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Background: Access to and use of urgent and emergency care in the United Kingdom's National Health Service reduced during COVID-19 related lockdowns but demand reportedly increased since then. We investigated the impact of COVID-19 on urgent and emergency health care services activity in an eastern England population of 1.1 million. Methods: We used health care activity data from a municipal health department, recorded at the level of discrete events (such as visits to hospital or ambulance calls) to compare system activity between 2018–2020 (pre-COVID), 2020–2021 (lockdown) and 2021–2023 (post-lockdown), carrying out interrupted time series analyses to describe changes in activity. Results: Daily emergency department (ED) attendances were 10% (95% confidence interval 9–12%) lower during the lockdown period, and 7% (6–8%) higher in the post-lockdown period than pre-COVID. Attendances arriving by ambulance were 13% (12–14%) lower post-lockdown than pre-COVID, while attendances of arrivals by other means were 17% (16–19%) higher. Post-lockdown, overall attendances were continually reducing. ED waiting times were 45% (44–47%) longer in the post-lockdown period compared to the pre-COVID period and continued to increase post-lockdown. There was a 15% (14–16%) reduction in daily ambulance dispatches post-lockdown versus pre-COVID. Ambulance arrivals with delayed handover to hospital care exceeding 60 minutes increased by 17% (16–18%) post-lockdown versus pre-COVID, and probability of delay showed a continuously upward trend post-lockdown of 20% (19–21%) per year. Conclusion: Patients are facing long waits in EDs to be admitted to hospital, discharged or transferred. This results in delays in ambulances handing over patients and attending to other calls, which may explain decreasing rates of ambulance dispatches. Potential solutions are likely to involve enhancing the flow through and discharge of patients from hospital, and a whole systems approach which considers the capacity of the local health and care infrastructure, including intermediate care and social care. [ABSTRACT FROM AUTHOR]

While there is growing academic attention to readers of hyperpartisan, alternative, and conspiracy (HAC) media, our understanding of these sites has developed in separate bodies of work. We make a case for studying HAC media in unison, recognizing them as different information sources that share the same underlying anti-establishment sentiment. We do so by painting a detailed portrait of HAC media users, detailing 1) who consumes HAC media; 2) how they access it; and 3) how its consumption relates to public opinion. This is made possible by the unique combination of panel surveys taken before and after the first COVID-19 lockdowns in Germany and Switzerland, and webtracking data capturing participants' actual online behavior. Our results show that those exposed to HAC media have a strong distrust of government and place themselves at the ideological extremes. While social media was a quintessential entry point for such media, most visits were registered by a small percentage of repeat visitors. Lastly, we show that those who consumed HAC media developed distinct opinions about the threat posed by COVID-19, mirroring the sentiments expressed in HAC media that the danger of the virus was exaggerated and that the real threat was to individual freedoms. With this case study, we showcase the theoretical utility of taking an integrated approach to HAC media, while providing nuanced insights into their audience. [ABSTRACT FROM AUTHOR]

Purpose: Before COVID-19, Kenya was among the countries in sub-Saharan Africa already dealing with high Gender-Based Violence (GBV) issues. Kenya had experienced prior convoluted emergencies and endemics, which had an inordinate impingement on women and girls that heightened their vulnerability to GBV. The Kenyan Ministry of Public Service and Gender reported that in 2020, there was an increase of 36% in GBV cases (Roy et al., 2021). COVID-19 had a devastating effect in rural communities, whereby women were most impacted. This study aims to understand the lessons learned from public leaders in implementing policies that could address GBV through better leadership approaches. Design/methodology/approach: This is an exploratory-qualitative study in which six participants comprised of policymakers or government representatives that were interviewed in semi-structured interviews. Findings: The qualitative narratives provided evidence that suggests a complex relationship between the COVID-19 lockdowns and movement restrictions policies and played a direct factor in the rise in GBV in vulnerable populations. The individual country policies and sectoral policies varied in how vulnerable women's needs were addressed, which led to diverse socioeconomic and health consequences. Originality/value: This research delineates the impacts of the failure of Kenyan leaders to implement gender focused COVID-19 policies and guidelines that considered the physical, mental, violence and the economic impact such emergencies have on women and girls in rural communities. [ABSTRACT FROM AUTHOR]

The UK retail sector is witnessing substantial increases in violence and abuse towards its customer-facing workers in the post-pandemic era. The costs of this violence to employee wellbeing, local community stability and economic losses to the retail industry are manifold. COVID-19 has been implicated as a central driver in these increases, as the legacy of abuse in retail settings during the pandemic lockdowns continues to affect workers across the sector. This article adopts a series of conceptual tools from critical criminology to argue that rising violence against retail staff cannot be explained by the pandemic alone. Rather, criminology must consider these trends against a background of longer-standing increases in interpersonal violence and rapidly shifting cultural currents under late-neoliberal capitalism. This article also reflects on the hardening of consumer subjectivities and declining deference to mechanisms of authority that continue to manifest under postmodern cultural conditions. These all serve as prominent features in the contextual aetiology of abuse against retail staff and render the possibility of addressing retail violence through deterrence and prevention measures problematic. [ABSTRACT FROM AUTHOR]

Cancellation or delay of non-essential medical interventions, limitation of face-to-face assessments or outpatient attendance due to lockdown restrictions, illness or fear of hospital or healthcare centre visits, and halting of research to allow diversion of healthcare resources to focus on the pandemic led to the interruption of many clinical trials during the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic. Appropriate analysis approaches are now required for these interrupted trials. In trials with long follow-up and longitudinal outcomes, data may be available on early outcomes for many patients for whom final, primary outcome data were not observed. A natural question is then how these early data can best be used in the trial analysis. Although recommendations are available from regulators, funders, and methodologists, there is a lack of a review of recent work addressing this problem. This article reports a review of recent methods that can be used in the setting of the analysis of interrupted clinical trials with longitudinal outcomes with monotone missingness. A search for methodological papers published during the period 2020–2023 identified 43 relevant publications. We categorised these articles under the four broad themes of missing value imputation, modelling and covariate adjustment, simulation and estimands. Although motivated by the interruption due to SARS-CoV-2 and the resulting disease, the papers reviewed and methods discussed are also relevant to clinical trials interrupted for other reasons, with follow-up discontinued. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. Methods: We analyzed data from 263 observational study participants undergoing drug susceptible (DS)-TB DOT between May 2017 to March 2022. Participants enrolled before October 2019 were considered 'pre-COVID-19' and those enrolled after September 2020 were considered 'post-COVID-19 lockdown groups. Negative binomial regression models were used to compare DOT non-adherence rates between the two lockdown groups. We then conducted a sensitivity analysis which only included participants enrolled in the immediate period following the first COVID-19 lockdown. Results: DOT non-adherence rate was higher in the post-COVID-19 lockdown group (aIRR = 1.42, 95% CI = 1.04–1.96; p = 0.028) compared to pre-COVID-19 lockdown period, adjusting for age, sex, employment status, household hunger, depression risk, and smoked substance use. DOT non-adherence was highest immediately following the initial lockdown (aIRR = 1.74, 95% CI = 1.17–2.67; p = 0.006). Conclusion: The COVID-19 lockdowns adversely effected adherence to TB DOT in the period after lockdowns were lifted. The change in DOT adherence persisted even after adjusting for socioeconomic and behavioral variables. We need a better understanding of what treatment adherence barriers were exacerbated by COVID-19 lockdowns to improve outcomes in post-pandemic times. Trial registration: ClinicalTrials.gov Registration Number: NCT02840877. Registered on 19 July 2016. [ABSTRACT FROM AUTHOR]

Rodents are well known to impact nesting seabirds. However, not all seabird species are equally susceptible to rodents due to variations in size, nest-site selection, or nesting behaviour. The Black Noddy Anous minutus, a common tropical, tree-nesting species, began colonisation of North Bay on Australia's Lord Howe Island in 1989, 70 years after the establishment of Black Rats Rattus rattus. In 2014, when the breeding colony consisted of 560 pairs, we commenced a pilot study to assess impacts of rodents. Ten motion-triggered cameras monitoring 12 nests showed no rodent presence on any branches within view; 11 of those nesting attempts (92%) resulted in fledglings. A further 38 nests were monitored for breeding success, of which 28 (74%) produced a fledgling. In 2019, coincident with the eradication of rodents from Lord Howe Island, noddies started breeding in small numbers in the Settlement Area. In 2020, visitor disturbance was low at this colony due to COVID-19 lockdowns and by the 2022 season, the entire original North Bay colony had relocated here. From initial colonisation until 2014, the population grew at 10% per annum, but it increased only marginally (0.7% per annum) during 2014-2024. It appears that neither colony establishment nor breeding by the Black Noddy is affected by the presence of Black Rats. Contributing factors may include the selection of tree nest sites, which reduces rodent access and provides only one point of contact to a nest, and the presence of adults at nests during all nocturnal periods, which enables nest defence. [ABSTRACT FROM AUTHOR]

Lockdown restrictions reduce the spread of COVID‐19 but disrupt livelihoods and lifestyles that can induce harmful behavior changes, including problematic lockdown drinking fueled by cheap alcohol. Exploiting differences amongst the four constituent countries of the United Kingdom, we use triple difference analysis on alcohol retail sales to examine the efficacy of minimum unit pricing as a price control device to help curb excessive consumption in a pandemic setting. We find the policy is remarkably effective and well‐targeted in reducing demand for cheap alcohol, with minimal spillover effects, and consumers overall buying and spending less. [ABSTRACT FROM AUTHOR]

International organisations and their local allies continue to press for the further expansion of social protection across Africa, often in the face of resistance. The future politics of social protection in Africa will be shaped by endogenous and exogenous changes. Endogenous changes involve feedback effects from the past and continuing expansion of social protection; these can be either positive or negative in terms of further expansion. Exogenous effects result from the changing structural context, including especially population growth, urbanisation, and climate change. As the Covid-19 pandemic and related lockdowns showed, even those exogenous shocks which reveal gaps in current provision need not prompt enduring expansions of social protection. Neither endogenous nor exogenous changes are likely to shift African countries off their current varied pathways; considerable political obstacles to the further expansion of social protection will persist. [ABSTRACT FROM AUTHOR]

ABSTRACT The outbreak of the COVID‐19 pandemic in early 2020 caused serious concern about the potential negative effects on children and young people. In Denmark, policymakers and interest organizations worried that insecurity about the future and the multiple lockdowns of society would harm the well‐being of children and young people and their school‐to‐school transitions. The COVID‐19 pandemic and the ensuing lockdowns of society can be regarded as a naturally occurring experiment. We utilise this abrupt exogenous shock to investigate whether the COVID‐19 pandemic affected the share of Danish 9th‐grade pupils who start an education after the 9th grade. Cohorts graduating from the 9th grade before 2020 were unaffected by the pandemic in their school‐to‐school transitions and constitute a suitable control group to explore the causal effects of the pandemic. To this end, we use registered data with information about the total population of 9th‐grade cohorts from 2018 to 2022. To adjust for the minor observable differences between cohorts, we employ augmented inverse probability weighting (AIPW), taking into account a multitude of covariates relevant for school‐to‐school transitions. We find that the COVID‐19 pandemic reduced the transition rate to education overall, but the largest reduction is in relation to starting upper secondary education. Our results indicate that the pandemic led young people to opt for types of education that entail a more social or recreational aspect before moving on to secondary education. Furthermore, effect sizes vary according to socio‐economic status, and our results suggest increased educational inequality. [ABSTRACT FROM AUTHOR]

In the shadow of the COVID‐19 pandemic, familiar life may be said to have become unequivocally altered as a result of the diffuse death threat posed by the virus and the unprecedented experience of a global lockdown. The unexpected superposition of familiarity and unfamiliarity can be linked to the psychoanalytic notion of the uncanny. For Freud, the uncanny was considered a derivative of the reappearance of the repressed, whose context is dominated by the alien nature of the repression. I suggest that a further perspective can be implied—that the sudden disruption of what is familiar is traumatic and engenders a sense of the uncanny. Reflecting on the COVID‐19 pandemic, this dynamic can be identified in the following aspects: (i) an overwhelming intrusion of an unfamiliar virus upon familiar life, encouraging paranoid denial and projection of the threat and increasing the tendency to stigmatise; (ii) a continuous re‐manifestation of hidden familiarities, both repressed individual conflicts and collective inequalities, illustrating the fragility of the ‘norm’; and (iii) the sudden disruption of an adopted belief (that the virus is beatable), and re‐confrontation with the threat of death following lockdown failure. [ABSTRACT FROM AUTHOR]

Fear and anxiety are rarely confined to specific stimuli or situations. In fear generalisation, there is a spread of fear responses elicited by physically dissimilar generalisation stimuli (GS) along a continuum between danger and safety. The current study investigated fear generalisation with a novel online task using COVID-19-relevant stimuli (i.e., busy or quiet shopping street/mall scenes) during pandemic lockdown restrictions in the United Kingdom. Participants (N = 50) first completed clinically relevant trait measures before commencing a habituation phase, where two conditioned stimuli (CSs; i.e., a busy or quiet high street/mall scene) were presented. Participants then underwent fear conditioning where one conditioned stimulus (CS+) was followed by an aversive unconditioned stimulus (US; a loud female scream accompanied by a facial photograph of a female displaying a fearful emotion) and another (CS-) was not. In a test phase, six generalisation stimuli were presented where the US was withheld, and participants provided threat expectancy and fear ratings for all stimuli. Following successful conditioning, fear generalization was observed for both threat expectancy and fear ratings. Trait worry partially predicted generalised threat expectancy and COVID-19 fear strongly predicted generalised fear. In conclusion, a generalisation gradient was evident using an online remote generalisation task with images of busy/quiet streets during the pandemic. Worry and fear of COVID-19 predicted fear generalisation. [ABSTRACT FROM AUTHOR]

Changes in society and how others view us often have an impact on our own identity. For some people, societal changes may prompt reflection and sense-making. With the global health pandemic COVID-19, many changes evolved in mandates and restrictions to mitigate the pandemic. One of these mitigation efforts involved the use of face masks. For some people, wearing masks is medically challenging. This study seeks to understand the lived experiences of those who cannot wear masks and find out how they coped with the situations in which they found themselves during the COVID-19 lockdowns and restrictions. The experiences of people with medical difficulty wearing face masks led to strained relationships with family and society, impacting their identity. Using the photo-elicitation interview method, a qualitative study obtained ten interviews that showed experiences connected to current literature on ostracism, invisible disability, and the communication theory of identity. [ABSTRACT FROM AUTHOR]

Introduction: During 2020–2021 Australia maintained comparatively low rates of COVID-19 in the community and residential aged care facilities (RAC) due to stringent public health measures such as lockdowns. However, the public health measures implemented may have had unintended impacts on critical RAC resident health outcomes, such as falls, due to routine care disruptions and aged care resident isolation. We utilised a longitudinal data to assess the association between COVID-19 lockdowns and the rate of falls in RAC settings. Methods: A longitudinal cohort study was conduct using routinely collected data from 25 RAC facilities from one non-profit aged care provider in Sydney, Australia. The study included 2,996 long term residents between March 2019 and March 2021. The outcome measures were all falls, injurious falls, and falls assessed as requiring hospitalisation. Generalised estimating equations (GEE) were applied to determine the association between COVID-19 lockdown periods and fall-related outcomes while adjusting for confounders and seasonality. Results: During the study period 11,658 falls were recorded. Residents frequently experienced at least one fall during the study period (median: 1, interquartile range: 0–4). During Lockdown 1 (March-June 2020) the rate of all falls increased 32% (IRR 1.32, 95% CI 1.19–1.46, p < 0.01) and the rate of injurious falls increased by 28% (IRR 1.28, 95% CI 1.12–1.46, p < 0.01) compared to pre-pandemic rates. The rate of falls assessed as requiring hospitalisation remained unchanged during Lockdown 1 (IRR 1.07, 95% CI 0.86–1.32, p = 0.519). During Lockdown 2 (Dec 2020-Jan 2021) the rate of all falls, injurious falls, and falls assessed as requiring hospitalisation did not change significantly compared to pre-pandemic rates. Conclusion: These findings suggest that the consequences of stringent COVID-19 restrictions, as seen in Lockdown 1, produced changes in residents' care which contributed to more falls and associated harm. The subsequent lockdown, which were less restrictive and occurred after staff had gained experience, was associated with no significant increase in falls rate. The nature and extent of lockdowns implemented for infection control in RAC need to balance multiple potential adverse effects. Factors which facilitated resilience during this period require exploration in future research. [ABSTRACT FROM AUTHOR]

We sought to understand the impact of the initial COVID-19 mitigation strategies in 2020 on drug-resistant (DR) TB diagnoses in KwaZulu-Natal province (KZN), South Africa. We compared the number, spatial distribution, and characteristics of DR TB diagnoses before and after the initial COVID-19 lockdown on March 26th, 2020. Information on DR TB diagnoses was collected from the CONTEXT prospective cohort study and municipality characteristics were collected from Statistics South Africa. We used Bayesian conditional autoregressive models and relative-risk surface maps to examine spatial correlates and patterns of DR TB notifications. Between October 2018 and February 2022, there were 693 individuals diagnosed with DR TB in KZN, South Africa. The rate of diagnoses per year was 274 and 155 prior and after to the initial lockdowns, respectively, corresponding to a 43 % decrease in the notification rate of cases. Compared to cases diagnosed before the lockdown, cases diagnosed after were less likely to have a fuel source for heating, piped water, a flush toilet, or own a phone (p-values≤0.02). Changes in notifications were not homogenously distributed, with predominantly rural northeastern and southwestern municipalities having significantly greater relative-risks after the lockdown. We found a reduction in the rate of DR TB diagnoses after the COVID-19 pandemic lockdowns and observed that individuals diagnosed after the lockdowns had worse living conditions, fewer household resources, and more adults living in their household compared to before the pandemic. [ABSTRACT FROM AUTHOR]

The photochemical mechanisms of ozone (O3) formation are complex, and simply reducing nitrogen oxide (NOx) emissions is insufficient to reduce O3 concentrations. The lockdown due to the Coronavirus Disease 2019 (COVID-19) pandemic provided a rare opportunity to explore the mechanisms of O3 formation and evaluate the performance of NOx emission control strategies through practical observations. This study integrates data from ground stations with observations from the TROPOMI sensor on the Sentinel-5P satellite to analyze air quality changes during the two one-month lockdown periods in Guangzhou, China, in March and November 2022. Our analysis particularly focuses on the impact of these lockdowns on O3 and NO2 concentrations, along with shifts in the sensitivity of ozone formation. Furthermore, we have assessed concentration changes of four major pollutants: PM2.5, PM10, SO2, and CO. The results show that the average O3 concentration in Guangzhou decreased during the March lockdown, while the average O3 concentration at three stations in the western part of Guangzhou increased during the November lockdown. The western part of Guangzhou is a VOCs (volatile organic compounds)-limited zone, and the NO2 emission reduction from the lockdown reduced the titration effect on O3, which led to the increase in O3 concentration. Overall, the impact of COVID-19 lockdowns on O3 concentrations depended on the local O3 producing sensitive system, and emissions of other major pollutants were reduced substantially, as reported in many other cities around the world. [ABSTRACT FROM AUTHOR]

(1) Background: The association of COVID-19 infection and mortality with mobility and weather in Indiana and Kentucky was compared for the period from 1 March to 15 May 2020. (2) Methods: The risk of COVID-19 infection and mortality was evaluated using Cox regressions with the following covariates: mobility (retail/recreation, grocery/pharmacy, and workplace), weather (precipitation, minimum and maximum temperature, ultraviolet [UV] index), and metropolitan status. (3) Results: A higher maximum temperature (adjusted hazard ratioinfection (aHRi) = 1.01; adjusted hazard ratiodeath (aHRd) = 1.001), metropolitan status (aHRi = 1.12; aHRd = 2.05), and a higher minimum temperature (aHRi = 1.01) were associated with increased risks of COVID-19 infection and/or mortality. Protection against COVID-19 infection and/or mortality was associated with retail/recreation (aHRi = 0.97; aHRd = 0.937), grocery/pharmacy (aHRi = 0.991; aHRd = 0.992), workplace (aHRi = 0.99; aHRd = 0.965), precipitation (aHRi = 0.999; aHRd = 0.9978), UV index (aHRi = 0.37; aHRd = 0.748), and a higher minimum temperature (aHRd = 0.994). COVID-19 infection (aHRi = 1.18) and mortality (aHRd = 1.59) risks were higher in Indiana compared to Kentucky. (4) Conclusions: COVID-19 infection and mortality were 18% and 59% more likely among Indiana residents compared to Kentucky residents, respectively. This may be attributed to variations in stay-at-home order compliance and enforcement between Indiana and Kentucky. [ABSTRACT FROM AUTHOR]

To examine the pain experiences of women in midlife with existing health conditions, including changes from prior to the COVID-19 pandemic through the first 6 months of the crisis. Women ages 40-60 with health conditions (e.g., hypertension; N = 35, MBMI = 32.2 kg/m2) were prompted to complete 5 surveys per day for 5 days at 3 time points: pre-COVID-19, during stay-at-home orders, and at initial reopening. Pain occurrence (yes/no), number of locations, and intensity. Women reported pain at 35% of surveys, particularly after waking and before bed compared to the middle of the day. The occurrence of pain decreased over time, whereas pain intensity decreased between pre-COVID-19 and stay-at-home orders but then remained stable. The number of pain locations decreased between stay-at-home orders and reopening, and pain was more variable during the pandemic than prior to its onset (srs = 0.24-0.32). Women experienced decreased pain frequency and intensity from prior to during the COVID-19 pandemic, though pain was less predictable during (vs. prior to) the pandemic. This information may be useful for informing care in this at-risk group, to prevent the development of chronic pain. [ABSTRACT FROM AUTHOR]

COVID-19 has sickened and killed millions of people globally. Conventional non-pharmaceutical interventions, particularly stay-at-home orders (SAHOs), though effective for limiting the spread of disease have significantly disrupted social and economic systems. The effects also have been dramatic in Africa, where many states are already vulnerable due to their developmental status. This study is designed to test hypotheses derived from the public health policymaking literature regarding the roles played by medical and political factors as well as social, economic, and external factors in African countries' issuance of SAHOs in response to the early stages of the COVID-19 pandemic. Using event history analysis, this study analyzed these five common factors related to public health policy to determine their impact on African states' varying decisions regarding the issuance of SAHOs. The results of this analysis suggest that medical factors significantly influenced decisions as did factors external to the states, while the role of political factors was limited. Social and economic factors played no discernible role. Overall, this study suggests how African leaders prioritized competing factors in the early stages of a public health crisis.

BackgroundIn Alpine regions, which are very similar due to their topographical location and their wide-ranging sports offerings, the restrictions on sports activities during the COVID-19 pandemic differed in type and level: while in some regions (Tyrol, South Tyrol, Trentino), all sports activities were forbidden except for walking near the home, in other regions (Upper Bavaria, Vorarlberg), people were allowed to go hiking and running during the first lockdown.ObjectiveThe aim of this study was to investigate the change in physical activity (PA) behavior in different Alpine regions (Upper Bavaria, Vorarlberg, Tyrol, South Tyrol, Trentino) over four periods in 2020, to examine the effects of COVID-19 measures of varying severity on PA behavior and to identify factors associated with a change in PA over time.MethodsA retrospective online survey was conducted (N = 2975) from December 2020, to January 2021. Using the questionnaire of the Eurobarometer 472 study, PA behavior was measured over four periods: before COVID-19 (March), during the first lockdown (March and April), during the relaxed period (May-October) and during the second lockdown (November and December) in 2020.ResultsDuring the first (M = 5.0h, SD = 4.5) and the second lockdowns (M = 4.9h, SD = 4.3), the participants (age: 42 years, overly active in sports) engaged less in sports than before (M = 5.9h, SD = 4.8) and during the relaxed period in summer (M = 6.4h, SD = 5.0) (average number of hours per week being physically active). A larger percentage of participants from Alpine regions with severe restrictions (Tyrol, South Tyrol, Trentino) decreased their PA during the first lockdown as compared to participants from Upper Bavaria and Vorarlberg with a less strict first lockdown. Those with psychological distress, male participants, and individuals with decreased physical health and less free time during COVID-19 were more likely to reduce their PA.ConclusionsDespite a short-term negative effect of COVID-19 restrictions on exercise participation during lockdowns, the majority of respondents returned to their original levels of PA during the relaxed COVID-19 phases. As a comparison of Alpine regions shows, particularly severe COVID-19 measures seem to have reduced PA with potential negative health effects. For the future, policy makers and sports organizations should collaborate to support the population in their PA behavior during pandemics to outweigh restrictions.

Objectives The measures used to contain the COVID-19 pandemic led to a significant reduction in physical activity. Due to the health benefits of exercise, recommendations were made for lockdown restrictions. Within the CoCo-Fakt study (Cologne-Corona counselling and support for index and contacts during the quarantine period), we aimed to determine how these recommendations were implemented, especially by individuals who were officially quarantined due to an infected persons (IPs) or as close contacts (CPs), and how this affected their physical and psychological condition.Methods From 12 December 2020 to 6 January 2021, all IPs and CPs registered by Cologne’s public health department up to the survey period were surveyed online. Of 10 547 people in the CoCo-Fakt sample, 8102 were integrated into the current analysis. In addition to demographic data, information regarding COVID-19-specific and persistent symptoms or conditions and their association with the amount and type of exercise and screen time before and during the quarantine were collected.Results Before quarantine, 66.9% of IPs and 69% of CPs were physically active; during quarantine, this decreased by 49.4% in IPs depending on the course of the disease and by 30.6% in CPs. Physically active IPs and CPs felt less exhausted and more fit during their quarantine periods than those who were inactive, with active IPs significantly less likely to report prolonged physical and psychological symptoms than their more sedentary counterparts.Conclusion Given the acute and long-term positive effects of exercise on quarantined individuals, corresponding recommendations should be communicated to those affected, especially CPs. Recommendations for IPs depend on their health status.

ABSTRACT Objective To verify the association of changes on physical activity levels during coronavirus disease 2019 (COVID-19) outbreak of individuals with normal weight and overweight/obesity, and the influence of sex in this relationship. Methods This cross-sectional study (survey research) was conducted in Brazil between May 5 and May 17, 2020. Participants (n=1,828 / 1,062 women >18 years) were invited through social media to answer a structured questionnaire via Google Forms. The online assessment included self-reported responses to questions on physical activity, overall health, weight, and height. Binary logistic regression analyzed the relationship between overweight/obesity (body mass index ≥25kg/m2), the impact of COVID-19 on physical activity level, and the influence of sex. Results Compared to normal weight people, those with overweight/obesity practice less moderate to vigorous physical activity (p

In early 2020, many states issued stay-at-home orders to slow the spread of COVID-19. I analyze Google Mobility data to consider the extent to which state-level stay-at-home orders induced people to stay at home. I find that much of the change in residential, retail and recreational, park, workplace, transit station, and, to a lesser extent, grocery and pharmacy activity preceded state-level stay-at-home orders. [ABSTRACT FROM AUTHOR]

The outbreak of the Covid-19 pandemic led to restrictions in production worldwide. Numerous firms were affected and unable to keep up production due to lockdowns. In disruptive events like this, the resilience of the production system is of central importance, as the survivability of the entire firm depends on it. In this context, the literature argues that cutting-edge technologies, such as Artificial Intelligence (AI), raise the proactive and reactive capabilities of firms, enabling them to better resist and recover from disruptive events and thus, show a higher resilience. This paper takes up this topic and observes the Covid-19 pandemic with the aim to analyse whether a firm's AI-readiness had an impact on its production resilience during the spring 2020 lockdown in Germany. For this purpose, we combine two large-scale surveys containing data from 237 manufacturers in Germany and test hypotheses based on quantitative analyses. Our results show that firms could indeed benefit from AI-enabled production during the lockdown. However, it is also clear that manufacturers have to exceed a certain AI threshold to significantly increase their resilient capabilities and realise positive effects. Our findings not only hold implications for research, but also provide recommendations for the resilience management of manufacturers. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65 years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

Pandemic lockdowns in early 2020 disrupted daily life worldwide and created an opportunity for self-reflection and consumption paradigm shifts. However, consumption patterns might take different directions, and opposing views exist about whether consumers (1) prolong reduced consumption after lockdown or (2) compensate for lockdown consumption restrictions through self-indulgence. Drawing from self-determination theory and individual–cultural values frameworks, this article develops a conceptual model of postlockdown consumption patterns related to three factors: consumers' fulfillment of basic psychological needs during lockdowns, individual consumer values, and country-level cultural orientations. Consumer surveys conducted after the first lockdowns in three culturally different European countries (the United Kingdom, Germany, and Romania) show that both satisfaction and dissatisfaction of psychological needs during lockdown impact consumption patterns, at least in the short term. The direction of consumption patterns is driven by hedonism and universalism values at an individual level and differences in postmaterialism and indulgence at a country level. The results provide implications for international marketers and policy makers in postpandemic marketplaces. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore parent perceptions of changes in child physical activity during COVID-19 stay-at-home orders.Design: A cross-sectional study.Setting: The research team used social media, relevant organizations, and neighborhood groups to distribute the survey link in May and June of 2020.Subjects: A convenience sample of parents of children aged 5–12.Measures: Survey to assess parental perceptions of changes in children's physical activity before and during stay-at-home orders, and environmental and social barriers to physical activity.Analysis: Results were analyzed using descriptive statistics, bivariate comparisons, and multinomial-logistic regression models with covariates of environmental factors, social factors, and frequency of factors as barriers on association with perceived physical activity change.Results: Data from 245 parents were analyzed. A majority (63.7%) of parents reported a decrease in children's physical activity during stay-at-home orders. More parents indicated social barriers (e.g., lack of access to playmates) than environmental barriers (e.g., lack of access to neighborhood play spaces) to children's physical activity. In multivariate analyses, the odds of parents reporting decreased physical activity was greater for those reporting lack of playmates (OR = 4.72; 95% CI: 1.99–11.17) and lack of adult supervision (OR = 11.82; 95% CI: 2.48–56.28) as barriers. No environmental barriers were significantly associated with decreased children's physical activity.Conclusion: The unique aspects of the COVID-19 pandemic provide a natural experiment for developing social and environmental strategies to improve children's overall physical activity. Assessing parental perceptions is a way to inform these future efforts.

Objectives: We sought to evaluate the success of telemedicine during New York City's COVID-19 pandemic stay-at-home period, and understand the distribution of sleep complaints seen. We also compared positive airway pressure (PAP) therapy compliance for a random patient sample to determine whether the pandemic influenced PAP usage. Methods: Encounters from the stay-at-home period were reviewed for patient characteristics and clinician impressions, and were compared to administrative data from the prior 2.5 months (“control” period). PAP compliance was compared between the periods for a randomly selected group of forty patients. Results: The telemedicine show rate was 89.37%. Sleep apnea then insomnia were the predominant diagnoses. Insomnia complaints were higher during the stay-at-home period. PAP compliance and AHI were similar between the periods. Conclusions: Sleep apnea and insomnia were common complaints; insomnia was significantly more common during the pandemic. PAP compliance was similar between the two periods for a randomly selected cohort.

Background Public health interventions have been implemented to contain the outbreak of coronavirus disease 2019 (COVID-19) in New York City. However, the assessment of those interventions—for example, social distancing and cloth face coverings—based on real-world data from published studies is lacking. Methods The Susceptible-Exposed-Infectious-Removed (SEIR) compartmental model was used to evaluate the effect of social distancing and cloth face coverings on the daily culminative laboratory confirmed cases in New York City (NYC) and COVID-19 transmissibility. The latter was measured by Rt reproduction numbers in 3 phases that were based on 2 interventions implemented during this timeline. Results Transmissibility decreased from phase 1 to phase 3. The initial R0 was 4.60 in phase 1 without any intervention. After social distancing, the Rt value was reduced by 68%, while after the mask recommendation, it was further reduced by ~60%. Conclusions Interventions resulted in significant reduction of confirmed case numbers relative to predicted values based on the SEIR model without intervention. Our findings highlight the effectiveness of social distancing and cloth face coverings in slowing down the spread of severe acute respiratory syndrome coronavirus 2 in NYC. [ABSTRACT FROM AUTHOR]

Objectives: Physical distancing precautions during the COVID-19 pandemic may challenge the provision of tangible support many middle age and older adults receive in managing their health. We examined the association between unmet tangible support needs and self-management behaviors and mental health status during the stay-at-home orders in Chicago and New York. Methods: We used data from the COVID-19 & Chronic Conditions study collected between May 1st and May 22nd, 2020. A total of 801 middle age and older adults with ≥1 chronic condition in Chicago and New York City completed the telephone interview. Adequacy of tangible social support was measured using a brief, validated scale that determined whether an individual needed assistance managing his or her health, and if yes, whether this need was met. Participants reported their level of difficulty engaging in self-management behaviors using 2 discrete items; they also self-reported medication adherence using the ASK-12 medication adherence scale. Mental health status was measured using the depression and anxiety PROMIS short-form instruments. Results: Participants’ mean age was 63 years; 30% identified as Black, 26% identified as Latino, and 12% identified unmet support needs. Inadequacy of tangible support was associated with greater difficulty managing one’s health and accessing medications due to COVID-19, as well as poorer medication adherence, increased anxiety and depressive symptoms, and poorer overall well-being ( P ’s

In 2020, a novel emerging infectious disease - COVID-19 - became a global pandemic and prompted unprecedented social distancing measures. We examined the associations of voluntary stay-at-home (SAH) orders during the COVID-19 pandemic with vulnerability assessments and precautionary intentions (e.g. social distancing, hand washing). A quasi-experimental study using an online adult sample was conducted in U.S. states with and without voluntary SAH orders during the COVID-19 pandemic. Self-report surveys assessed vulnerability assessments and precautionary intentions. Participants living in states with SAH orders showed inflated vulnerability assessments for contracting COVID-19, and this association was stronger for affect-laden than cognitively-based assessments. Moreover, only affect-laden vulnerability assessments were uniquely associated with precautionary intentions and accounted for the relationship between SAH orders and precautionary intentions. Our study was among the first to explore the impact of voluntary SAH orders on vulnerability assessments and precautionary intentions. Results are discussed in terms of their implications for health behavioral models and applications for promoting self-protective actions during a pandemic.

We identify the effectiveness of social distancing policies in reducing the transmission of the COVID-19 spread. We build a model that measures the relative frequency and geographic distribution of the virus growth rate and provides hypothetical infection distribution in the states that enacted the social distancing policies, where we control time-varying, observed and unobserved, state-level heterogeneities. Using panel data on infection and deaths in all US states from February 20 to April 20, 2020, we find that stay-at-home orders and other types of social distancing policies significantly reduced the growth rate of infection and deaths. We show that the effects are time varying and range from the weakest at the beginning of policy intervention to the strongest by the end of our sample period. We also found that social distancing policies were more effective in states with higher income, better education, more white people, more democratic voters, and higher CNN viewership. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic in Egypt triggered national preparedness, public engagement, and an integrated response that included social distancing measures, for example, staying at home. We aimed to investigate community awareness of and commitment to complying with the stay-at-home orders in Damietta Governorate, Egypt, during the COVID-19 pandemic. Methods: A web-based cross-sectional survey was designed and completed by 500 adult participants from Damietta, Egypt, between April 10 and July 15, 2020. Participants were asked about their sociodemographics, sources of knowledge about COVID-19, awareness of COVID-19 prevention methods, commitment to stay-at-home orders, and their trust in governmental measures, community resources, and emergency services. The participants were classified as stay-at-home responders or nonresponders. Results: Of the participants, 18.4% responded to stay-at-home orders; the main reasons for leaving home were buying essentials, especially food, and going to work. Compliance was significant among elderly individuals and those with a history of chronic illness. Nonresponse was significant among individuals who were married, working, or had low family income. More than one-third (39.2%) had good knowledge of effective methods of COVID-19 prevention, and the overall accepted knowledge was significantly higher among stay-at-home responders than nonresponders. Their trust in governmental measures, community resources, and emergency services to manage the pandemic was poor—84.6%, 71.8%, and 79%, respectively—with no significant differences between the groups. Conclusions: Participants' compliance with and engagement in stay-at-home orders in Damietta Governorate, Egypt, was poor. Public response to stay-at-home orders is affected by sociodemographics, and the public's trust in governmental measures, community resources, and emergency services was poor. Understanding how social distancing is perceived in Egypt is important to provide public support and improve pandemic disease containment. [ABSTRACT FROM AUTHOR]

Governments issue "stay-at-home" orders to reduce the spread of contagious diseases, but the magnitude of such orders' effectiveness remains uncertain. In the United States these orders were not coordinated at the national level during the coronavirus disease 2019 (COVID-19) pandemic, which creates an opportunity to use spatial and temporal variation to measure the policies' effect. Here, we combine data on the timing of stay-at-home orders with daily confirmed COVID-19 cases and fatalities at the county level during the first seven weeks of the outbreak in the United States. We estimate the association between stay-at-home orders and alterations in COVID-19 cases and fatalities using a difference-in-differences design that accounts for unmeasured local variation in factors like health systems and demographics and for unmeasured temporal variation in factors like national mitigation actions and access to tests. Compared to counties that did not implement stay-at-home orders, the results show that the orders are associated with a 30.2 percent (11.0 to 45.2) average reduction in weekly incident cases after one week, a 40.0 percent (23.4 to 53.0) reduction after two weeks, and a 48.6 percent (31.1 to 61.7) reduction after three weeks. Stay-at-home orders are also associated with a 59.8 percent (18.3 to 80.2) average reduction in weekly fatalities after three weeks. These results suggest that stay-at-home orders might have reduced confirmed cases by 390,000 (170,000 to 680,000) and fatalities by 41,000 (27,000 to 59,000) within the first three weeks in localities that implemented stay-at-home orders.

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs’ visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents’ responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.

The coronavirus outbreak has led to abrupt changes in people’s daily lives as many state governments have restricted individuals’ movements in order to slow the spread of the virus. We conducted a natural experiment in the United States of America in April 2020, in which we compare responses from states with “stay-at-home orders” (3 states) and no such orders (6 states). We surveyed 458 participants (55.6% female, age range 25–64, Mage = 36.5) and examined the effects of these government-imposed restrictions on social, mental, physical, and financial well-being as well as the mediating role of resilience. Structural equation modeling reveals that resilience buffers stay-at-home orders’ potential side-effects on well-being. Specifically, individuals living in states with stay-at-home orders report lower functional well-being than individuals living in states without such orders, which negatively relates to resilience. Resilience in turn is associated with higher social, mental, physical, and financial well-being. Thus, resilience can be seen as an effective means of buffering stay-at-home orders’ potential negative effects on the components of well-being. Our results indicate the central role of resilience, which is crucial in dampening the effects of stay-at-home orders on well-being. Following our results, governments and policymakers should focus their efforts on strengthening individuals’ resilience, which is a key predictor of social, mental, financial, and physical well-being.

Introduction The data on gender differences in mental health make the investigation of the specific impact of the pandemic and of the stay-at-home orders on men and women relevant. Objectives The study focuses on the quality of the relationship in couples and mental health in men and women during the COVID-19 pandemic. Methods The study was conducted through an online survey a few weeks after the pandemic was declared and the stay-at-home order was introduced in Russia. 274 participants (50 men and 224 women) engaged in long-term relationships aged from 18 to 62 (M=34.2; SD=9.1) took part in the research. The instruments included the Warwick-Edinburgh Mental Well-Being Scale, the Perceived Relationship Quality Components, and the Depression Anxiety Stress Scales. Results Women show a considerably higher level of stress (t=3.805; p