ABSTRACT
This study aims to identify the psychological constructs that are antecedents to people's intention to travel to a tourist destination during the COVID-19 pandemic using the extended theory of planned behavior (ETPB) and necessary condition analysis (NCA). Online survey responses collected from 1,259 participants in the United States in May-June 2021 are used for the study. We find a moderating effect of public trust towards the government on the relationship between travel concerns and intentions. Results suggest that certain levels of public trust, subjective norm, perceived benefit of travel, perceived behavioral control, and perceived knowledge of the pandemic are necessary to manifest travel intentions. We uncover that providing travel incentives and better dissemination of the pandemic-related information can potentially encourage people to regain their original travel intention that was lost due to the pandemic. Furthermore, the bottlenecks obtained using NCA show that travel intentions are more easily manifested by perceived knowledge of the pandemic versus others. This study demonstrates the application of NCA, which can be further extended to make policy-level decisions for transportation systems. © 2022 American Society of Civil Engineers.
ABSTRACT
Objectives: We aimed at the identification of the association of comorbidities with the COVID-19 severity and hospitalization. Methods: It is a retrospective cross-sectional study to investigate the variation in age, sex, dwelling, comorbidities, and medication with the COVID-19 severity and hospitalization by enrolling 1025 recovered individuals while comparing their time of recovery with or without comorbidities. Results: COVID-19 patients mostly suffered from fever. The predominant underlying medical conditions in them were hypertension (HTN) followed by diabetes mellitus (DM). Patients with cardiovascular disease (CVD) (54.3%) and hepatic disorders (HD) (43.6%) experienced higher severity. The risk of symptomatic cases was higher in aged (odds ratio, OR = 1.04, 95% CI = 1.02-1.06) and comorbid (OR = 1.87, 95% CI = 1.34-2.60) patients. T-test confirmed the differences between the comorbid and non-comorbid patients' recovery duration. The presence of multiple comorbidities increased the time of recovery (15-27 days) and hospitalization (20-40%). Increased symptomatic cases were found for patients having DM+HTN whereas CVD+Asthma patients were found with higher percentage of severity. Besides, DM+CKD (chronic kidney disease) was associated with higher hospitalization rate. Higher odds of severity were found for DM+CVD (OR = 4.42, 95% CI = 1.81-10.78) patients. Hospitalization risk was also increased for them (OR = 5.14, 95% CI = 2.02-13.07). Moreover, if they had HTN along with DM+CVD, they were found with even higher odds (OR = 6.82, 95% CI = 2.37-19.58) for hospitalization. Conclusion: Our study indicates that people who are aged, females, living in urban area and have comorbid conditions are at a higher risk for developing COVID-19 severity. Clinicians and health management authorities should prioritize these high-risk groups to reduce mortality attributed to the disease.