"You want to be politically correct”: Opposition to political correctness predicts less adherence to COVID-19 guidelines in the US

Previous research has demonstrated that conservative individuals (relative to liberal individuals) were less likely to adhere to COVID-19 guidelines (e.g., social distancing). We argue that because adherence to COVID-19 guidelines was largely characterized as "politically correct” behavior, individuals opposed to political correctness (PC) norms would follow COVID-19 guidelines less, controlling for political conservatism and other relevant demographic variables. In two correlational studies and one preregistered experiment, we tested whether opposition to political correctness (OPC) predicts less adherence to COVID-19 guidelines. Study 1 showed that OPC correlates negatively with mask-wearing and social distancing, controlling for conservatism, gender, age, and religious identity. Study 2 replicated and extended these effects, demonstrating that seeing mask-wearing as a common good (i.e., as a beneficial COVID-19 mitigation strategy) mediated the relationship between OPC and mask-wearing, social distancing, handwashing, and vaccination intentions. Study 3 experimentally manipulated feelings toward PC. Inconsistent with our preregistered hypothesis but consistent with previous research, participants induced to have positive feelings toward PC adhered to COVID-19 guidelines the most and had the most positive feelings toward wearing masks. We discuss how moralization of health guidelines can predict individuals' likelihood of adhering to these guidelines. We also discuss how best to persuade individuals who see adherence to health guidelines as "politically correct,” as well as future research directions to address this concern. © 2023 The Authors. Journal of Applied Social Psychology published by Wiley Periodicals LLC.

COVID-19 among University of Otago students living in North Dunedin households in the first half of 2022: was the prevalence underestimated?

Aims: To estimate the prevalence of COVID-19 among occupants of North Dunedin student flats between Flat Orientation Week (Flo-Week, week starting 14 February 2022) and the end of Semester 1 (week starting 30 May 2022);to investigate the potential under-reporting of cases to the University of Otago and under-recording of positive rapid antigen test (RAT) results in My Covid Record;to explore the COVID-related experiences of students during the above period. methods: Randomly selected households in the North Dunedin area were visited at the end of Semester 1 and oral consent was sought for a short interview comprising closed- and open-ended questions. Households were eligible for inclusion if at least one resident was a University of Otago student. Result(s): One hundred and thirty-five (96.4%) of 140 eligible households participated, and in 94.1% of these households at least one resident tested positive for COVID-19 between the start of Flo-Week and the date of the interview (a mean period of 109 days [standard deviation 3.6]). In total, 73.6% of the occupants in the participating households tested positive. Of the cases who were University of Otago students, 60.4% reported their positive status to the University. Of all cases diagnosed via a RAT, 66.9% uploaded their result to My Covid Record. Students reported various academic, financial and mental health stresses associated with the general COVID-19 situation during the study period. Conclusion(s): These findings suggest that the number of COVID-19 cases reported to the University of Otago between Flo-Week and the end of Semester 1 was a substantial underestimate of the true number, as was the number of cases recorded in My Covid Record. The findings also highlight the considerable impact that COVID-19 had on students during Semester 1.Copyright © 2023 New Zealand Medical Association. All rights reserved.

Maternal Transmission of SARS-CoV-2-specific Antibodies, but not Cytokines/Chemokines to Neonates Following Infection and Vaccination During Pregnancy

Background. Despite extensive studies of human immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination, research examining protective correlates of vertical transmission following maternal exposure in pregnancy remain limited. Here, we characterized antibody and cytokine responses in maternal and cord blood following infection or vaccination at various timepoints during gestation. Methods. Spike S1 protein-specific binding antibodies and antibodies capable of blocking the interaction between the receptor binding domain (RBD) and the angiotensin converting enzyme 2 (ACE2) were measured in maternal and cord blood by ELISA. Serum concentrations of 74 cytokines/chemokines were measured by multiplex assay. Humoral responses and cytokine levels from matched maternal and fetal cord sera were compared and examined for potential correlations. Results. We observed a highly significant correlation between Spike S1-specific antibody titer and RBD-ACE2 blocking antibody activity between maternal and fetal cord serum (p < 2.2e-16, R > 0.90). Blocking antibody activity was significantly higher for mothers infected during the 3rd trimester compared to earlier trimesters;however, vaccinated mothers developed and transferred higher antibody titers with greater RBD-ACE2 blocking antibody activity to their neonates than infected mothers. Furthermore, vaccine-induced Spike S1 IgG transfer ratios (fetal cord/maternal) were significantly higher than those induced by infection (p = 0.002). Multiplex assay showed significantly elevated levels of 33 cytokines/chemokines, mainly pro-inflammatory in infected maternal serum samples, while the paired fetal cord samples exhibited an anti-inflammatory cytokine predominance. Conclusion. Our data support selective vertical transmission of potentially protective humoral responses against SARS-CoV-2, especially following vaccination in the 3rd trimester. The anti-inflammatory cytokine predominance in cord blood that persists despite maternal SARS-CoV-2 infection may offset the adverse outcomes of inflammation in pregnancy for the neonate.

Evaluating the Relationship Between Obesity and the Humoral Immune Response to COVID-19 Vaccines

Background. The pro-inflammatory state associated with obesity leads to B- and T-lymphocyte dysfunction that may lead to an inadequate immune response to natural infection and vaccination. Preliminary studies, conducted outside of the US, involving multiple COVID-19 vaccines indicate that obesity may impact antibody response. The objective of this study was to evaluate the role of inflammatory status as a mediator in the relationship between obesity and COVID-19 vaccine immune response in a predominantly African-American population. Methods. This cross-sectional analysis involved 54 participants 18 years of age who had completed the primary dosing schedule and booster for Novavax's recombinant COVID-19 vaccine, NVX-CoV2373. Weight, height, and waist circumference (WC) measurements were taken. Medical history including COVID-19 vaccination and known COVID-19 infection were obtained. Blood samples were taken for measurement of c-reactive protein (CRP) and anti-SARS-CoV-2 spike protein IgG levels. Spearman correlation coefficient was used to assess the presence of a relationship between BMI and CRP, WC and CRP, CRP and spike protein IgG, BMI and spike protein IgG, and finally, WC and spike protein IgG. Mediation analysis was used to evaluate the moderating effect of plasma CRP on the relationship between WC and spike protein IgG while adjusting for suspected confounders. Statistical significance was defined as p < .05. Results. There was an expected positive relationship betweenWCand CRP, (rho = 0.37, p< .05). CRP and spike protein IgG trended towards a weak, negative relationship (rho= -0.13, p > .05). WC and BMI both trended towards a positive relationship with anti-SARS-CoV-2 spike protein IgG (rho = 0.29 and 0.15, respectively, p >.05). The mediation analysis showed that WC positively influenced spike protein IgG (p< .05), and this effect was not mediated by CRP. Conclusion. Inflammation may be negatively associated with antibody response to COVID-19 vaccines. WC and antibody response may be positively related in NVX-CoV2373 recipients, in spite of chronic low-grade inflammation. Further research is needed to fully characterize the impact of obesity on COVID-19 vaccine immunogenic responses.

Playful Pedagogy in the Pandemic: Pivoting to Game-Based Learning

Educational technology adoption is more widespread than ever in the wake of COVID-19, as corporations have commodified student engagement in makeshift packages marketed as gamification. This book seeks to create a space for playful learning in higher education, asserting the need for a pedagogy of care and engagement as well as collaboration with students to help us reimagine education outside of prescriptive educational technology. Virtual learning has turned the course management system into the classroom, and business platforms for streaming video have become awkward substitutions for lecture and discussion. Gaming, once heralded as a potential tool for rethinking our relationship with educational technology, is now inextricably linked in our collective understanding to challenges of misogyny, white supremacy, and the circulation of misinformation. The initial promise of games-based learning seems to linger only as gamification, a form of structuring that creates mechanisms and incentives but limits opportunity for play. As higher education teeters on the brink of unprecedented crisis, this book proclaims the urgent need to find a space for playful learning and to find new inspiration in the platforms and interventions of personal gaming, and in turn restructure the corporatized, surveilling classroom of a gamified world. Through an in-depth analysis of the challenges and opportunities presented by pandemic pedagogy, this book reveals the conditions that led to the widespread failure of adoption of games-based learning and offers a model of hope for a future driven by new tools and platforms for personal, experimental game-making as intellectual inquiry. © 2023 Emily K. Johnson and Anastasia Salter.

Miro, Miro: Student perceptions of a visual discussion board

The COVID-19 pandemic forced those in education and industry to rethink how collaboration can take place remotely. This experience report describes the way the author reimagined the typical online discussion using a visual discussion board, Miro, in an asynchronous online graduate course, Media Aesthetics, in Fall of 2020. This paper includes student perceptions of benefits and limitations from the use of this platform along with lessons learned and notes for improving the use of this and other digital tools in future courses. Overall, most students reported enjoying the change of pace from the standard learning management system's discussion board and enjoyed the ability to share images, videos, and links within the platform. Students also indicated that they found Miro to be easy to learn and conducive to collaboration and discussion. Perceived limitations included lack of structure, difficulty locating specific posts at times, and a feeling of isolation from peers due to the asynchronous course structure. © 2022 ACM.

EXERCISE THERAPY TO COMBAT THE POSTACUTE SEQUELAE OF COVID-19: A CASE SERIES

SESSION TITLE: Post-COVID-19 Outcomes SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Short- and long-term postacute sequelae of SARS-CoV-2 infection (PASC) includes a constellation of clinical symptoms that persist following recovery from COVID-19. The precise pathophysiology of PASC is unknown but likely multifactorial, and intervention strategies to combat PASC are lacking. Our aim was to investigate whether homebased exercise training (HBExT) enhances recovery of and/or improves exercise capacity, pulmonary function, symptoms, and overall health-related quality of life (HRQoL) in people with PASC. METHODS: Pulmonary function [including lung diffusing capacity for carbon monoxide (DLCO) and maximal inspiratory pressure (MIP)] and the cardiopulmonary responses to maximal incremental treadmill exercise (CPET) were assessed before and after 8-weeks of HBExT in three adults (2 males, 48 and 40 years old;1 female, 37 years old) with PASC. Symptoms (via standard questionnaire) and HRQoL (via EQ-5D-3L questionnaire) were also assessed before and after HBExT. HBExT consisted of 3-to-4 aerobic (duration 25-40 min, intensity 60-80% heart rate reserve) and 2-to-3 resistance (7 exercises, 8-12 repetitions, 2-3 sets) sessions per week, and was prescribed and tracked in each participant using a mobile application (Connected mHealth) integrated with a heart rate monitor (Polar H7). RESULTS: Time from initial SARS-CoV-2 infection to enrollment in the study (in months) and adherence rate to HBExT was 8 and 66%, 4 and 71%, and 3 and 100% for the three participants. Before to after HBExT, there was a 13 ± 7% increase in exercise time (12.6 ± 2.0 vs. 14.1 ± 1.3 min) and a 14 ± 9% increase in peak O2 uptake (V̇O2peak;27.6 ± 2.8 vs. 31.5 ± 2.5 ml/kg/min) during the CPET. Neither the heart rate nor the pulmonary gas exchange (V̇E/V̇CO2, PETCO2, SpO2) response to CPET was different before vs. after HBExT. Conversely, peak-exercise breathing reserve was lower (13 ± 16 vs. 30 ± 11 L/min) and O2pulse was greater (16.3 ± 1.2 vs. 13.8 ± 0.2 ml/beat) following HBExT. No remarkable changes in pulmonary function or DLCO were noted after HBExT;however, there was a 16 ± 12% increase in MIP from before to after HBExT (74 ± 21 vs. 85 ± 18 cmH2O). After HBExT, a fraction of the participants reported resolution of persistent fatigue (n = 1), breathlessness (n = 2), chest tightness (n = 1), palpitations (n = 1), and dizziness (n = 2), and overall health score (via EQ-5D-3L) was increased (42 ± 34 vs. 81 ± 6;100 = ‘best health imaginable’). CONCLUSIONS: Prescribed exercise training may increase exercise capacity and inspiratory muscle strength, alleviate persistent symptoms of fatigue and breathlessness, and improve overall HRQoL in people with PASC. CLINICAL IMPLICATIONS: Exercise-based therapy may improve functional capacity and partially alleviate persistent symptoms in people with PASC, strengthening calls for cardiopulmonary rehabilitation as a potential therapeutic intervention in such individuals. DISCLOSURES: No relevant relationships by Natalie Bonvie-Hill No relevant relationships by Isabel Cortopassi No relevant relationships by Igor Fernandes No relevant relationships by Scott Helgeson No relevant relationships by Elizabeth Johnson No relevant relationships by Augustine Lee No relevant relationships by Amy Lockwood No relevant relationships by Patricia Mergo No relevant relationships by Bala Munipalli No relevant relationships by Tathagat Narula No relevant relationships by Brian Shapiro Competitive research grant recipient relationship with Gilead Sciences Inc. Please note: 1 year Added 03/30/2022 by Bryan Taylor, value=Grant/Research Support

IMPLEMENTING A CIRRHOSIS ORDER SET: A QUALITATIVE ANALYSIS OF PROVIDER-IDENTIFIED BARRIERS AND FACILITATORS

Background: Cirrhosis is the leading cause of mortality and morbidity in individuals with gastrointestinal disease. Multiple care gaps exist for hospitalized patients with cirrhosis, resulting in high rates of re-hospitalization (e.g. 44% at 90 days in Alberta). The Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial with an aim to reduce acute-care utilization by implementing an electronic order set and supporting education across eight hospital sites in Alberta. Aims: As part of the pre-implementation evaluation, this qualitative study analyzed data from provider focus groups to identify barriers and facilitators to implementation. Methods: We conducted focus groups at eight hospital sites with a total of 54 healthcare providers (3-12 per site). A semi-structured interview guide based upon constructs of the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory (NPT) frameworks was used to guide the focus groups. Focus groups were recorded and transcribed verbatim. Data was analyzed thematically and inductively. Results: Five major themes emerged across all eight sites: (i) understanding past implementation experiences, (ii) resource challenges, (iii) competing priorities among healthcare providers, (iv) system challenges, and (v) urban versus rural differences. Site-specific barriers included perceived lack of patient flow, time restraints, and concerns about the quality and quantity of past implementation interventions. Facilitators included passionate project champions, and an ample feedback process. Conclusions: Focus groups were useful for identifying pre-implementation barriers and facilitators of an electronic orders set. Findings from this study are being refined to address the influence of COVID-19, and the data will be used to inform the intervention roll-out at each of the sites.

VIDEO GUIDED PELVIC PHYSICAL THERAPY FOR STRESS URINARY INCONTINENCE

Introduction: Pelvic Floor Physical Therapy (PFPT) is a first-line treatment for stress urinary incontinence according to expert guidance, including the American Urogynecologic Society. Barriers such as cost, time commitment, motivation, and uncertainty of efficacy have been previously identified. These barriers make access to PFPT difficult for many. Additionally, those who are motivated may not receive timely care due to the current coronavirus pandemic. Objective: The objective of this video is to detail evidence-based PFPT exercises known to be effective in treating SUI. Methods: This animation film is a multidisciplinary effort and has been developed in collaboration with female pelvic medicine and reconstructive surgery clinicians, PFPT providers, and students in cinematic arts. Results: The PFPT exercises include five sections and follow the order of recommendations by our institution's PFPT. These include diaphragmatic breathing, Kegel exercises, bridge with Kegels, leg raises, and squat with Kegels. Conclusions: This video was created as an additional resource for patients with limited access to PFPT, especially given current limitations due to the coronavirus pandemic. The video is part of a single-blinded randomized controlled trial comparing video-guided PFPT versus a routine informational video on SUI. Both videos will be in English and Spanish. Eventually, the goal is for more widespread distribution and increased accessibility for all patients.

Physical Therapist Training Challenges for an Embedded Pragmatic Trial: Fibromyalgia TENS in Physical Therapy Study

Transcutaneous electrical nerve stimulation (TENS), a non-pharmacological treatment, is safe and effective for movement-evoked pain in individuals with Fibromyalgia (FM). The purpose of our NIH-funded pragmatic clinical trial, Fibromyalgia TENS in PT Study (FM-TIPS), assesses feasibility and effectiveness of adding TENS to usual physical therapy (PT) treatment in individuals with FM. We partnered with 33 sites in 6 healthcare systems, training 150+ Midwest clinicians. Outpatient PT clinic sites are cluster randomized to a TENS or a No-TENS intervention, stratified by system and clinic size. We will recruit ∼600 patients with a primary or secondary diagnosis of FM. We developed comprehensive communication and training procedures to ensure study fidelity and adapted over the course of the study to enhance learning. We will provide an overview and the impact of the pandemic on these procedures. Representatives for each healthcare system, each clinic and the study team were identified for communication and training. Training included initial study introduction, human subjects protection, and study procedures. We used a hybrid approach with written, video, onsite, and virtual instruction. All materials and procedures, for clinician and patient-facing materials, website, videos, equipment use (iPad for screening, TENS units), and clinician procedures for PT visits 1-3, were piloted and reviewed by clinicians from each healthcare system. Additional communication and feedback include weekly enrollment reports, monthly newsletters, relationship building with clinicians, enrollment incentives, and continuing education webinars. The pandemic required creative and evolving solutions to maintain study involvement and recruitment. Barriers for enrollment are screening PT Visit 1, comfort level of clinicians for PT Visits 2 and 3, delays/alterations in training and planning, clinician demands, clinicians/patient illness, and staff shortages in the clinics. Current enrollment, study training and implementation has been affected by COVID-19 and we developed creative methods for training and implementation for FM-TIPS. Grant support from Research supported in this USASP was supported by National Institutes of Health Heal Initiative Grant UG3/UH3 AR076387-01 and UL1TR002537.

Facilitators and Barriers to Implementation of a Transcutaneous Electrical Nerve Stimulation Intervention in a Pragmatic Clinical Trial

Fibromyalgia TENS in Physical Therapy (PT) Study (FM-TIPS) is testing feasibility and efficacy of Transcutaneous Electrical Nerve Stimulation (TENS). We present our experience for implementing TENS into PT clinics and virtual training to participants on TENS in a pragmatic clinical. FM-TIPS is a pragmatic, cluster-randomized clinical trial examining if the addition of TENS to routine PT improves movement-evoked pain in fibromyalgia (FM). FM patients (n=600) will be enrolled from 35 PT clinics across six Midwest healthcare systems into either a TENS or no-TENS group. All subjects randomized by TENS clinics receive TENS starting on Day 1. The no-TENS clinics start after completion of the primary outcome on Day 60. In the TENS group, Physical therapists (PTs) provide TENS education in person, while in the no-TENS group, study staff provide TENS education virtually. To facilitate implementation, we selected a study-specific TENS unit that provides mixed frequency TENS with intensity as the only adjustable parameter. All PTs were trained in proper use of the TENS unit in-person. While most PTs embraced the addition of TENS, some had not used TENS and had difficulty adapting practice to include TENS. For virtual visits in the no-TENS group, a standardized procedure was developed and completed by study staff PTs. TENS units were shipped to subject's and zoom visits were scheduled at the subject's convenience within a 10-day window. Most subjects completed virtual TENS training and implementation without difficulties. Technology limitations provided a significant barrier for some subjects. Most clinics have adopted and incorporated TENS intervention. Implementing virtual TENS training in a pragmatic trial can be successful for participant intervention. Due to the current COVID-19 pandemic, participants are more aware of the need to complete interventions via virtual mechanisms. Barriers to virtual TENS instruction are often due to internet and device limitations. FM-TIPS work is supported by the National Institutes of Health (NIH) through the NIH HEAL Initiative under award number UG3AR076387 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. This work also received logistical and technical support from the PRISM Resource Coordinating Center under award number U24AT010961 from the NIH through the NIH HEAL Initiative. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or its HEAL Initiative.

Preparing the post-pandemic workforce for the cruise and hospitality industry

Purpose The aim of this article is to examine some of the imperatives surrounding the preparation of the workforce for the cruise and hospitality industry after the COVID-19 pandemic. This includes a competency-based approach to training. Design/methodology/approach An analysis of peer-reviewed material was conducted. This involved looking at the literature on the cruise and hospitality industry in the Caribbean region and specifically, Jamaica. Attention was then given to how aspects of training in competency-based education/training (CBE/T) could be utilised to prepare the workforce to sustain a viable cruise and hospitality industry during and after the pandemic. Findings The pandemic reveals some of the weaknesses of global tourism and academia more generally in terms of curricula and has pointed out that most of the training methods, techniques, pedagogies and subject areas may change in times of crisis in order to better prepare for response and recovery policies, strategies and research. Some of the competencies that the post-pandemic cruise and hospitality workforce will require were identified in the review, such as technological, health management and resilience competencies. Practical implications The review implies that there are new and emerging competencies that are driven by the COVID-19 pandemic. These must be reflected in a competency-based education and training (CBET) curricula as educational change will be required to prepare the post-pandemic workforce. Social implications Relationships and results will need to be the focus of CBET for the cruise and hospitality industry. Although the customer focus will remain for industry workers, the workforce will need to learn to interact with tourists via touchless applications, simulations and virtual interactions. Originality/value This paper is of value to educators and trainers in the cruise and hospitality industry.

Effectiveness of a multi-disciplinary community respiratory team during the COVID-19 pandemic

P157 Figure 1ConclusionsThe NHS GGC CRRT was able to safely and appropriately risk stratify patients and complement tertiary care by providing support at home with potential impact on reducing hospital admissions and deaths. Wider implementation of multidisciplinary community respiratory care could benefit patients and the healthcare service.

Managing the adult congenital heart disease patient in the covid-19 pandemic—a new york perspective

Adults with congenital heart disease (ACHD) are likely at increased risk for complications of COVID-19. ACHD centers should prepare to deliver routine cardiac care and support for patients with COVID-19 safely at home, as the number of COVID-19 infections worldwide continues to increase. This brief report aims to share the strategies we have used in our ACHD program to manage and treat our patients during this global health crisis at one of the initial epicenters of the pandemic in New York City, and offer suggestions for preparation for ACHD clinicians.

Covid-19 support guidelines for individuals with intellectual and developmental disabilities

People with intellectual and/or developmental disabilities (IDD) are at greater risk for contracting the coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus and experiencing more severe outcomes that people without IDD. Many people with IDD live and work in congregate settings, which provide an ideal environment for rapid spread and outbreaks. Although sources such as the World Health Organization and the US Centers for Disease Control and Prevention have issued guidelines to inform responses to COVID-19 in communities globally and in the United States, few address the specific needs of people with IDD. In this paper, authors evaluate generally available guidelines and adapt them to the needs of people with IDD, with recommendations on application to congregate settings including group homes.

The Opioid Epidemic Meets the Coronavirus Pandemic: Rates and Patient Characteristics of Emergency Department Visits for Opiate Use Disorder During the COVID-19 Pandemic in the Los Angeles County Public Hospital System

Study Objective: The COVID-19 pandemic led to profound challenges for health systems and disruptions in care for society’s most vulnerable patients, in particular people with opiate use disorders (OUD). The closure of outpatient addiction clinics, cessation of harm-reduction services, and lack of access to support groups have all been attributed to worsening outcomes for patients with OUD during the COVID-19 pandemic. Most concerningly, emerging evidence points to accelerated rates of overdose deaths. In Los Angeles, a city disproportionately affected by high rates of COVID-19, chronic housing insecurity, and substance use disorder, the Department of Public Health reported a 48% increase in accidental drug overdose deaths during the first five months of the pandemic. In March of 2020, a state of emergency was declared for COVID-19 and stay-at-home orders were issued. These events were associated with a sharp reduction in total ED visits. However, with the profound disruption in usual sources of care and support for people with substance use disorders, emergency departments (EDs) remained a critical access point for these patients. Methods: We examined all visits to public safety-net hospital EDs in Los Angeles County. We considered OUD-related ED visits as those which included any of the following: visits with a discharge diagnosis related to OUD, patients who received buprenorphine or naloxone while in the ED, and visits where a prescription for buprenorphine or naloxone was given on discharge. We performed a logistic regression to examine patient characteristics of opiate use disorder-related visits from April 2019-Feb 2020 compared with April 2020-Feb 2021. Results: Overall, there was a 22% increased odds of an ED visit being related to OUD when we compared pre- and post- COVID shutdown periods in Los Angeles. Visit acuity levels increased across all ESI scores. There was a statistically significant increase in the predicted probability of OUD visits for black and Hispanic patients of 17% and 25% respectively compared to pre-COVID levels. Patients were more likely to present for OUD-related encounters if they were publicly insured, uninsured, or brought in by ambulance. Admitted patients were four times more likely to have an OUD-related ED visit on presentation. Conclusions: Rates of OUD-related ED visits increased during COVID-related shutdowns. These increases were most pronounced among black and Hispanic patients and those with no insurance or publicly funded insurance plans. Patients admitted to the hospital had higher odds of OUD-related complaints. This reinforces the importance of the emergency department as a safety net resource for the most vulnerable patients suffering from OUD during the pandemic and highlights the opportunity to address these disparities with ED-based interventions.