Change in Reported Adherence to Nonpharmaceutical Interventions During the COVID-19 Pandemic, April-November 2020.
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ABSTRACT:
SUBMITTER: Crane MA
PROVIDER: S-EPMC7823422 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
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Change in Reported Adherence to Nonpharmaceutical Interventions During the COVID-19 Pandemic, April-November 2020.
Crane Matthew A MA Shermock Kenneth M KM Omer Saad B SB Romley John A JA
JAMA 20210301 9
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Project description:BackgroundIn early 2020, following the start of the coronavirus disease 2019 (COVID-19) pandemic, institutions of higher education (IHEs) across the United States rapidly pivoted to online learning to reduce the risk of on-campus virus transmission. We explored IHEs' use of this and other nonpharmaceutical interventions (NPIs) during the subsequent pandemic-affected academic year 2020-2021.MethodsFrom December 2020 to June 2021, we collected publicly available data from official webpages of 847 IHEs, including all public (n = 547) and a stratified random sample of private four-year institutions (n = 300). Abstracted data included NPIs deployed during the academic year such as changes to the calendar, learning environment, housing, common areas, and dining; COVID-19 testing; and facemask protocols. We performed weighted analysis to assess congruence with the October 29, 2020, US Centers for Disease Control and Prevention (CDC) guidance for IHEs. For IHEs offering ≥50% of courses in person, we used weighted multivariable linear regression to explore the association between IHE characteristics and the summated number of implemented NPIs.ResultsOverall, 20% of IHEs implemented all CDC-recommended NPIs. The most frequently utilized NPI was learning environment changes (91%), practiced as one or more of the following modalities: distance or hybrid learning opportunities (98%), 6-ft spacing (60%), and reduced class sizes (51%). Additionally, 88% of IHEs specified facemask protocols, 78% physically changed common areas, and 67% offered COVID-19 testing. Among the 33% of IHEs offering ≥50% of courses in person, having < 1000 students was associated with having implemented fewer NPIs than IHEs with ≥1000 students.ConclusionsOnly 1 in 5 IHEs implemented all CDC recommendations, while a majority implemented a subset, most commonly changes to the classroom, facemask protocols, and COVID-19 testing. IHE enrollment size and location were associated with degree of NPI implementation. Additional research is needed to assess adherence to NPI implementation in IHE settings.
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Project description:BackgroundThe emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020 led to the implementation of nonpharmaceutical interventions (NPIs) to curb its spread. Studies have shown that adult asthma exacerbations and viral infections decreased during NPI use. However, few studies have shown the effects of NPIs on pediatric asthma exacerbations and infections during and after the pandemic.ObjectiveThis study aimed to understand the impact of NPIs on asthma exacerbations and viral respiratory infections in pediatric patients at our institution from March 2018 to December 2022.MethodsThe medical record numbers of children with asthma exacerbations seen at our institution between March 2018 and December 2022 were analyzed. Subjects were categorized on the basis of timing of their exacerbation in relation to NPI enforcement. We used the results from clinical testing with the BioFire Respiratory Panel (BRP) to detect up to 22 respiratory pathogens and then correlated these results with asthma exacerbation severity.ResultsThere were 5,758 asthma exacerbations recorded, with a 50% decline in average weekly exacerbations during NPI enforcement. Of the 70,682 BRP tests performed, 87% returned a positive result for at least 1 pathogen. Several viruses (respiratory syncytial virus, parainfluenza, and influenza) had a decrease in positivity rate with NPIs, whereas rhinovirus/enterovirus positivity rates were unchanged throughout the pandemic. Asthma exacerbations with a positive BRP result required higher clinical levels of care during the admission.ConclusionNPIs were associated with significantly reduced numbers of asthma exacerbations and respiratory viral infections. The post-NPI period saw a return to prepandemic levels of asthma exacerbations and an unusual surge in respiratory syncytial virus infections, emphasizing the need for continuous monitoring and adaptive strategies in the postpandemic landscape.
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Project description:This study estimated the excess suicidal mortality during the COVID-19 pandemic in Japan. A Poisson regression model was used to assess the association between unemployment rates, expenditure for alcohol, eating out, and suicide, from January 2008 to March 2020. The excess suicidal mortality was assessed by applying the identified model to data from April 2020 to December 2021. The number of estimated excess deaths during COVID-19 was 3397 in men and 2390 in women. COVID-19 may have caused unprecedented psychological distress among people, owing to restricted social gatherings and prolonged uncertainties.
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Project description:This study examined the trajectory of alcohol use frequency among parents from April-2020 to May-2021 during the COVID-19 pandemic in the state of Victoria, Australia (who experienced one of the longest lockdowns in the world), compared to parents from the other states of Australia (who experienced relatively fewer restrictions). We further examined the extent to which baseline demographic factors were associated with changes in alcohol use trajectories among parents. Data were from the COVID-19 Pandemic Adjustment Survey (2,261 parents of children 0-18 years). Alcohol use frequency was assessed over 13 waves. Baseline demographic predictors included parent gender, age, speaking a language other than English, number of children, partnership status, education, employment, and income. Overall, alcohol trajectories declined over time. Victorian parents, in comparison to parents from other states, reported a smaller reduction in alcohol use frequency across 2020, with a more notable decline during 2021. Female/other gender, speaking a language other than English at home, unemployment, and lower income (Victoria only) were associated with alcohol trajectories of less frequent use, and older age was associated with a trajectory of more frequent use. Results suggest subtle difference in alcohol trajectories reflecting COVID-19 restrictions, when comparing Victoria and other states in Australia. Socioeconomically advantaged groups were most at risk for elevated trajectories of alcohol use frequency. Population level support may beneficial to reduce drinking behaviours.
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Project description:ContextDuring the COVID-19 pandemic, demand for telehealth services increased to reduce disease exposure for patients and providers and to meet preexisting demand for physician services in health resource shortage areas.ObjectiveTo estimate self-reported telehealth availability, equipment for accessing telehealth, and telehealth usage among Medicare beneficiaries during the COVID-19 pandemic.DesignWe used data from the 2020 Medicare Current Beneficiary Survey (MCBS) COVID-19 Fall Supplement Public Use File to estimate the weighted percentages of beneficiaries who had (a) access to telehealth before or during COVID-19; (b) equipment for accessing telehealth; and (c) telehealth visits during COVID-19. We used logistic regression to examine sociodemographic factors associated with telehealth usage.ParticipantsBeneficiaries who participated in the MCBS COVID-19 Fall Supplements.ResultsDuring October and November 2020, telehealth appointments offered by providers were available to 63.8% (95% confidence interval [CI], 61.8-65.9) of Medicare beneficiaries who had accessed medical care by telephone or video. Among those, only 18.0% (95% CI, 16.1-19.9) had been offered telehealth before the pandemic. The majority of beneficiaries (92.2%; 95% CI, 91.2-93.1) had 1 or more types of equipment available for accessing telehealth, but only 44.9% (95% CI, 43.0-46.9) had had a telehealth visit since July 1, 2020. Older adults, minorities, those with a lower income, and non-English speakers had less availability of telehealth equipment. Patient characteristics were significantly (P < .05) associated with telehealth use, including age, sex, race/ethnicity, and equipment availability.ConclusionTelehealth availability for Medicare beneficiaries increased substantially during the COVID-19 pandemic. Even with the improvement in telehealth offerings and use hastened by the pandemic, gaps in access and use still exist. Effectiveness and implementation research can find ways to close gaps in telehealth services between vulnerable and underrepresented populations and counterparts.
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Project description:The world is experiencing an ongoing pandemic of coronavirus disease-2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In attempts to control the pandemic, a range of nonpharmaceutical interventions (NPIs) has been implemented worldwide. However, the effect of synchronized NPIs for the control of COVID-19 at temporal and spatial scales has not been well studied. Therefore, a meta-population model that incorporates essential nonlinear processes was constructed to uncover the transmission characteristics of SARS-CoV-2 and then assess the effectiveness of synchronized NPIs on COVID-19 dynamics in China. Regional synchronization of NPIs was observed in China, and it was found that a combination of synchronized NPIs (the travel restrictions, the social distancing and the infection isolation) prevented 93.7% of SARS-CoV-2 infections. The use of synchronized NPIs at the time of the Wuhan lockdown may have prevented as much as 38% of SARS-CoV-2 infections, compared with the unsynchronized scenario. The interconnectivity of the epicenter, the implementation time of synchronized NPIs, and the number of regions considered all affected the performance of synchronized NPIs. The results highlight the importance of using synchronized NPIs in high-risk regions for the control of COVID-19 and shed light on effective strategies for future pandemic responses.Supplementary informationThe online version contains supplementary material available at 10.1007/s11071-021-06505-0.
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