Strict Social Distancing Measures Research Articles

P047 Mortality in patients with rheumatic disease over a three year period encompassing the COVID-19 pandemic: clinically extremely vulnerable status and short form 12 scores are predictive

Abstract Background/Aims In the United Kingdom (UK), to combat the coronavirus disease 2019 (COVID-19) pandemic, social distancing measures were implemented to varying degrees between March-2020 and December-2021. UK policy deemed patients with rheumatic disease (RD) at higher risk from COVID-19 and many were categorised as ‘clinically extremely vulnerable’ (CEV), these patients were required to follow more stringent social distancing measures. Social isolation and loneliness are implicated as predictors of mortality; the impact of these strict social distancing measures in patients with RD on mortality is unknown. In addition, Health related quality of life (HRQoL) measures provide useful insights into a patients physical and mental wellbeing. HRQoL is recognised as an important measure of health outcomes and there is limited evidence suggesting HRQoL measures such as the Health Assessment Questionnaire (HAQ) and the Short Form-36 questionnaire (SF-36) are associated with mortality in patients with rheumatoid arthritis. The predictive value of the SF-12 (a validated, shortened version of the SF-36) in RD patient’s mortality is unknown. In this UK-based, observational cohort study we evaluated the impact of stricter social distancing measures during the pandemic on 3-year mortality and assessed the utility of the SF-12 in predicting mortality in patients with RD. Methods We distributed a web-based survey via a linked mobile-phone SMS message, to all rheumatology patients, with a validated mobile number, under follow-up at the Royal Wolverhampton Trust, April-2020. We collected demographics, CEV status, and Short Form-12 mental (MCS) and physical health component scores (PCS) for health-related quality of life. Mortality was audited July-2023. Data were analysed using SPSS version 26 and R. Results There were 7,911 active follow up patients with linked mobile numbers. Survey responses were received from 1605 (20%); responders were female (69%), white (94%), CEV (47%), had a mean age of 61years, and most had autoimmune rheumatic disease (78%). Of the responders, 58 (4%) had died by July-2023 - compared to the alive group these patients had significantly worse MCS (p < 0.001) and PCS (p = 0.004) at baseline; significantly more in those that had died were CEV (p < 0.001), and older (p < 0.001), while gender, ethnicity, and diagnosis did not differ. Conclusion These data demonstrate in a large cohort of patients with RD over a 3-year period those patients considered CEV, advised to follow more stringent social isolation measures were at significantly greater risk of death. Further, baseline SF-12 scores for both mental and physical components were lower in patients that died over a 3-year period. These data potentially highlight the utility of the SF-12 and assessing social isolation and loneliness in patients with RD to predict mortality. In addition, our methods demonstrate the merits of communicating with patients through SMS-messaging and can be used in delivering important health-care communications in future. Disclosure N. Cox: None. J. Bateman: None.

Variability in the serial interval of COVID-19 in South Korea: a comprehensive analysis of age and regional influences.

Quantifying the transmissibility over time, particularly by region and age, using parameters such as serial interval and time-varying reproduction number, helps in formulating targeted interventions. Moreover, considering the impact of geographical factors on transmission provides valuable insights into the effectiveness of control measures. Drawing on a comprehensive dataset of COVID-19 cases in South Korea, we analyzed transmission dynamics with a focus on age and regional variations. The dataset, compiled through the efforts of dedicated epidemiologists, includes information on symptom onset dates, enabling detailed investigations. The pandemic was divided into distinct phases, aligning with changes in policies, emergence of variants, and vaccination efforts. We analyzed various interventions such as social distancing, vaccination rates, school closures, and population density. Key parameters like serial interval, heatmaps, and time-varying reproduction numbers were used to quantify age and region-specific transmission trends. Analysis of transmission pairs within age groups highlighted the significant impact of school closure policies on the spread among individuals aged 0-19. This analysis also shed light on transmission dynamics within familial and educational settings. Changes in confirmed cases over time revealed a decrease in spread among individuals aged 65 and older, attributed to higher vaccination rates. Conversely, densely populated metropolitan areas experienced an increase in confirmed cases. Examination of time-varying reproduction numbers by region uncovered heterogeneity in transmission patterns, with regions implementing strict social distancing measures showing both increased confirmed cases and delayed spread, indicating the effectiveness of these policies. Our findings underscore the importance of evaluating and tailoring epidemic control policies based on key COVID-19 parameters. The analysis of social distancing measures, school closures, and vaccine impact provides valuable insights into controlling transmission. By quantifying the impact of these interventions on different age groups and regions, we contribute to the ongoing efforts to combat the COVID-19 pandemic effectively.

The role of interpersonal stressors and connectedness in acute suicide risk and the suicide crisis syndrome during the COVID-19 pandemic

BackgroundThe global COVID-19 pandemic rapidly and drastically impacted everyday life and relationships. Fear of contracting and spreading the virus brought governments and individuals to adopt strict social distancing measures. These changes have had a significant negative impact on mental health, including a suggested increase in suicidal behaviors. The present study examined the role of interpersonal stress and connectedness in suicidal ideation, deliberate self-harm, suicide attempts, and the suicide crisis syndrome during the COVID-19 pandemic. MethodsAn international sample of 7837 adult participants was recruited across ten participating countries to complete an anonymous online battery of self-report questionnaires. Questionnaires assessed suicide-related outcomes, stressful life events (SLE), and connectedness. Multilevel regression analyses were used to examine the associations between SLE and connectedness on suicide-related outcomes within the past month. ResultsInterpersonal SLEs and low connectedness were associated with an increased likelihood of suicide-related outcomes and increased severity of suicide crisis syndrome. Specifically, higher rates of SLEs and lower levels of connectedness were associated with more suicide-related outcomes. LimitationsThe use of a cross-sectional design and snowball sampling method may restrict the ability to establish causal relationships and limit the representativeness of the findings. ConclusionsOur findings suggest elevated suicide-related outcomes during the COVID-19 pandemic among individuals experiencing multiple interpersonal stressful life events and low connectedness with others. The circumstances of social life during the COVID-19 pandemic highlight the urgency of implementing preventive programs aimed at mitigating potential suicide risks that may arise in the aftermath of public stress situations.

The Impact of COVID-19 on Children and Adolescents with Chronic Illness.

Children and adolescents living with chronic illness may already be at a disadvantage when compared to their healthy peers in achieving developmental milestones as they are required to manage healthcare aspects of their condition in addition to the typical transitions associated with this developmental stage. The COVID-19 pandemic has significantly impacted on the physical and mental well-being of children and adolescents including those young people living with a chronic illness. Disruptions and delays of healthcare service provision, prolonged lockdowns, strict social distancing measures, and school closures are some of the pandemic implications that have affected daily routines imposing strains on young people themselves, but also on their caregivers. This chapter presents a critical elaboration on the available evidence documenting the unique impact of the pandemic at an individual-, family-, and system-level on children and adolescents aged up to 18years old living with a non-communicable disease (e.g., cancer, diabetes, asthma).

Characterizing load profile-based enterprise profiling under COVID-19 lockdown policy: A provincial case in China

The COVID-19 epidemic has led to devastating consequences worldwide due to strict social distancing measures, travel bans, city lockdowns, and other activity restrictions. Numerous lessons have been accumulated by various industries or sectors in the process of coping with COVID-19. In our paper, the actual electricity consumption of 1.145 million enterprises in a province of China is investigated in the normal period, the breakout period, and the recovery period. An artificial intelligence based enterprise profiling model is established to characterize power consumption profile geographically, temporally, and industrially. The recovery rate of enterprise power consumption is proposed as a key indicator representing the status of production resumption. Under lockdown measures, enterprise in different regions or sectors exhibits diversified responses in power consumption, the unsupervised learning model and the correlated coefficient extract the abstract characteristics and labels from various enterprise power profile. Ultimately, enterprises with similar electricity consumption characteristics are grouped and labeled to provide customized power services. Accurate enterprise profiling can effectively aid in facing with the challenges of insufficient orders, tight capital chains, and rising costs caused by the epidemic.

Rapid response redevelopment: a study of an English-to-Chinese translation course moving online

Abstract In early 2020, the tertiary sector in Australia, as in many other parts of the world, was confronted with a series of unforeseen challenges arising from the coronavirus epidemic. As governments responded to the crisis by implementing increasingly strict social distancing and isolation measures, universities had little choice but to adapt their courses for online delivery. The ensuing chaos and confusion prompted academics and support staff to adapt quickly to changing delivery while continuing to offer high-quality teaching and learning experiences. This mixed-methods study explores the approaches that were adopted in a translation course that moved fully online and examines students’ engagement with and evaluation of the new course design. The findings reveal that it is possible to maintain high levels of student satisfaction by ensuring a clearly structured course design in an online mode with interactive and engaging course materials. This has implications for university lecturers wishing to redesign courses in an online or blended format, especially under time pressure.

Speech acts and the communicative functions of emojis in LIHKG online discussion forum amid COVID-19.

Since the beginning of 2022, the Hong Kong government has imposed strict social distancing measures and changed its stance on various regional policies with the aim to contain the so-called 'fifth wave' of COVID-19. In these pandemic and 'infodemic' times filled with uncertainty and fear, Hong Kong netizens used local online discussion forums as a resource to establish an innovative form of 'helping network.' This study is based on 230 posts from a popular local online discussion forum 'LIHKG' in February 2022 when the pandemic was regarded as most critical by the Department of Health. Speech Acts theoretic approach was adopted to explore how forum users employed speech acts to perform various communicative practices such as expressing concerns, asking for information, and engaging with others in a CMC environment amid a global health crisis. Representatives were found to be the most dominant text-based speech acts, followed by directives, expressives and commissives. Speech acts provide forum users a context in which emoji usage occurs. Forum users not only make use of words to 'do' things in the online self-help forum, but they also employ emojis to either supplement or complement speech acts. This study also shows that emojis perform multiple functions in the discussion posts and argues that they do not merely function as emotion indicators of their textual company, but also carry significant pragmatic meanings by illustrating how they can also carry illocutionary force and in some cases, even alter the illocutionary force of their preceding texts. The findings of this study enhance our understanding of how forum users communicate via verbal and nonverbal means within the underexplored 'helping domain' of online discussion forums. It also suggests that online discussion forum interactions need to be approached differently than other better understood alternatives.

Tightened social distancing measures and increased violence during the COVID-19 pandemic in South Korea.

In 2020, the South Korean government introduced social distancing measures, varied by region, to address the pandemic. We captured variations in social distancing measures among regions in South Korea and investigated the association between the stringency of measures and the increased incidence of violence. Incidence reports from calls to violence hotlines, including school and domestic violence and sexual harassment, from 2016 to 2021 were retrieved. The regional per capita incidence rates for each violence hotlines were calculated. Difference-in-difference design with fixed effects was used to elucidate different trends in the incidence rate of violence between regions with stringent social distancing measures and regions with looser measures. Social distancing measures led to a decreased incidence rate of school violence and an increased incidence rate of domestic violence and sexual harassment. Different trends in the incidence of violence were noted between regions with strict social distancing measures and regions with more lenient measures. Tightened measures caused surges in domestic violence and sexual harassment. Social distancing measures have been an inevitable mitigation strategy against virus transmission throughout the pandemic. However, women residing in tightened social distancing measures, in particular urban areas, need more support against domestic violence.

A Large-Scale Study of Students’ E-Service-Learning Experiences and Outcomes During the Pandemic

Background: The COVID-19 pandemic resulted in strict social distancing and lockdown measures to contain the spread of the disease. These measures significantly impacted experiential pedagogies, including service-learning. Many teachers pivoted to e-service-learning. While past literature suggests that e-service-learning is as, or even more effective than, traditional service-learning, there are few large-scale comparative studies that support this claim. Purpose: Our study fills the research gap via a large-scale study into student e-service-learning experiences and outcomes during COVID-19. Methodology/Approach: The study examines learning outcomes of students taking e-service-learning subjects during the early stage of the pandemic, i.e., the 2020/21 academic year, in a Hong Kong university, and compares their learning experiences and gains with a similar group of students who studied the same subjects from 2014/15 to 2018/19. Findings/Conclusions: Results indicate that while e-service-learning is effective in enhancing students’ cognitive and civic learning, it is less effective than traditional service-learning in facilitating civic learning outcomes. Implications: Investigating students’ learning experiences suggests that the quality of reflection and interaction with the community, which are critical learning experience components, may have been impacted by online communication. These factors may have played a key role in influencing the effectiveness of e-service-learning compared to traditional service-learning.

Mild COVID-19 outcomes in adults with inborn errors of immunity: a single-center experience

Currently, 640 million cases of coronavirus disease 2019 (COVID-19) and 6.6 million deaths have been reported world-wide. Risk factors for severe COVID-19 are known, including those with compromised immunity. Among patients with inborn errors of immunity (IEI), early reports of severe outcomes lead to strict masking and social distancing measures. While this resulted in relatively low infection rates among those with IEI, real-world data describing the clinical course of COVID-19 in this patient population have remained limited. We performed a retrospective study of adult IEI patients followed by our center in which a positive test (rapid antigen or PCR) for COVID-19 was determined between November 2021-November 2022. Medical charts were reviewed, and patient interviews conducted. All patients provided informed consent. Twenty-nine patients were enrolled (22 females, 7 males), aged between 18–69 years (median: 20–29 years). The cohort included those with antibody deficiencies (41.37%), combined immunodeficiencies (34.48%; HIES, CARD11, STAT1-GOF), immune dysregulation disorders (20.69%; LRBA deficiency, AIRE deficiency) and phagocyte defect (3.45%; CGD). The duration of symptoms ranged between 3 days-4 weeks (median: < 1 week). Upper respiratory symptoms (including sore throat, congestion) were reported in 97% while fever was present in 41% of patients. Prior to infection, 14 (48%) patients had underlying asthma or bronchiectasis - 2 subsequently experienced shortness of breath and were treated with inhalers or Sotrovimab, respectively. No treatment was required in 65.5% of cases. The remaining received Paxlovid (10.3%), Sotrovimab (13.79%), or antibiotics (10.3%). Of the 2 patients with STAT1-GOF, one tested positive during a repeat episode of febrile neutropenia which required hospitalization. No other patients were hospitalized or needed ICU admission. No deaths were recorded. In light of these favourable outcomes, patients with IEI can gradually and safely return to normal activities.

Who can work from home in MENA?

ABSTRACT The COVID-19 pandemic has had a profound impact on the world economy. The need for social distancing, lockdowns, or complete curfews has meant that this impact varied significantly across segments of society. Those unable to work remotely, or who work in settings necessitating close contact with others faced a trade-off between their lives and livelihoods. This trade-off was especially pronounced early on during the pandemic when vaccines had not yet been developed, hospitals were overwhelmed and governments were resorting to strict social distancing measures to mitigate the impact on their already strained healthcare systems. In this study, I examine the extent to which jobs can be successfully performed remotely in five MENA countries: Algeria, Egypt, Jordan, Palestine and Tunisia. I develop a teleworkability index using micro data on occupational characteristics. I find that relatively few jobs in MENA countries are compatible with teleworking and this share varies considerably by industry, gender, age and the formality of employment. I further investigate the ability to work from home in practice by considering the digital divide (a lack of reliable access to vital tools for teleworking, such as a personal computer and reliable internet access) as well as actual work from home behavior during the pandemic using real time surveys. I find that even for those who have high telework potential only few have access to computer and internet. Surveys conducted during the pandemic suggest that our measure of teleworkability was quite close to actual work from home behavior in each country.

The COVID-19 pandemic's impact on mental health care use among Norwegian students in higher education: a nation-wide register-based pre-post cohort study.

The COVID-19 pandemic, and its associated social distancing measures, gave profound changes to the everyday and academic life of students in higher education. The current study is the first to use nation-wide data to evaluate the long-term effect of the pandemic and its countermeasures on university students' mental health care use. Using nation-wide individual-level data, we studied mental health consultations in primary care (data available from January 2017 to February 2022) and dispensed prescription drugs used to treat anxiety, depression, and sleep disturbances (data available from October 2018 to February 2021) for first-year undergraduate university students. We compared changes over time in mental health care use in a pandemic cohort (12,501 first-year students enrolled in 2019) to the same change in a pre-pandemic cohort (25,990 first-year students enrolled in 2017 and 2018). Event study and difference-in-difference models allowed us to separate the impact of the pandemic, experienced by the pandemic cohort only, from secular and seasonal changes experienced by all cohorts. The percentage of students with a mental health consultation temporarily decreased during the first period of strict social distancing measures in March 2020. At the end of the second round with strict measures in April 2021, the level of mental health consultations increased by 73% (95% CI 40-106.3). There was also a 42% (95% CI 5.7-79.5) increase in mental health consultations in November 2021. No similar increases were observed for dispensed prescription drugs between March 2020 and February 2021. The COVID-19 pandemic was associated with increases in mental health consultations in primary care among students, especially during/after longer periods of strict social distancing measures. The benefits of social distancing measures in future pandemic preparedness should be weighed against the cost of potentially worsening mental health in vulnerable groups.

The Impact of First UK-Wide Lockdown (March–June 2020) on Sexual Behaviors in Men and Gender Diverse People Who Have Sex with Men During the COVID-19 Pandemic: A Cross-Sectional Survey

The global COVID-19 pandemic resulted in strict social distancing measures restricting close physical contact. Men (cis and trans) and other gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs) and may have experienced changes in sexual behavior during government restrictions on social and sexual contact. We aimed to examine self-reported sexual behavior of MGDSM during the first UK-wide lockdown to identify the characteristics of the individuals who might most require sexual health promotion and clinical support. In April–May 2020, we conducted an online survey of MGDSM, promoted on social media and Grindr. Our exploratory approach used descriptive analysis to identify self-reported changes in sexual behavior and performed regression analyses to identify correlates of casual sex during the lockdown. A total of 1429 respondents completed the survey: mean age 36 years, 84% White, 97% male or trans male, 98% assigned male sex at birth, 2% female or non-binary, 65% degree educated or higher. During the lockdown, 76% reported not having any casual sex partners. While the majority reported reduced casual sex, 3% reported an increase in casual sex with one person and 2% with three or more people (group sex). About 12% of the sample engaged in casual sex with only one person and 5% with four or more sexual partners during the lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR = 2.37 [95% CI 1.40–4.01]; identifying as a member of an ethnic minority OR = 2.27[1.40–3.53]; daily usage of sexual networking apps OR = 2.24[1.54–3.25]; being less anxious about contracting SARS-CoV-2 through sex OR = 1.66[1.12–2.44]; using PrEP before lockdown OR = 1.75[1.20–2.56]; continuing to use PrEP OR = 2.79[1.76–4.57]; and testing for STIs during lockdown OR = 2.65[1.76–3.99]. A quarter of respondents remained sexually active with casual partners, indicating a need to provide STI screening services and health promotion targeted to groups most likely to have need over this period. Future research is required to better understand how to support sexual and gender minorities to manage sexual risk in the context of pandemic public health initiatives.

Impact of the COVID-19 pandemic on the severity and management of acute appendicitis.

BackgroundThe literature seems to indicate that the number of appendectomies dropped at the beginning of the coronavirus disease in 2019 (COVID-19 pandemic), while the number of complicated appendicitis increased due to late presentation. In addition, a longer delay before surgical treatment resulted in a higher morbidity. This study aims to compare the number of appendectomies, the severity, and the management of acute appendicitis during the first two pandemic peaks of COVID-19 with those observed during the same seasonal periods in the previous 2 years in a regional hospital in Switzerland.MethodsWe retrospectively reviewed and compared the number of appendectomies, rate of complicated appendicitis, delay to consultation and to surgery, distribution of appendectomies over a 24-h schedule, postoperative outcomes, and rates of overall complications in 177 patients, that is, 66 during the COVID-19 pandemic and 111 before the pandemic.ResultsNo statistical difference was found in the number of appendectomies, duration of symptoms before consultation, median time to surgery, number of appendectomies performed outside the usual scheduled time for non-urgent surgery, length of postoperative stay, or the rates of overall complications. However, there was a trend in the rate of complicated appendicitis (p = .05).ConclusionIn spite of a high incidence rate of COVID-19 in our canton, the impact of COVID-19 on our population did not follow the pattern observed elsewhere. The reasons for this might be that people would still present to the emergency department due to less strict social distancing measures. Great availability of emergency operating room may also account for the unchanged delay preceding surgical treatment and complication rates.

Strict social distancing measures helped early control of SARS-CoV-2 spread in Duhok city, Iraq.

The aim of this letter is to discuss the pandemic management measures, including social distancing and community containment, taken in Duhok city in Northern Iraq, where a few patients were infected with COVID-19. During the first three months of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, 15 patients were diagnosed with SARS-CoV-2 in Duhok city. All the patients were asymptomatic and were discharged to their home within 10 ± 3.2 days after throat swabs indicated a negative SARS-CoV-2 Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test. The social distancing and lockdown measures taken by the city were implemented in three stages. In the first stage, all educational institutions including schools, colleges and universities were closed. In the second stage, all gatherings were banned. Finally, state-imposed community-wide containment was declared. The social distancing measures helped control infections in the city. Gradual reopening is recommended to avoid the spread of infection.

Psychosocial Intervention in Response to COVID-19 Pandemic in Sarawak

In the wake of the COVID-19 pandemic, the world has been anticipating a greater need for mental health and psychosocial support with the rise in mental health issues when facing many struggles and uncertainties, testing the limits of our current health care system. In this paper, we aim to present a general view of the psychosocial support implemented in Sarawak during the COVID-19 pandemic from the lens of different socio-ecological systems in Sarawak which include the healthcare system, community organizations, and the policy makers. Firstly, this paper provides an overview of the COVID-19 situation in Sarawak in general for the past year. Worth to mention, Sarawak was the first state in Malaysia recorded fatality case resulted from COVID-19 and this inevitably triggered strong negative emotional response during the initial stage of the pandemic. Secondly, the combined efforts initiated by the local state government, the state health departments, several general hospitals and major health clinics were addressed. The delivery of health care service had to be modified according to the strict preventive and social distancing measures recommended by the public health system, including the shift of conventional service to the provision of tele-counselling and psychological first aid. Also, the COVID-19 pandemic and its impact on mental health has brought the politicians’ attention. Lastly, the challenges faced in dealing with the mental health services during the COVID-19 pandemic and the potential paths of the mental health movement were discussed.

The COVID-19 Pandemic and Sexual Debut Among South Korean Adolescents

Objective: This study assesses the impact of the SARS-CoV-2 (COVID-19) pandemic on the first time Korean adolescents have sex. Methods: The study examines 2017–2021 data from an annual, cross-sectional survey. Results: There is a significant drop in the percentages of male adolescents initiating sexual intercourse in 2020 and noticeable rebounds in 2021. However, the sexual debut among female students shows no significant change. Conclusions: We suggest that strict social distancing measures in 2020 and loosening of them in 2021, different orientations toward having sex by gender, and a strong sexual double standard are responsible for these findings.

Dietary Habits and Lifestyle Behaviors of Saudi Residents during the COVID-19 Pandemic: A Cross-Sectional Study.

Coronavirus disease 2019 (COVID-19) has continued to spread rapidly worldwide, forcing countries to enact lockdowns and strict social-distancing measures that affect individual and population health. This study investigates the changes in dietary habits and lifestyle behaviors among Saudi residents during the COVID-19 pandemic. A cross-sectional survey was conducted on 786 participants, with a mean age of 30 years. The questionnaire was administered online and sent via social media applications. Dietary habits, physical activity, TV-watching time, sleep patterns, stressors, and socio-demographic data were evaluated. Among the survey respondents, there was an increase in weight gain, food consumption, and decreased physical activity. Respondents who gained weight consumed more snacks, ate larger food portions, and engaged in less physical activity. Furthermore, a high fish, water, and supplements intake was noticed. Although respondents’ intake of fruits and vegetables was low, most individuals reported a negatively changed intake. However, most respondents reported increased consumption of lean meat and sweet foods. Observing changes in dietary and lifestyle habits during the lockdown period may help elaborate on the pandemic’s consequences for population health and assist in formulating and implementing policies for future closures, while supporting vulnerable groups.

The Negative Impact of Routine, Dietary Pattern, and Physical Activity on Obesity and Dysglycemia During the COVID-19 Pandemic.

The global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, has disrupted routines in education, work, exercise, and dining habits. To prevent viral spread, communal spaces including offices, schools, restaurants, and gyms have closed or drastically limited their capacity. Additionally, government-mandated lockdown orders have forced people to spend more time at home. Studies have shown that these COVID-19 restrictions have led to unhealthier eating patterns, increased sedentary behaviors, and decreased physical activity, leading to weight gain, dysglycemia, and increased metabolic risk. While strict social distancing measures have been necessary to curb the spread of the SARS-CoV-2 virus, people have been forced to adapt by altering their daily routines. Based on existing literature, a model is proposed for intentionally creating daily routines to ensure healthy habits, minimize weight gain, and prevent worsening dysglycemia.

How Did the COVID-19 Pandemic Affect the Use of Emergency Medical Services by Patients Experiencing Mental Health Crises?

The COVID-19 pandemic and its resulting social restrictions have significant implications for mental health. The objective of this study was to determine the monthly trends and types of patients experiencing a mental health crisis (MHC) who used emergency medical services (EMSs) before and during the COVID-19 pandemic. A retrospective observational study was conducted using EMS data. During the study period, 8577 patients used EMSs for MHCs. EMS dispatches for MHCs and suicide completion after the COVID-19 pandemic were decreased by 12.4% and 12.7%, respectively, compared to those before the COVID-19 pandemic. Segmented regression analysis found that the number of patients per month was 6.79 before the COVID-19 pandemic. The number decreased to 4.52 patients per month during the COVID-19 pandemic, although the decrease was not statistically significant. The monthly number of patients experiencing an MHC decreased during strict social distancing measures but increased during relaxed social distancing measures. The percentage of hanging increased from 14.20% before the COVID-19 pandemic to 14.30% (p = 0.03) during the COVID-19 pandemic, whereas the percentages of jumping (from 15.55% to 15.28%, p = 0.01) and self-harm by smoke (from 4.59% to 3.84%, p < 0.001) during the COVID-19 pandemic were decreased compared to those before COVID-19. However, the effect size for the above findings was small (below 0.20). More than 25% of the patients experiencing an MHC who used EMSs refused to transfer to the ED over both study periods (26.49% in the pre-COVID-19 period and 28.53% in the COVID-19 period). The COVID-19 pandemic and social restrictions seemed to have some effects on the use of EMSs by MHC patients. Hanging is mainly performed indoors and is not found easily if social distancing persists, and a patient experiencing an MHC who refuses to be transferred could potentially attempt suicide. Subsequent studies should be performed to determine whether these findings are temporary during the COVID-19 pandemic or whether they will show different aspects after the COVID-19 pandemic.