Mating in Captivity: The Influence of Social Location on Sexual Satisfaction through Phases of the COVID-19 Pandemic.

The recent global pandemic provides a natural experiment "intervention" to examine how differing baseline social dynamics such as gender, education, and politics shaped diverging patterns of well-being during rapidly shifting societal conditions. Using married adults from a nationally representative panel study in the United States from August 2019 to August 2021, discontinuous growth curves reveal a large drop in average married sexual satisfaction in both quality and frequency directly following the pandemic onset. Moreover, sexual satisfaction remained largely suppressed for the subsequent 18 months, apart from a brief "optimism blip" in the fall of 2020. Race, age, income, employment, parenthood, education, and political affiliation all appear as meaningful predictors, but these differ across various phases of the pandemic and by gender. These results reveal evidence of lingering changes in subjective sexual well-being as well as patterns of catastrophe risk and resilience moderated by social location factors.

The shock, the coping, the resilience: smartphone application use reveals Covid-19 lockdown effects on human behaviors.

Human mobility restriction policies have been widely used to contain the coronavirus disease-19 (COVID-19). However, a critical question is how these policies affect individuals' behavioral and psychological well-being during and after confinement periods. Here, we analyze China's five most stringent city-level lockdowns in 2021, treating them as natural experiments that allow for examining behavioral changes in millions of people through smartphone application use. We made three fundamental observations. First, the use of physical and economic activity-related apps experienced a steep decline, yet apps that provide daily necessities maintained normal usage. Second, apps that fulfilled lower-level human needs, such as working, socializing, information seeking, and entertainment, saw an immediate and substantial increase in screen time. Those that satisfied higher-level needs, such as education, only attracted delayed attention. Third, human behaviors demonstrated resilience as most routines resumed after the lockdowns were lifted. Nonetheless, long-term lifestyle changes were observed, as significant numbers of people chose to continue working and learning online, becoming "digital residents." This study also demonstrates the capability of smartphone screen time analytics in the study of human behaviors. Supplementary Information: The online version contains supplementary material available at 10.1140/epjds/s13688-023-00391-9.

Using Randomized Controlled Trials in the Sports Medicine and Performance Environment: Is It Time to Reconsider and Think Outside the Methodological Box?

SYNOPSIS: Randomized controlled trials (RCTs) are ubiquitous in medicine and have facilitated great strides in clinical care. However, when applied in sport, RCTs have limitations that hinder implementing effective interventions in the real-world clinical setting. Pragmatic clinical trials offer some solutions. Yet due to the competitive, high-pressure nature of sport at the individual, team, and governing body level, RCTs are likely infeasible in certain sport settings. The small number of athletes at the elite team level, along with the potential financial consequences of randomizing at the individual athlete and team level, also restricts study power and feasibility, limiting conclusions. Consequently, researchers may need to "think outside the box" and consider other research methodology, to help improve athlete care. In this Viewpoint, we detail alternative study designs that can help solve real-world problems in sports medicine and performance, while maintaining robust research standards and accounting for the challenges that RCTs pose. We also provide practical examples of alternative designs. J Orthop Sports Phys Ther 2023;53(6):1-4. Epub: 18 April 2023. doi:10.2519/jospt.2023.11824.

Using automated active infrared counters to estimate footfall on urban park footpaths: behavioural stability and validity testing.

BACKGROUND: Using infrared counters is a promising unobtrusive method of assessing footfall in urban parks. However, infrared counters are susceptible to reliability and validity issues, and there is limited guidance for their use. The aims of this study were to (1) determine how many weeks of automated active infrared count data would provide behaviourally stable estimates of urban park footfall for each meteorological season, and (2) determine the validity of automated active infrared count estimates of footfall in comparison to direct manual observation counts. METHODS: Three automated active infrared counters collected daily footfall counts for 365 days on three footpaths in an urban park within Northampton, England, between May 2021 - May 2022. Intraclass correlation coefficients were used to compare the behavioural stability of abbreviated data collection schedules with total median footfall within each meteorological season (Spring, Summer, Autumn, Winter). Public holidays, events, and extreme outliers were removed. Ten one-hour manual observations were conducted at the site of an infrared counter to determine the validity of the infrared counter. RESULTS: At least four-weeks (28 days) of infrared counts are required to provide 'good' to 'excellent' (Intraclass correlation > 0.75, > 0.9, respectively) estimates of median daily footfall per meteorological season in an urban park. Infrared counters had, on average, -4.65 counts per hour (95% LoA -12.4, 3.14; Mean absolute percentage error 13.7%) lower counts compared to manual observation counts during one-hour observation periods (23.2 ± 15.6, 27.9 ± 18.9 counts per hour, respectively). Infrared counts explained 98% of the variance in manual observation counts. The number of groups during an observation period explained 78% of the variance in the difference between infrared and manual counts. CONCLUSIONS: Abbreviated data collection schedules can still obtain estimates of urban park footfall. Automated active infrared counts are strongly associated with manual counts; however, they tend to underestimate footfall, often due to people in groups. Methodological and practical recommendations are provided.

Social pressure in football matches: an event study of ‘Remote Matches' in Japan

Sports matches during the COVID-19 pandemic have been held without spectators. Exploiting this unprecedented situation as a natural experiment, we examine the impacts of social pressure on the match outcomes in Japan's professional football league. As a result of the difference-in-difference estimation, we find that the number of fouls awarded to home team significantly decreases by about 1.05 in the matches with spectators, supporting the referee bias due to social pressure by the home-team's supporters. In addition, the results indicate that the absolute number of the home-team's supporters is more dominant in the source of referee bias than their share in the stadium.

The Impacts of Lockdown on Open Source Software Contributions during the COVID-19 Outbreak

We leverage the lockdown of Wuhan, China in January 2020 in response to COVID-19 as a natural experiment to study its impacts on individuals' contributions to open source software (OSS) on GitHub - the world's largest OSS platform. We find that Wuhan developers' contributions decreased by 10.2% relative to those in Hong Kong, Macau, and Taiwan (HMT) regions in the five weeks after the lockdown. Moreover, the contributions of Wuhan developers who interacted more with local developers on GitHub were reduced more after the lockdown. We conjecture that the lack of face-to-face (F2F) collaboration for Wuhan developers is the main driver of their reduced contributions, providing important insights for OSS platforms and stakeholders. © 2022 IEEE Computer Society. All rights reserved.

How do buildings adapt to changing occupancy? A natural experiment

Most office buildings regulate their indoor climate through conservative setpoints and schedules based on maximum occupancy. However, the occupancy of most office buildings rarely exceeds 50%. Buildings' lack of adaptability to partial occupancy exacts a toll on their energy use by providing building services excessively and inefficiently. Largely vacant office buildings left in the wake of the COVID-19 pandemic present a natural experiment to evaluate the extent of this problem. Three-parameter univariate changepoint models were employed to estimate the change in energy use before and during the pandemic in two institutional office buildings: one with occupancy-based ventilation, and one with traditional ventilation. A calibrated energy model was developed for the traditional building to determine how much energy could have been saved if occupancy-based ventilation was implemented. It was found that the building could have saved up to 32% and 12% for heating and cooling, respectively, in the pre-pandemic period alone. © International Building Performance Simulation Association, 2022

Estimating the effect of attendance on home advantage in the National Basketball Association

Using COVID-19 safety protocols as a natural experiment, we are able to delineate three distinct attendance categories in the NBA: 1) unrestricted games played prior to the pandemic, 2) attendance-restricted games played with socially distanced fans, and 3) ‘ghost games' played without fans. Further, since attendance at restricted games was exogenously determined by local COVID-19 protocols that were in turn driven by changes in COVID-19 case counts, we are able to estimate whether the ‘marginal fan' contributes to home advantage. Taken together, our results indicate that the presence of fans matters to home team performance;in fact, ‘ghost games' eliminated home advantage in totality. With a relatively small number of socially distanced fans, however, the entirety of home advantage was retained. Interestingly, since the size of socially distanced crowds had a statistically insignificant impact on home advantage, we find no evidence of a ‘marginal fan' effect. Finally, since researchers have found that officiating is influenced by fans in international soccer (e.g. Anders and Rotthoff, 2014), we explore whether NBA officiating behaviour was altered due to changes in attendance conditions. Our results indicate that NBA officials were not measurably influenced by the presence or quantity of fans.

Short-term and long-term effects of the COVID-19 pandemic on child psychological well-being: a four-wave longitudinal study.

As the COVID-19 pandemic further unfolds, it becomes a key theoretical and practical question to identify trajectories of child psychological well-being and to explore risk and resilience factors for developmental adjustment. The current study addressed this research gap by means of an ecological design: A (lockdown)-B (relaxation)-B (relaxation)-A (lockdown). We collected parental reports via online questionnaires over four measurement occasions during the COVID-19 pandemic in Germany (non-probabilistic sample): from the first lockdown (T1-spring 2020, N = 1769) to the following period of relaxation (T2-summer 2020, n = 873; T3-fall 2020, n = 729) on to the second lockdown (T4-winter 2020/21, n = 748). Key measures at T1-T4 were child emotional and behavioral problems as well as hyperactivity, child emotional and family-related well-being, parental strain, and parent-child relationship quality. We found evidence for quadratic growth models. While child problem behaviors (b = 0.32, p < 0.001) and emotional well-being (b = - 0.33, p < 0.001) improved after the first lockdown during subsequent periods of relaxation before worsening again in the second lockdown, child family-related well-being steadily decreased over all four measurement points (T1-T2: p < 0.001; T2-T3: p = 0.045; T3-T4: p = 0.030). Importantly, parental stress emerged as a strong risk factor (ps < 0.11) and the parent-child relationship quality constituted a resilience factor (p = 0.049) for child psychological well-being. These findings have major implications for policies aiming to further child health during the COVID-19 pandemic.

Short and medium-term effects of the COVID-19 lockdowns on child and parent accelerometer-measured physical activity and sedentary time: a natural experiment.

BACKGROUND: The COVID-19 pandemic has resulted in marked impacts on children's physical activity, with large reductions in moderate-to-vigorous physical activity (MVPA) reported during lockdowns. Previous evidence showed children's activity levels were lower and sedentary time higher immediately post-COVID lockdown, while there was little change in parental physical activity. We need to know if these patterns persist. METHODS: Active-6 is a natural experiment using repeated cross-sectional data conducted in two waves. Accelerometer data were collected on 393 children aged 10-11 and their parents from 23 schools in Wave 1 (June 2021-December 2021), and 436 children and parents from 27 schools in Wave 2 (January 2022-July 2022). These were compared to a pre-COVID-19 comparator group (March 2017-May 2018) of 1,296 children and parents in the same schools. Mean minutes of accelerometer-measured MVPA and sedentary time were derived for week- and weekend-days and compared across waves via linear multilevel models. We also analysed the date of data collection as a time series, to explore temporal patterns via generalised additive mixed models. RESULTS: There was no difference in children's mean MVPA in Wave 2 (weekdays: -2.3 min; 95% CI: -5.9, 1.3 and weekends: 0.6 min; 95% CI: -3.5, 4.6) when compared to the pre-COVID-19 data. Sedentary time remained higher than pre-pandemic by 13.2 min (95% CI:5.3, 21.1) on weekdays. Differences compared to pre-COVID-19 changed over time, with children's MVPA decreasing over winter, coinciding with COVID-19 outbreaks, and only returning to pre-pandemic levels towards May/June 2022. Parents' sedentary time and weekday MVPA was similar to pre-COVID-19 levels, with MVPA higher than pre-pandemic by 7.7 min (95% CI: 1.4, 14.0) on weekends. CONCLUSION: After an initial drop, children's MVPA returned to pre-pandemic levels by July 2022, while sedentary time remained higher. Parents' MVPA remained higher, especially at weekends. The recovery in physical activity is precarious and potentially susceptible to future COVID-19 outbreaks or changes in provision, and so robust measures to protect against future disruptions are needed. Furthermore, many children are still inactive, with only 41% meeting UK physical activity guidelines, and so there is still a need to increase children's physical activity.

The raptor lockdown menu—Shifts in prey composition suggest urban peregrine diets are linked to human activities

Raptors can thrive in cities where food supplies are abundant and seasonally stable. The availability of such resources may be linked to spatiotemporally predictable human activities generating reliable food subsidies for both raptors and their prey, capable of sustaining large populations. However, raptors may become affected by shifts in human behaviour. Here, we explore how urban peregrine falcon Falco peregrinus diets respond to changes in human activity levels amidst COVID-19 pandemic social restrictions. We used online nest cameras to study peregrine diets and reproduction across 31 sites in 27 UK cities over three breeding seasons, including one during lockdown. Prey composition changed significantly between years, and these differences varied by region. During lockdown, London peregrines took a lower proportion of pigeons (−14.5%), offset by a greater proportion of starlings Sturnus vulgaris (+6.9%) and ring-necked parakeets Psittacula krameri (+3.2%). In other cities, lockdown diets showed no change for pigeons (+0.3%), starlings comprised a lower prey proportion (−4.3%), while non-dominant corvid prey (+2.3%) and waterbirds (+2%) had greater importance. Racing pigeon prey also decreased during lockdown, significantly outside London. However, breeding parameters (number of eggs, hatchlings, fledglings) were not significantly different, suggesting urban peregrines may not have experienced food shortages amidst restrictions. Thus, our study demonstrates that human activity can influence urban peregrine predation opportunities but is unlikely to be more important than other factors like habitat availability. It also highlights how impacts can vary regionally, which may have been driven by social and geographical differences between the capital and other cities. Read the free Plain Language Summary for this article on the Journal blog. © 2023 The Authors. People and Nature published by John Wiley & Sons Ltd on behalf of British Ecological Society.

Spontaneous charitable donations in sweden before and after covid: A natural experiment

Did the outbreak of COVID-19 influence spontaneous donation behavior? To investigate this, we conducted a natural experiment on real donation data. We analyzed the absolute amount, and the proportion of total payments, donated by individuals to charitable organizations via Swish-a widely used mobile online payment application through which most Swedes prefer to make their donations to charity-each day of 2019 and 2020. Spontaneous charitable donations were operationalized as Swish-payments to numbers starting with 90, as this number is a nationally acknowledged quality control label that is provided to all fundraising operations that are monitored by the Swedish Fundraising Control. The results show that the Swish-donations fluctuated substantially depending on season (less donations in January-February and during the summer months, and more donations in April-May and during the last months of the year) and specific events (peaks in Swish-donations often coincided with televised charity fundraising galas). Interrupted time-series analyses revealed that spontaneous donations were overall unaffected by the pandemic outbreak. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Team performance and the perception of being observed: Experimental evidence from top-level professional football

We exploit the natural experimental setting provided by the Covid-19 lockdown to analyse how performance is affected by a friendly audience. Specifically, we use data on all football matches in the top-level competitions across France, Germany, Italy, Spain, and the United Kingdom over the 2019/2020 season. We compare the difference between the number of points gained by teams playing at home and teams competing away before the Covid-19 outbreak, when supporters could attend any match, with the same difference after the lockdown, when all matches took place behind closed doors. We find that the performance of the home team is halved when stadiums are empty. Further analyses indicate that offensive (defensive) actions taken by the home team are drastically reduced (increased) once games are played behind closed doors. Referees are affected too, as they change their behaviour in games without spectators. Finally, the home advantage is entirely driven by teams that do not have international experience. Taken together, our findings corroborate the hypothesis that social pressure influences individual behaviour.

Effects of the COVID-19 Pandemic on Neural Responses to Reward: A Quasi-experiment.

BACKGROUND: The COVID-19 pandemic has been a prolonged period of stress due to social isolation, illness, death, and other major life disruptions. Neural reward sensitivity, essential for healthy functioning, may become reduced under major naturalistic stressors, though few studies have examined this. The present study sought to test whether neural responses to rewards were significantly blunted by the stress of the pandemic. METHODS: We compared 2 groups of young adult participants, who completed a monetary reward task while an electroencephalogram was recorded, at 2 time points, 1 to 3 years apart. Our measure of reward sensitivity was the reward positivity (RewP), a neural marker enhanced to gain relative to loss feedback. The magnitude of the RewP is sensitive to stress exposure and can prospectively predict depression. The pre-pandemic group (n = 41) completed both time points before the pandemic, while the pandemic group (n = 39) completed the baseline visit before the pandemic and the follow-up visit during its second year. RESULTS: The pandemic group reported having experienced significant stressors over the course of the pandemic. We did not observe a significant decrease in the RewP from baseline to follow-up in the pre-pandemic group. In contrast, in the pandemic group, the RewP was significantly blunted at the follow-up visit to the extent that it no longer distinguished gain from loss feedback. CONCLUSIONS: These results suggest that prolonged naturalistic stressors can result in adaptations in neural responses to rewards. Our findings also highlight a possible mechanism linking stress to the development of depression.

Upper Quarter Injury Rates and Risk in United States High School Athletes Prior To and During the Prolonged Sport Stoppage.

Background: Upper quarter injuries are a serious problem in high school sports. The distinctive differences in males and females and within sports concerning specific upper quarter body parts necessitates the need to evaluate these injuries across these groups. The COVID-19 pandemic has created an opportunity to evaluate the potential added burden abrupt and prolonged sport stoppage had on upper quarter injury risk. Hypothesis/Purpose: To 1) describe and compare upper quarter injury rates and risk in high school athletes in the 2019-2020 and 2020-2021 academic school years; 2) examine injuries by gender, sport, injury type, and location of injury. Methods: An ecological study of the athletes from 176 high schools over six states, matching high schools between 2019-2020 (19-20) and 2020-2021 (20-21) years was performed. Injuries were reported by at least one high school athletic trainer assigned to each school into a centralized database and data collected from July 1, 2019, to June 30, 2021. Injury rates were calculated per 1,000 athletes per academic year. Interrupted time series models assessed the incidence ratio between academic years. Results: A total of 98,487 athletes from all sports participated in 19-20 and 72,521 in 20-21. Upper quarter injury rates increased in from 19-20 [41.9 (40.6, 43.1)] to 20-21 [50.7 (48.1, 51.3)]. Upper quarter injury risk [1.5 (1.1, 2.2)] was greater in 20-21 compared to 19-20. Females did not demonstrate increased injury rates between 19-20 [31.1 (29.4, 32.7)] to 20-21 [28.1 (26.4, 30.0)]. Males reported increased injury rates from 19-20 [50.3 (48.5, 52.2)] to 20-21 [67.7 (65.2, 70.2)]. Increased injury for the shoulder, elbow, and hand were reported in 20-21. Collision, field, and court upper quarter injury rates were increased in 20-21. Discussion: Upper quarter injury rates and injury risk were greater during the 2020-2021 school year than in the prior year. Males demonstrated increased upper quarter injury rates, while females did not. Return to play protocols for high school athletes should be considered following abrupt sport stoppage. Level of Evidence: 2.

Understanding faculty acceptance of online teaching during the COVID-19 pandemic: a Saudi Arabian case study

Purpose: This study aims to leverage the Unified Theory of Acceptance and Use of Technology framework developed by Venkatesh et al. (2003) to explore the factors influencing faculty willingness and acceptance of online teaching at a major Saudi Arabian university as we move to a post-COVID-19 new normal. Design/methodology/approach: We surveyed business school faculty from a major Saudi Arabian university that transitioned to online learning because of the COVID-19 lockdown. We used partial least square structural equation modeling to examine the factors that impact faculty satisfaction and behavioral intention to continue using online teaching in the future. Findings: The results of the study indicated that when faculty perceive that e-learning improves their teaching performance and effectiveness (performance expectancy) and find that online teaching tools are relatively easy to use (effort expectancy), then they are more open to considering online teaching and using digital tools even after the pandemic. Research limitations/implications: The study uses a Saudi Arabian sample, so the results of the study may not be generalizable to other countries. The study was cross-sectional in nature;a longitudinal design would help in uncovering more stable relationships and enabling us to draw stronger conclusions. Lastly, the sample size for the study was relatively small, resulting in a loss of power in statistical testing. Notwithstanding these limitations, our study contributes to a greater understanding and appreciation of faculty acceptance of online teaching as we progress to a post-COVID-19 new normal. As such, it should be useful to educators, institutions and policymakers as they seek to reimagine business education going forward. Originality/value: The present study is one of the first scholarly studies to focus on exploring e-learning acceptance in a business school from a faculty perspective, considering the natural experiment that forced institutions to move to online teaching irrespective of their prior acceptance or experience with this teaching modality. © 2023, Emerald Publishing Limited.

COVID-19 online teaching intervention and learning performance of college foreign language students.

This quasi-natural experimental study examined an online teaching intervention implemented in response to COVID-19 in China in 2020. It applied the difference-in-difference model to examine the impact and path of the intervention on students' learning performance of a college foreign language (LPCFL). Based on data from records of withdrawing and changing courses, classroom learning, and teaching evaluations; a questionnaire survey of teachers and students; and relevant school documents during the last seven terms, the results indicated that the online teaching intervention could significantly improve students' LPCFL. This finding remained robust after adopting a placebo test approach to mitigate possible endogeneity issues. Additionally, this study also conducted a group test through sub-sample regression based on students' discipline characteristics and intervention organization methods. The results showed that the students who participated in the intervention significantly improved in the three disciplines: humanities was most significantly affected, science and engineering were least significantly affected, and economics and management were in the middle. A range effect was observed for organizational methods. The two downward transmission methods by college teaching management terms had significant positive effects, whereas the other two methods of downward transmission by college student management had significant negative effects. An analysis of the action mechanism indicated that the online teaching intervention mostly improved LPCFL through two channels: students' learning input and learning support. Overall, these findings not only help expand the research framework on macro environmental intervention policy and micro-learning behavior but also have implications for the in-depth understanding of the real learning effect of online learning interventions for college students and their design in the post-COVID-19 era.

Management of Consumer Payment Determined by Gender During the COVID-19 Pandemic

The article discusses the subject of the consumer's gender and factors that affect shopping, and more specifically whether there is a relationship between gender and preferred means of payment in times of the COVID-19 pandemic. I explore the relationship between cash and other payment instruments using the outbreak of the COVID-19 pandemic as a natural experiment exogenously affecting both the payment industry and consumers' habits. This article sheds more light on changing the payment habits of consumers since the beginning of the pandemic. The purpose of this article is to examine the styles of payment-related decision making and to identify differences and similarities in this regard according to gender. Women are different from men in every activity they perform, and therefore also in shopping styles. Consumer behaviour is an area in which the diversity of behaviour between men and women is very clear. The author conducted an empirical study in the period of January-February 2022 among the students of the University of the Third Age. The study participants were women and men over 55 years of age. The basic research method was the PAPI (Paper and Pencil Interview) method, based on a questionnaire. In the first part of the article, it was attempted to present some theoretical aspects of payment methods by consumers in Poland and in Europe, based on the analysis of literature sources. Then, the gender-dependent differences in consumer behaviour are presented. The next section describes the procedure of empirical research, as well as the most important conclusions of the research. © 2022, Academic Conferences and Publishing International Limited. All rights reserved.

Has the COVID-19 pandemic affected infection avoidance tendencies? Adjustment of house effects on Web survey by propensity score

This study examines whether the psychological tendencies during the new coronavirus infection (COVID-19) pandemic differed from that in normal times based on Web-based survey data from two different samples. The target of the analysis was the tendency to avoid infection. In doing so, we considered the house effects of the different survey media and attempted to compensate for them by inverse probability weighted estimation using propensity scores calculated with several covariates. The results showed that even after adjustment, infection avoidance tendencies were higher during the pandemic than normal times. We discussed the significance of adjusting for house effects in the Web-based survey and some of the limitations of this study. © 2022 Japanese Psychological Association. All rights reserved.

Effects of different levels of non-pharmaceutical interventions on hand, foot and mouth disease in Guangzhou, China.

BACKGROUND: Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) may have suppressed the transmission of other infectious diseases. This study aimed to evaluate the impact of different degrees of NPIs during the COVID-19 pandemic on hand, foot and mouth disease (HFMD) in Guangzhou, China. METHODS: Weekly reported HFMD cases and pathogens information during 2015-2021 in Guangzhou were collected from the China National Notifiable Disease Reporting System. The observed number of HFMD cases in 2020 and 2021 was compared to the average level in the same period during 2015-2019. Then, an interrupted time-series segmented regression analysis was applied to estimate the impact of NPIs on HFMD, such as social distancing, suspension of schools, community management and mask wearing. The effects across different subgroups stratified by gender, children groups and enterovirus subtype of HFMD were also examined. RESULTS: A total of 13,224 and 36,353 HFMD cases were reported in 2020 and 2021, which decreased by 80.80% and 15.06% respectively compared with the average number of cases in the same period during 2015-2019. A significant drop in the number of HFMD cases during time when strict NPIs were applied (relative change: 69.07% [95% confidence interval (CI): 68.84%-69.30%]). The HFMD incidence rebounded to historical levels in 2021 as the lockdown eased. The slightest reduction of HFMD cases was found among children at kindergartens or childcare centres among the three children groups (children at kindergartens or childcare centres: 55.50% [95% CI: 54.96%-56.03%]; children living at home: 72.64% [95% CI: 72.38%-72.89%]; others: 74.06% [95% CI: 73.19%-74.91%]). CONCLUSIONS: The strong NPIs during the COVID-19 epidemic may have a significant beneficial effect on mitigating HFMD. However, the incidence of HFMD rebounded as the NPIs became less stringent. Authorities should consider applying these NPIs during HFMD outbreaks and strengthening personal hygiene in routine prevention.