What Makes Systemic Discrimination, "Systemic?" Exposing the Amplifiers of Inequity (preprint)

Drawing on work spanning economics, public health, education, sociology, and law, I formalize theoretically what makes systemic discrimination "systemic." Injustices do not occur in isolation, but within a complex system of interdependent factors; and their effects may amplify as a consequence. I develop a taxonomy of these amplification mechanisms, connecting them to well-understood concepts in economics that are precise, testable and policy-oriented. This framework reveals that these amplification mechanisms can either be directly disrupted, or exploited to amplify the effects of equity-focused interventions instead. In other words, it shows how to use the machinery of systemic discrimination against itself. Real-world examples discussed include but are not limited to reparations for slavery and Jim Crow, vouchers or place-based neighborhood interventions, police shootings, affirmative action, and Covid-19.

Association between assisted living facility context and resident pain during the COVID-19 pandemic: A repeated cross-sectional study (preprint)

Background Resident pain has been a common quality issue in congregate care for older adults, and COVID-19-related public health restrictions may have negatively affected resident pain. Most studies have focused on nursing homes (NHs), largely neglecting assisted living (AL). AL residents are at similar risk for pain as NH resident, but with AL providing fewer services and staffing resources. Our study examined whether potentially modifiable AL home characteristics were associated with resident pain during the first two waves of the COVID-19 pandemic.Methods This repeated cross-sectional study linked AL home surveys, collected in COVID-19 waves 1 (March-June 2020) and 2 (October 2020-February 2021) from a key contact, to administrative Resident Assessment Instrument – Home Care (RAI-HC) records in these homes. Surveys assessed preparedness for COVID-19 outbreaks, availability of a registered nurse or nurse practitioner, direct care staff shortages, decreased staff morale, COVID-19 outbreaks, confinement of residents to their rooms, supporting video calls with physicians, facilitating caregiver involvement. The dependent variable (moderate daily pain or pain of a severe intensity) and resident covariates came from the RAI-HC. Using general estimating equations, adjusted for repeated resident assessments and covariates, we assessd whether AL home factors were associated with resident pain during the pandemic.Results We included 985 residents in 41 facilities (wave 1), and 1,134 residents in 42 facilities (wave 2). Pain prevalence [95% confidence interval] decreased non-significantly from 20.6% [18.6%-23.2%] (March-June 2019) to 19.1% [16.9%-21.6%] (October 2020-February 2021). Better preparedness (odds ratio = 1.383 [1.025–1.866]), confinement of residents to their rooms (OR = 1.616 [1.212–2.155]), availability of a nurse practitioner (OR = 0.761 [0.591–0.981]), and staff shortages (OR = 0.684 [0.527–0.888]) were associated with resident pain.Conclusions AL facility-level factors were associated with resident pain during the COVID-19 pandemic. Policy and management interventions can and must address such factors, providing potentially powerful levers for improving AL resident quality of care.

Immunological imprinting shapes the specificity of human antibody responses against SARS-CoV-2 variants (preprint)

The spike glycoprotein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to accumulate substitutions, leading to breakthrough infections of vaccinated individuals and prompting the development of updated booster vaccines. Here, we determined the specificity and functionality of antibody and B cell responses following exposure to BA.5 and XBB variants in individuals who received ancestral SARS-CoV-2 mRNA vaccines. BA.5 exposures elicited antibody responses that primarily targeted epitopes conserved between the BA.5 and ancestral spike, with poor reactivity to the XBB.1.5 variant. XBB exposures also elicited antibody responses that targeted epitopes conserved between the XBB.1.5 and ancestral spike. However, unlike BA.5, a single XBB exposure elicited low levels of XBB.1.5-specific antibodies and B cells in some individuals. Pre-existing cross-reactive B cells and antibodies were correlated with stronger overall responses to XBB but weaker XBB-specific responses, suggesting that baseline immunity influences the activation of variant-specific SARS-CoV-2 responses. HighlightsO_LIVariant breakthrough infections boost ancestral cross-reactive antibodies and B cells C_LIO_LIFirst and second BA.5 exposures fail to elicit variant-specific antibodies and B cells C_LIO_LIXBB infections and monovalent vaccinations elicit XBB.1.5-specific responses in some individuals C_LIO_LIXBB.1.5-specific responses correlate with low levels of pre-existing humoral immunity C_LI

Modeling the Risk of In-Person Instruction during the COVID-19 Pandemic (preprint)

During the COVID-19 pandemic, safely implementing in-person indoor instruction was a high priority for universities nationwide. To support this effort at the University, we developed a mathematical model for estimating the risk of SARS-CoV-2 transmission in university classrooms. This model was used to evaluate combinations of feasible interventions for classrooms at the University during the pandemic and optimize the set of interventions that would allow higher occupancy levels, matching the pre-pandemic numbers of in-person courses. Importantly, we determined that requiring masking in dense classrooms with unrestricted seating with more than 90% of students vaccinated was easy to implement, incurred little logistical or financial cost, and allowed classes to be held at full capacity. A retrospective analysis at the end of the semester confirmed the model's assessment that the proposed classroom configuration would be safe. Our framework is generalizable and was used to support reopening decisions at Stanford University. In addition, our framework is flexible and applies to a wide range of indoor settings. It was repurposed for large university events and gatherings and could be used to support planning indoor space use to avoid transmission of infectious diseases across various industries, from secondary schools to movie theaters and restaurants.

Effects of aluminum-salt, CpG and emulsion adjuvants on the stability and immunogenicity of a virus-like particle displaying the SARS-CoV-2 receptor binding domain (RBD) (preprint)

Second-generation COVID-19 vaccines with improved immunogenicity (e.g., breadth, duration) and availability (e.g., lower costs, refrigerator stable) are needed to enhance global coverage. In this work, we formulated a clinical-stage SARS-CoV-2 receptor binding domain (RBD) virus-like particle (VLP) vaccine candidate (IVX-411) with widely available adjuvants. Specifically, we assessed the in vitro storage stability and in vivo mouse immunogenicity of IVX-411 formulated with aluminum-salt adjuvants (Alhydrogel, AH and Adjuphos, AP), without or with the TLR-9 agonist CpG-1018 (CpG), and compared these profiles to IVX-411 adjuvanted with an oil-in-water nano-emulsion (AddaVax, AV). Although IVX-411 bound both AH and AP, lower binding strength of antigen to AP was observed by Langmuir binding isotherms. Interestingly, AH- and AP-adsorbed IVX-411 had similar storage stability profiles as measured by antigen binding assays (competitive ELISAs), but the latter displayed higher pseudovirus neutralizing titers (pNT) in mice, at levels comparable to titers elicited by AV-adjuvanted IVX-411. CpG addition to alum (AP or AH) resulted in a marginal trend of improved pNTs in stressed samples only, yet did not impact the storage stability profiles of IVX-411. In contrast, previous work with AH-formulations of a monomeric RBD antigen showed greatly improved immunogenicity and decreased stability upon CpG addition to alum. At elevated temperatures (25, 37{degrees}C), IVX-411 formulated with AH or AP displayed decreased in vitro stability compared to AV-formulated IVX-411and this rank-ordering correlated with in vivo performance (mouse pNT values). This case study highlights the importance of optimizing antigen-adjuvant interactions to develop low cost, aluminum-salt adjuvanted recombinant subunit vaccine candidates.

Correlating physicochemical and biological properties to define critical quality attributes of a recombinant AAV vaccine candidate

Recombinant adeno-associated viruses (rAAVs) are a preferred vector system in clinical gene transfer. A fundamental challenge to formulate and deliver rAAVs as stable and efficacious vaccines is to elucidate interrelationships between the vector's physicochemical properties and biological potency. To this end, we evaluated an rAAV-based COVID-19 vaccine candidate which encodes the Spike antigen (AC3) and is produced by a commercially viable process. First, state-of-the-art analytical techniques were employed to determine key structural attributes of AC3 including primary and higher-order structures, particle size, empty/full capsid ratios, aggregates and multi-step thermal degradation pathway analysis. Next, several quantitative potency measures for AC3 were implemented and data were correlated with the physicochemical analyses on thermal-stressed and control samples. Results demonstrate links between decreasing AC3 physical stability profiles, in vitro transduction efficiency in a cell-based assay, and importantly, in vivo immunogenicity in a mouse model. These findings are discussed in the general context of future development of rAAV-based vaccines candidates as well as specifically for the rAAV vaccine application under study.

Changes in the microbiology, epidemiology, and outcomes of candidemia in Connecticut: A comparison between two periods using statewide surveillance.

Using statewide surveillance, we describe candidemia in Connecticut during 1998-2000 and 2019. In 2019, candidemia was more frequently associated with community-onset and non-albicans Candida species and less frequently associated with central vascular catheters, recent surgery, and in-hospital mortality. Understanding changes in candidemia can optimize clinical management and prevention strategies.

The number of circulating CD26 expressing cells is decreased in critical COVID-19 illness.

We evaluated the number of CD26 expressing cells in peripheral blood of patients with COVID-19 within 72 h of admission and on day 4 and day 7 after enrollment. The majority of CD26 expressing cells were presented by CD3+ CD4+ lymphocytes. A low number of CD26 expressing cells were found to be associated with critical-severity COVID-19 disease. Conversely, increasing numbers of CD26 expressing T cells over the first week of standard treatment was associated with good outcomes. Clinically, the number of circulating CD26 cells might be a marker of recovery or the therapeutic efficacy of anti-COVID-19 treatment. New therapies aimed at preserving and increasing the level of CD26 expressing T cells may prove useful in the treatment of COVID-19 disease.

Delivery platforms for broadly neutralizing antibodies.

PURPOSE OF REVIEW: Passive administration of broadly neutralizing antibodies (bNAbs) is being evaluated as a therapeutic approach to prevent or treat HIV infections. However, a number of challenges face the widespread implementation of passive transfer for HIV. To reduce the need of recurrent administrations of bNAbs, gene-based delivery approaches have been developed which overcome the limitations of passive transfer. RECENT FINDINGS: The use of DNA and mRNA for the delivery of bNAbs has made significant progress. DNA-encoded monoclonal antibodies (DMAbs) have shown great promise in animal models of disease and the underlying DNA-based technology is now being tested in vaccine trials for a variety of indications. The COVID-19 pandemic greatly accelerated the development of mRNA-based technology to induce protective immunity. These advances are now being successfully applied to the delivery of monoclonal antibodies using mRNA in animal models. Delivery of bNAbs using viral vectors, primarily adeno-associated virus (AAV), has shown great promise in preclinical animal models and more recently in human studies. Most recently, advances in genome editing techniques have led to engineering of monoclonal antibody expression from B cells. These efforts aim to turn B cells into a source of evolving antibodies that can improve through repeated exposure to the respective antigen. SUMMARY: The use of these different platforms for antibody delivery has been demonstrated across a wide range of animal models and disease indications, including HIV. Although each approach has unique strengths and weaknesses, additional advances in efficiency of gene delivery and reduced immunogenicity will be necessary to drive widespread implementation of these technologies. Considering the mounting clinical evidence of the potential of bNAbs for HIV treatment and prevention, overcoming the remaining technical challenges for gene-based bNAb delivery represents a relatively straightforward path towards practical interventions against HIV infection.

Examining COVID-19 pandemic-related economic and household stress and its association with mental health, alcohol, and substance use in a national sample of Latinx sexual minority and heterosexual adults.

OBJECTIVE: Sexual minority adults of Latinx descent faced compounded intersectional stressors during the COVID-19 pandemic across socioeconomic and health domains. Latinx people have experienced some of the highest COVID-19 infection, hospitalization, and mortality rates in the United States in addition to significant economic challenges. Yet, current data have not observed the unique pandemic-related experiences of sexual minority Latinx (SML) adults. We examined sexual identity differences in economic and household stress, social support, mental health symptomatology (depression, anxiety), alcohol, and substance use among sexual minority and nonsexual minority Latinx adults in the United States. METHOD: Primary data were collected via the AmeriSpeak panel, a national probability sample of U.S.-based 2,286 Latinx adults [sexual minority = .34% (n = 465)]. Data were collected from November 2020 to January 2021, during the third wave of the COVID-19 pandemic. RESULTS: SML adults endorsed higher levels of economic and household stress, mental health symptomatology, and alcohol and substance use than nonsexual minority Latinx adults. Economic stress was associated with increased mental health symptomatology, alcohol, and substance use among SML adults. Social support moderated the association between economic stress and mental health symptomatology and substance use, but not alcohol use. CONCLUSION: Findings highlighted unique intersectional considerations among SML adults during the COVID-19 pandemic, including the importance of social support and the negative toll of economic stress on mental health and substance use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Process of Responding to COVID-19 Misinformation in a Social Media Feed.

Misinformation can undermine public health recommendations. Our team evaluated a 9-week social media campaign promoting COVID-19 prevention to mothers (n = 303) of teen daughters in January-March 2021. We implemented an epidemiological model for monitoring, diagnosing, and responding quickly to misinformation from mothers. Overall, 54 comments out of 1617 total comments (3.3%) from 20 mothers (6.6% of sample) contained misinformation. Misinformation was presented in direct statements and indirectly as hypothetical questions, source derogation, and personal stories, and attributed to others. Misinformation occurred most (n = 40; 74%) in comments on vaccination posts. The community manager responded to 48 (89%) misinformation comments by acknowledging the comment and rebutting misinformation. No mothers who provided misinformation left the Facebook groups and a few commented again (n = 10) or reacted (n = 3) to responses. Only a small number of comments conveyed misinformation. Our quick-response epidemiological protocol appeared to prevent debate and dropout and exposed these mothers to credible information.

Examining Mental Health, Academic, and Economic Stressors During the COVID-19 Pandemic Among Community College and 4-Year University Students

Objective: The COVID-19 global pandemic has created severe, long-lasting challenges to college students in the United States (US). In the present study, we assessed mental health symptomatology (depression, anxiety, life stress), academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Method: A total sample of 361 college students (Mage = 22.26, SD = 5.56) was gathered from a community college (N = 134) and mid-size public university (N = 227) in Southwest US, both designated as Hispanic Serving Institutions. Results: Pearson and point biserial correlations indicated associations between mental health symptomatology, academic challenges, and economic stress, including expected delays in graduation. Multivariate analysis revealed that community college students had statistically significantly higher scores on anxiety F(1, 312) = 5.27, p = .02, η p 2  = .01 than 4-year university students, as well as key differences with respect to academic challenges. Chi Square analyses revealed that Latinx families experienced greater economic hardships, including job loss or reduced work hours (χ2 (1, N = 361) = 28.56, p = .00) than other ethnic/racial groups. Conclusions/Contributions: Findings revealed that community college students faced disparately negative mental health symptomatology, academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Further, Latinx students' families experienced significant economic hardship that may have impacted students' academic progress and future planning. [ FROM AUTHOR] Copyright of Community College Review is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Examining the experiences of pediatric mental health care providers during the early stage of the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic fundamentally impacted the way that mental health services were provided. In order to prevent the spread of infection, many new public health precautions, including mandated use of masks, quarantine and isolation, and closures of many in-person activities, were implemented. Public health mandates made it necessary for mental health services to immediately shift their mode of delivery, creating increased confusion and stress for mental health providers. The objective of this study is to understand the impact of pandemics on the clinical and personal lives of mental health providers working with children during the early months of the COVID-19 pandemic, March -June 2020. METHODS: Mental health providers (n = 98) were recruited using purposive sampling from a public health service in Canada. Using qualitative methods, semi-structured focus groups were conducted to understand the experiences of mental health service providers during the beginning of the COVID-19 pandemic. RESULTS: Data from the focus groups were analysed and three main themes emerged: (1) shift to virtual delivery and working from home; (2) concerns about working in person; (3) exhaustion and stress from working through the pandemic. DISCUSSION: This study gave voice to mental health providers as they provided continuity of care throughout the uncertain early months of the pandemic. The results provide insight into the impact times of crisis have on mental health providers, as well as provide practical considerations for the future in terms of supervision and feedback mechanisms to validate experiences.

Impact of the COVID-19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry.

To better understand the impact of the COVID-19 pandemic on the care of patients with pulmonary hypertension, we conducted a retrospective cohort study evaluating health insurance status, healthcare access, disease severity, and patient reported outcomes in this population. Using the Pulmonary Hypertension Association Registry (PHAR), we defined and extracted a longitudinal cohort of pulmonary arterial hypertension (PAH) patients from the PHAR's inception in 2015 until March 2022. We used generalized estimating equations to model the impact of the COVID-19 pandemic on patient outcomes, adjusting for demographic confounders. We assessed whether insurance status modified these effects via covariate interactions. PAH patients were more likely to be on publicly-sponsored insurance during the COVID-19 pandemic compared with prior, and did not experience statistically significant delays in access to medications, increased emergency room visits or nights in the hospital, or worsening of mental health metrics. Patients on publicly-sponsored insurance had higher healthcare utilization and worse objective measures of disease severity compared with privately insured individuals irrespective of the COVID-19 pandemic. The relatively small impact of the COVID-19 pandemic on pulmonary hypertension-related outcomes was unexpected but may be due to pre-established access to high quality care at pulmonary hypertension comprehensive care centers. Irrespective of the COVID-19 pandemic, patients who were on publicly-sponsored insurance seemed to do worse, consistent with prior studies highlighting outcomes in this population. We speculate that previously established care relationships may lessen the impact of an acute event, such as a pandemic, on patients with chronic illness.

Routine Assessment of Surgical Resident Wellness-Related Concerns During Biannual Review.

BACKGROUND: Surgery residency confers stress burdens on trainees. To monitor and mitigate areas of concerns, our education team implemented a six-item biannual survey querying potential stressors. We reviewed the initial five-year experience to assess for trends and improve efforts in maintaining well-being. METHODS: Surgery residents from all postgraduate years were asked to complete a survey of common concerns, prioritizing them in order of importance. Ranked items were 1) needs of family/friends, 2) nonwork time for study, 3) financial concerns, 4) personal well-being needs, 5) concerns for clinical performance, and 6) administrative demands. Changes were trended over ten review periods. Results were analyzed using Kruskal-Wallis test. RESULTS: 333 surveys were completed, rendering a 96.5% completion rate. Rankings changed significantly for nonwork time for study (p=0.04), personal well-being needs (p=0.03) and concerns for clinical performance (p=0.004). Nonwork time for study and concerns on clinical performance were consistently ranked as top two stressors over study period, except for Spring 2020. Personal well-being needs ranked highest in Spring 2020; 41% of residents placed this as top two rankings. A decrease in concerns for clinical performance was observed in Spring 2020, corresponding to the COVID-19 pandemic emergency declaration. CONCLUSION: Surgery residents generally prioritized time for study and concerns for assessment of clinical performance as highest areas of concern. With the occurrence of a pandemic, increased prioritization of personal well-being was observed. Used routinely with biannual reviews, the survey was able to identify plausible changes in resident concerns. Determination of levels of actual stress and actual association with the pandemic requires additional study.

Structure and function of the SIT1 proline transporter in complex with the COVID-19 receptor ACE2 (preprint)

Proline is widely known as the only proteogenic amino acid with a secondary amine. In addition to its crucial role in protein structure, the secondary amino acid modulates neurotransmission and regulates the kinetics of signaling proteins. To understand the structural basis of proline import, we solved the structure of the proline transporter SIT1 in complex with the COVID-19 viral receptor ACE2 by cryo-electron microscopy. The structure of pipecolate-bound SIT1 reveals the specific sequence requirements for proline transport in the SLC6 family and how this protein excludes amino acids with extended side chains. By comparing apo and substrate-bound SIT1 states, we also identify the structural changes which link substrate release and opening of the cytoplasmic gate, and provide an explanation for how a missense mutation in the transporter causes iminoglycinuria.

Effect of Coronavirus Disease 2019 Lockdowns on Identification of Advanced Human Immunodeficiency Virus Disease in Outpatient Clinics in Uganda.

Using data from 67 Ugandan human immunodeficiency virus (HIV) clinics (July 2019-January 2022), we report a 40% (1005/1662) reduction in the number of people with HIV presenting to care after August 2021 compared to prepandemic levels, with a greater proportion presenting with advanced HIV disease (20% vs 16% in the pre-coronavirus disease 2019 period).

Examining pandemic stress and mental health among a community-based sample of sexual minority women in Los Angeles County

In partnership with community stakeholders, the present study aimed to gather descriptive data on pandemic-related stress and its association with mental health outcomes among a community sample of self-identified sexual minority women (SMW) in Los Angeles County (N = 84;Mage = 35.61). The sample was comprised solely of women (i.e. self-identified gender identity as woman, including cisgender and transgender women). Data were collected in April 2021, the ‘third wave' of the COVID-19 global pandemic. Los Angeles experienced some of the highest COVID-19 incidence rates in the United States. Yet, there was a significant lack of COVID-19 data on SMW, thus making it difficult to address the specific needs of this community. Background data were collected on pre-existing health conditions and COVID-19 infection history. Data were specific to COVID-19 stressors in the areas of mental health, financial strain, social isolation and health and discrimination concerns. Findings revealed that mental health concern was strongly associated with financial strain (r = .63, p < .01), social isolation (r = .62, p < .01) and health and discrimination concerns (r = .63, p < .01), thus demonstrating the wide-ranging negative impact of pandemic stressors on the mental health of SMW in Los Angeles during the third wave of COVID-19. Recommendations for future research, practice and policy implications are discussed. [ FROM AUTHOR] Copyright of Psychology & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Risk for depression tripled during the COVID-19 pandemic in emerging adults followed for the last 8 years.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly increased depression rates, particularly in emerging adults. The aim of this study was to examine longitudinal changes in depression risk before and during COVID-19 in a cohort of emerging adults in the U.S. and to determine whether prior drinking or sleep habits could predict the severity of depressive symptoms during the pandemic. METHODS: Participants were 525 emerging adults from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a five-site community sample including moderate-to-heavy drinkers. Poisson mixed-effect models evaluated changes in the Center for Epidemiological Studies Depression Scale (CES-D-10) from before to during COVID-19, also testing for sex and age interactions. Additional analyses examined whether alcohol use frequency or sleep duration measured in the last pre-COVID assessment predicted pandemic-related increase in depressive symptoms. RESULTS: The prevalence of risk for clinical depression tripled due to a substantial and sustained increase in depressive symptoms during COVID-19 relative to pre-COVID years. Effects were strongest for younger women. Frequent alcohol use and short sleep duration during the closest pre-COVID visit predicted a greater increase in COVID-19 depressive symptoms. CONCLUSIONS: The sharp increase in depression risk among emerging adults heralds a public health crisis with alarming implications for their social and emotional functioning as this generation matures. In addition to the heightened risk for younger women, the role of alcohol use and sleep behavior should be tracked through preventive care aiming to mitigate this looming mental health crisis.

Reshaping Social Capital During the Pandemic Crisis: Age Group Differences in Face‐to‐Face Contact Network Structures

This article presents findings about the impact of the first Covid‐related lockdown on the face‐to‐face (FTF) interpersonal contact networks of the Hungarian adult population. Our primary objective is to understand how the size, composition, and quality of such networks have changed. We base our analysis on the contact‐diary method. Our data were collected from two representative surveys of the Hungarian adult population: one in 2015 (N = 372) and one in May 2020 (N = 1001) during the first wave of the Covid‐19 epidemic. No decline in the overall bonding social capital can be detected;however, social isolation has increased. A restructuring has occurred: a considerable increase manifests in the proportion of kin ties, especially children, and a decrease in the importance of non‐kin ties, with a particularly sharp decline in friendships. FTF contacts indicate an increased emotional intensity (except for non‐kin, non‐household members) and an increase in the length of conversations, but there is a decrease in the frequency of meeting alters. The changes wrought different effects on different age groups, with the restrictions most negatively affecting the size of FTF contact networks for respondents aged 60 years or older. Our findings point to the stability and resilience of close family relations, yet the doubling of social isolation as early as May 2020 underlines fears about the pandemic's potentially detrimental effects on social connectedness. The decline in friendship ties (and most probably in other weak ties) may lead to a reduction not only in the amount and scope of accessible social capital but also to a weakening social integration. © 2023 by the author(s);licensee Cogitatio (Lisbon, Portugal). This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY).