Time series analysis of the demand for COVID-19 related chest imaging during the first wave of the SARS-CoV-2 pandemic: An explorative study.

OBJECTIVES: The aim of this study was to investigate possible patterns of demand for chest imaging during the first wave of the SARS-CoV-2 pandemic and derive a decision aid for the allocation of resources in future pandemic challenges. MATERIALS AND METHODS: Time data of requests for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) lung disease were analyzed between February 27th and May 27th 2020. A multinomial logistic regression model was used to evaluate differences in the number of requests between 3 time intervals (I1: 6am - 2pm, I2: 2pm - 10pm, I3: 10pm - 6am). A cosinor model was applied to investigate the demand per hour. Requests per day were compared to the number of regional COVID-19 cases. RESULTS: 551 COVID-19 related chest imagings (32.8% outpatients, 67.2% in-patients) of 243 patients were conducted (33.3% female, 66.7% male, mean age 60 ± 17 years). Most exams for outpatients were required during I2 (I1 vs. I2: odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.62-0.86, p = 0.01; I2 vs. I3: OR = 1.24, 95% CI 1.04-1.48, p = 0.03) with an acrophase at 7:29 pm. Requests for in-patients decreased from I1 to I3 (I1 vs. I2: OR = 1.24, 95% CI 1.09-1.41, p = 0.01; I2 vs. I3: OR = 1.16, 95% CI 1.05-1.28, p = 0.01) with an acrophase at 12:51 pm. The number of requests per day for outpatients developed similarly to regional cases while demand for in-patients increased later and persisted longer. CONCLUSIONS: The demand for COVID-19 related chest imaging displayed distinct distribution patterns depending on the sector of patient care and point of time during the SARS-CoV-2 pandemic. These patterns should be considered in the allocation of resources in future pandemic challenges with similar disease characteristics.

How Social Media Comments Inform the Promotion of Mask-Wearing and Other COVID-19 Prevention Strategies.

Current COVID-19 messaging efforts by public health departments are primarily informational in nature and assume that audiences will make rational choices in compliance, contradicting extensive research indicating that individuals make lifestyle choices based on emotional, social, and impulsive factors. To complement the current model, audience barriers to prevention need to be better understood. A content analysis of news source comments in response to daily COVID-19 reports was conducted in Montana, one of the states expressing resistance to routine prevention efforts. A total of 615 Facebook comments drawn from Montana news sources were analyzed using the Persuasive Health Message Framework to identify perceived barriers and benefits of mask-wearing. A majority (63%) of comments expressed barriers, the most common of which were categorized as either misinformation about the virus or conspiracy theories. Benefits (46%) of mask-wearing were articulated as benefits to loved ones or people in one's community or saving hospital space. This paper analyzes the implications of low perceived threat accompanied by low perceived efficacy of mask-wearing to make recommendations for future prevention efforts.