ABSTRACT
Intro Enforced country-wide social distancing and suspension of most non- emergency medical care due to the COVID-19 pandemic will undoubtedly affect public health in multiple ways. While non-pharmaceutical interventions are expected to reduce transmission of several infectious diseases, severe disruptions to healthcare systems have hampered diagnosis, treatment, and routine vaccination. We examine the pre-pandemic community carriage prevalence together with the effect of this disruption on meningococcal disease and vaccination in the UK. Methods By adapting an existing mathematical model for meningococcal carriage and disease, we address the following questions:a) What is the predicted impact of the adolescent MenACWY vaccination on meningococcal transmission pre-pandemic? b) What is the predicted impact of social distancing on current infection rates? c) What effect might reductions in vaccine uptake have on future infection rates? d) Will catch-up vaccination campaigns be necessary for the MenACWY vaccine? Findings Model findings indicate that the MenACWY vaccine programme was already generating indirect protection and supressing transmission. Even without pandemic modelling assumptions, we observe that carriage prevalence could approach near-elimination in around 30 years due to the new lower community carriage prevalence observed by UKMenCar4 and effects of the 2015 MenACWY catch-up campaign. Moreover, COVID-19 social distancing is expected to have accelerated the decline, causing significant long-lasting reductions in the carriage prevalence of meningococcal strains A, C, W, and Y leading to near- elimination in under 20 years. Conclusion In all scenarios modelled, pandemic social mixing effects outweighed potential reductions in vaccine uptake (of up to 50%) causing an overall decline in carriage prevalence.
ABSTRACT
Background: It is unclear whether patients with cancer experience greater distress as a result of the COVID-19 pandemic. Thus, we assessed the relationship of the COVID-19 pandemic with quality of life (QOL) and depression symptoms in patients newly diagnosed with advanced lung cancer. Methods: We conducted a cross-sectional study of patients with advanced lung cancer enrolled in two multisite randomized supportive care trials. We enrolled adult patients within 12 weeks of diagnosis of advanced lung cancer and an Eastern Cooperative Oncology Group (ECOG) Performance Status from 0 to 3 across 23 institutions in the United States. At the time of enrollment, participants completed the Functional Assessment of Cancer Therapy-Lung (FACT-L), which includes four wellbeing subscales (i.e., physical, social, emotional, and functional) as well as lung cancer symptoms, and the Patient Health Questionnaire-9 (PHQ-9) to assess their QOL and depression symptoms, respectively. We compared QOL and depression symptoms between participants enrolled prior to COVID-19 (i.e., those enrolled in the following time periods: March 2018 to January 2019 and March 2019 to January 2020) and during the COVID-19 pandemic (March 2020 to January 2021). We used linear regression models adjusting for age, race, gender, and time since diagnosis of advanced cancer to examine the relationship between the period of enrollment and patients' QOL and depression symptoms. Results: A total of 860 patients were included in this analysis (665 participants enrolled prior to COVID-19 and 195 participants during COVID-19). The two cohorts did not differ significantly with respect to baseline demographic factors [Mean age 65.4 (SD = 11.4), 51.9% female]. In multivariate regression models, enrollment during COVID-19 was not associated with physical (B = -0.16, SE = 0.52, P = 0.763), social (B = -0.48, SE = 0.39, P = 0.217), emotional (B = -0.16, SE = 0.41, P = 0.693), functional (B = -0.83, SE = 0.55, P = 0.128) wellbeing, or lung cancer symptoms (B = -0.11, SE = 0.44, P = 0.806). Enrollment during COVID-19 was not associated with overall QOL (FACT-L: B = -1.32, SE = 1.69, P = 0.436) or depression symptoms (PHQ-9: B = -0.02, SE = 0.45, P = 0.973). Conclusions: Despite the prevailing belief that COVID-19 has negatively impacted QOL and distress in patients with cancer, we found no differences in QOL or depression symptoms in patients newly diagnosed with advanced lung cancer during the COVID-19 pandemic compared to those diagnosed prior to the pandemic. These findings suggest that factors other than the COVID- 19 pandemic, such as patients' experience with their cancer, contribute to their QOL and depression symptoms.
ABSTRACT
This study details research currently underway exploring the perceived roles that higher education instructors embody during the COVID-19 pandemic. Of interest to this study-up research, are the ways that instructors evaluate themselves as they pivot from previous modalities into emergency remote instruction and how their response provides insights into emergency continuity strategies. Through teleconferenced interviews, perspectives are transcribed, qualitatively coded through two coding cycles, culminating in an inductively derived insights that provide guidance to instructors and institutions. © 2020 Owner/Author.