Sexual Behavior Change Among Gay and Bisexual Men During the First COVID-19 Pandemic Wave in the United States.

BACKGROUND: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. METHODS: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. RESULTS: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. CONCLUSION: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners.

The Psychology of COVID-19 Booster Hesitancy, Acceptance and Resistance in Australia.

COVID-19 booster vaccinations have been recommended as a primary line of defence against serious illness and hospitalisation. This study identifies and characterises distinct profiles of attitudes towards vaccination, particularly the willingness to get a booster dose. A sample of 582 adults from Australia completed an online survey capturing COVID-related behaviours, beliefs and attitudes and a range of sociodemographic, psychological, political, social and cultural variables. Latent Profile Analysis (LPA) identified three subgroups: Acceptant (61%), Hesitant (30%) and Resistant (9%). Compared to the Acceptant group, the Hesitant and Resistant groups were less worried about catching COVID-19, used fewer official COVID-19 information sources, checked the news less, were lower on the agreeableness personality dimension and reported more conservatism, persecutory thinking, amoral attitudes and need for chaos. The Hesitant group also reported checking the legitimacy of information sources less, scored lower on the openness to new experiences personality dimension and were more likely than the Resistant and Acceptant groups to report regaining freedoms (e.g., travel) and work requirements or external pressures as reasons to get a booster. The Resistant group were higher on reactance, held more conspiratorial beliefs and rated their culture as being less tolerant of deviance than the Hesitant and Acceptant groups. This research can inform tailored approaches to increasing booster uptake and optimal strategies for public health messaging.

Indoor Air Quality Improvements to Reduce Global Catastrophic Biological Risk

The importance of indoor air quality (IAQ) to reduce infectious disease transmission has become clear during the COVID-19 pandemic. In addition to SARS-CoV-2, other diseases, including RSV and influenza, are spread by airborne transmission, and often indoors-where most people spend over 90% of their lives. Given the importance of indoor environments in the spread of infectious disease, ventilation and filtration to improve IAQ should play a major role in preparing for a global catastrophic biological risk event (GCBR). This study involves performing a review of peer-reviewed literature and reports about improving indoor air quality in public spaces and interviewing technical experts in the fields of indoor air, building ownership, IAQ policy, and disease transmission control. The goal of the study is to identify and develop near and long-term policy actions for improving IAQ aimed to reduce GCBRs and other infectious diseases at various levels, including local and national. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

The shortfalls of vulnerability indexes for public health decision-making in the face of emergent crises: the case of COVID-19 vaccine uptake in Virginia.

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is to compare four vulnerability indexes produced by private, federal, and state institutions to assess the application of these measures to the needs of the COVID-19 pandemic and other emergent crises. We focus on federal, state, and private industries' vulnerability indexes for the Commonwealth of Virginia. Qualitative comparison is done by considering each index's methodologies to see how and why they defined and measured "vulnerability." We also quantitatively compare them using percent agreement and illustrate the overlaps in localities identified as among the most vulnerable on a choropleth map. Finally, we provide a short case study that explores vaccine uptake in the six localities that were identified by at least three indexes as most vulnerable, and six localities with very low vaccine coverage that were identified by two or fewer indexes as highly vulnerable. By comparing the methodologies and index (dis)agreements, we discuss the appropriateness of using pre-existing vulnerability indexes as a public health decision-making tool for emergent crises, using COVID-19 vaccine uptake as a case study. The inconsistencies reflected by these indexes show both the need for context-specific and time-sensitive data collection in public health and policy response, and a critical critique of measured "vulnerability."

School-related violence during the COVID-19 pandemic

During a global pandemic, there are unique and unprecedented challenges to all segments of society. For more than 3 years, schools and families alike have been faced with compromising life situations that have resulted in forms of anxiety and violence. Early studies are provided as are directions for further research in this area. Addressed are issues related to violence in the home, issues related to quarantined situations, some of the stresses of the global COVID-19 pandemic on children, parents, teachers, and community members, and the lessons learned during this very difficult time frame. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Model‐informed health system reorganization during emergencies

The COVID‐19 pandemic presented the world to a novel class of problems highlighting distinctive features that rendered standard academic research and participatory processes less effective in properly informing public health interventions in a timely way. The urgency and rapidity of the emergency required tight integration of novel and high‐quality simulation modeling with public health policy implementation. By introducing flexibility and agility into standard participatory processes, we aligned the modeling effort with the imposed reality of the emergency to rapidly develop a regional system dynamics (SD) model integrating diverse streams of data that could reliably inform both health system restructuring and public health policy. Using Lombardy data, our SD model was able to generate early projections for the diffusion of the pandemic in neighbor Ticino. Later, it projected the timing and size of peak patient demand. Our work also supported the need for reorganization of the healthcare system and volume flexibility strategies increasing hospital capacity (e.g., intensive care unit [ICU] and ward beds, medical and nursing staff, and oxygen supply) in Ticino. Counterfactual analyses quantify the impact of the decisions supported by our interventions. Our research contributes to our understanding of volume flexibility strategies used by healthcare organizations during emergencies, highlighting the critical role played by available response time in the deployment of strategies that either prioritize critical services or leverage available resources. It also contributes to the literature on participatory systems modeling by describing a flexible and agile participatory process that was successfully deployed in a rapidly evolving high‐stakes emergency.

Attempted suicide rates before and during the COVID-19 pandemic: interrupted time series analysis of a nationally representative sample.

BACKGROUND: To characterize the association between the protracted biopsychosocial coronavirus disease 2019 (COVID-19) pandemic exposures and incident suicide attempt rates. METHODS: Data were from a nationally representative cohort based on electronic health records from January 2013 to February 2021 (N = 852 233), with an interrupted time series study design. For the primary analysis, the effect of COVID-19 pandemic on incident suicide attempts warranting in-patient hospital treatment was quantified by fitting a Poisson regression and modeling the relative risk (RR) and the corresponding 95% confidence intervals (CIs). Scenarios were forecast to predict attempted suicide rates at 10 months after social mitigation strategies. Fourteen sensitivity analyses were performed to test the robustness of the results. RESULTS: Despite the increasing trend in the unexposed interval, the interval exposed to the COVID-19 pandemic was statistically significant (p < 0.001) associated with a reduced RR of incident attempted suicide (RR = 0.63, 95% CI 0.52-0.78). Consistent with the primary analysis, sensitivity analysis of sociodemographic groups and methodological factors were statistically significant (p < 0.05). No effect modification was identified for COVID-19 lockdown intervals or COVID-19 illness status. All three forecast scenarios at 10 months projected a suicide attempt rate increase from 12.49 (7.42-21.01) to 21.38 (12.71-35.99). CONCLUSIONS: The interval exposed to the protracted mass social trauma of the COVID-19 pandemic was associated with a lower suicide attempt rate compared to the unexposed interval. However, this trend is likely to reverse 10 months after lifting social mitigation policies, underscoring the need for enhanced implementation of public health policy for suicide prevention.

Policy Disparities Between Singapore and Israel in Response to the First Omicron Wave.

Purpose: The purpose of this study is to evaluate public health measures during the first Omicron wave in Singapore and Israel to inform other countries confronted by COVID-19 outbreaks. Methods: A comparative analysis was conducted using epidemiological data from Singapore and Israel between November 25th, 2021 and May 2nd, 2022 and policy information to examine the effects of public health measures in the two countries during the COVID-19 pandemic. Results: Public health measures implemented by Singapore and Israel in response to the first Omicron wave were primarily intended to mitigate the effects of the COVID-19 pandemic. In Singapore, the pandemic led to more than 910,000 confirmed cases, a mortality rate of approximately 0.047%, a hospitalization rate of approximately 10.95%, and a severe illness rate of approximately 0.48%, without a second peak. In Israel, the pandemic not only resulted in over 2.74 million confirmed cases, a mortality rate of 0.095%, a hospitalization rate of about 7.39%, and a severe illness rate of approximately 2.30% but also returned after the significant relaxation of prevention regulations from March 1st, 2022. Conclusion: Early and strict border control measures and surveillance measures are more effective in preventing and controlling the rapid spread of new strains of COVID-19 in the early stage. Furthermore, to prevent and control this highly infectious disease, COVID-19 vaccinations and booster shots must be promoted as soon as possible, medical service capacity must be enhanced, the hierarchical medical system must be improved, and non-pharmacological interventions must be implemented.

Non-pharmaceutical interventions in the State of Georgia: Economic implications.

Background: As Covid-19 spread rapidly, many countries implemented a strict shelter-in-place to "flatten the curve" and build capacity to treat in the absence of effective preventative therapies or treatments. Policymakers and public health officials must balance the positive health effects of lockdowns with economic, social, and psychological costs. This study examined the economic impacts of state and county level restrictions during the 2020 Covid-19 pandemic for two regions of Georgia. Methods: Taking unemployment data from the Opportunity Insights Economic Tracker with mandate information from various sites, we examined trends before and after a mandate's implementation and relaxation using joinpoint regression. Results: We found mandates with the largest impact on unemployment claims rates were the shelters-in-place (SIPs) and closures of non-essential businesses. Specific to our study, mandates had an effect where first implemented, i.e., if the state implemented an SIP after the county, the state-wide SIP had no additional measurable effect on claims rates. School closures had a consistent impact on increasing unemployment claims rates, but to a lesser degree than SIPs or business closures. While closing businesses did have a deleterious effect, implementing social distancing for businesses and restricting gatherings did not. Notably, the Coastal region was less affected than the Metro Area. Additionally, our findings indicate that race ethnicity may be a larger predictor of adverse economic effects than education, poverty level, or geographic area. Conclusions: Our findings coincided with other studies in some areas but showed differences in what indicators may best predict adverse effects and that coastal communities may not always be as impacted as other regions in a state. Ultimately, the most restrictive measures consistently had the largest negative economic impacts. Social distancing and mask mandates can be effective for containment while mitigating the economic impacts of strict SIPs and business closures.

Public health by organizational fix?

In August 2020 the UK government announced without warning the abolition of Public Health England (PHE), the principal UK agency for the promotion and protection of public health. We undertook a research programme seeking to understand the factors surrounding this decision. While the underlying issues are complex two competing interpretations have emerged: an 'official' explanation, which highlights the failure of PHE to scale up its testing capacity in the early weeks of the COVID-19 pandemic as the fundamental reason for closing it down and a 'sceptical' interpretation, which ascribes the decision to blame-avoidance behaviour on the part of leading government figures. This paper reviews crucial claims in these two competing explanations exploring the arguments for and against each proposition. It concludes that neither is adequate and that the inability adequately to address the problem of testing (which triggered the decision to close PHE) lies deeper in the absence of the norms of responsible government in UK politics and the state. However our findings do provide some guidance to the two new organizations established to replace PHE to maximize their impact on public health. We hope that this information will contribute to the independent national COVID inquiry.

Priming COVID-19's consequences can increase support for investments in public health.

Can messaging that emphasizes the costs of COVID-19 increase popular support for more proactive public health policies? People who experience disasters often become more supportive of policies to address their underlying causes, and the pandemic may have similar spillover effects for public opinion. To test this idea, the study implements a survey experiment in Italy, Germany, and the United States in which half of the respondents were randomly assigned to a prime about the impact of the pandemic prior to answering questions about their support for public health policies. The results show that respondents who received the prime became more favorable toward increased government spending on domestic and foreign public health programs alike. These treatment effects were consistent across countries, across two different surveys in the United States conducted at different points in time, and across partisan subgroups. However, the treatment did not consistently increase support for more active and intrusive government policies to address specific public health challenges like smoking or HIV/AIDS. The results suggest that public health advocates may benefit from messaging that connects COVID-19 to the need for public health funding beyond the context of the pandemic.

Race/Ethnicity Differences in COVID-19 Vaccine Uptake Among Nurses.

INTRODUCTION: There is evidence for relatively lower COVID-19 vaccine uptake among people of color in the United States. The purpose of this study was to investigate associations between race/ethnicity and COVID-19 vaccine uptake among nurses. METHODS: Nurses in Southern California (N = 1183) completed a one-time, web-based survey to assess COVID-19 vaccine perceptions and uptake. RESULTS: In all, 82.8% of respondents (N = 979) received at least one COVID-19 vaccine dose. Identifying as East Asian was associated with 14% higher odds of COVID-19 vaccine uptake relative to identifying as White (odds ratio [OR] = 1.14/95% confidence interval [CI] = [1.06, 1.24]); identifying as Filipino was associated with 14% higher odds of uptake (OR = 1.14/95% CI = [1.08, 1.20]); and identifying as Hispanic/Latinx was associated with 6% higher odds of uptake (OR = 1.06/95% CI = [1.00, 1.12]). DISCUSSION: Although nurses and people of color have been identified as groups with low levels of COVID-19 vaccine uptake, this study found that nurses of color received the vaccine at higher levels than their White counterparts.

Following the Science? Examining the Issuance of Stay-At-Home Orders Related to COVID-19 by U.S. Governors

Informed by the public health policymaking literature, this study's objective is to identify scientific, political, social, economic, and external factors related to U.S. governors' decisions to issue stay-at-home orders (SAHOs) in response to the first wave of the COVID-19 pandemic. Public health experts advocate for social distancing to slow the spread of infectious diseases, but government mandates to social distance can impose substantial social and economic costs. This study uses event history analysis to investigate the issuance of COVID-19-related gubernatorial SAHOs during a 41-day period in the 50 U.S. states. The findings indicate that scientific, political, and economic factors were associated with the issuance of SAHOs, but that external considerations played the largest role, particularly those related to the timing of other governors' decisions. This study offers evidence about how some U.S. political leaders balance public health concerns against other considerations and, more broadly, how state governments address crisis-level issues.

Policymaking during COVID-19: Preemptive State Interventions and the Factors Influencing Policy Implementation Success

COVID-19 sparked a public health crisis and created a series of public policy challenges. This article examines how COVID-19 interventions played out at the state level given the absence of guidance and coordinated national response. We focus on how the level of policy rigidness and enforcement of behavioral interventions helps us understand the success and failures of reducing the number of positive test rates over a 20-week period (March–July 2020). Specifically, we examine how four specific interventions (masking, school closures, restaurant closures, and travel restrictions) moved through the policy creation and implementation process as outlined by a modified version of Kingdon's multiple streams approach. We leverage a pooled-OLS approach to identify the agenda-setting and decision-making windows to verify the narrative derived from applying a modified multiple streams approach to the initial wave of policy making around COVID-19 interventions. Using this technique, we find evidence of two distinct agenda-setting windows and a decision-making window. Using these windows, we ascertain that highly restrictive policies are effective in controlling the spread of COVID-19. We find that governors acting as political entrepreneurs may not play as large of a role in the policy-making process, but they are responsive to constituent policy preferences.

In God We Trust: Community and Immunity in American Religions during COVID-19

From the systemic issues of race and class division to political partisanship and religious identity, the pandemic has affected many aspects of American social and political life. I interrogate the role that religions have played in communal identity-making during the pandemic, and how such identities shaped ideological responses, particularly in the US, stymying public health efforts to stop, or at least significantly slow, the spread of COVID-19. Drawing from Gabriel Garcia Marquez's Love in the Time of Cholera as a historical case study, I use Garcia Marquez's depiction of religion's identity-making power during the cholera pandemic depicted in the novel as a comparison by which to understand current experiences of white Evangelical Christians in America during the current COVID-19 pandemic, particularly those who reject risk-minimizing practices such as mask wearing, quarantining, and vaccination. Drawing both from representations of Roberto Esposito's theory of immunity and community, and from Lauren Berlant's concept of "cruel optimism”, as well as sociological understandings of religion and identity, I argue that the boundary-making practices of religion and of communal and national identity are related to the complex and often contradictory set of moral practices that led many white Evangelicals to disregard public health policies surrounding COVID-19. A concurrent analysis of Garcia Marquez's novel and of current events will allow me to explore this phenomenon, as Lauren Berlant would put it, both through the historically affective aesthetic and through the affective present. © 2023 by the author.

Institutional quality and COVID-19 vaccination: does decentralization matter?

Vaccination campaigns are one of the factors that can help mitigate the adverse effects of viral pandemics. The aim of this paper is to understand the institutional factors that are associated with a higher success rate, measured by the percentage of vaccinated population against COVID-19 across countries. Along with supply side determinants, institutional factors, related, at the national level, to the organization of the healthcare sector, governance and organization of the State and social capital, and, at the subnational level related to the authority and autonomy of lower tiers of government, are important correlates of successful vaccination campaigns, suggesting potential areas of public policy interventions.

Vital Needs of Dutch Homeless Service Users: Responsiveness of Local Services in the Light of Health Equity.

BACKGROUND: Healthcare and social services aim to ensure health equity for all users. Despite ongoing efforts, marginalized populations remain underserved. The Dutch HOP-TR study intends to expand knowledge on how to enable the recovery of homeless service users. METHODS: A naturalistic meta-snowball sampling resulted in a representative sample of homeless services (N = 16) and users (N = 436). Interviews collected health and needs from user and professional perspectives in a comprehensive, rights-based ecosystem strategy. We calculated the responsiveness to needs in four domains (mental health, physical health, paid work, and administration). RESULTS: Most service users were males (81%) with a migration background (52%). In addition to physical (78%) and mental health needs (95%), the low education level (89%) and functional illiteracy (57%) resulted in needs related to paid work and administration support. Most had vital needs in three or four domains (77%). The availability of matching care was extremely low. For users with needs in two domains, met needs ranged from 0.6-13.1%. Combined needs (>2 domains) were hardly met. CONCLUSIONS: Previous research demonstrated the interdependent character of health needs. This paper uncovers some causes of health inequity. The systematic failure of local services to meet integrating care needs demonstrates the urgency to expand recovery-oriented implementation strategies with health equity in mind.

Exploring young adults' e-cigarette use behavior during COVID-19.

INTRODUCTION: Changes in daily life related to COVID-19 have impacted e-cigarette use, particularly in young adults. This cross-sectional mixed-methods study explored young adults' perceptions regarding how COVID-19 influenced their e-cigarette use. METHODS: We analyzed Fall 2020 survey data from 726 past 6-month e-cigarette users (mean age=24.15 years, 51.1% female, 35.5% sexual minority, 4.4% Black, 10.2% Asian, 12.1% Hispanic) and Spring 2021 semi-structured interview data among a subset of 40 participants (mean age=26.30 years, 35.0% female, 45.0% sexual minority, 5.0% Black, 22.5% Asian, 12.5% Hispanic). Participants were drawn from 6 metropolitan statistical areas with varied tobacco and cannabis legislative contexts. RESULTS: Among survey participants, 44.4% also smoked cigarettes, 54.0% other tobacco products, and 60.1% used cannabis. They reported various changes in their daily lives, including changes in the nature and/or status of employment (e.g. 15.3% were laid off, 72.8% experienced household income loss). Regarding changes in e-cigarette use since COVID-19, 22.6% tried to cut down and 16.0% tried to quit. Interview participants commonly indicated that they increased their use due to stress, boredom, changes in accessibility, and/or changes to daily environment that made e-cigarette use more feasible. CONCLUSIONS: Results highlight the importance of promoting opportunities for young adults to build relationships to decrease stress, foster a sense of belonging, and increase quality of life (e.g. increasing the accessibility to mental health and social support services, intentionally engaging young adults in pandemic-appropriate community-building and extracurricular activities). This research may help to inform future e-cigarette cessation interventions that consider the unique challenges of societal stressors, such as pandemics.

A discourse and content analysis of representation in the mainstream media of the South African National Health Insurance policy from 2011 to 2019.

BACKGROUND: Media is a crucial factor in shaping public opinion and setting policy agendas. There is limited research on the role of media in health policy processes in low- and middle-income countries. This study profiles South Africa as a case example, currently in the process of implementing a major health policy reform, National Health Insurance (NHI). METHODS: A descriptive, mixed methods study was conducted in five sequential phases. Evidence was gathered through a scoping review of secondary literature; discourse analysis of global policy documents on universal health coverage and South African NHI policy documents; and a content and discourse analysis of South African print and online media texts focused on NHI. Representations within media were analysed and dominant discourses that might influence the policy process were identified. RESULTS: Discourses of 'health as a global public good' and 'neoliberalism' were identified in global and national policy documents. Similar neoliberal discourse was identified within SA media. Unique discourses were identified within SA media relating to biopolitics and corruption. Media representations revealed political and ideological contestation which was not as present in the global and national policy documents. Media representations did not mirror the lived reality of most of the South African population. The discourses identified influence the policy process and hinder public participation in these processes. They reinforce social hierarchy and power structures in South Africa, and might reinforce current inequalities in the health system, with negative repercussions for access to health care. CONCLUSIONS: There is a need to understand mainstream media as part of a people-centred health system, particularly in the context of universal health coverage reforms such as NHI. Harmful media representations should be counter-acted. This requires the formation of collaborative and sustainable networks of policy actors to develop strategies on how to leverage media within health policy to support policy processes, build public trust and social cohesion, and ultimately decrease inequalities and increase access to health care. Research should be undertaken to explore media in other diverse formats and languages, and in other contexts, particularly low- and middle-income countries, to further understand media's role in health policy processes.