California and Oklahoma, 2 states with the largest American Indian populations. We assessed rates and factors associated with cancer screenings among American Indian adults during the pandemic. From October 2020 through January 2021, we surveyed 767 American Indian adults residing in California and Oklahoma. We asked participants whether they had planned to obtain screenings for breast cancer, cervical cancer, and colorectal cancer (CRC) from March through December 2020 and whether screening was postponed because of COVID-19. We calculated adjusted odds ratios (AORs) for factors associated with reasons for planned and postponed cancer screening. Among 395 participants eligible for breast cancer screening, 234 (59.2%) planned to obtain the screening, 127 (54.3%) of whom postponed it. Among 517 participants eligible for cervical cancer screening, 357 (69.1%) planned to obtain the screening, 115 (32.2%) of whom postponed it. Among 454 participants eligible for CRC screening, 282 (62.1%) planned to obtain CRC screening, 80 of whom (28.4%) postponed it. In multivariate analyses, women who lived with a child (vs did not) had lower odds of planning to obtain a breast cancer screening (AOR = 0.6; 95% CI, 0.3-1.0). Adherence to social distancing recommendations was associated with planning to have and postponement of cervical cancer screening (AOR = 7.3; 95% CI, 0.9-58.9). Participants who received (vs did not receive) social or financial support had higher odds of planning to have CRC screening (AOR = 2.0; 95% CI, 1.1-3.9). The COVID-19 pandemic impeded completion of cancer screenings among American Indian adults. Interventions are needed to increase the intent to receive evidence-based cancer screenings among eligible American Indian adults.

Association between the COVID-19 pandemic and mental health in very old people in Sweden.

During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health. We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression. Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]). A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.

Family-Perceived Barriers and Facilitators Toward a Tele-Audiology Infant Diagnostic Testing Approach in Victoria, Australia.

Background: Universal newborn hearing screening programs allow for early identification of congenital hearing loss. However, some families experience difficulties accessing diagnostic audiology services following a refer screen result. Methods: This study aimed to assess the opinions of families who had experienced infant diagnostic audiology assessments regarding a telehealth option for these appointments within Victoria, Australia. Families who attended in-person infant diagnostic audiology appointments were sent a questionnaire exploring their experiences of the service and their opinion regarding a proposed telehealth option for infant diagnostic audiology (50 responses received). These results were also compared to those of families who were surveyed following testing in 2020, where the audiologist conducted the appointment remotely to comply with COVID-19-related social distancing recommendations at the time (10 responses received). Results: There were not significant differences between the duration or number of appointments, perceived understanding of results, or concerns regarding a tele-audiology model between families who experienced face-to-face and tele-audiology infant diagnostic audiology appointments. Opinions of infant diagnostic audiology appointments utilizing telehealth technology were largely positive, and minimal technological difficulties were identified. Conclusion: Overall positive attitudes of many families with infant diagnostic appointment experiences toward a tele-audiology option of this service suggest that offering a telehealth model of appointments may be an appropriate model to improve service access for families requiring infant diagnostic audiology in Victoria.

Impact of COVID-19 social distancing recommendations on pulmonary function, nutritional status, and morbidity in patients with cystic fibrosis.

To evaluate the impact of COVID-19 social distancing recommendations on nutritional status, pulmonary function, and morbidity in patients with cystic fibrosis (CF). A retrospective cohort study including patients older than six years with a diagnosis of CF was performed. Demographic and clinical data, anthropometric measurements, pulmonary function, days of antibiotic use, and length of hospital stay were recorded. Variables were recorded at three time points relative to the baseline for implementation of social distancing measures: T-1 (14 months before implementation), T0 (baseline), and T1 (14 months after implementation). Delta (Δ) was calculated for each period: Δ1 (pre-pandemic T0-T-1) and Δ2 (pandemic T1-T0). The study included 25 patients, with a mean age of 11.7±4.3 years. The mean forced expiratory volume in the first second (FEV1) was 85.6±23.6%, and body mass index (BMI) was 17.5±3.0 kg/m2. When comparing the two periods (Δ1 and Δ2), there was a significant increase in the FEV1/forced vital capacity (FVC) ratio (p=0.013) and in the forced expiratory flow between 25 and 75% of vital capacity (FEF25-75%) (p=0.037) in the pandemic period. There was also a significant reduction (p=0.005) in the use of antibiotics in the pandemic period compared with the pre-pandemic period. The Δ1 and Δ2 values did not differ significantly for BMI, FEV1, or length of hospital stay. COVID-19 social distancing recommendations had a positive impact (decrease) on morbidity (use of antibiotics) and small airway obstruction (FEF25-75%) in patients with CF.

Characterizing spatio-temporal patterns of coastal navigation to inform mitigation strategies for conflict between ocean users and the protected humpback whale (Megaptera novaeangliae) in Bahía de Banderas, Mexico

Characterizing specific pressures on natural resources is a key component of developing sustainable management strategies. Here we explored the spatiotemporal distribution of marine vessels in a potentially high conflict area between humpback whales and tourism activities, namely Bahía de Banderas, Mexico, from 2017 to 2023. Using high-resolution satellite imagery, we identified high-use areas and their relationship to the presence of urban areas, vessel departure points, and the coastline before, during, and after restrictions put in place during the peak of the COVID-19 pandemic. High-resolution satellite imagery (3m/px - 5m/px) retrieved through the Planet Application Program was used to perform manual detection and annotation of vessels and spatial patterns of marine navigation were characterized through point pattern analyses The spatial distribution of all marine vessel observations in the study area was not random; four high-use coastal areas closer to urban areas were identified, three of which overlap the current marine protected area established to protect whale nursing grounds. Furthermore, as the COVID-19 pandemic began, coastal navigation decreased due to lockdown before picking up again at a higher level than the pre-COVID baseline due to social distancing restrictions. While these changes were not statistically significant, they potentially indicate a behavioral change caused by COVID-19 social distancing recommendations during 2021; the amplified demand for marine vessels appears to have increased the absolute number of vessel chartering and decreased the number of passengers onboard commercial vessels. Our preliminary work provides a reproducible remote sensing methodology that can support future mitigation strategies.

Predicting COVID-19 Risk Information-Seeking Behaviors in Relation to Food Purchasing Concerns

COVID-19 drastically altered the way consumers shopped for food as they had to adhere to recommendations for social distancing. However, the public has been divided across political parties in their assessment of the severity of COVID-19 and must filter through misinformation related to the pandemic to make informed choices for personal safety. Therefore, the purpose of this study was to explore the influences on Oklahoma consumers’ risk information-seeking behaviors about COVID-19 within the context of risk perceptions while shopping for food. The Risk Information Seek and Processing (RISP) model and cultural cognition provided the framework for this study. An online instrument was distributed to Oklahoma consumers to collect quantitative data (n = 410). Respondents reported they were only slightly concerned while making food purchases and possessed moderately high knowledge about COVID-19. They also reported needing moderately high knowledge to make judgments about the issue. Additionally, the respondents engaged more often in systematic processing of COVID-19 information compared to heuristic processing, but neither agreed nor disagreed that they engaged in active information-seeking behaviors. The findings from this research provide Extension agents and agricultural communicators guidance for creating and researching risk communication during a pandemic in relation to food purchasing behaviors.

Seroconversion rate of SARS-CoV-2 IgG antibodies and dating behaviour in HIV-PrEP users in a German metropolis during the COVID-19 pandemic.

At the beginning of the COVID-19 pandemic, when mortality was high, social distance was the only option to prevent transmission of SARS-CoV-2 and prohibit uncontrolled spreading. As the impact of social distancing on sexual behavior was unclear, we aimed to assess the influence of sexual risk behavior on SARS-CoV-2 seroconversion in HIV pre-exposition prophylaxis (PrEP) users after declaration of the pandemic. Prospective study on SARS-CoV-2 IgG-antibody seroconversion rate over time in men having sex with men (MSM) using PrEP at a single tertiary university hospital in Munich, Germany, during quarterly (Q) routine HIV-PrEP visits over 1year per participant (May 2020 - September 2021). Seroconversion was defined as at least one positive anti-nucleocapsid (anti-N) SARS-CoV-2 IgG antibody test as surrogate for past infection. In addition, sexually transmitted infections (STIs), personal estimated risk behavior and sexual contacts were assessed. Seroconversion rate during the full observation period was 7.3% (9/124 subjects) by September 2021. Percentage of subjects with symptomatic STIs (T. pallidum, N. gonorrhoeae, C. trachomatis and M. genitalium) was 18.7% in Q3-20, 8.1% in Q4-20, 11.1% in Q1-21, 11.6% in Q2-21 and 9.5% in Q3-21. Perception of subjective threat of SARS-CoV-2 infection and adequacy of preventive measures decreased during the observation period. However, self-reported sex behavior remained stable during the observation period. Our cohort showed low proportion of PrEP-users with anti-N IgG by September 2021, comparable to the local incidence. Sexual behavior in this cohort did not change, despite local recommendations for social distancing.

The impact of postpartum social support on postpartum mental health outcomes during the COVID-19 pandemic.

Social support is an influential component of postpartum recovery, adjustment, and bonding, which was disrupted by social distancing recommendations related to the COVID-19 pandemic. This study reports on changes in the availability of social support for postpartum women during the pandemic, investigates how those changes may have contributed to postpartum mental health, and probes how specific types of social support buffered against poor postpartum mental health and maternal-infant bonding impairment. Participants were 833 pregnant patients receiving prenatal care in an urban USA setting and using an electronic patient portal to access self-report surveys at two time points, during pregnancy (April-July 2020) and at ~12 weeks postpartum (August 2020-March 2021). Measures included an assessment of COVID-19 pandemic-related change in social support, sources of social support, ratings of emotional and practical support, and postpartum outcomes including depression, anxiety, and maternal-infant bonding. Overall self-reported social support decreased during the pandemic. Decreased social support was associated with an increased risk of postpartum depression, postpartum anxiety, and impaired parent-infant bonding. Among women reporting low practical support, emotional support appeared to protect against clinically significant depressive symptoms and impaired bonding with the infant. Decreases in social support are associated with a risk for poor postpartum mental health outcomes and impaired maternal-infant bonding. Evaluation and promotion of social support are recommended for healthy adjustment and functioning of postpartum women and families.

Mental health services for all: Factors influencing desire for mental health services among underresourced adults during COVID-19.

The coronavirus disease (COVID-19) pandemic has substantially impacted psychological health in the U.S and has disproportionately impacted underresourced individuals. Despite the higher need for mental health services during this time, service availability and access were disrupted due to increased demand, social distancing recommendations, and stay-at-home orders. Thus, it is crucial to understand factors that predict the desire for psychological services for underresourced individuals. The present study examined factors at multiple levels of Bronfenbrenner's socioecological model (Bronfenbrenner, 1994) to determine which factors best predicted the desire for mental health services including individual, group, in-person, and online services. The sample consisted of 155 underresourced adults in North Carolina. Participants completed an online survey of mental health symptoms, coping strategies, COVID-19 related stressors, and provided demographic information including ZIP code, which was used to classify urban-central and urban-outlying dwellers. Results from univariate general linear models demonstrated that depression symptoms, venting as a coping strategy, COVID-related stress, and living in more rural regions were all significant predictors of the desire for psychological services. Venting as a predictor of the desire for services may signify a general misunderstanding regarding the purpose of psychotherapy as well as the need for individuals to gain social support and connectedness during a pandemic. This study helps to clarify individual-level and contextual factors that impact the desire for psychological services during a global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patient experiences of COVID-19-induced changes to methadone treatment in a large community-based opioid treatment program in Baltimore

IntroductionFollowing the March 2020 federal declaration of a COVID-19 public health emergency, in line with recommendations for social distancing and decreased congregation, federal agencies issued sweeping regulation changes to facilitate access to medications for opioid use disorder (MOUD) treatment. These changes allowed patients new to treatment to receive multiple days of take-home medications (THM) and to use remote technology for treatment encounters—allowances that previously had been reserved exclusively for “stable” patients who met minimum adherence and time-in-treatment criteria. The impact of these changes on low-income, minoritized patients (frequently the largest recipients of opioid treatment program [OTP]-based addiction care), however, is not well characterized. We aimed to explore the experiences of patients who were enrolled in treatment prior to COVID-19 OTP regulation changes, with the goal of understanding patients' perceptions of the impact of these changes on treatment. MethodsThis study included semistructured, qualitative interviews with 28 patients. We used a purposeful sampling method to recruit individuals who were active in treatment just before COVID-19-related policy changes went into effect, and who were still in treatment several months later. To ensure a diverse array of perspectives, we interviewed individuals who either had or had not experienced challenges with methadone medication adherence from 3/24/21 to 6/8/21, approximately 12–15 months following the onset of COVID-19. Interviews were transcribed and coded using thematic analysis. ResultsParticipants were majority male (57 %), Black/African American (57 %), with a mean age of 50.1 (SD = 9.3). Fifty percent received THM prior to COVID-19, which increased to 93 % during the pandemic. COVID-19 program changes had mixed effects on treatment and recovery experiences. Themes identified convenience, safety, and employment as reasons for preferring THM. Challenges included difficulty with managing/storing medications, experiencing isolation, and concern about relapse. Furthermore, some participants reported that telebehavioral health encounters felt less personal. ConclusionsPolicymakers should consider patients' perspectives to foster a more patient-centered approach to methadone dosing that is safe, flexible, and accommodating to a diverse array of patients' needs. Additionally, technical support should be provided to OTPs to ensure interpersonal connections are maintained in the patient-provider relationship beyond the pandemic.

Impact of COVID-19 on orthopedic surgery residency programs in Algeria: a qualitative study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. Medical education has been negatively impacted. From an educational standpoint, teaching conferences for residents have been suspended. Grand rounds and in-person meetings have also been cancelled to comply with social distancing recommendations. Objective: The purpose of this study was to assess the impact of the COVID-19 pandemic on the orthopedic surgery residents’ education, clinical practice, and well-being. Materials and methods: An online cross-sectional survey was shared with orthopedic surgery residents of 6 teaching hospitals in Algiers (Algeria). Results: We received 58 responses (response rate: 24.57%). Fifty-four percent of the residents have been deployed on COVID-19 screening’ duties. Nearly 97% of the trainees reported that the COVID-19 pandemic had negatively impacted their surgical training. Most participants referred inadequate supply in personal protective equipment and indicated that the orthopedic surgery-training program should include a session about personal protective equipment every year. Among all the subjects, 54 (93%) perceived an increase in stress levels during the COVID-19 crisis and 90% were concerned about transmitting infection to their family members. Conclusions: The COVID-19 pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. The changes in the orthopedic activities have negatively impacted the residents’ learning, especially surgical training and affected their well-being. Adapted measures must be taken to face this unprecedented challenge and ensure the continuity of training for our residents.

Impact of COVID-19 Pandemic on the Incidence of Sexually Transmitted Infections in Northern Finland in 2019 to 2022.

The coronavirus SARS-CoV-2 (COVID-19) pandemic led to major restrictions in daily life and social contacts in Finland in March 2020. The effect of these restrictions on sexually transmitted infections (STIs) is unclear. The aim of this study was to analyse the incidence and positive rates of sexually transmitted infections in Northern Finland between 2020 and 2021 and compare these with the years prior to the pandemic. Numbers of positive Chlamydia trachomatis, HIV and hepatitis C samples were lower in 2020 to 2021 than in previous years, whereas more gonorrhoea and syphilis was found during pandemic than in previous years. The number of new cases of C. trachomatis reported each month decreased in the first months of the pandemic, but exceeded the prior pandemic-level in autumn 2020. When the mean positive sample rates were compared with the years 2015 to 2019, there was a significant decrease in positive C. trachomatis (p < 0.001) and hepatitis C (p < 0.001) sample rates in both 2020 and 2021. The positive rates for Treponema pallidum in 2020 did not differ significantly (p = 0.38) from previous years. In conclusion, these results show that sexually transmitted infections occurred despite recommendations for social distancing during the COVID-19 pandemic. Thus, easy access to STI testing should always be available, even during exceptional circumstances.

The prospective relations of substance use frequency to social distancing behaviors and intentions during the COVID-19 pandemic: the role of social distancing self-efficacy.

To identify factors that increase risk for nonadherence to recommended health protective behaviors during pandemics, this study examined the prospective relations of substance use frequency to both adherence to social distancing recommendations and social distancing intentions during the COVID-19 pandemic, as well as the role of social distancing self-efficacy in these relations. A U.S. community sample of 377 adults completed a prospective online study, including an initial assessment between March 27 and April 5, 2020, and a follow-up assessment one-month later. Results revealed a significant direct relation of baseline substance use frequency to lower adherence to social distancing recommendations one-month later. Results also revealed significant indirect relations of greater substance use frequency to lower levels of both social distancing behaviors and intentions one-month later through lower social distancing self-efficacy. Results highlight the relevance of substance use and social distancing self-efficacy to lower adherence to social distancing during the COVID-19 pandemic.

34926 Dermatology education for medical students in the era of COVID-19

Online dermatology education has been around for years, but the COVID-19 pandemic has significantly increased dependence on it. With the recommendations for social distancing, medical school curriculum has adjusted to keep education virtual and distanced, yet effective. Herein, we discuss the various modifications that have been made to medical student education to continue delivering dermatology education along with patient exposure and faculty interaction. To quantify the availability and method of virtual education adaptations for medical students, we reviewed 140 ACGME accredited dermatology residency program websites.

Characterizing Ride-Hailing Driver Attrition and Supply in the City of Chicago Through the COVID-19 Pandemic

The flexible nature of on-demand ride services provided by transportation network companies (TNC) has resulted in unique supply-side challenges as the industry deals with the COVID-19 pandemic. Early during the pandemic, there was a 70% decrease in the number of drivers accepting trips on TNC platforms, as individual drivers chose to reduce their risk of viral infection and abide by social distancing recommendations. Given the two-sided market nature of TNCs, the decrease was also the effect of reduced rider demand creating a less desirable driver experience. This paper characterizes and quantifies this change in supply as it relates to driver residency, tenure, attrition, and the number of trips provided. The distribution of drivers accepting trips shifted slightly toward the lower income and higher minority areas of Chicago. Using survival analysis methods, we find that retention among drivers who started in the early months of the pandemic was significantly lower than in reference years, after six months of driving. The results of the negative binomial regression show that drivers on a single TNC platform provided 20% less trips than drivers on multiple platforms. This difference increases to 30% during the pandemic. Additionally, new drivers joined multiple apps during COVID-19, likely to serve more trips and secure higher income. The results of this paper can be used to understand and target driver retention to accelerate the recovery of the TNC industry.

A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19.

BackgroundThis article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household.MethodsWe used a regression discontinuity design—in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39–79 years) and national register data (age range: 39–100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)—to estimate the effects of the policy.ResultsOur primary analyses showed a sharp drop in the weekly number of visits to crowded places (−13%) and severe COVID-19 cases (−16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800–2700 severe COVID-19 cases, depending on model specification.ConclusionsIt seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.

Impact of the COVID-19 Pandemic on Incidence of Asthma Exacerbations and Hospitalizations in US Subspecialist-Treated Patients with Severe Asthma: Results from the CHRONICLE Study.

PurposePatients with severe asthma (SA) are at an increased risk of asthma-related hospitalizations and exacerbations. Despite concerns that COVID-19 circulation would increase exacerbations of SA, anecdotal reports suggest that social distancing and exposure avoidance may have led to reduced exacerbations.Patients and methodsCHRONICLE is an ongoing noninterventional observational study of 3100 subspecialist-treated patients with SA. Eligible adults (≥ 18 years of age) have (1) current use of monoclonal antibody (ie, biologic) therapy for SA, (2) use of maintenance systemic corticosteroids (mSCS) or other systemic immunosuppressants for ≥ 50% of the prior 12 months for SA, or (3) persistently uncontrolled asthma while treated with high-dosage inhaled corticosteroids with additional controllers. For enrolled patients, electronic medical records were reviewed to record all exacerbations and asthma-related hospitalizations. Descriptive analyses were conducted of the monthly incidence of exacerbations, exacerbation-related visits to the emergency department (ED), and asthma hospitalizations from July 2018 through July 2021.ResultsExacerbations, exacerbation-related ED visits, and hospitalizations decreased since April 2020. Exacerbations in 2020 were 20% to 52% lower in April through August relative to the same months in 2019. Exacerbations remained lower than the prior year through May 2021. Similar results were observed by United States (US) census region, with an earlier decrease in exacerbation rates in the western US versus other regions. Across all months, exacerbation rates were lower among biologic recipients.ConclusionIn a clinical cohort of subspecialist-treated patients with SA, there was a meaningful reduction in exacerbations, exacerbation-related ED visits, and asthma hospitalizations following COVID-19–related stay-at-home orders and social distancing recommendations. Reasons for these reductions are likely multifactorial, including reduced viral infections due to less social contact and altered patient behavior.

Implementation of Virtual Preoperative Evaluation During a Pandemic

<h3>Background Information</h3> Preadmission testing visits have historically been in-person and or via phone calls facilitated by nurse practitioners and registered nurses. Due to the pandemic, a change in process was required to address national and state social distancing recommendations. Project was conducted at a 171-bed community teaching hospital in the Northeast United States. <h3>Objectives of Project</h3> To implement a smooth transition from onsite preoperative evaluations via phone or in-person visit, to 100% virtual visit. <h3>Process of Implementation</h3> In October of 2020 the interdisciplinary leadership and Chief NP made the decision that all permanent RN staff would work from home and that all NP visits would become virtual. The Chief NP and Project Manager collaborated and created a Microsoft Teams account, revised paper resources, and uploaded them so that staff could access electronically. The Telecommunications team transferred existing telephone numbers and linked them with hospital provided laptops, head- sets and Jabber accounts for RN staff. They also provided cameras for the desktops utilized by the NPs. The Clinical Business Analysis team updated and created new appointment types to facilitate phone screens. The Chief NP updated the After Visit Summary which included, Covid screening, visitor restrictions and safe patient commitment. Education was provided to all staff regarding the change in process and available updated resources by the Chief NP and one staff NP. <h3>Statement of Successful Practice</h3> In November 2020 100% of all preoperative visits became remote or virtual. Staff are utilizing a messaging app for internal communication to communicate patient concerns, inquire with clinical questions, scheduling changes. Positive feedback from nursing staff regarding new process. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> High satisfaction and safety for patients and clinicians are the driving force behind these visits. To aid in addressing the long-standing concerns surrounding location and availability, telehealth provides greater flexibility to both patients and clinician while closing the service gap. Having local resources more broadly available via a common online resource, provides the clinician access to the most current clinical information while integrating care efforts that improve health outcomes.