ABSTRACT
The COVID-19 pandemic had significant impact on water utilities, which had to continue providing clean water under safe-distancing measures. Water use patterns were affected, shifting peak demand and changing volumes, though changes varied from place to place. This study analyses the effects of the safe-distancing measures on water use patterns in different countries and cities with the aim of drawing general conclusions on causes and impacts of changes in water use patterns, as well as providing some insights on the impacts on finances of utilities and potential long-term implications. The analysis is based on information collected by the members of the IWA Specialist Group on Statistics and Economics for Belgium, Cyprus, Germany, Japan, Switzerland, Portugal, Romania, the Netherlands and Singapore. Temporal, spatial/sectoral and volume changes can be distinguished. The main temporal change in domestic water use was a delay in the morning peak, while commercial water use patterns changed significantly. In general, the volume of domestic water use increased between about 3% and 8%, while non-domestic water use decreased between about 2% and 11% over 2020. Indirect evidence suggests shifts have taken place between sectors and spatially. The impact on finances of utilities has likely been only short-term.
ABSTRACT
Purpose: Patients interact with healthcare providers (HCP) and pharmacists to manage medications. Little is known about the impact of COVID-19 on medication management. The purpose of this study was to describe medication management, HCP/pharmacist interactions, and adherence, including initiation, implementation and persistence, during the COVID-19 pandemic in kidney transplant (KT) patients and those on the KT wait list. Method(s): The IRB determined this study was exempt. Using a mixed methods design, 340 adults at a transplant center in the midwestern US were recruited. The Managing Medications in the Midst of a Pandemic Survey measured HCP/pharmacy encounters and medication management. The Basel assessment of adherence to medications scale measured medication adherence. Result(s): The sample average age was 58.2 years, 61% male, and 86% White. During the COVID-19 pandemic, 90% had/were currently practicing socially distancing, 87% had /were currently wearing a face mask when out in public, 19% had/were currently diagnosed with COVID-19, and 84% received the vaccine. Additional survey results include: Medication management: 82% percent plan/organize their own medications. Healthcare team interactions: 98% talked with their HCP since the beginning of social distancing;13% delayed seeing a HCP because of COVID-19 concerns. Pharmacy interactions: 11% changed their method of obtaining medications from pharmacy due to social distancing and 3.5% delayed refilling medications. Medication adherence-Initiation: 2.5% were prescribed a new medication but did not begin taking it. Medication adherence-Implementation: in the 4 weeks prior to the survey, 19% missed a dose, 6.7% skipped a dose, 16% took a medication more than 2-hour time difference from the prescribed time, and 2.5% altered prescribed amount. Medication adherence- Persistence: 3.4% stopped taking a prescribed medication without a doctor's order during the pandemic. Conclusion(s): A majority of the patients waiting for a KT and KT patients acted to prevent COVID-19 but some still contracted the virus. The pandemic changed medication management interactions with HCP and pharmacists. Adherence implementation problems were nearly 20%. Findings are relevant to transplant HCP and pharmacists, who must support patients attempting to manage and adhere to prescribed medications during the pandemic.