Views on the need to implement restriction policies to be able to address COVID-19 in the United States

Multiple developmental disabilities among American children: prevalence and secular trends 2016-2022

OBJECTIVES

We aimed to estimate the prevalence of multiple developmental disabilities, identify associated characteristics, and examine trends among American children from 2016 to 2022.

STUDY DESIGN

This was a cross-sectional study.

METHODS

Using the National Survey of Children's Health data from 2016 to 2022, we estimated the prevalence of multiple developmental disabilities among children aged 3-17 years. Multiple developmental disabilities were defined as two or more concurrent disabilities from 12 common disabilities. Trends were investigated using log-linear regression. Multivariate log-binominal regression was used to compare the prevalence prior to the COVID-19 pandemic (2016-2019) with prevalence during the COVID-19 pandemic (2020-2022).

RESULTS

From 239,534 eligible children (mean age = 10.1 years; male = 51.7%), we found the overall prevalence of multiple developmental disabilities was 10.6%. The most predominant phenotype was attention-deficit/hyperactivity disorder concurrent with behavioural problems (2.1%). Higher prevalence was found among boys, non-Hispanic black children, those from low-household-income families and from families with lower education levels. Prevalence of multiple developmental disabilities increased from 9.8% in 2016 to 11.5% in 2022 (P = 0.014) with significantly higher prevalence during COVID-19 pandemic than before (11.2% vs 10.1%). These increases were found consistently across most sociodemographic groups.

CONCLUSIONS

Children from certain socio-disadvantaged groups were disproportionally affected by multiple developmental disabilities, highlighting the need for targeted strategies to improve health. The increasing prevalence during the pandemic suggests the need for ongoing monitoring of the trend and the impact of these conditions.

'Staying in the lane' of public health? Boundary-work in the roles of state health officials and experts in COVID-19 policymaking

The state-level COVID-19 response in the United States necessitated collaboration between governor' offices, health departments and numerous other departments and outside experts. To gain insight into how health officials and experts contributed to advising on COVID-19 policies, we conducted semi-structured interviews with 25 individuals with a health specialisation who were involved in COVID-19 policymaking, taking place between February and December 2022. We found two diverging understandings of the role of health officials and experts in COVID-19 policymaking: the role of 'staying in the lane' of public health in terms of the information that they collected, their advocacy for policies and their area of expertise and the role of engaging in the balancing of multiple considerations, such as public health, feasibility and competing objectives (such as the economy) in the crafting of pandemic policy. We draw on the concept of boundary-work to examine how these roles were constructed. We conclude by considering the appropriateness as well as the ethical implications of these two approaches to public health policymaking.

Development of New Stringency Indices for Nonpharmacological Social Distancing Policies Implemented in Korea During the COVID-19 Pandemic: Random Forest Approach

BACKGROUND

In the absence of an effective treatment method or vaccine, the outbreak of the COVID-19 pandemic elicited a wide range of unprecedented restriction policies aimed at mitigating and suppressing the spread of the SARS-CoV-2 virus. These policies and their Stringency Index (SI) of more than 160 countries were systematically recorded in the Oxford COVID-19 Government Response Tracker (OxCGRT) data set. The SI is a summary measure of the overall strictness of these policies. However, the OxCGRT SI may not fully reflect the stringency levels of the restriction policies implemented in Korea. Korea implemented 33 COVID-19 restriction policies targeting 4 areas: public facilities, public events, social gatherings, and religious gatherings.

OBJECTIVE

This study aims to develop new Korea Stringency Indices (KSIs) that reflect the stringency levels of Korea's restriction policies better and to determine which government-implemented policies were most effective in managing the COVID-19 pandemic in Korea.

METHODS

The random forest method was used to calculate the new KSIs using feature importance values and determine their effectiveness in managing daily COVID-19 confirmed cases. Five analysis periods were considered, including November 01, 2020, to January 20, 2021 (Period 1), January 20, 2021, to June 27, 2021 (Period 2), November 01, 2020, to June 27, 2021 (Period 3), June 27, 2021, to November 01, 2021 (Period 4), and November 01, 2021, to April 24, 2022 (Period 5).

RESULTS

Among the KSIs, public facilities in period 4, public events in period 2, religious gatherings in periods 1 and 3, and social gatherings in period 5 had the highest importance. Among the public facilities, policies associated with operation hour restrictions in cinemas, restaurants, PC rooms, indoor sports facilities, karaoke, coffee shops, night entertainment facilities, and baths or saunas had the highest importance across all analysis periods. Strong positive correlations were observed between daily confirmed cases and public facilities, religious gatherings, and public events in period 1 of the pandemic. From then, weaker and negative correlations were observed in the remaining analysis periods. The comparison with the OxCGRT SI showed that the SI had a relatively lower feature importance and correlation with daily confirmed cases than the proposed KSIs, making KSIs more effective than SI.

CONCLUSIONS

Restriction policies targeting public facilities were the most effective among the policies analyzed. In addition, different periods call for the enforcement of different policies given their effectiveness varies during the pandemic.

Trends in Orthopedic Management of Distal Radius Fractures Among Medicare Beneficiaries From 2019 to 2020: A Claims Analysis

Purpose

Radius and ulna fractures are among the most common fractures. These fractures are managed through operative or nonsurgical treatment, with varying implications in terms of cost and functional outcome. There are few studies that robustly characterize the management of distal radius fractures (DRFs) in the United States during the COVID-19 pandemic. Furthermore, this has not been studied among the Medicare patient population, who are particularly vulnerable to fragility fractures and COVID-19. The purpose of this study is to analyze the services provided to Medicare beneficiaries both before and during the COVID-19 pandemic to determine how procedure volume was affected in this patient population.

Methods

We retrospectively analyzed services using the physician or supplier procedure summary data from the Centers for Medicare and Medicaid Services. All services provided by physicians between January 1, 2019, and December 31, 2020, were included. The data were stratified by US census region using insurance carrier number and pricing locality codes. We also compared data between states that maintained governors affiliated with the Democratic or Republican parties for the duration of the study.

Results

There was an overall decrease in claims regarding DRFs management from 2019 to 2020. There was a dramatic decline in procedure volume (-6.3% vs -12.9%). Of all distal radius related claims there was a relative increase in the proportion of operatively managed DRFs in 2020, from 50.2% to 52.0%. The Midwest saw the greatest decline in operatively managed DRFs, whereas the West experienced the smallest per-capita decline across all procedures. After separating the data by party affiliation, it was also found that operative and nonsurgical procedure volumes fell more sharply in states with Democratic governors.

Conclusions

This study shows a decrease in DRF procedural volume among Medicare beneficiaries. This data suggests that the operative and nonsurgical management of DRFs may have been affected by pandemic factors such as quarantine guidelines and supply chain or resource limitations. This may assist surgeons and health care systems in predicting how similar crises may affect operative volume.

Type of study/level of evidence

Therapeutic IV.

COVID-19 Government restriction policy, COVID-19 vaccination and stock markets: Evidence from a global perspective

We use the COVID-19 stringency index to investigate the relationship among COVID-19 government restriction policy, COVID-19 vaccination and stock markets. We find that the impact of the change rate of COVID-19 stringency index on stock returns turns from significant in the pre-vaccination period to insignificant in the post-vaccination period. Bad news from COVID-19 restriction policy cause more stock volatilities than good news. The advent of COVID-19 vaccination weakens the linkage of COVID-19 stringency index and stock market, while COVID-19 stringency index only plays a partially mediate role in the correlation between COVID-19 cumulative vaccination rate and stock market performance.

Impact of Personal Experience of COVID-19 Disease on Recreational Anglers' Attitudes and Behaviors

BACKGROUND

Anglers are a large social group with access to a "relatively safe" form of recreation, that allows the opportunity to relieve stress. An important question, however, is how they did so, and to what extent their perceived COVID-19 transition status influenced decisions both in life and at the fishing site.

AIM

Our study aimed to determine the dynamics of anglers' attitudes and behaviors during the COVID-19 pandemic as a result of the different statuses of their exposure to the SARS-CoV-2 virus. We assumed that the behavior of anglers who have not experienced the disease (were not ill and not sure if ill) will be similar and, on the other hand, different from the behavior of those who have experienced COVID-19.

METHODS

The web-assisted interviews survey was used among 586 anglers with different COVID-19 disease experience statuses. Their pandemic behavior and activities by four age groups were studied using non-metric multidimensional scaling. Redundancy analysis has been used to identify the relationship between anglers' life attitudes and socioeconomic and demographic factors, taking into account their preferences and involvement in fishing.

RESULTS

We have demonstrated that the behavior of anglers who have not experienced COVID-19 disease and do not present a reckless attitude toward pandemic threats, do not show significant differences from the life attitudes of the group experienced by the SARS-CoV-2 virus. These two groups comprise more than 70% of anglers. However, the rest show a lack of interest in an aware diagnosis of their health and a low level of acceptance of self-restraint in the area of direct social contact.

CONCLUSIONS

Unawareness, combined with ignorance, could be a potential factor in the transmission of the virus while fishing. The behaviors of almost 30% of anglers are particularly risky when combined with a strong need to fish in the company of friends and familiar people. Anglers' social identity should be tapped by fishery managers. Targeted educational campaigns should be aimed at groups around specific fishing spots. The need for self-limitation under the pandemic should be promoted for the benefit of the general public and to maintain the reputation of angling as a safe recreational activity.

Association of Republican partisanship with US citizens’ mobility during the first period of the COVID crisis

While Republican states have been criticized for their limited efforts to contain the spread of COVID-19, it is important to consider that political orientation can modify human behaviour via complex effects that are still poorly understood. During the first period of the pandemic, we found that the association of Republican partisanship with US citizens' mobility varied depending on the nature of the exposure being considered. First, Republican partisanship was associated with increased mobility when the stringency of anti-COVID measures increased. Second, Republican partisanship was associated with decreased mobility when COVID-related deaths increased. Third, Republican partisanship was associated with increased mobility over time, i.e. as time went by, citizens living in Republican states were more mobile than those in Democratic states. These findings raise caution on any over-interpretation of the impact of polarization in US politics on COVID-related behaviour. They prompt consideration of persuasive tools that emphasize risk perception to promote social distancing in Republican states, rather than relying heavily on stringent anti-COVID interventions.

Post-Pandemic Stress Disorder as an Effect of the Epidemiological Situation Related to the COVID-19 Pandemic

According to many experts in the fields of psychology and psychiatry, the destabilization resulting from the coronavirus pandemic may not be as noticeable now as it will be after the pandemic period is over. Undoubtedly, the fact that the surrounding reality is standardized and normalized by many at present contributes to this. In the opinion of many researchers, the scale and degree of trauma experienced by society will only be noticed by many once the pandemic is over. Many also suggest that we will experience post-pandemic stress disorder. This literature review aims to bring together in one place the information that speaks to the nature of the problem, which is post-pandemic stress disorder. The main sections of the paper deal with exposure to the disorder in the general population and a review of the current literature on the subject. The second section deals with a group of medical personnel who are on the direct frontline in the fight against the COVID-19 pandemic; it is assumed here that they are those who are at much higher risk of developing post-pandemic stress disorder.

Reconsidering the role of place in health and welfare services: lessons from the COVID-19 pandemic in the United States and Canada

Places-the meaningful locations of daily life-have been central to the wellbeing of humans since they first formed social groups, providing a stable base for individuals, families, and communities. In the United States and Canada, as elsewhere, place also plays a foundational role in the provision of critical social and health services and resources. Yet the globally destabilizing events of the COVID-19 pandemic have dramatically challenged the concept, experience, and meaning of place. Place-centered public health measures such as lockdowns and stay-at-home orders have disrupted and transformed homes, neighborhoods, workplaces, and schools. These measures stressed families and communities, particularly among marginalized groups, and made the delivery of vital resources and services more difficult. At the same time, the pandemic has stimulated a range of creative and resilient responses. Building from an overview of these effects and drawing conceptually on theories of people-place relationships, this paper argues for critical attention to reconsidering and re-envisioning prevailing assumptions about place-centric policies, services, and practices. Such reappraisal is vital to ensuring that, going forward, scholars, policymakers, and practitioners can effectively design and deliver services capable of maintaining social connections, safety, and wellbeing in contexts of uncertainty, inequality, and flux.

Managing employees’ health, safety and anxiety in a pandemic

Purpose

This paper identifies and discusses the strategies adopted by a manufacturing company to manage its national and international employees' anxiety, health and safety with the onset of the COVID-19 pandemic, to fill a current research gap.

Design/methodology/approach

This paper uses the qualitative method to identify the strategies employed by a manufacturing company to manage its employees' anxiety, health and safety during the COVID-19 pandemic. Thematic analysis of data from fourteen semi-structured interviews is presented.

Findings

Results from the data analysed show that five strategies that help manage employees' health, safety and anxiety are - enhanced communication, formulation and enforcement of policies, rules and regulation, education and training, and management commitment. The findings indicate that the implementation of these strategies does not lead to a negative effect and therefore can conclude that there was no cobra effect.

Research limitations/implications

Although exploratory and based on one organisation; the findings lay the foundation for future theoretically grounded research on management of employees' health, safety and anxiety.

Practical implications

Findings could be the basis for training for managers and also be used to modify the strategies applied in managing employees' anxiety, health and safety.

Originality/value

This paper investigates and offers insight into the best strategies to adopt to manage employees' anxiety, safety and health during the COVID-19 pandemic in the manufacturing sector.

The impact of the COVID-19, social distancing, and movement restrictions on crime in NSW, Australia

The spread of COVID-19 has prompted Governments around the world to impose draconian restrictions on business activity, public transport, and public freedom of movement. The effect of these restrictions appears to vary from country to country and, in some cases, from one area to another within a country. This paper examines the impact of the COVID-19 restrictions imposed in New South Wales (NSW) by the State Government. We examine week-to-week changes in 13 categories of crime (and four aggregated categories) from 2 January 2017 to 28 June 2020. Rather than using the pre-intervention data to make a forecast and then comparing that with what is actually observed, we use a Box-Jenkins (ARIMA) approach to model the entire time series. Our results are broadly in accord with those of other studies, but we find no effect of the lockdown (upward or downward) on domestic assault.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s40163-021-00160-x.

Associations Between Governor Political Affiliation and COVID-19 Cases, Deaths, and Testing in the U.S

INTRODUCTION

The response to the COVID-19 pandemic became increasingly politicized in the U.S., and the political affiliation of state leaders may contribute to policies affecting the spread of the disease. This study examines the differences in COVID-19 infection, death, and testing by governor party affiliation across the 50 U.S. states and the District of Columbia.

METHODS

A longitudinal analysis was conducted in December 2020 examining COVID-19 incidence, death, testing, and test positivity rates from March 15, 2020 through December 15, 2020. A Bayesian negative binomial model was fit to estimate the daily risk ratios and posterior intervals comparing rates by gubernatorial party affiliation. The analyses adjusted for state population density, rurality, Census region, age, race, ethnicity, poverty, number of physicians, obesity, cardiovascular disease, asthma, smoking, and presidential voting in 2020.

RESULTS

From March 2020 to early June 2020, Republican-led states had lower COVID-19 incidence rates than Democratic-led states. On June 3, 2020, the association reversed, and Republican-led states had a higher incidence (risk ratio=1.10, 95% posterior interval=1.01, 1.18). This trend persisted through early December 2020. For death rates, Republican-led states had lower rates early in the pandemic but higher rates from July 4, 2020 (risk ratio=1.18, 95% posterior interval=1.02, 1.31) through mid-December 2020. Republican-led states had higher test positivity rates starting on May 30, 2020 (risk ratio=1.70, 95% posterior interval=1.66, 1.73) and lower testing rates by September 30, 2020 (risk ratio=0.95, 95% posterior interval=0.90, 0.98).

CONCLUSIONS

Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the U.S. Future policy decisions should be guided by public health considerations rather than by political ideology.

Associations between governor political affiliation and COVID-19 cases, deaths, and testing in the United States

INTRODUCTION

The response to the COVID-19 pandemic became increasingly politicized in the United States (US) and political affiliation of state leaders may contribute to policies affecting the spread of the disease. This study examined differences in COVID-19 infection, death, and testing by governor party affiliation across 50 US states and the District of Columbia.

METHODS

A longitudinal analysis was conducted in December 2020 examining COVID-19 incidence, death, testing, and test positivity rates from March 15 through December 15, 2020. A Bayesian negative binomial model was fit to estimate daily risk ratios (RRs) and posterior intervals (PIs) comparing rates by gubernatorial party affiliation. The analyses adjusted for state population density, rurality, census region, age, race, ethnicity, poverty, number of physicians, obesity, cardiovascular disease, asthma, smoking, and presidential voting in 2020.

RESULTS

From March to early June, Republican-led states had lower COVID-19 incidence rates compared to Democratic-led states. On June 3, the association reversed, and Republican-led states had higher incidence (RR=1.10, 95% PI=1.01, 1.18). This trend persisted through early December. For death rates, Republican-led states had lower rates early in the pandemic, but higher rates from July 4 (RR=1.18, 95% PI=1.02, 1.31) through mid-December. Republican-led states had higher test positivity rates starting on May 30 (RR=1.70, 95% PI=1.66, 1.73) and lower testing rates by September 30 (RR=0.95, 95% PI=0.90, 0.98).

CONCLUSION

Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the US. Future policy decisions should be guided by public health considerations rather than political ideology.

A Cross-Sectional Survey of Risky Travel and Leisure Behaviors During the COVID-19 Pandemic

PURPOSE

COVID-19 is largely spread through close contact with infected people in indoor spaces. Avoiding these spaces is one of the most effective ways to slow the spread. This study assessed who had engaged in risky travel and leisure behaviors before the availability of vaccines.

DESIGN

National cross-sectional on-line survey collected in November and December 2020. Setting: United States; Participants: 2589 adults representative by gender and race/ethnicity to the US population; Measures: The survey assessed if people had resumed 11 risky behaviors during the pandemic, prior to vaccines. Independent variables included age, race/ethnicity, region of the country, education, income, preexisting conditions, perceived severity and susceptibility, positive COVID diagnosis, and political ideology.

ANALYSIS

Univariate analysis and logistic regressions were used to assess demographic and psychological factors of those resuming these behaviors. Results: Most (60.3%) of people had resumed at least 1 behavior with eating inside of restaurants (33.2%) and visiting family and friends (37.5%) being the most prevalent. In the multivariate analyses, perceived susceptibility was significant across all behaviors. Young people, fiscal conservatives, and people with higher perceived severity were more likely to perform several of the behaviors. Preexisting conditions did not predict any of the behaviors.

CONCLUSIONS

Travel and leisure behaviors vary by type of risk and may need specific tailored, prevention messages to promote risk reduction during future pandemics.