Suicide Deaths in Cook County, Illinois Before and During the COVID-19 Pandemic

Background: To combat the COVID-19 pandemic, the Governor of Illinois signed a stay-at-home order that took effect on March 21, 2020 and extended through the end of May 2020. Mental health was an important consideration during this time as the health impact of the pandemic and the measures taken, including physical distancing and isolation at home, disrupted people's daily lives. Consequently, deaths due to suicide were a concern for public health officials. Design: We performed a retrospective review of the Cook County Medical Examiner's Office electronic database for all suicide cases during the first year of the COVID-19 pandemic (April 2020-March 2021) and compared those findings with the previous corresponding time period (April 2019-March 2020). Patient demographics and mechanism of death were analyzed. Results: A total of 478 and 445 suicide deaths occurred during the time period of 4/1/2019 - 3/31/2020 and 4/1/2020 - 3/31/2021, respectively (Table 1). In the first year of the pandemic, deaths due to gunshot wounds increased by 10%, deaths due to hanging decreased by 6% (Figure 1) and deaths in the Black population increased by 5%. During the stay-at-home order, there was a decrease in overall suicide deaths compared to the previous year (Figure 2). During both time periods, all mechanisms of suicides were markedly higher for men than women, except in the drug/alcohol toxicity mechanism. Deaths due to gunshot wounds increased by 6% in the 18-30 age group during the first year of the pandemic. Deaths due to drug/alcohol toxicity increased by 11% in the Black population, and this involved mostly Black women. Deaths due to impact by a train decreased 12% overall during the first year of the pandemic;however, there was a 10% increase seen both in the Black and Asian populations compared to the previous year. Conclusions: Our study did not find an increase in number of suicide deaths during the first year of the COVID-19 pandemic. However, future suicide prevention requires an assessment of factors that influence suicide risk. In Cook County, there was a significant rise in gunshot suicides in the overall population and an increase in drug/alcohol toxicity suicides among Black women during the first year of the pandemic. Our study shows how changes in lifestyle, access to drugs and transportation method used influence the mechanism of suicide deaths. Future analyses should continue to examine changes in mechanism of death and demographic trends.

Impact of Covid-19 on farming systems in Europe through the lens of resilience thinking.

Context: Resilience is the ability to deal with shocks and stresses, including the unknown and previously unimaginable, such as the Covid-19 crisis. Objective: This paper assesses (i) how different farming systems were exposed to the crisis, (ii) which resilience capacities were revealed and (iii) how resilience was enabled or constrained by the farming systems' social and institutional environment. Methods: The 11 farming systems included have been analysed since 2017. This allows a comparison of pre-Covid-19 findings and the Covid-19 crisis. Pre-Covid findings are from the SURE-Farm systematic sustainability and resilience assessment. For Covid-19 a special data collection was carried out during the early stage of lockdowns. Results and conclusions: Our case studies found limited impact of Covid-19 on the production and delivery of food and other agricultural products. This was due to either little exposure or the agile activation of robustness capacities of the farming systems in combination with an enabling institutional environment. Revealed capacities were mainly based on already existing connectedness among farmers and more broadly in value chains. Across cases, the experience of the crisis triggered reflexivity about the operation of the farming systems. Recurring topics were the need for shorter chains, more fairness towards farmers, and less dependence on migrant workers. However, actors in the farming systems and the enabling environment generally focused on the immediate issues and gave little real consideration to long-term implications and challenges. Hence, adaptive or transformative capacities were much less on display than coping capacities. The comparison with pre-Covid findings mostly showed similarities. If challenges, such as shortage of labour, already loomed before, they persisted during the crisis. Furthermore, the eminent role of resilience attributes was confirmed. In cases with high connectedness and diversity we found that these system characteristics contributed significantly to dealing with the crisis. Also the focus on coping capacities was already visible before the crisis. We are not sure yet whether the focus on short-term robustness just reflects the higher visibility and urgency of shocks compared to slow processes that undermine or threaten important system functions, or whether they betray an imbalance in resilience capacities at the expense of adaptability and transformability. Significance: Our analysis indicates that if transformations are required, e.g. to respond to concerns about transnational value chains and future pandemics from zoonosis, the transformative capacity of many farming systems needs to be actively enhanced through an enabling environment.