Possible substance use disorders among first responders during the COVID-19 era: a quasi-experimental study of personal and residential vulnerability.

Background: During the COVID-19 pandemic possible substance use disorders (SUD) were exacerbated from increased stress and isolation. Experiences of symptomology differ widely by occupations.Objectives: The objectives were to determine if there is a temporal relationship between COVID-19 vulnerability and possible SUDs among first responders, and to examine the association with neighborhood vulnerability.Methods: We conducted an analysis with two distinct cohorts dependent on time of entry: 1) First responders that began counseling prior to COVID-19 and 2) First responders that began counseling after the start of COVID-19. Data were collected at intake from first responders seeking mental health services between 2017 and 2021 at an organization in Dallas/Fort Worth, Texas. The study sample included 195 mostly male (75%) first responders (51% law enforcement officers; 49% emergency medical technicians/firefighters). Bivariate models tested unadjusted relationships between covariates and possible SUD. Adjusted models consisted of a two-level multivariable logistic regression models.Results: Nearly 40% (n = 77) screened positive for a possible SUD. Those beginning counseling after COVID-19 did not have higher odds of SUDs. For every unit increase in neighborhood Severe COVID-19 Health Risk Index at a first responder's residential location there was an increase in the odds of a possible SUD (AOR = 3.14, 95% CI: 1.47, 6.75).Conclusions: Our study highlights the degree to which personal and residential vulnerability to COVID-19 impacted first responders. The increased occupational stress of this population, and an established pattern of maladaptive coping, elucidates the need for preventative and clinical approaches to strengthen the resilience of this population.

Trends and Correlates of Breakthrough Infections With SARS-CoV-2.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant has been hypothesized to decrease the efficacy of COVID-19 vaccines. Factors associated with infections with SARS-CoV-2 after vaccination are unknown. In this observational cohort study, we examined two groups in Harris County, Texas: (1) individuals with positive Nucleic Acid Amplification test between 12/14/2020 and 9/30/2021 and (2) the subset of individuals fully vaccinated in the same time period. Infected individuals were classified as a breakthrough if their infection occurred 14 days after their vaccination had been completed. Among fully vaccinated individuals, demographic and vaccine factors associated with breakthrough infections were assessed. Of 146,731 positive SARS-CoV-2 tests, 7.5% were breakthrough infections. Correlates of breakthrough infection included young adult age, female, White race, and receiving the Janssen vaccine, after adjustments including the amount of community spread at the time of infection. Vaccines remained effective in decreasing the probability of testing positive for SARS-CoV-2. The data indicate that increased vaccine booster uptake would help decrease new infections.

COVID-19 related employment change is associated with increased alcohol consumption during the pandemic.

Introduction: The COVID-19 pandemic has had sweeping impacts on income and employment. Previous research has indicated that loss of employment is associated with mental illness and increased alcohol consumption. However, no studies have explored this relationship in the context of the COVID-19 pandemic in the United States.Objective: The purpose was twofold: (1) Evaluate the association between pandemic-related employment status and alcohol consumption and (2) assess the interacting effect of depression and employment change on alcohol consumption. We hypothesized that (1) employment change would be associated with increased alcohol consumption during the pandemic and (2) the combined effects of depressive symptoms with pandemic-related-employment-change would strengthen the association with alcohol consumption.Methods: A self-report, web-based survey collected information on sociodemographics, COVID-19-related employment impact (e.g., decreased pay, laid off), change in alcohol consumption since the pandemic, reasons for consumption change, and depressive symptoms. Multinomial regression modeling explored the associations between variables.Results: One-third (33%) of participants (n = 2,441; 67% female) reported consuming more alcohol compared to pre-pandemic and 11% reported that COVID-19 had a negative impact on their employment. Participants reported drinking more alcohol due to having more time (28%) or boredom (22%). The adjusted odds of increased alcohol consumption were 47% greater among those who reported negative employment impact compared to those who reported no employment impact (AOR: 1.47, 95% CI: 1.03-2.11); depression did not moderate this relationship.Conclusion: Given the pandemic's far-reaching impact, the potential for alcohol harm is demonstrably great. Mitigating consumption should be considered when addressing loss of employment in this context.

Longer time spent at home during COVID-19 pandemic is associated with binge drinking among US adults.

Background: The COVID-19 pandemic has introduced and exacerbated stressors (e.g., job loss, poor mental health) for adults across the United States (US) since the first statewide shelter-in-place order on March 19, 2020. Limited research has evaluated if, and how, pandemic-related stressors are associated with changes in alcohol consumption and binge drinking.Objectives: This analysis aims to identify COVID-19-related stressors associated with changes in alcohol consumption and binge drinking since the outbreak of the coronavirus.Methods: Data were collected on sociodemographics, alcohol consumption, and COVID-19-related stressors (household composition, job status, essential worker, stay-at-home duration, and depression) using a web-based, self-report survey to US adults from mid-March to mid-April 2020. Multivariable logistic and multinomial regression models were used to assess associations between COVID-19-related stressors and binge drinking and changes in alcohol consumption. Among 1,982 participants, 69% were female and 31% male.Results: Thirty-four percent of the sample reported binge drinking during the COVID-19 pandemic. More binge drinkers increased alcohol consumption during the pandemic (60%) than non-binge drinkers (28%). After adjusting for sociodemographics, for every 1-week increase in time spent at home during the pandemic, there was 1.19 (95% CI: 1.06-1.34) greater odds of binge drinking. Additionally, binge drinkers with a previous diagnosis of depression and current depression symptoms had greater odds of increased alcohol consumption compared to those reporting no depression (AOR: 1.77, 95% CI: 1.16, 2.73).Conclusion: Specific COVID-19-related stressors are related to alcohol consumption. This highlights the ancillary and unintended effects of the COVID-19 pandemic which could have long-lasting population health consequences.

Trends in Family Violence Are Not Causally Associated with COVID-19 Stay-at-Home Orders: a Commentary on Piquero et al.

COVID-19 has caused a wave of research publications in academic and pre-print outlets which have resulted in several high-profile retractions. While the breadth of emerging research has been instrumental in understanding and curbing the global pandemic in near real-time, unfortunately manuscripts with major methodological challenges have fallen through the cracks. In this perspective, we illustrate this issue in light of a recent manuscript by Piquero et al. (2020). In the study, a statistically significant association between stay-at-home orders and family violence was not detected; however, the authors widely disseminated a "12.5% increase in family violence" offenses to a variety of media outlets. This negligent dissemination of inaccurate research findings has important implications for policy and the virus mitigation efforts, which might urge policymakers to terminate stay-at-home orders in an effort to reduce family violence and other social risk factors. Changes may ultimately result in more COVID-related deaths as stay-at-home orders are prematurely and inappropriately lifted to prevent purported injuries in the home. Therefore, the widespread propagation of these claims in the absence of scientific evidence of an increase has great potential to cause harm.

Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA.

The objective of this study is to describe intimate partner violence (IPV) severity and types of victimization during the early states of the COVID19 pandemic. A survey was distributed through social media and email distribution lists. The survey was open for 14 days in April 2020 and 2441 participated. Information on IPV, COVID19-related IPV severity, sociodemographics, and COVID19-related behaviors (eg, job loss) were collected. Regression models were used to evaluate COVID19-related IPV severity across victimization types and sociodemographics. 18% screened positive for IPV. Among the respondents that screened positive, 54% stated the victimization remained the same since the COVID19 outbreak, while 17% stated it worsened and 30% stated it got better. The odds of worsening victimization during the pandemic was significantly higher among physical and sexual violence. While the majority of IPV participants reported victimization to remain the same, sexual and physical violence was exacerbated during the early stages of the pandemic. Addressing victimization during the pandemic (and beyond) must be multi-sectorial.