The nature of the pandemic: exploring the negative impacts of the COVID-19 pandemic upon recreation visitor behaviors and experiences in parks and protected areas. (Special Issue: Covid-19 and outdoor recreation.)

The COVID-19 pandemic dramatically affected parks and protected areas and overall recreation visitation across the United States. While outdoor recreation has been demonstrated to be beneficial, especially during a pandemic, the resulting increase in recreation visitation raises concerns regarding the broader influence of social, situational, ecological, and behavioral factors upon overall visitor experiences. This study investigated the extent to which recreation visitors' behaviors and experiences have been impacted by the COVID-19 pandemic within the White Mountain National Forest (WMNF). A modified drop-off pick-up survey method was employed to collect population-level data from WMNF visitors from June to August of 2020 (n=317), at the height of the pandemic. Results from this mixed-method study suggest social factors (e.g., crowding and conflict), situational factors (e.g., access and closures), ecological factors (e.g., vegetation damage), behavioral factors (e.g., substitution), and sociodemographic factors (e.g., gender and income) significantly influenced overall visitor decision-making and experience quality within the WMNF. For example, more than one-third of visitors indicated the pandemic had either a major or severe impact upon their WMNF recreation experience. A more nuanced investigation of qualitative data determined that the majority of pandemic-related recreation impacts revolved around the themes of social impacts, general negative recreation impacts, situational and ecological impacts, and behavioral adaptation impacts. Moreover, historically marginalized populations (e.g., low-income households and females) within the sample reported significantly higher recreation experience impacts during the pandemic. This study demonstrates the influence of the pandemic upon outdoor recreation visitor experiences and behaviors and considers outdoor recreation as a central component within the broader social-ecological systems framework. This study demonstrates the influence of the pandemic upon outdoor recreation visitor experiences and behaviors and considers resource users a central component within the broader social-ecological systems conceptual framework.

SARS-CoV-2 testing and patient waiting times in the emergency department

Aim Emergency Departments (EDs) were impacted early in the coronavirus disease 2019 (COVID-19) pandemic, with high attendance numbers. EDs relied upon SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR) tests to triage patients and facilitate admission to appropriate wards, meaning positive patients were isolated as early as possible. In October 2020, we introduced a 24-hour SARS-CoV-2 testing service. We examined the impact of this on patient experience times (PETs) in the ED, and on healthcare-associated (HA) COVID-19 infections. Methods Data on PETs before and after the introduction of 24-hour testing were available from the ED. HA COVID-19 infections were reported weekly to the Health Services Executive as a key performance indicator. Results Mean PET prior to the pandemic was 20 hours and dropped to 10 and 13 hours respectively in the first and second wave. A surge in case numbers and ED attendances during the third wave was not reflected in a rise in PETs, with a mean PET of 11 hours, significantly below pre-pandemic levels. HA-COVID-19 infections remained stable between wave one and three (83 v 92). Conclusion The introduction of 24-hour SARS-CoV-2 testing in our ED contributed to a reduction in PETs, facilitated appropriate patient placement at ward level, and kept HA-COVID-19 infections at acceptably low levels.

Defining a Trauma-Informed Approach to Social Work Field Education: A Path Forward for the Profession

Despite the recognized importance of social work field education, concerns about its dependence on already strained service delivery systems for student learning persist. The growing complexity of student needs, and the deleterious effects of COVID-19 on service systems adds to the problematic landscape. A trauma-informed approach, because it applies to individuals and environments, presents a useful framework for exploring these concerns. A trauma-informed framework to field education, once defined, could edify the profession's response to these challenges. A qualitative survey (n=103) was developed to aid in understanding trauma-informed practices that support student learning. Key findings are that a trauma-informed approach to field education entails creating safe environments where expectations and boundaries are clear, supporting students by processing and validating emotional responses, and utilizing relational, collaborative approaches to supervision. Strategies for each area are delineated. Barriers to promoting trauma-informed field education include lack of time, and lack of organizational support. Authors recommend the adoption of trauma-informed field as a universal precaution approach, ensuring that students experience the principles and atmosphere of a trauma-informed field setting, enabling them to translate these into practice. Social work programs are called upon to better support placement agencies and assume more responsibility for training. © 2022 Authors.

SARS-CoV-2 Testing and Patient Waiting Times in the Emergency Department.

Aim Emergency Departments (EDs) were impacted early in the coronavirus disease 2019 (COVID-19) pandemic, with high attendance numbers. EDs relied upon SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR) tests to triage patients and facilitate admission to appropriate wards, meaning positive patients were isolated as early as possible. In October 2020, we introduced a 24-hour SARS-CoV-2 testing service. We examined the impact of this on patient experience times (PETs) in the ED, and on healthcare-associated (HA) COVID-19 infections. Methods Data on PETs before and after the introduction of 24-hour testing were available from the ED. HA COVID-19 infections were reported weekly to the Health Services Executive as a key performance indicator. Results Mean PET prior to the pandemic was 20 hours and dropped to 10 and 13 hours respectively in the first and second wave. A surge in case numbers and ED attendances during the third wave was not reflected in a rise in PETs, with a mean PET of 11 hours, significantly below pre-pandemic levels. HA-COVID-19 infections remained stable between wave one and three (83 v 92). Conclusion The introduction of 24-hour SARS-CoV-2 testing in our ED contributed to a reduction in PETs, facilitated appropriate patient placement at ward level, and kept HA-COVID-19 infections at acceptably low levels.

Mitigation policies, community mobility, and COVID-19 case counts in Australia, Japan, Hong Kong, and Singapore.

OBJECTIVES: The objective of the study was to characterize the timing and trends of select mitigation policies, changes in community mobility, and coronavirus disease 2019 (COVID-19) epidemiology in Australia, Japan, Hong Kong, and Singapore. STUDY DESIGN: Prospective abstraction of publicly available mitigation policies obtained from media reports and government websites. METHODS: Data analyzed include seven kinds of mitigation policies (mass gathering restrictions, international travel restrictions, passenger screening, traveler isolation/quarantine, school closures, business closures, and domestic movement restrictions) implemented between January 1 and April 26, 2020, changes in selected measures of community mobility assessed by Google Community Mobility Reports data, and COVID-19 epidemiology in Australia, Japan, Hong Kong, and Singapore. RESULTS: During the study period, community mobility decreased in Australia, Japan, and Singapore; there was little change in Hong Kong. The largest declines in mobility were seen in places that enforced mitigation policies. Across settings, transit-associated mobility declined the most and workplace-associated mobility the least. Singapore experienced an increase in cases despite the presence of stay-at-home orders, as migrant workers living in dormitories faced challenges to safely quarantine. CONCLUSIONS: Public policies may have different impacts on mobility and transmission of severe acute respiratory coronavirus-2 transmission. When enacting mitigation policies, decision makers should consider the possible impact of enforcement measures, the influence on transmission of factors other than movement restrictions, and the differential impact of mitigation policies on subpopulations.

Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room?

The role of the hospital environment in the transmission of infection is well described. With an emerging infection whose mode of transmission is under investigation, strict infection prevention and control measures, including patient isolation, hand hygiene, personal protective equipment that is doffed on exiting the patient room, and environmental cleaning should be implemented to prevent spread. Environmental testing demonstrated that COVID-19 patients contaminated the patient area (11/26, 42.3% of tests) but contamination of general ward areas was minimal (1/30, 3%) and the virus was detected after cleaning on one item only (1/25, 4%) which was noted to be in disrepair.

A Novel Approach for a Novel Pathogen: using a home assessment team to evaluate patients for 2019 novel coronavirus (SARS-CoV-2) ;Clinical Infectious Diseases ;Oxford Academic

Thousands of people in the United States have required testing for SARS-CoV-2. Evaluation for a special pathogen is resource intensive. We report an innovative approach to home assessment that, in collaboration with public health, enables safe evaluation and specimen collection outside the healthcare setting, avoiding unnecessary exposures and resource utilization.