Week Of April Research Articles

B.1.617.2 variant and increasing surge of COVID-19 in Nepal

As the coronavirus disease 2019 (COVID-19) pandemic goes on, there has been an evolution of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) leading to the mutations. As of May 2021, the B.1.617 variant has become the dominant strain across India and has spread to about 40 nations. Among different strains of B.1.617, the mutations of great concern are E484Q, L452R, P681R and T478K, because of the stronger affinity of the spike protein of these mutants for the Angiotensin Converting Enzyme (ACE) 2 receptor making it more transmissible and infectious, and causing decreased recognition capability of the immune system. Among the sub-variants of B.1.617, the B.1.617.3 shares the L452R and E484Q mutations found in B.1.617.1, whereas B.1.617.2 does not have the mutation E484Q, but it has the T478K mutation, not found in B.1.617.1 and B.1.617.3. With the increasing surge of COVID-19 in India with dominant B.1.617.2 variant, Nepal also witnessed the parallel increasing number of COVID-19 cases starting from the early weeks of April 2021, which could have been triggered by the influx of people due to the long open border of Nepal with neighboring India. Obviously, as of May 2021, the second wave of COVID-19 in Nepal has been linked with this new variant B.1.617.2 of SARS-CoV-2. Despite the challenges imposed by the new variant, the vaccines are likely to remain effective against different variants including B.1.617.2 and to limit severe disease. Moreover, there is an urgent need of an effective locally based system for the testing, contact tracing, and isolation. The risk reduction behavior, such as washing hands frequently, keeping at least 1m distance from others and wearing a mask, should be adapted to the daily habits during this COVID-19 pandemic era. There should be a long term planning for the control of COVID-19 with the effective vaccination and public health measures; otherwise, even after the control of the current surge, the next wave of COVID-19 might be knocking at door in the coming days.

Effect of COVID-19 pandemic-induced lockdown (general holiday) on air quality of Dhaka City.

A worldwide pandemic of COVID-19 has forced the Government of Bangladesh to implement a lockdown during April–May 2020 by restricting people’s movement; shutdown of industries and motor vehicles; and closing markets, public places, and schools to contain the virus. This type of strict measures caused an outcome, the reduction of urban air pollution, around the world. The present study aims to investigate the reduction of the concentration of pollutants in the air of Dhaka City and the reduction of the Air Quality Index (AQI). Necessary time-series data of the concentration of PM2.5, NO2, SO2, and CO have been collected from the archive of the Air Quality Monitoring Station of the US Embassy in Dhaka and Sentinel-5P. The time-series data have been analyzed by descriptive statistics, and AQI was calculated following an appropriate formula suggested by the Environmental Protection Agency (EPA) based on the criteria pollutants. The study found that the concentrations of PM2.5, NO2, SO2, and CO during April–May 2020 have been reduced by 26, 30, 07, and 07%, respectively, compared with the preceding year’s concentrations. Moreover, the AQI has also been reduced by about 35% on average during the lockdown period than the same times of the previous year. However, the magnitude of pollution reduction in Dhaka is lower than in other cities and countries globally, including Delhi, Sao Paulo, Wuhan, Spain, Italy, the USA. The main reasons may include, among others, the poor implementation of lockdown (especially in the first week of April and the second fortnight of May), pre-existing pollution, transboundary pollution, incineration of solid waste, etc. This study will help policymakers figure out how to regulate pollution sources and improve the air quality of Dhaka.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10661-021-09120-z.

The identifiable victim effect and public opinion toward immigration; a natural experiment study

The 2010s migrant crisis cost the lives of many immigrants on their way to Europe. In 2015 alone, about 3,800 immigrants and refugees died trying to cross the Mediterranean Sea on board of large vessels or small floating boats. Among those tragic incidents, two specific occurrences are investigated here: over the course of a week in April 2015, about 1,200 people drowned in two consecutive events after their boats capsized in the Mediterranean Sea. Later that year, on September 2nd, Alan Kurdi, a 3-year-old Syrian boy, tragically drowned. We used these two incidents to investigate the “identifiable victim effect” on public opinion toward immigrants using a natural experiment framework, based on the timing of the European Social Survey in Portugal. Results showed that the tragic drowning of an identified child can affect a change in public sentiment, in contrast to the drowning of more than a thousand statistical victims. We also examined the temporal pattern and duration of the effect on public sentiment, and found that the impact of Alan Kurdi's death lasted for a little over a month and significantly abated, with public sentiment returning to the same level of opposition to immigration as before the incident.

The Impact of COVID-19 on Heart Transplantations and Waitlist Additions in the United States.

The Impact of COVID-19 on Heart Transplantations and Waitlist Additions in the United States.

Indian Covid Crisis

India is going through its second surge of COVID-19 pandemic caught off-guard, after it declared rather publicly that India had vanquished the enemy in September 2020. In the last 2 weeks of April 2021, India has beaten several world records for new cases and deaths by official estimates. The real numbers are likely to much higher as the testing and reporting infrastructure remains in shambles. The triple whammy of mass gatherings, lack of administrative and infrastructure preparedness and low vaccination is probably to blame.
 The humanitarian catastrophe that is played out so visually in heart-wrenching stories across the interconnected digital world is of scrambling for oxygen, scarcity of hospital beds, lack of medication and the incessant burying or cremating of the dead. The desperation in the eyes of the people as they queue outside of locked hospital gates, the oxygen cylinders supplying minutes of life to patients in cars or auto-rickshaws as they wait is heartbreaking. For members of the Indian diaspora, these pictures hurt deep and one is bound to feel helpless.
 Yet through all this, there is hope. The Gurudwara’s with their oxygen langars, the elderly vacating beds for the younger and often sicker patients, the journalists who are using every social media access to request essential oxygen and drugs, the volunteers who ferry, bury and burn the abandoned dead are testimony of the good that exists in humanity. The world is rising to the call of India including efforts by the Indian diaspora. There are lessons to be learnt but first, let us help and heal.

A general framework of covid-19 model with control strategies: the application of large-scale social restrictions, self-quarantine, and immune system improvement in Surabaya, Indonesia

A covid-19 is a virus disease of worldwide importance which spread not only in a small country such as Mongolia but also in a large country like the United State. It is caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and well known as droplet-borne disease. The droplets containing coronavirus are spread through the air within a meter and deposited on the mucous membranes of suscpetible person. The aim of this study was to produce a general framework model of corona virus disease with the application of large-scale social restriction, self-quarantine and immune system improvement as control strategies to reduce the spread of the disease. This study was conducted in Surabaya, Indonesia with a total of 299 positive patients infected with covid-19 until the fourth week of April, 2020. The transmission routes of the disease had been constructed based on the real problem. Therefore, human population have been divided into some sub-population based on the characteritics of disease symptoms. The spread of covid-19 have been formulated mathematically by using compartment model. Stability analysis had been done for a free disease equilbrium and an endemic equilibrium. Moreover, numerical simulation were also provided to quantify the disease dynamics.

COVID-19 in Iran: What was done and what should be done.

The current COVID-19 pandemic started in Wuhan, China, in December 2019. The World health Organization (WHO) declared the COVID-19 as a public health emergency of international concern on January 30, 2020, and recognized the situation as a pandemic on March 11, 2020. Around 135 million confirmed cases and around 2.9 million deaths until the first week of April 2021 have been among its direct impacts on human health. All countries have been affected in different degrees, and each of them has used different strategies to protect themselves against health and nonhealth consequences of this epidemic. Although all approaches are full of mistakes with fatal and painful results, some of them were successful in limiting the epidemic. One of the astonishing improvements is development of several vaccines in a relatively short period of time, which has increased hopes for epidemic control. This review aims to critically appraise the strategies for COVID-19 epidemic control in Iran since the beginning of the disease until the fourth peak of disease in March 2021.

Patterns of Phenological Characteristics of Important Tree Species of Kumaun Himalaya

Phenology is one of the simplest and most effective study to understanding the role of climate change in recent scenario. A number of biotic and abiotic drivers controlled the timing and duration of various phenophases in same or different species. Temperature, rainfall and photoperiod are key drivers which adversely affect the phenology of woody plant. The study sites were conductedat 413 and 2345m elevation in Nainital forest division of Kumaun Himalaya. The phenological study were carried out onShores robusta, Mallotus philippinensis, Pinus roxburghii, Myrica esculenta,Quercus leucotrichophora and Rhododendron arboreum. The phenological observations were made at 15 days interval for low activity period and weekly in the periods of high activity. Phenological records were made for four phenophases, viz., leafing, leaf drop, flowering and seed fall.The leaf fall in S. robusta started from March 2nd week and was complete by the end of April. In M. philippinensis the fruiting commenced from the beginning of December and seed fall was complete by the 3rd week of April. In M. esculenta male flowers appear from August end and flowering was complete by October end.In R. arboreum seed dispersal started from February end and all the capsules had opened by mid-March. It is apparent from the present study that the phenological events of species controlled/shifted due to climatic irregularities and temperaturerise and these phenomena showed worldwide. Microclimatic condition alsoresponsible for controlling/shifting the phenological patterns of same or different species.

A Simulation Model for Forecasting COVID-19 Pandemic Spread: Analytical Results Based on the Current Saudi COVID-19 Data

The coronavirus pandemic (COVID-19) spreads worldwide during the first half of 2020. As is the case for all countries, the Kingdom of Saudi Arabia (KSA), where the number of reported cases reached more than 392 K in the first week of April 2021, was heavily affected by this pandemic. In this study, we introduce a new simulation model to examine the pandemic evolution in two major cities in KSA, namely, Riyadh (the capital city) and Jeddah (the second-largest city). Consequently, this study estimates and predicts the number of cases infected with COVID-19 in the upcoming months. The major advantage of this model is that it is based on real data for KSA, which makes it more realistic. Furthermore, this paper examines the parameters used to understand better and more accurately predict the shape of the infection curve, particularly in KSA. The obtained results show the importance of several parameters in reducing the pandemic spread: the infection rate, the social distance, and the walking distance of individuals. Through this work, we try to raise the awareness of the public and officials about the seriousness of future pandemic waves. In addition, we analyze the current data of the infected cases in KSA using a novel Gaussian curve fitting method. The results show that the expected pandemic curve is flattening, which is recorded in real data of infection. We also propose a new method to predict the new cases. The experimental results on KSA’s updated cases reveal that the proposed method outperforms some current prediction techniques, and therefore, it is more efficient in fighting possible future pandemics.

No Choice but to Be Essential: Expanding Dimensions of Precarity During COVID-19

Under COVID-19, low-wage service sector workers found themselves as essential workers vulnerable to intensified precarity. Based on in-depth interviews with a sample of 52 low-wage service workers interviewed first in Summer 2019 and then in the last two weeks of April 2020, we argue that COVID-19 has created new and heightened dimensions of precarity for low-wage workers. They experience (1) moments of what we call precarious stability, in which an increase in hours and predictable schedules is accompanied by unpredictability in the tasks workers are assigned, (2) increased threats to bodily integrity, and (3) experiences of fear and anxiety as background conditions of work and intensified emotional labor. The impacts of COVID-19 on workers’ lives warrant an expanded conceptualization of precarity that captures the dynamic and shifting nature of precarious stability and must incorporate workers’ limited control over their bodily integrity and emotions as core components of precarious working conditions.

Quantifying the Resilience of the U.S. Domestic Aviation Network During the COVID-19 Pandemic

This paper analyzes the impacts of COVID-19 pandemic on the United States air transportation network between March and August 2020. Despite dramatic reductions in flight and passenger volumes, the network remained robust and resilient against perturbation. Although 24% of airports closed, the reduction in network efficiency was only 5.1%, which means airlines continued to serve most destinations. A deeper analysis of airport closures reveals that 1) small peripheral airports were the most likely to be closed; 2) socio-economic and epidemiological factors characterizing the airport’s region such as income, income inequality, political leaning, and the number of observed COVID cases were not predictive of airport closure. Finally, we show that high network robustness has a downside: although emissions from United States air traffic in 2020 fell by 37.4% compared to 2019, mostly due to the drop in the number of flights, emissions per passenger doubled in the period April to August 2020 and increased eightfold in the week of April 5–11. This rise indicates inefficient use of resources by airlines.

Olive leaf extract effect on cardiometabolic profile among adults with prehypertension and hypertension: a systematic review and meta-analysis.

BackgroundThis systematic review and meta-analysis aimed to determine the effectiveness of olive leaf extract on cardiometabolic profiles among prehypertensive and hypertensive groups. MethodologyThe Cochrane central register of controlled trials, Medline (1966 to April week 1, 2020), Embase (1966 to April week 1, 2020) and trial registries for relevant randomized clinical trials were used. Published and unpublished randomized clinical trials were reviewed and evaluated. Random effects models were used to estimate the continuous outcomes and mean differences (MDs); both with 95% confidence intervals (CIs). The primary outcomes were changes in systolic and diastolic BP. The secondary outcomes were changes in lipid profile, glucose metabolism, inflammatory markers for CVD, kidney and liver functions safety parameters. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias and quality of evidence.ResultsFive trials were included involving 325 patients aged 18–80 years. Two trials involved high-income countries and three trials involved moderate-income countries. The analysis performed was based on three comparisons. No significant changes were found between systolic or diastolic blood pressure (BP) for the first comparison, 1,000 mg per day for a combined formulation of olive leaf extract versus a placebo. The second comparison, 500 mg per day of olive leaf extract versus placebo or no treatment, showed a significant reduction in systolic BP over a period of at least 8 weeks of follow up (MD −5.78 mmHg, 95% CI [−10.27 to −1.30]) and no significant changes on diastolic BP. The third comparison, 1,000 mg per day of olive leaf extract versus placebo shows no significant difference but an almost similar reduction in systolic BP (−11.5 mmHg in olive leaf extract and −13.7 mmHg in placebo, MD 2.2 mmHg, 95% CI [−0.43–4.83]) and diastolic BP (−4.8 mmHg in olive leaf extract and −6.4 mmHg in placebo, MD 1.60 mmHg, 95% CI [−0.13–3.33]). For secondary outcomes, 1,000 mg per day of olive leaf extract versus captopril showed a reduction in LDL (MD −6.00 mg/dl, 95% CI [−11.5 to −0.50]). The 500 mg per day olive leaf extract versus placebo showed a reduction in inflammatory markers for CVD IL-6 (MD −6.83 ng/L, 95% CI [−13.15 to −0.51]), IL-8 (MD −8.24 ng/L, 95% CI [−16.00 to −0.48) and TNF-alpha (MD −7.40 ng/L, 95% CI [−13.23 to −1.57]).ConclusionsThe results from this review suggest the reduction of systolic BP, LDL and inflammatory biomarkers, but it may not provide a robust conclusion regarding the effects of olive leaf extract on cardiometabolic profile due to the limited number of participants in the included trials.Review registrationsPROSPERO CDR 42020181212.

Unequal consequences of Covid 19: representative evidence from six countries

Covid-19 and the measures taken to contain it have led to unprecedented constraints on work and leisure activities, across the world. This paper uses nationally representative surveys to document how people of different ages and incomes have been affected in the early phase of the pandemic. The data was collected in six countries (China, South Korea, Japan, Italy, UK, and US) in the third week of April 2020. First, we document changes in job circumstances and social activities. Second, we document self-reported negative and positive consequences of the crisis on well-being. We find that young people have experienced more drastic changes to their life and have been most affected economically and psychologically. There is less of a systematic pattern across income groups. While lower income groups have been more affected economically, higher income groups have experienced more changes in their social life and spending. A large fraction of people of low and high income groups report negative effects on well-being.

Influence of Spraying Kaolin, Silicon and Calcium on Productivity and Quality of Sultani Fig

During the 2019 and 2020 seasons, Sultani fig trees were sprayed two times (at 1st week of April and 1st week of May) with two levels of potassium silicates (1 and 2 %), two levels of Calcium nitrate (1 and 2 %) and kaolin at 5 %. The study focused on the effect of foliar application of kaolin, silicon and Calcium on vegetative growth, tree nutritional status, number of fruits per tree yield and fruit quality.Results showed that applications of 1% or 2% potassium silicate, 1% or 2% calcium nitrate and 5% kaolin were very effective in enhancing the main shoot number, main shoot length, main shoot thickness, number of leaves/shoot, leaf area and percentages of N, P, K, Ca and yield as well as fruit quality relative to the check treatment. The promotion was associated with using 5% kaolin, 1% calcium nitrate, 1% potassium silicate, 2% calcium nitrate and 2% potassium silicate in ascending order. Using potassium silicates and Calcium nitrate was preferable to using kaolin in this respect.Treating Sultani fig trees two times (1st week of April), and (1st week of May) with 2% potassium silicate was suggested to be beneficial for promoting yield quantitively and qualitatively.

562 Burn Bed Availability in the Northeast Region During the COVID-19 Pandemic

IntroductionThe coronavirus disease pandemic has placed enormous strain on all medical services with ICU capabilities throughout the Northeast region. The surge in ICU beds might severely limit burn centers to accept burn patients in a regional mass casualty incident.MethodsBurn bed data was collected by a regional burn disaster consortium. Open burn bed census was collected via telephone from each burn center in the consortium on April 15th, May 7th, May 21st, June 4th and June 18th of 2020. This data was compared to published data from 2009 to 2016.ResultsThe results are listed in Table 1. Lowest available burn bed was 35 beds on April 15th, 2020.ConclusionsAlthough a disaster may impact surrounding local and state hospitals, it does not always impact a burn center’s ability to transfer patients from a local trauma center or nearby burn center. A pandemic however affects a larger region and impacts all hospitals within that region.Peak ICU utilization in the Northeast was between the second and third week of April. During the peak utilization time, burn bed census was about 50% of the historical average. Burn bed census did not return to historical average until May 7, 2020. If a mass casualty event occurred in the pandemic region, the Northeast region would have to reach out to other ABA designated regions for assistance.Historically, burn mass casualty plans are based on the capacity to move burn patients to other burn centers in order to relieve surge capacity at the affected center. This data illustrates that, in a pandemic, burn beds are being utilized for non-burn patients. The ability to follow these plans will be greatly impacted.

Effect of foliar application of micronutrients and soil application of zinc sulphate on total chlorophyll and carotenoid content in sweet orange (Citrus sinensis) cv. blood red

The present investigation was carried out for two consecutive years of 2016 and 2017 at experimental orchard of Department of Horticulture, CCS HAU, Hisar to assess the performance of sweet orange cv. Blood Red to foliar application of micronutrients and soil application of zinc sulphate. In experiment I, the foliar application of micronutrients was done two times i.e. Ist spray was done on first week of april and 2nd spray on first week of july. The experiment comprises of thirteen treatments, viz., Zinc sulphate (ZnSO4) @ 0.25%, 0.50% &1.00%; Iron sulphate (FeSO4) @ 1.5%, 2.0% & 2.5%; Manganese sulphate (MnSO4) @ 0.25%, 0.50% & 1.00%; Boric acid (H3BO3) @ 0.1%, 0.2% & 0.3% and Control (No micronutrients). In experiment II, the soil application of zinc sulphate (ZnSO4) was done two times i.e. half dose in second fortnight of february and half dose in second fortnight of May. The experiment comprises of six treatments, viz., Zinc sulphate (ZnSO4) @ 50 g/plant, 100 g/plant, 150 g/plant, 200 g/plant, 250 g/plant and Control (No Zn application). Results indicated that foliar application of micronutrients and soil application of zinc sulphate affected significantly the chlorophyll and carotenoid content.

Peculiarities of tomatillo (Physalis philadelphica) field production in Ukraine with the use of different elements of technology

Tomatillo is a fairly common plant in South America but is rare for the conditions of the European continent. Therefore, in Ukraine there are no recommendations for its cultivation in specialized vegetable farms. Such recommendations should take into account the biological characteristics of the plant and the application of new elements of technology for plant productivity. The article is devoted to the study of the influence of the main elements of the technology of growing tomatillo for open ground conditions. The aim of the research was to find and optimize such elements in the open ground. To achieve this goal, the tasks solved were selection of high-yielding varieties, identification of the most effective factors for pre-sowing seed treatment and the term of planting seedlings is substantiated. This research was conducted during 2016 to 2018 on the research fields of Vinnytsia National Agrarian University (Central part of Ukraine) on gray-podzolic soils. The experimental varieties of tomatillo were divided into two groups (short and tall) according to plant height. Three varieties viz., Ananasovyi, Jemovyi and Kondyter were in the first group with a height of 80.1 to 81.4 cm and the second group included two varieties viz., Marmeladnyi and Korolyok. The varieties of foreign selection including Ananasovyi and Korolyok and, a domestic variety Likhtaryk were characterized by higher yields (30.6 to 32.0 t/ha). By studying the effect of pre-sowing seed treatment with heating the seeds at 40°C for 4 hrs or seed treatment with a magnetic field of 50 E for 12 hrs or Baikal EM-1 solution at a dose of 1.0 l/tonne provides an increase in total yield of tomatillo to 33.0 t/ha. When studying the impact of seedlings planting in the open ground, it was found that planting of seedlings was done in the third week of April or first week of May with a seedling age of 60 days under temporary film shelters. The varieties Likhtaryk and Ananasovyi were characterized by early budding in 47-48 days, flowering in 56-57 days, fruit tying in 69-70 days and fruiting in 101days. These varieties form a higher fruit yield of 33.4 t/ha. The biochemical composition determined a higher content of dry matter, protein and ash in the fruits of the variety Korolyok, with an index of 10.7, 1.6 and 1.0 %, respectively. These studies did not research the impact of tillage, pest control to obtain quality and environmentally friendly products and methods of harvesting, therefore, there is a need to further improve the technology of growing tomatillo in the open ground of Ukraine.

Early impact of school closure and social distancing for COVID-19 on the number of inpatients with childhood non-COVID-19 acute infections in Japan.

Many countries have implemented school closures as part of social distancing measures intended to control the spread of coronavirus disease 2019 (COVID-19). The aim of this study was to assess the early impact of nationwide school closure (March–May 2020) and social distancing for COVID-19 on the number of inpatients with major childhood infectious diseases in Japan. Using data from the Diagnosis Procedure Combination system in Japan, we identified patients aged 15 years or younger with admissions for a diagnosis of upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), influenza, gastrointestinal infection (GII), appendicitis, urinary tract infection (UTI), or skin and soft tissue infection (SSTI) between July 2018 and June 2020. Changes in the trend of the weekly number of inpatients between the two periods were assessed using interrupted time-series analysis. A total of 75,053 patients in 210 hospitals were included. The overall weekly number of inpatients was decreased by 52.5%, 77.4%, and by 83.4% in the last week of March, April, and May 2020, respectively, when compared on a year-on-year basis. The estimated impact was a reduction of 581 (standard error 42.9) inpatients per week in the post-school-closure period (p < 0.001). The main part of the reduction was for pre-school children. Remarkable decreases in the number of inpatients with URI, LRTI, and GII were observed, while there were relatively mild changes in the other groups.Conclusion: We confirmed a marked reduction in the number of inpatients with childhood non-COVID-19 acute infections in the post-school-closure period. What is Known:• Most countries have implemented social distancing measures to limit the spread of the novel coronavirus disease 2019 (COVID-19).• A large decrease in pediatric emergency visits has been reported from several countries after the social distancing.What is New:• Based on administrative claims data, a marked reduction in the number of inpatients for childhood non-COVID-19 acute infections was found in the post-school-closure period in Japan.• The magnitude of the reduction was different between the disease groups.

The Case Number Changes in Adult Heart Transplantation and Waitlist Addition Due to COVID-19

PurposeTo understand the long term effect of COVID-19 on 1) heart transplant waitlist trends and on 2) heart transplant case numbers in the United States.MethodsThe number of new adult heart transplant waitlist additions and transplant procedures were obtained from the UNOS database. Our time frame includes the 52 weeks between September 3, 2019 and September 4, 2020. Temporal changes in waitlist additions and heart transplants were analyzed using interrupted time series analyses with two transition periods. The first transition from the pre-COVID to the post-COVID era was determined as the week of March 11, 2020, when the first state imposed stay-at-home orders. The second transition period was determined as the first state re-opening during the week of April 22, 2020.ResultsWeekly waitlist additions were decreasing at -0.19 additions per week (95% CI: -0.35 to -0.03, p=0.018) prior to the COVID-19 era, defined as before the week of March 11, 2020, with a significant decrease in weekly waitlist additions of -2.09 (95% CI: -2.44 to -1.73, p< 0.001) during the post-COVID-19 era and prior to the first state re-opening the week of April 22, 2020 (Figure A). Weekly waitlist additions increased at 2.16 additions per week (95% CI: 1.81 to 2.51, p<0.001) following the first state announcing re-opening the week of April 22, 2020.Weekly transplants were relatively unstable, although decreasing at -0.003 transplants per week (95% CI: -0.279 to 0.273, p=0.984) in the pre-COVID era, and were trending downward at -0.18 transplants per week (95% CI: -0.3702 to 0.0036, p=0.054) thereafter (Figure B). The number of transplants rebounded and increased significantly at 0.49 transplants per week (95% CI: 0.26 to 0.72, p<0.001) after April 22, 2020.ConclusionThe number of heart transplants and waitlist additions decreased significantly due to COVID-19 and rebounded following the first US state reopening the week of April 22, 2020. Waitlist additions continue to rise past levels observed during the pre-COVID era.

Healthcare Encounter and Financial Impact of COVID-19 on Children's Hospitals.

Children's hospitals responded to COVID-19 by limiting nonurgent healthcare encounters, conserving personal protective equipment, and restructuring care processes to mitigate viral spread. We assessed year-over-year trends in healthcare encounters and hospital charges across US children's hospitals before and during the COVID-19 pandemic. We performed a retrospective analysis, comparing healthcare encounters and inflation-adjusted charges from 26 tertiary children's hospitals reporting to the PROSPECT database from February 1 to June 30 in 2019 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic). All children's hospitals experienced similar trends in healthcare encounters and charges during the study period. Inpatient bed-days, emergency department visits, and surgeries were lower by a median 36%, 65%, and 77%, respectively, per hospital by the week of April 15 (the nadir) in 2020 compared with 2019. Across the study period in 2020, children's hospitals experienced a median decrease of $276 million in charges.