The Use of Geographic Information Systems to Shape COVID-19 Policies Regarding Masking and Distancing with a Partially Vaccinated Population

Geographic information systems (GIS) and choropleth maps for COVID-19 cases as well as COVID-19 test and vaccination rates proved very valuable to informing decision-making on the local and regional levels of government in Shelby County, Tennessee, USA. The authors have all served on the City of Memphis and Shelby County COVID Joint Task Force and share here their observations about the challenges and promises related to these techniques in the context of a fast-changing environment. As the pandemic unfolded, new virus variants emerged and the population became increasingly vaccinated. Consequently, the use of GIS changed, and maps needed to be continually adapted to the shifting needs of decision makers. The authors describe their approaches to leveraging GIS techniques to monitor the spread of the disease, draw conclusions about the effect of policy measures, and address health disparities. They outline the strengths and weaknesses of choropleth maps, reflect on how best to facilitate interorganizational communication of the derived information, and suggest desirable aspects of educational courses for GIS as well as skill sets in personnel that they came to appreciate as essential. © 2023 Taylor and Francis Group, LLC.

A framework for sustainable adaptive reuse: understanding vacancy and underuse in existing urban buildings

Cities have been built on the benefits of density, proximity, and connectivity. However, the recent COVID-19 pandemic, along with continuously evolving communication technologies, has seen an increase in vacancies and underuse of urban buildings, challenging the agglomeration benefits of cities and our understanding of business-as-usual. By reflecting on these continuous changes in our urban environment, we can better understand the dynamics in play, the various user needs, the temporary or permanent nature of these changes, and possible adaptive strategies to navigate our future toward a more sustainable and resilient state. This article, therefore, presents a systematic literature review, using PRISMA, to examine and map how vacancy intersects with adaptive reuse literature. This review examined 43 academic articles and revealed research predominately focusing on whole-building adaptive reuse of completely vacant buildings. This review highlighted that vacancy is mainly assumed in research, and both vacancy and adaptive reuse are insufficiently unpacked. A new adaptive reuse framework is proposed to address the misalignment between the realities of how a vacancy is distributed in building stocks and the focus on whole-building adaptive reuse. The framework is set to inform urban policy development supporting sustainable reuse. This article presents a point of departure to understand how adaptive planning approaches could be applied to enhance broader sustainability and resilience initiatives.

In-State versus Out-of-State Ophthalmic Telemedicine Utilization during the COVID-19 Pandemic

Purpose : During the COVID-19 pandemic, regulatory changes in the United States allowed physicians to practice telemedicine across state lines. Data on the use of interstate ophthalmic telemedicine during the pandemic are limited. We aimed to evaluate the geographic characteristics and interstate utilization of telemedical care as compared to in-person care at a tertiary eye care center during the pandemic. Methods : In this single-center, retrospective, cross-sectional study at Massachusetts Eye and Ear (MEE) from January 1 to December 31, 2020, clinical encounters were reviewed to extract patient and visit characteristics. In-person versus telemedical visit types were identified based on institutional categories and billing codes. Residential zip codes were used to estimate geographic characteristics of patients including distance from MEE and in-state versus out-of-state status. Pearson chi-squared tests were used to compare telemedical and in-person care groups. Results : A total of 1911 telemedical patients (2262 encounters) and 65763 in-person patients (147211 encounters) were included. The median (interquartile range;IQR) age of telemedicine patients was 61 (43-72) years, 62% of which were female. The median (IQR) age of in-person patients was 63 (49-72) years, 58% of which were female. Telemedicine patients included 14.7% (n=281) out-of-state patients, as compared to 12.0% (n=7876) out-of-state in-person patients (p<0.001). Regarding distance, 42.5% of telemedicine patients and 47.5% of in-person patients lived <10 miles (p<0.001), 41.9% and 41.3% lived 10-50 miles (p=0.611), 8.8% and 7.0% lived 51-100 miles (p=0.002), 3.9% and 2.5% lived 101- 250 miles (p<0.001), and 3.0% and 1.8% lived >250 miles (p<0.001) away from MEE, respectively. Conclusions : A significantly greater proportion of telemedical care, as compared to in-person care, was provided to out-of-state patients at a large eye care center during the pandemic. Moreover, a significantly greater proportion of telemedical care was utilized by patients living further away from the eye center. Proposals to revert to pre-pandemic policies requiring in-state telemedicine could set back forward progress made during the pandemic, including negative impacts on access to care and continuity of care for established patients. Expanded telemedicine licensure and scope could help advance the efficiency and deployment gains seen during the pandemic.

The chance of transition: strategies for multidisciplinary collaboration.

Many long-term childhood cancer survivors suffer from treatment-related late effects, which may occur in any organ and include a wide spectrum of conditions. Long-term follow-up (LTFU) is recommended to facilitate early diagnosis and to ensure better health outcomes. Due to the heterogeneity of these sequelae, different specialists work together in the diagnosis and treatment of these conditions. Experts from both pediatric and internal medicine are involved in age-appropriate care by providing a transition process. Hence, LTFU of childhood cancer survivors is a prototypic example of multidisciplinary care for patients with complex needs treated in a specialized setting. International collaborations of healthcare professionals and scientists involved in LTFU of childhood cancer survivors, such as the International Guideline Harmonization Group, compile surveillance recommendations that can be clinically adopted all over the world. These global networks of clinicians and researchers make a joint effort to address gaps in knowledge, increase visibility and awareness of cancer survivorship and provide an excellent example of how progress in clinical care and scientific research may be achieved by international and multidisciplinary collaboration.

Hospitalisation During Lockdown – Patients' Bed's-Eye View

Background: Global COVID pandemic and lockdowns have affected the patterns of hospital presentations for non-COVID related illnesses. Apprehension and perceived risk of hospitalisation has been postulated to be a significant deterrent to presentation. This study aims to explore pandemic and lockdown related concerns with regards to hospital admission from a patient’s perspective. Method: A cross sectional study was undertaken in the form of inpatient questionnaire for patients admitted to coronary care unit and the cardiology ward during level 4 lockdown. Questionnaire included six questions designed to gather patient perception of the impact of lockdown on their hospital presentation. Results: Out of 91 patients who completed the questionnaire, 41 (45%) were >70 years old. Twenty (22%) patients answered that lockdown delayed or affected their decision to present to hospital. Within this cohort, there was a statistical difference between those aged 70 years and younger and over 70 years old (16/50 [32%] versus 4/41 [10%], p=0.011). Conclusion: Apprehension and concerns regarding the risk of COVID was prevalent in a significant proportion of patients and affected/delayed their decision to present to hospital. This may partly explain lower rates of presentation during the pandemic.

Interrogating the Public Health Approach: Lessons from the Field of Urban Violence

Governmental responses to the COVID-19 pandemic have brought public health discourse to the fore in societies around the world. The public health idiom had already made serious inroads into understandings of, and attempts to address, urban violence (particularly among young men). With COVID-19 almost inevitably becoming ‘endemic’, the role of public health discourse will only become further entrenched and extend to the analysis of a wider range of societal ‘ills’ (not all of which are directly connected with COVID-19 and other Corona viruses). This article seeks to analyse the application of the public health approach to attempts to address urban violence using fieldwork conducted in London. As explained more fully below, the fieldwork was carried out in a number of settings across the English capital, between 2009 and 2018. We are especially interested in interrogating the public health model on its own terms. For example: What is the disease? How are symptoms identified and gauged? Who are the victims? How is the ‘cure’ formulated and administered? And how is recovery from the social ill of urban violence captured and calibrated? More prosaically, while we know about some of the theoretical-conceptual implications of viewing urban violence through a public health frame (Riemann 2019), we know less about how these implications play out in the everyday settings wherein agencies are expected to work together to combat urban violence © 2022. Urbanities

Emergence of SARS-CoV-2 B.1.1.7 lineage - United States, December 29, 2020-January 12, 2021

This report focuses on the emergence of the B.1.1.7 variant in the United States. As of 12 January, 2021, neither the B.1.351 nor the P.1 variants have been detected in the United States. For information about emerging SARS-CoV-2 variants of concern, CDC maintains a webpage dedicated to providing information on emerging SARS-CoV-2 variants. The B.1.1.7 variant has a mutation in the S protein that affects the binding domain of the receptor. It also has 13 other lineage-defining variants that are related to the S protein. These variants, which include a deletion at position 69 and 70, have been known to cause S-gene target failure. Multiple lines of evidence show that B.1.1.7 is a more efficiently transmitted variant of SARS-CoV-2 than other variants. In the UK, infections with this variant were more common than those with other variants. The potential increase in the number of cases of B.1.1.7 in the U.S. could affect the trajectory of the pandemic. A simple two-variant compartmental model has been developed to model this phenomenon. The potential impact of vaccinations was simulated assuming that 1 million doses were administered each day starting in 2021. It was estimated that 95% immunity was achieved 14 to 30 days after receiving 2 doses, and although B.1.1.7 is still the dominant strain, its transmission was significantly reduced after becoming the dominant variant. Currently, there is no evidence that the COVID-19 variants cause better clinical outcomes than the SARS-CoV-2 strains. However, a higher transmission rate increases the number of patients requiring hospitalisation, which could result in more deaths. The experiences of the UK and the B.1.1.7 variant illustrate the importance of having a coordinated and comprehensive approach to control the spread of this highly contagious variant. This approach involves the use of both mitigation and vaccination measures. The increased transmissibility of B.1.1.7 warrants the implementation of robust public health strategies to minimize its impact and prevent further spread. Data from the Centers for Disease Control and Prevention show that increasing the use of effective mitigation measures, such as vaccinations, is critical to curbing the spread of the disease.