Psychotropic medication prescribing during the COVID-19 pandemic

This study examined changes in psychotropic medication use associated with the early months of the coronavirus disease 2019 (COVID-19) pandemic. Using Kaiser Permanente Northern California electronic health records, the authors identified adult patients with fills for psychotropic medications and a non-psychotropic comparator (statins) in the 13 weeks before and after the first-known COVID-19-related death in California (March 4, 2020). Generalized estimating equations were used to derive relative risk ratios (RRR) for medication fills compared with the prior year. Analyses were stratified by new and continued fills and patient characteristics. Among 2,405,824 patients, the mean (SD) age was 49.8 (17.9) years; 52.9% were female; 47.9% identified as White; 8.0% and 7.9% had anxiety and depression disorder diagnoses, respectively. Accounting for secular trends, in the 13 weeks following March 4, 2020, there were increased fills for trazodone (RRR = 1.03, 95% CI = 1.02, 1.04), decreased fills for benzodiazepines (RRR = 0.95, 95% CI = 0.94, 0.96) and hypnotics (RRR = 0.97, 95% CI = 0.96, 0.99), and stable fills for antidepressants (RRR = 1.00, 95% CI = 0.99, 1.00). Relative rates of new fills decreased across most medication classes and continued fills either remained stable or demonstrated non-clinically significant decreases. Patients aged ≥65 years demonstrated decreased fills for most medication classes. In the first 13 weeks of the COVID-19 pandemic, fills for most psychotropic medications remained constant or showed small changes relative to the previous year. Continued (compared with new) fills accounted for observed increases in some medication classes. Older adults demonstrated decreased fills of most medications.     

Factors affecting the mental health of medical students during the COVID-19 pandemic: A cross-sectional study

The coronavirus disease 2019 outbreak has impacted many educational institutions by imposing restrictions on offline or in-person lessons. Many students were stressed by “the loss of everyday life” due to the pandemic, and it is important to examine the impact of this loss on adolescents’ mental health. This study aimed to investigate the factors that affect students’ mental health during the pandemic from various perspectives. A total of 166 medical students participated in this study. Participants completed questionnaires about their demographics, life stress, mental health, and stress factors during in-person and online lecture days. Participants were divided into 2 groups, those with low and high mental health. The researchers compared independent variables between the groups using the χ² test or Fisher’s exact test. Multiple logistic regression analysis was performed, with mental health as the dependent variable. The multiple logistic regression analysis indicated that increased time spent online was significantly associated with mental health (P < .05). Human relations and the inability to meet/talk with friends trended toward a significant association with mental health (P < .1). The students who were not stressed about the increased time spent online were at a risk of low mental health. The students who appreciated interacting with others experienced more stress during the lockdown. To reduce students’ stress on online days, teachers should devise a lecture style with frequent breaks and introduce active learning. The findings of this study will contribute to addressing students’ low mental health and reducing their stress during the coronavirus disease 2019 pandemic.     

Prevalence and influencing factors of anxiety and depression symptoms among the first-line medical staff in Wuhan mobile cabin hospital during the COVID-19 epidemic: A cross-sectional survey

To investigate the prevalence of anxiety and depressive symptoms and the associated risk factors among first-line medical staff in Wuhan during the coronavirus disease 2019 (COVID-19) epidemic.From March 5 to 15, 2020, the Hamilton Anxiety Scale and Hamilton Depression scale were used to investigate the anxiety and depression status of medical staff in Wuhan Cabin Hospital (a Hospital). Two hundred seventy-six questionnaires were received from 96 doctors and 180 nurses, including 79 males and 197 females.During the COVID-19 epidemic, the prevalence rate of anxiety and depression was 27.9% and 18.1%, respectively, among 276 front-line medical staff in Wuhan. The prevalence rate of anxiety and depression among doctors was 19.8% and 11.5%, respectively, and the prevalence rate of anxiety and depression among nurses was 32.2% and 21.7%, respectively. Females recorded higher total scores for anxiety and depression than males, and nurses recorded higher scores for anxiety and depression than doctors.During the COVID-19 epidemic, some first-line medical staff experienced mental health problems such as depression and anxiety. Nurses were more prone to anxiety and depression than doctors. Effective strategies toward to improving the mental health should be provided to first-line medical staff, especially female medical staff and nurses.     

Baduanjin exercise can alleviate anxiety and depression of patients with COVID-19 in Square cabin hospital: A cross-sectional survey

To investigate the anxiety and depression of patients with the coronavirus disease 2019 (COVID-19) who participated in Baduanjin exercise.From February 20, 2020 to March 7, 2020, the Hospital Anxiety and Depression scale (HAD) were used to investigate the anxiety and depression levels of patients with COVID-19 who participated in Baduanjin exercise. Ninety one questionnaires were received, including 40 males and 51 females. Stepwise regression analysis was used to analyze the effects of related factors on anxiety and depression levels.In Square cabin hospital, 91% of patients participated in Baduanjin exercise had no obvious anxiety and 82% had no obvious depression. The scores of anxiety and depression of female patients were significantly higher than that of male patients. Bachelor degree or above with low scores for anxiety and depression. The frequency of Baduanjin exercise was negatively correlated with anxiety and depression score.The development of Baduanjin exercise has a certain positive influence on the COVID-19 patients in the Square cabin hospital, which is conducive to alleviate anxiety and depression symptoms of the patients.     

Effect of pandemic on DOTS treatment during COVID-19 lockdown- A cross-sectional study

BackgroundTuberculosis (TB) is still the most common infectious disease globally, affecting 1.5 million people per year. Prior to COVID-19 outbreak, India was struggling with a rampant attack of Tuberculosis. With the surge of COVID-19 implementation of all national health programs including NTEP was disrupted. Prioritization of services, the challenges to reaching all types of communities and the role of stigmatization, and the possibility of increased disease transmission were few problems in the implementation of DOTS during the lockdown.AimTo assess effect of pandemic on DOTS treatment during COVID-19 lockdown.MethodsA cross-sectional study was conducted among 254 tuberculosis patients who were under DOTS during Covid-19 lockdown in Belagavi district. Participants who were on DOTS during 2019–2021 period.ResultOf 254 participants, only 5 (2.0%) were supervised while taking drugs, 67 (26.4%) of subject's empty blister packs were taken back by health personnel and 106 (41.7%) participants were regularly followed up for treatment by health department. The variables like gender, literacy status, socioeconomic status, and occupation were all significantly associated with hampered access to DOTS during the lockdown period at p < 0.05.ConclusionThis study concluded that the participants had hampered accessibilities to DOTS during lockdown.     

Emotions,Perceptions and Health Behaviors of Adult Congenital Heart Disease Patients during COVID-19 in New York City

Background: Adults with congenital heart disease (ACHD) have increased prevalence of mood and anxiety disorders. There are limited data regarding the influence of the COVID-19 pandemic on the mental health and health behaviors of these patients. Objective: The purpose is to evaluate the perceptions, emotions, and health behaviors of ACHD patients during the COVID-19 pandemic. Methods: In this cross-sectional study of ACHD patients, we administered surveys evaluating self-reported emotions, perceptions and health behaviors. Logistic regressions were performed to determine the adjusted odds of displaying each perception, emotion and health behavior based on predictor variables. Results: Ninety-seven patients (mean age 38.3 years, 46.4% female, 85.6% moderate or complex lesion) completed the survey. The majority of patients reported feeling moderately or very sad (63.1%), and 48.4% of patients identified themselves as feeling moderately or very anxious. The majority of patients perceived their risk of COVID-19 as moderate or high. Females were more likely to report feeling sad and anxious (95% CI 1.06–10.96, p-value 0.039, and 95% CI 1.44–15.30, p-value = 0.012, respectively), and were associated with higher odds of having a perceived increased risk of COVID-19 (95% CI 1.33–10.59, p-value 0.012). There was no association between ACHD anatomic or physiologic classification and perceptions, emotions and health behaviors. Conclusions: Females were more likely to report feeling sad, anxious and an increased risk of COVID-19 in comparison to males. These findings indicate the need for mental health support and promotion of health behaviors during the pandemic amongst all ACHD patients, regardless of underlying condition.     

Mental problems and risk factors for depression among medical students during the COVID-19 pandemic: A cross-sectional study

Prevalence of depression is high among medical students and several mental problems are identified as risk factors. Coronavirus disease 2019 (COVID-19) pandemic causes difficulties that could adversely affect mental health. However, data concerning prevalence of mental problems, and whether or not these problems remain risk factors for depression during the COVID-19 pandemic in medical students are scarce. To investigate the prevalence of depression, social media addiction, game addiction, sleep quality, eating disorder risk, and perceived stress among Thai medical students, risk factors for depression were investigated. Online surveys via our faculty’s learning portals were advertized to medical students who engaged online learning and 224 respondents provided complete data. Study-related medical students’ data were collected using the Patient Health Questionnaire-9 for depression, the Social-Media Addiction Screening Scale for social media addiction, the Game Addiction Screening Test for game addiction, the Pittsburgh Sleep Quality Index for sleep quality, the Eating Attitudes Test for eating disorder risk, and the Perceived Stress Scale for perceived stress. Depression was reported in 35.7% of medical students, social-media addiction in 22.3%, game addiction in 4.5%, eating disorder risk in 4.9%, poor sleep quality in 80.8%, and moderate-to-high perceived stress in 71.4%. The independent predictors of depression were lower grade point average, social media addiction, and moderate-to-high perceived stress. A high prevalence of depression, stress, and poor sleep was found among medical students during the COVID-19 pandemic. Medical students who are stressed, have lower grades, and/or who are addicted to social media warrant depression screening.     

Future anxiety and coping methods of nursing students during COVID-19 pandemic: A cross-sectional study

The aim of this research is to examine the methods of nursing students to deal with future anxiety and stress.It is a cross-sectional survey conducted in Turkey with 291 students in Çukurova University of Faculty of Health Sciences, Kahramanmaraş Sütçü İmam University Health College and Batman University Health College Nursing Department in June 2020. Personal Data Form, Stress Coping Scale, State and Trait Anxiety Scale were sent online to students’ smartphones and/or e-mails as data collection tools and it was collected this way.The mean age of the participants was 21.09 ± 2.02 (years). 78% of respondents were women. 48.4% of the participants were students of Çukurova University. It was determined that 201 (69.1%) of the participants isolated themselves during the pandemic. It was found that 171 students (58.8%) spent 23 to 24 hours at home, whereas 284 students (97.6%) spent time with their parents/siblings. 47.4% of respondents stated that they had spent the pandemic watching a series/film. 47.1% of respondents had good family relationships. 50.2% of respondents had good relationships with college friends. 74.9% of respondents said they were happy. Women''s trait anxiety scale scores were higher than men''s (P < .05). Men have higher problem-Oriented coping scores than women (P < .05). Significant differences were found in the Status Anxiety Scale scores and trait anxiety scale scores according to self-isolation status (P < .05). A significant difference was found in terms of state anxiety scale and trait anxiety scale according to happiness status (P < .05). The problem-based coping scores of those who were happy with the Stress Coping Scale were higher than those who were not happy (P < .05). The state anxiety scale of the students was 42.54, and the trait anxiety scale was 45.16.Nursing students’ status and sustained Anxiety Scale scores were moderate. It is important for individuals to have good family and friends and to be happy in the process of the Corona Virus Disease pandemic.     

Students’ perception of online learning during the COVID-19 pandemic: A survey study of Polish medical students

The COVID-19 pandemic has disrupted teaching in a variety of institutions, especially in medical schools. Electronic learning (e-learning) became the core method of teaching the curriculum during the pandemic. After 8 weeks of only online learning, a survey was conducted to investigate perception of this type of learning among medical students.A survey was conducted by distributing an online questionnaire to Polish medical students. Data gathered from the survey were analyzed with routine statistical software.Eight hundred four students answered the questionnaire. According to respondents’ answers, the main advantages of online learning were the ability to stay at home (69%), continuous access to online materials (69%), learning at your own pace (64%), and comfortable surroundings (54%). The majority of respondents chose lack of interactions with patients (70%) and technical problems with IT equipment (54%) as the main disadvantages. There was no statistical difference between face-to-face and online learning in terms of opinions on the ability of the learning method to increase knowledge (P = .46). E-learning was considered less effective than face-to-face learning in terms of increasing skills (P < .001) and social competences (P < .001). Students assessed that they were less active during online classes compared to traditional classes (P < .001). E-learning was rated as enjoyable by 73% of respondents.E-learning is a powerful tool for teaching medical students. However, successful implementation of online learning into the curriculum requires a well thought-out strategy and a more active approach.     

COVID-19疫情期间人群压力应对行为与焦虑、抑郁的关系

目的　探讨压力应对行为倾向与焦虑、抑郁的关系,为今后开展健康教育和心理干预提供证据及建议。方法　以年龄＞15岁男性为研究对象,采用分阶段整群抽样的方法,获得有效问卷4027份。压力应对行为采用自我报告的题目测量。焦虑自评量表和患者问卷抑郁量表用于测量心理健康状况。用多元Logistic回归模型检验变量间关系。用边际预测分析检验焦虑、抑郁对压力应对行为倾向的预测幅度。所有的分析均控制了城市间群组效应。结果　多元Logistic回归模型结果显示,与“不采纳”组相比,较高抑郁程度（偶尔采纳 OR=1.25,95%CI：1.21～1.28;有时采纳 OR=1.29,95%CI：1.22～1.37;经常采纳 OR=1.24,95%CI：1.18～1.31）和较高焦虑程度（偶尔采纳 OR=1.09,95%CI：1.07～1.10;有时采纳 OR=1.15,95%CI：1.11～1.18;经常采纳 OR=1.17,95%CI：1.14～1.20）与消极压力应对行为采纳倾向呈正相关。边际预测分析结果显示,抑郁对“偶尔采纳”者和“有时采纳”者行为采纳概率的边际回报持续增高,而焦虑则对“经常采纳”者有更明显的边际回报增高的趋势。结论　突发性公共卫生事件中应重视人群的不良心理状态及不适应对行为问题。     

Income and social support related with mental health during COVID-19 outbreak in China

To investigate psychological response of Chinese public during the regular prevention and control of Corona Virus Disease 2019 (COVID-19), and explore the relationship among income loss, social support and mental health.Five hundred twenty-six participants were randomly selected by snowball sampling method. Chinese version of Perceived Psychological Stress Scale, Perceived Social Support Scale, self-rating anxiety scale, and the PTSD Checklist for DSM-5 were used to measure the levels of psychological stress, social support, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Demographic variables, income loss and income satisfaction during the outbreak period were also collected.The prevalence rate of anxiety, PTSD symptoms and stress problems were 19.8%, 23.8%, and 24.7% respectively. Multiple Regression Analysis illustrated that social support associated with stress, anxiety and PTSD after controlling demographic variables; for non-student samples, stress, anxiety, and PTSD were corelated with change in income and social support.During the regular prevention and control of COVID-19, social support might help reducing stress, anxiety, and PTSD symptoms. In addition to social support, change of income level was also an important factor for mental health. This study suggested the importance of maintaining a steady income after acute outbreak of COVID-19.     

Changes in healthcare workers’ knowledge,attitudes, practices,and stress during the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) has caused an unprecedented health crisis around the world, not least because of its heterogeneous clinical presentation and course. The new information on the pandemic emerging daily has made it challenging for healthcare workers (HCWs) to stay current with the latest knowledge, which could influence their attitudes and practices during patient care.This study is a follow-up evaluation of changes in HCWs’ knowledge, attitudes, and practices as well as anxiety levels regarding COVID-19 since the beginning of the pandemic. Data were collected through an anonymous, predesigned, self-administered questionnaire that was sent online to HCWs in Saudi Arabia.The questionnaire was sent to 1500 HCWs, with a 63.8% response rate (N = 957). The majority of respondents were female (83%), and the most common age group was 31 to 40 years (52.2%). Nurses constituted 86.3% of the respondents. HCWs reported higher anxiety during the COVID-19 pandemic which increased from 4.91 ± 2.84 to 8.6 ± 2.27 on an 11-point Likert scale compared to other viral outbreaks. HCWs believed that their own preparedness as well as that of their hospital''s intensive care unit or emergency room was higher during the COVID-19 pandemic than during the Middle East respiratory syndrome coronavirus pandemic (2012–2015). About 58% of HCWs attended one or more simulations concerning the management of COVID-19 patients in their intensive care unit/emergency room, and nearly all had undergone N95 mask fit testing. The mean score of HCWs’ knowledge of COVID-19 was 9.89/12. For most respondents (94.6%), the perception of being at increased risk of infection was the main cause of anxiety related to COVID-19; the mean score of anxiety over COVID-19 increased from 4.91 ± 2.84 before to 8.6 ± 2.27 during the pandemic in Saudi Arabia.HCWs’ anxiety levels regarding COVID-19 have increased since a pandemic was declared. It is vital that healthcare facilities provide more emotional and psychological support for all HCWs.     

Lifestyle and mental health disruptions during COVID-19

Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the COVID-19 pandemic (N=682), we document large disruptions to physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 10,000 to 4,600 steps per day, sleep increases by 25 to 30 min per night, time spent socializing declines by over half to less than 30 min, and screen time more than doubles to over 5 h per day. Over the course of the pandemic from March to July 2020 the proportion of participants at risk for clinical depression ranges from 46% to 61%, up to a 90% increase in depression rates compared to the same population just prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits through a short-term intervention does not meaningfully improve mental well-being.

A mental health crisis has emerged during the COVID-19 pandemic. The US Centers for Disease Control and Prevention (CDC) estimates that as of June 2020 nearly one-third of US adults were suffering from anxiety or depression (1). The rates are almost two times higher for young adults, a population that has already seen a significant increase in the prevalence of mental health disorders over the past decade (2). Over 60% of individuals age 18 to 24 y were estimated to be at risk for depression or anxiety and a quarter reported considering suicide in the previous month. These estimates represent a large increase in depression rates compared to about 11% of all adults in 2019 (3) and about 25% of college students prior to the pandemic (4). The rise in depression has occurred at the same time that stay-at-home orders, campus closures, and social distancing measures have caused major disruptions to everyday life, altering the way people live, work, study, and interact.In this paper we document disruptions in physical activity, sleep, and time use among young adults at the onset of the pandemic and examine the relationship between these disruptions and mental health. We take advantage of a wellness study that has enrolled multiple cohorts of US college students from February 2019 through July 2020. Participants received wearable devices (Fitbits) and answered repeated surveys about their well-being and time use over the course of a semester. Participants in the 2020 cohort began the study in February and continued participating after the university moved all classes online in March and encouraged students not to return to campus.These data allow us to make two primary contributions. First, we can conduct longitudinal analysis examining how physical activity and mental health have evolved during the pandemic compared both to baseline prepandemic levels as well as to prior cohorts. The use of prepandemic data are critical as the studied behaviors exhibit significant seasonal patterns. Second, we can link biometric measures of physical activity and sleep to survey measures of mental well-being and social distancing. This approach allows us to identify risk factors for depression during COVID-19 and compare those factors to predictors of depression prior to the pandemic.We first document large changes to physical activity and sleep. Over the course of the 3-mo semester, average steps decline by over half from 10,000 to 4,600 steps per day, overall physical activity declines by about a third from 4.4 h to 2.9 h per day, and sleep increases by about 25 to 30 min per night. We also find dramatic shifts in self-reported time use. Time spent socializing with others declines by over half to less than 30 min per day, while screen time more than doubles to over 5 h per day (excluding screen time for classes or work). These lifestyle disruptions stand alongside stark increases in depression during the pandemic. We estimate that at the end of the spring 2020 semester in April an estimated 61% of our participants were at risk for clinical depression. This represents about a 90% increase over rates of 32% in the same population just 2 mo earlier prior to the pandemic.Using difference-in-differences and individual fixed-effects regressions, we show that the changes in physical activity, sleep, social interactions, screen time, and depression are all statistically significant compared to changes in prior cohorts (P<0.001). The concurrent decline of both physical activity and mental health is particularly worrisome, as prior work suggests that the coexistence of mental health problems alongside poor physical activity worsens overall health outcomes (5). In line with this work, we find that large declines in physical activity during COVID-19 are associated with 15 to 18 percentage point higher rates of depression compared to small disruptions in baseline habits (P=0.012).To link lifestyle and mental health we exploit our rich longitudinal data and use tree-based classification methods to identify risk factors for depression during COVID-19. Taken together, the predictors of depression in the 2020 cohort differ significantly from prior cohorts (P<0.001). When we examine specific risk factors we find that changes in lifestyle behaviors are more closely linked to depression during the pandemic than in prior cohorts. In particular, large disruptions in physical activity emerge as a leading risk factor for depression during COVID-19. In contrast to prepandemic cohorts in which there is little relationship between disruptions and mental health, those participants who sustain their baseline exercise habits during the pandemic are at significantly lower risk of depression.Building on this analysis, after the spring 2020 semester ended in April we continued to track a subsample of our participants through July 2020. During this period, we find evidence of a partial “bounce back” in physical activity and mental health toward baseline levels. Average daily steps increase to about 6,400 steps per day in May and remain steady through July, closing about a third of the decline from the onset of the pandemic in March and April. There is also some decline in average measures of depression, with estimated rates of depression ranging from 46% to 50% in May through July. This represents an improvement compared to the end of the semester in April but remains flat over this period and is still about 50% higher than prepandemic rates.In order to examine whether a policy intervention could help counteract some of the adverse impacts of the pandemic, we implemented a randomized intervention halfway through this period. Building on our findings and on prior work on the link between physical activity and mental health (6), in June 2020 we randomized half of our participants to receive incentives for walking at least 10,000 steps per day for 2 wk. Our intervention significantly increased average steps by about 2,300 steps per day and physical activity by almost 40 min per day compared to the control group (P<0.001), with the treatment group close to their baseline prepandemic levels. However, the impact on exercise did not translate into an improvement in mental health measured at the end of the intervention period.In a postintervention follow-up we find that average steps in the treatment group declined to the same levels as in the control group about a week after the intervention ended. In July 2020, 1 mo after the intervention ended, we find no differences in average measures of depression between treatment participants who were randomized to the physical activity intervention and participants in the control group.Our study contributes to the growing literature examining the impact of the coronavirus pandemic on physical activity and mental well-being. Lifestyle disruptions during COVID-19 have been documented in studies focusing on a single type of behavior, such as exercise (7), sleep (8), social distancing (9, 10), or mental health (11–21). While our sample is not nationally representative, our measures of mental health are in line with those from larger and nationally representative samples using various measures of mental health both prior to the pandemic (4) and during the pandemic (1, 22).^*Related work using cross-sectional data finds an association between self-reported changes in physical activity during the pandemic and measures of mental health (25). This paper also relates to the broader research on the determinants of mental health (26–30) as well as work on health behavior change. Prior studies demonstrate how changing circumstances or context can quickly disrupt healthy habits (31, 32). In addition to documenting such disruptions as a consequence of the pandemic, our work investigates the relationships between disruptions in lifestyle habits and well-being.Taken together, our findings suggest a puzzle: Why are disruptions to physical activity and mental health strongly associated but restoration of physical activity through our intervention does not meaningfully improve mental health? First, the impact of physical activity may require a longer-term intervention. Second, physical activity may have important interactions with other lifestyle behaviors such as social interactions. It may also reflect correlation with other unobserved determinants of mental health. Finally, it could be the case that the relationship between physical activity and depression is driven more by mental health than it is by lifestyle habits. For example, the strong association between maintenance of healthy habits and depression during COVID-19 could partially reflect individuals’ ability to adapt to adversity and sustain their lifestyle despite the pandemic. Such resilience in the face of large disruptions may be critical for well-being during COVID-19.     

Brief Report: Dynamics of racial disparities in all-cause mortality during the COVID-19 pandemic

As research documenting disparate impacts of COVID-19 by race and ethnicity grows, little attention has been given to dynamics in mortality disparities during the pandemic and whether changes in disparities persist. We estimate age-standardized monthly all-cause mortality in the United States from January 2018 through February 2022 for seven racial/ethnic populations. Using joinpoint regression, we quantify trends in race-specific rate ratios relative to non-Hispanic White mortality to examine the magnitude of pandemic-related shifts in mortality disparities. Prepandemic disparities were stable from January 2018 through February 2020. With the start of the pandemic, relative mortality disadvantages increased for American Indian or Alaska Native (AIAN), Native Hawaiian or other Pacific Islander (NHOPI), and Black individuals, and relative mortality advantages decreased for Asian and Hispanic groups. Rate ratios generally increased during COVID-19 surges, with different patterns in the summer 2021 and winter 2021/2022 surges, when disparities approached prepandemic levels for Asian and Black individuals. However, two populations below age 65 fared worse than White individuals during these surges. For AIAN people, the observed rate ratio reached 2.25 (95% CI = 2.14, 2.37) in October 2021 vs. a prepandemic mean of 1.74 (95% CI = 1.62, 1.86), and for NHOPI people, the observed rate ratio reached 2.12 (95% CI = 1.92, 2.33) in August 2021 vs. a prepandemic mean of 1.31 (95% CI = 1.13, 1.49). Our results highlight the dynamic nature of racial/ethnic disparities in mortality and raise alarm about the exacerbation of mortality inequities for Indigenous groups due to the pandemic.     

Increased physical inactivity and weight gain during the COVID-19 pandemic in Sri Lanka: An online cross-sectional survey

AimsThis study aimed to investigate the immediate impact of COVID-19 quarantine measures on physical inactivity and weight gain among Sri Lankans.MethodsAn online cross-sectional survey was conducted from the 27th of May to 2^nd of June 2021 using Google forms. The questionnaire including socio-demographics and physical activity related questions was distributed through social media platforms.ResultsA total of 3707 respondents were included in the analysis (59.6% females). The majority were employed, resided in Colombo district and, as a minimum, had a degree. More than half of the respondents (52.4%) reported decreased exercise levels, 63.5% increased sitting time and 82.7% increased screen time. Adults of 31–35 (OR 1.96; 95% CI,1.321–2.894, p < 0.001) and 36–40 (OR 1.67; 95% CI, 1.099–2.524, p < 0.016) had increased sitting times compared to other age groups. A weight gain was reported by 38.5% with a mean (SD) increase of 3.61 (±2.35) kg. There was a significant difference in weight gain between genders (p < 0.001) and ethnic groups (p < 0.001).ConclusionsAn overall increase in physical inactivity such as reduced exercises, increased sitting time and screen time were observed. Furthermore, a considerable proportion of the population has increased body weight.     

COVID-19 impacts on drinking and mental health in emerging adults: Longitudinal changes and moderation by economic disruption and sex

Background

There are significant concerns that the COVID-19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross-sectional. In a sample of emerging adults, over a two-week period during the pandemic, the current study examined: (1) changes in drinking-related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra-pandemic measures were compared to pre-pandemic measures.

Methods

Participants were 473 emerging adults (M_age = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra-pandemic data were matched to participant pre-pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol-related consequences, and mental health indicators.

Results

Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression.

Conclusions

During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.

     

Factors related to Japanese nurses’ desire to quit their jobs during the COVID-19 pandemic: A cross-sectional study

The purpose of this study was to investigate the factors related to Japanese nurses’ desire to quit their jobs during the Omicron wave of the coronavirus disease 2019 pandemic. We distributed an original, self-administered questionnaire to nurses at 3 facilities that accepted patients with coronavirus disease 2019 in Ishikawa Prefecture, Japan. Of the 625 nurses, 152 responded (24.3%); after excluding 3 men to rule out the effects of sex, responses for 81 (53.3%) nurses were analyzed. In total, 49 (60.5%) nurses expressed a desire to quit their current job. After controlling for the effects of age and years of experience, factors related to the desire to quit the current job included having fewer than 2 years of experience (odds ratio [OR] 9.08, 95% confidence interval [CI] 1.69–48.87), feeling anxiety at work (OR 4.59, 95% CI 1.01–20.81), being afraid to go to work (OR 4.10, 95% CI 1.20–21.69), and experiencing difficulty talking to people (OR 10.26, 95% CI 1.48–70.99). Nurse managers should regularly screen nurses who have fewer than 2 years of experience, feel anxiety at work, are afraid to go to work, and find it difficult to talk to people. Early action may prevent the turnover of nurses during a public health emergency.     

COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract

The pandemic of coronavirus disease 2019(COVID-19), caused by a newly identified β-coronavirus(SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid(RNA) has been isolated from patient stools, suggesting a possible gastrointestinal(GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms' mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the gastroenteritis type symptoms predominate.     

Public health measures during the COVID-19 pandemic through the lens of community organisations and networks in the Netherlands (2020–2021): five lessons for pandemic decision-making

BackgroundDuring the coronavirus disease (COVID-19) pandemic, key persons who were formally or informally active in community organisations and networks, such as sports clubs or cultural, educational, day care and healthcare facilities, occupied a key position between governments and citizens. However, their experiences, the dilemmas they faced and the solutions they generated when implementing COVID-19 measures in their respective settings are understudied.AimWe aimed to understand how key persons in different community organisations and networks experienced and responded to the COVID-19 measures in the Netherlands.MethodsBetween October 2020 and December 2021, the Corona Behavioural Unit at the Dutch national public health institute, conducted qualitative research based on narratives derived from 65 in-depth interviews with 95 key persons from 32 organisations and networks in eight different sectors.ResultsFirstly, key persons enhanced adherence and supported the resilience and well-being of people involved in their settings. Secondly, adherence was negatively affected where COVID-19 measures conflicted with important organisational goals and values. Thirdly, small changes and ambiguities in COVID-19 policy had substantial consequences, depending on the context. Fourthly, problem-solving was achieved through trial-and-error, peer support, co-creation and transparent communication. Lastly, the COVID-19 pandemic and measures highlighted inequalities in access to resources.ConclusionPandemic preparedness requires organisational and community preparedness and a multidisciplinary public health approach. Structural engagement of governments with key persons in community organisations and networks is key to enhance public trust and adherence to pandemic measures and contributes to health equity and the well-being of the people involved.