Head lice: impact of COVID-19 and slow recovery of prevalence in Cambridgeshire, UK

Following school closures and changes in contact behavior of children and adults a reduced head louse prevalence has been reported from across the globe. In parallel, sales of treatments were observed to fall, partly because of supply problems of some products following the pandemic, but this did not appear to result in more cases of infestation. Surveys of schools in and around Cambridge, UK, found that infestation rates were significantly reduced particularly in city schools compared with similar surveys conducted before the COVID-19 pandemic. Contrary to expectation the number of cases in schools has only risen slowly since schools returned to normal full time working in 2022-2023.

Levels and drivers of urban black carbon and health risk assessment during pre- and COVID19 lockdown in Augsburg, Germany

This study aimed to evaluate the levels and phenomenology of equivalent black carbon (eBC) at the city center of Augsburg, Germany (01/2018 to 12/2020). Furthermore, the potential health risk of eBC based on equivalent numbers of passively smoked cigarettes (PSC) was also evaluated, with special emphasis on the impact caused by the COVID19 lockdown restriction measures. As it could be expected, peak concentrations of eBC were commonly recorded in morning (06:00-8:00 LT) and night (19:00-22:00 LT) in all seasons, coinciding with traffic rush hours and atmospheric stagnation. The variability of eBC was highly influenced by diurnal variations in traffic and meteorology (air temperature (T), mixing-layer height (MLH), wind speed (WS)) across days and seasons. Furthermore, a marked "weekend effect" was evidenced, with an average eBC decrease of ∼35% due to lower traffic flow. During the COVID19 lockdown period, an average ∼60% reduction of the traffic flow resulted in ∼30% eBC decrease, as the health risks of eBC exposure was markedly reduced during this period. The implementation of a multilinear regression analysis allowed to explain for 53% of the variability in measured eBC, indicating that the several factors (e.g., traffic and meteorology) may contribute simultaneously to this proportion. Overall, this study will provide valuable input to the policy makers to mitigate eBC pollutant and its adverse effect on environment and human health.

Methane sources from waste and natural gas sectors detected in Pune, India, by concentration and isotopic analysis

Methane (CH₄) is a potent greenhouse gas and also plays a significant role in tropospheric chemistry. High-frequency (sub-hourly) measurements of CH₄ and carbon isotopic ratio (δ¹³CH₄) have been conducted at Pune (18.53°N, 73.80°E), an urban environment in India, during 2018-2020. High CH₄ concentrations were observed, with a mean of 2100 ± 196 ppb (1844-2749 ppb), relative to marine background concentrations. The δ¹³CH₄ varied between -45.11 and -50.03 ‰ for the entire study period with an average of -47.41 ± 0.94 ‰. The diurnal variability of CH₄ typically showed maximum values in the morning (08:00-09:00 local time) and minimum in the afternoon (15:00 local time). The deepest diurnal amplitude of ~500 ppb was observed during winter (December-February), which was reduced to less than half, ~200 ppb, during the summer (March-May). CH₄ concentration at Pune showed a strong seasonality (470 ppb), much higher than that at Mauna Loa, Hawaii. On the other hand, δ¹³CH₄ records did not show distinct seasonality at Pune. The δ¹³CH₄ values revealed that the significant sources of CH₄ in Pune were from the waste sector (enhanced during the monsoon season; signature of depleted δ¹³CH₄), followed by the natural gas sector with a signature of enriched δ¹³CH₄. Our analysis of Covid-19 lockdown (April to May 2020) effect on the CH₄ variability showed no signal in the CH₄ variability; however, the isotopic analysis indicated a transient shift in the CH₄ source to the waste sector (early summer of 2020).

Pancreatic surgery during the COVID-19 pandemic 2020-2021: an observational cohort study from a third level referral center

Background

During the COVID pandemic there has been limited access to elective surgery including oncologic surgery in several countries world-wide. The aim of this study was to investigate if there was any lockdown effect on pancreatic surgery with special focus on malignant pancreatic and periampullary tumours.

Methods

Patients who underwent pancreatic surgery during the two Danish lockdown periods from 11. March 2020 and the following 12 months were compared with patients who were operated the preceding 3 years. Data on patients’ characteristics, waiting time, operations, and clinical outcomes were evaluated.

Results

During lockdown and the previous three years the annual number of resections were 242, 232, 253, and 254, respectively (p = 0.851). Although the numbers were not significantly different, there were fluctuations in operations and waiting time during the lockdown. During the second outbreak of COVID October 2020 to March 2021 the overall median waiting time increased to 33 days (quartiles 26;39) compared to 23 (17;33) days during the first outbreak from March to May 2020 (p = 0.019). The same difference was seen for patients with malignant tumours, 30 (23;36) vs. 22 (18;30) months (p = 0.001). However, the fluctuations and waiting time during lockdown was like the preceding three years. Neither 30- nor 90-days mortality, length of stay, number of extended operations, and complications and tumour stage were significantly different from previous years.

Conclusions

There were significant fluctuations in waiting time for operations during the lockdown, but these variations were not different from the preceding three years, wherefore other explanations than an impact from COVID are conceivable.

Interpreting the COVID effect on atmospheric constituents over the Indian region during the lockdown: chemistry, meteorology, and seasonality

Most of the published articles which document changes in atmospheric compositions during the various lockdown and unlock phases of COVID-19 pandemic have made a direct comparison to a reference point (which may be 1 year apart) for attribution of the COVID-mediated lockdown impact on atmospheric composition. In the present study, we offer a better attribution of the lockdown impacts by also considering the effect of meteorology and seasonality. We decrease the temporal distance between the impacted and reference points by considering the difference of adjacent periods first and then comparing the impacted point to the mean of several reference points in the previous years. Additionally, we conduct a multi-station analysis to get a holistic effect of the different climatic and emission regimes. In several places in eastern and coastal India, the seasonally induced changes already pointed to a decrease in PM concentrations based on the previous year data; hence, the actual decrease due to lockdown would be much less than that observed just on the basis of difference of concentrations between subsequent periods. In contrast, northern Indian stations would normally show an increase in PM concentration at the time of the year when lockdown was effected; hence, actual lockdown-induced change would be in surplus of the observed change. The impact of wind-borne transport of pollutants to the study sites dominates over the dilution effects. Box model simulations point to a VOC-sensitive composition.

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care Blood Center in southern Karnataka, India

Introduction

With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted.

Methods

We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted.

Results

During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff’ COVID-19 safety assurance, were followed.

Conclusion

The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.

Source attribution of air pollution using a generalized additive model and particle trajectory clusters

Speciated hourly measurements of fine aerosols were made for more than two years at an urban, an industrial and a port site in Busan, Korea. A Generalized Additive Model (GAM) was designed to deconvolve factors contributing to the pollutant concentrations at multiple scales. The model yields estimates of source contributions to pollution by separately identifying the signals in the time series due to meteorology, vertical mixing, horizontal wind transport and temporal variations such as diurnal, weekly, seasonal and annual trends. The GAM model was expanded to include FLEXPART back trajectory clusters generated using fuzzy c-means clustering. This made it possible to quantify the impact of long-range transport using the Trajectory Cluster Contribution Function (TCCF). TCCF provides a development of methods such as Concentration Field Analysis and Potential Source Contribution Function by providing numerical estimates of concentration changes associated with different air mass transport patterns while accounting for possible confounding factors from meteorology. The GAM simulations identified the importance of local transport for primary pollutants and long-range transport from China for secondary pollutants. Local factors accounted for up to 72% of the variance in concentrations of NO₂ and elemental carbon whereas large-scale/seasonal factors accounted for up to 56% of PM_2.5 and 80% of inorganic species. The algorithm further identified the importance of the weekend effect and the holiday effect at the different sites in Busan. The residual from the analysis was used to estimate the impact of the COVID-19 pandemic. The signature of the pandemic was different between the pollutants as well as from site to site. The model was able to distinguish small impacts from local pollutants at the residential site; short-lived acute impacts from industrial changes; and longer-term changes due to the early pandemic response in China.

Impact of lockdown on emergency general surgery during first 2020 COVID-19 outbreak

Purpose

To evaluate and analyze the impact of lockdown strategy due to coronavirus disease 2019 (COVID-19) on emergency general surgery (EGS) in the Milan area at the beginning of pandemic outbreak.

Methods

A survey was distributed to 14 different hospitals of the Milan area to analyze the variation of EGS procedures. Each hospital reported the number of EGS procedures in the same time frame comparing 2019 and 2020. The survey revealed that the number of patients during the COVID-19 pandemic outbreak in 2020 was reduced by 19% when compared with 2019. The decrease was statistically significant only for abdominal wall surgery. Interestingly, in 2020, there was an increase of three procedures: surgical intervention for acute mesenteric ischemia (p = 0.002), drainage of perianal abscesses (p = 0.000285), and cholecystostomy for acute cholecystitis (p = 0.08).

Conclusions

During the first COVID-19 pandemic wave in the metropolitan area of Milan, the number of patients operated for emergency diseases decreased by around 19%. We believe that this decrease is related either to the fear of the population to ask for emergency department (ED) consultation and to a shift towards a more non-operative management in the surgeons ‘decision making’ process. The increase of acute mesenteric ischaemia and perianal abscess might be related to the modification of dietary habits and reduction of physical activity related to the lockdown.

Assessment of lockdown effect in some states and overall India: A predictive mathematical study on COVID-19 outbreak

In the absence of neither an effective treatment or vaccine and with an incomplete understanding of the epidemiological cycle, Govt. has implemented a nationwide lockdown to reduce COVID-19 transmission in India. To study the effect of social distancing measure, we considered a new mathematical model on COVID-19 that incorporates lockdown effect. By validating our model to the data on notified cases from five different states and overall India, we estimated several epidemiologically important parameters as well as the basic reproduction number (R ₀). Combining the mechanistic mathematical model with different statistical forecast models, we projected notified cases in the six locations for the period May 17, 2020, till May 31, 2020. A global sensitivity analysis is carried out to determine the correlation of two epidemiologically measurable parameters on the lockdown effect and also on R ₀. Our result suggests that lockdown will be effective in those locations where a higher percentage of symptomatic infection exists in the population. Furthermore, a large scale COVID-19 mass testing is required to reduce community infection. Ensemble model forecast suggested a high rise in the COVID-19 notified cases in most of the locations in the coming days. Furthermore, the trend of the effective reproduction number (R_t ) during the projection period indicates if the lockdown measures are completely removed after May 17, 2020, a high spike in notified cases may be seen in those locations. Finally, combining our results, we provided an effective lockdown policy to reduce future COVID-19 transmission in India.

A single-centre observational cohort study to evaluate volume and severity of emergency general surgery admissions during the COVID-19 pandemic: Is there a "lockdown" effect?

INTRODUCTION

The COVID-19 pandemic has led to changes in NHS surgical service provision, including reduced elective surgical and endoscopic activity, with only essential emergency surgery being undertaken. This, combined with the government-imposed lockdown, may have impacted on patient attendance, severity of surgical disease, and outcomes. The aim of this study was to investigate a possible 'lockdown' effect on the volume and severity of surgical admissions and their outcomes.

METHODS

Two separate cohorts of adult emergency general surgery inpatient admissions 30 days immediately before (February 16, 2020 to March 15, 2020), and after UK government advice (March 16, 2020 to April 15, 2020). Data were collected relating to patient characteristics, severity of disease, clinical outcomes, and compared between these groups.

RESULTS

Following lockdown, a significant reduction in median daily admissions from 7 to 3 per day (p < 0.001) was observed. Post-lockdown patients were significantly older, frailer with higher inflammatory indices and rates of acute kidney injury, and also were significantly more likely to present with gastrointestinal cancer, obstruction, and perforation. Patients had significantly higher rates of Clavien-Dindo Grade ≥3 complications (p = 0.001), all cause 30-day mortality (8.5% vs. 2.9%, p = 0.028), but no significant difference was observed in operative 30-day mortality.

CONCLUSION

There appears to be a "lockdown" effect on general surgical admissions with a profound impact; fewer surgical admissions, more acutely unwell surgical patients, and an increase in all cause 30-day mortality. Patients should be advised to present promptly with gastrointestinal symptoms, and this should be reinforced for future lockdowns during the pandemic.