The 'hole' is greater than the sum of its parts: How conducting home visits during a pandemic revealed gaps in an educational system

Covid-19 turned the world upside down. What started as an impossible situation turned into a problem with new possibilities. Individuals, families, communities, and states worked tirelessly to restore balance to overworked systems. Using semi-structured interviews with teachers and administrators, this high school social worker set out to examine how COVID-19 challenged staff to rethink current educational practices like home visits. This qualitative ethno-infused phenomenological study examines the experiences of home visits by a school social worker during COVID-19. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Distance traveled in times of pandemic: an endogenous switching regression approach

This paper studies the change in the distance traveled by domestic tourists considering the pre- and post-pandemic outbreak summer periods of 2019 and 2020. Using representative monthly microdata involving more than 31,000 trips conducted by Spanish residents, we examine the heterogeneity in behavioral adaptation to COVID-19 based on sociodemographic and trip-related characteristics. To account for selection effects and the potential change in the population composition of travelers between the two periods, we estimate an endogenous switching regression that conducts separate regressions for the pre- and post-pandemic periods in a unified econometric framework. Our results point to heterogeneous shifts in the distance traveled by domestic travelers after COVID-19 outbreak per sociodemographic group, with notable differences by travel purpose and lower relevance of traditional determinants like income.

Response of e-traders to COVID-19 challenges: empirical evidence from north Macedonia

The COVID-19 pandemic caused several short- and mid-term disruptions, to which businesses must adapt. The main goal of this research is to investigate the impact of e-traders response to Covid-19 challenges on online growth. Using existing survey data results linear multiply regression was performed and statistically significant results confirmed that online growth during the Covid-19 emergency was higher in the companies that undertake marketing and delivery adaptation. Further, it was confirmed that e-traders that were selling traditionally and online made higher online growth. Companies with fewer employees were more adaptable to reach higher online growth. Online growth obviously was affected by online sales, and online visits do not statistically significantly influence online growth. The e-traders that believe in the potential for e-commerce in North Macedonia have achieved higher online growth. The timing of the start of the online business does not affect the online growth of e-traders.

Impact of COVID-19 Pandemic on Antenatal Healthcare in Al-Ramadi city, Iraq

Background:Antenatal care (ANC) is a form of preventive medicine, pregnancy-specific, and general health advice effectively given in the antenatal period. ANC is conducted by healthcare personnel on pregnant women at regular intervals to protect and improve maternal and neonatal health. Objectives: The study aimed to know if the COVID-19 pandemic affects the coverage rate of ANC visits of pregnant women. Materials and methods: This is a retrospective cross-sectional study conducted at Al-Andalus Primary Healthcare Center which is located in the center of Al-Ramadi city, Iraq. We reviewed the records of all ANC first, second, and total visits of the months February, May, and October during the years 2019, 2020, and 2021. Results: The study showed the coverage rate of ANC visits was statistically significantly declined with the restrictions imposed in response to the COVID-19 pandemic. At the end of 2021, there are some elevation in the coverage rate of ANC visits.. Conclusion: The study concluded that the lockdown period in the pandemic state due to COVID-19 led to a significant decline in the coverage rate of ANC visits. © 2022, Al-Anbar Medical Journal.

Interconception Care for Adolescent Women During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVE: Interconception care (ICC) is a means of improving health outcomes for women and children by mitigating maternal risks between pregnancies. Within a pediatric medical home ICC is reliant on adherence to well-child visits (WCVs). We hypothesized that a pediatric-based ICC model would remain successful in providing access to services for adolescent women for those seen during the COVID19 pandemic. The objective of this study was to determine if the COVID19 pandemic influenced LARC use and repeat pregnancy for those seen for ICC in a dyadic pediatric medical home. METHODS: The pre-COVID cohort was comprised of adolescent women seen for ICC from September 2018-October 2019. The COVID cohort was comprised of adolescent women seen for ICC from March 2020-March 2021. The two cohorts were compared across multiple characteristics including sociodemographic factors, age, education, number of visits, contraceptive choice and repeat pregnancy during the study interval. RESULTS: The COVID cohort were significantly more likely to be primiparous, seen with a younger infant, and attend fewer visits than the pre-COVID cohort. The COVID cohort were equally likely to initiate long-acting reversible contraception but less likely to experience a repeat pregnancy. CONCLUSIONS: The COVID19 pandemic limited access to routine healthcare and likely impacted access to ICC for many women. ICC provided during WCVs allowed access to care even amid the restrictions of the COVID19 pandemic. Both effective contraception and decreased repeat pregnancy were maintained, highlighting the effectiveness of this approach for ICC within a dyadic pediatric medical home.

Virtual Cardiology: Past, Present, Future Directions, and Considerations.

Purpose of Review: Through this review, we attempt to explore the role of telemedicine and virtual visits in the field of cardiology pre-COVID-19 and during COVID-19 pandemic, their limitations and their future scope for delivery of care. Recent Findings: Telemedicine, which rose to prominence during COVID-19 pandemic, helped not only in reducing the burden on the healthcare system during a time of crisis but also in improving patient outcomes. Patients and physicians also favored virtual visits when feasible. Virtual visits were found to have the potential to be continued beyond the pandemic and play a significant role in patient care alongside conventional face-to-face visits. Summary: Although tele-cardiology has proven beneficial in terms of patient care, convenience, and access, it comes with its fair share of limitations-both logistical and medical. Whilst there remains a great scope for improvement in the quality of patient care provided through telemedicine, it has shown the potential to become an integral part of medical practice in the future. Supplementary Information: The online version contains supplementary material available at 10.1007/s12170-023-00719-0.

Investigating the factors affecting adolescents' test anxiety in Greece during the COVID-19 pandemic

The most prevalent mental health challenges in teenagers are generalized anxiety disorder and depression. The (COVID-19) pandemic has added an extra negative effect on children's mental health.(1) This study focuses on the investigation of a specific form of adolescent anxiety, i.e. test anxiety (TA). TA in adolescents is associated with mental and behavioral comorbidities and may have adverse effects on students' academic performance as well as their physiological and psychological well-being. Therefore, this study examines the impact of family communication and body image dissatisfaction on adolescents' test anxiety in Greece. According to the results of the Structural Equation Model that was examined, family communication presented a minimal negative effect on students' TA. However, the main finding of this study was that body image dissatisfaction had an important direct and minimal indirect effect on students' TA. The indirect effect was via the physical activity hours that acted as a mediator between body image dissatisfaction and TA. As a result, examining body image concerns and enhancing family communication may be crucial in assisting adolescents at risk for severe TA symptoms. Implications of the findings are discussed.(1)

Face time with physicians: How do patients assess providers in video-visits?

Introduction: The COVID-19 pandemic has triggered a massive acceleration in the use of virtual and video-visits. As more patients and providers engage in video-visits over varied digital platforms, it is important to understand how patients assess their providers and the video-visit experiences. We also need to examine the relative importance of the factors that patients use in their assessment of video-visits in order to improve the overall healthcare experience and delivery. Methods: A data set of 5149 reviews of patients completing a video-visit was assembled through web scraping. Sentiment analysis was performed on the reviews and topic modeling was used to extract latent topics embedded in the reviews and their relative importance. Results: Most patient reviews (89.53%) reported a positive sentiment towards their providers in video-visits. Seven distinct topics underlying the reviews were identified: bedside manners, professional expertise, virtual experience, appointment scheduling and follow-up process, wait times, costs, and communication. Communication, bedside manners and professional expertise were the top factors patients alluded to in the positive reviews. Appointment-scheduling and follow-ups, wait-times, costs, virtual experience and professional expertise were important factors in the negative reviews. Discussion: To improve the overall experience of patients in video-visits, providers need to engage in clear communication, grow excellent bedside and webside manners, promptly attend the video-visit with minimal delays and follow-up with patients after the visit.

Challenges of the COVID-19 Pandemic Confront Georgia's Tourism Industry

Regardless of their healthcare systems' maturity and quality, the COVID-19 pandemic caused a slew of unexpected problems and harmful effects for people worldwide. Georgia responded to the pandemic's first wave (March-April 2020) with well-managed and well-coordinated activities based on the pandemic management principles: Find-Test-Trace-Isolate-Detect. Epidemiological monitoring, mobility limitations, and practical communication efforts were used to prevent and limit the spread of the infection, resulting in remarkable morbidity and mortality reductions. Due to pandemic fatigue, summer tourism brought increased mobility, disregard for mask-wearing, distancing habits and multiplication of regional clusters and two-rounds of Parliamentary elections with numerous mass meetings. All of these developments culminated in a remarkably different second wave with the pandemic hampering the growth of tourism, a significant sector of the Georgian economy that accounts for 8% of GDP and employs around 150, 000 people. It also exponentially increased morbidity and high mortality (40-55 daily deaths) in October-November 2020. The most popular tourist destinations in Georgia are Tbilisi, Ajara, Kvemo Kartli, Imereti, and Mtskheta-Mtianeti. COVID-19 severely harmed Georgia's tourism industry, especially international arrivals. In 2020, compared to 2019, international tourist visits to Georgia decreased by 80%. This research focuses on how the COVID-19 pandemic affected Georgia's tourism industry in terms of structure and geography. The study was conducted from March to December 2020. It employs the following methods: data collection, processing, an analysis from official Georgian sources, as well as the results of the authors' sociological survey, a review of academic and media articles on the subject, and preliminary analysis using GIS technologies. The key finding is that the COVID-19 pandemic had the greatest negative impact on Georgia's tourism market causing significant economic harm. International tourism dropped sharply, but domestic tourism remained nearly unchanged from previous years, revealing tourists' new regional preferences. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Investigation into workplace ventilation at COVID-19 outbreak sites

Site visits were made to ten (non-healthcare) workplace COVID-19 outbreaks to assess ventilation. Measurements of carbon dioxide (CO2), temperature and humidity were made. Room activity and occupancy was observed, and ventilation management assessed. CO2 readings were used to identify areas of poor air quality, and where possible, airflow measurements were made at ventilation openings and CO2 decay rates were used to estimate ventilation rates. Poorly ventilated, regularly occupied spaces were frequently identified by this work. Measures to reduce transmission risk and improve ventilation included opening windows and reducing room capacities. Attempts at reconfiguration of mechanical ventilation systems were not common. Thermal comfort and heating costs were factors cited that influenced decision making. Overall understanding of ventilation was low and identified a need for simple tools to allow stakeholders to assess their workspaces. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Impact of the Coronavirus Disease 2019 Pandemic on Dental Visits in Japan.

PURPOSE: This study aimed to clarify the impact of the coronavirus disease 2019 (COVID-19) pandemic on individual dental-visit behaviour and examine the difference between elderly and other individuals regarding the impact on dental visits. MATERIALS AND METHODS: An interrupted time-series analysis was performed to examine the change in data from the national database before and after the first declaration of a state of emergency. RESULTS: The number of patients visiting a dental clinic (NPVDC), number of dental treatment days (NDTD) and dental expenses (DE) during the first declaration of a state of emergency decreased by 22.1%, 17.9%, and 12.5% in the group under 64 years of age and 26.1%, 26.3%, and 20.1% in the group over 65 years of age, respectively, compared with those in the same month of the previous year. Between March and June 2020, the monthly NPVDC and NDTD were significantly reduced (p < 0.001, p = 0.013) in those over 65 years of age. The DE did not change statistically significantly in either the under 64 group or the over 65 group. There was no statistically significant change in the slope of the regression line in the NPVDC, NDTD, and DE before and after the first state-of-emergency declaration. CONCLUSION: The first state of emergency greatly reduced the NPVDC, NDTD, and DE compared to those in the previous year. In people aged over 65 years, it might still be unresolved 2 years after the postponement of dental treatment owing to the first declaration of a state of emergency.

Influence of Social Media on Applicant Perceptions of Anesthesiology Residency Programs During the COVID-19 Pandemic: Quantitative Survey.

BACKGROUND: Social media may be an effective tool in residency recruitment, given its ability to engage a broad audience; however, there are limited data regarding the influence of social media on applicants' evaluation of anesthesiology residency programs. OBJECTIVE: This study evaluates the influence of social media on applicants' perceptions of anesthesiology residency programs during the COVID-19 pandemic to allow programs to evaluate the importance of a social media presence for residency recruitment. The study also sought to understand if there were differences in the use of social media by applicant demographic characteristics (eg, race, ethnicity, gender, and age). We hypothesized that given the COVID-19 pandemic restrictions on visiting rotations and the interview process, the social media presence of anesthesiology residency programs would have a positive impact on the recruitment process and be an effective form of communication about program characteristics. METHODS: All anesthesiology residency applicants who applied to Mayo Clinic Arizona were emailed a survey in October 2020 along with statements regarding the anonymity and optional nature of the survey. The 20-item Qualtrics survey included questions regarding subinternship rotation completion, social media resource use and impact (eg, "residency-based social media accounts positively impacted my opinion of the program"), and applicant demographic characteristics. Descriptive statistics were examined, and perceptions of social media were stratified by gender, race, and ethnicity; a factor analysis was performed, and the resulting scale was regressed on race, ethnicity, age, and gender. RESULTS: The survey was emailed to 1091 individuals who applied to the Mayo Clinic Arizona anesthesiology residency program; there were 640 unique responses recorded (response rate=58.6%). Nearly 65% of applicants reported an inability to complete 2 or more planned subinternships due to COVID-19 restrictions (n=361, 55.9%), with 25% of applicants reporting inability to do any visiting student rotations (n=167). Official program websites (91.5%), Doximity (47.6%), Instagram (38.5%), and Twitter (19.4%) were reported as the most used resources by applicants. The majority of applicants (n=385, 67.3%) agreed that social media was an effective means to inform applicants, and 57.5% (n=328) of them indicated that social media positively impacted their perception of the program. An 8-item scale with good reliability was created, representing the importance of social media (Cronbach α=.838). There was a positive and statistically significant relationship such that male applicants (standardized ß=.151; P=.002) and older applicants (ß=.159; P<.001) had less trust and reliance in social media for information regarding anesthesiology residency programs. The applicants' race and ethnicity were not associated with the social media scale (ß=-.089; P=.08). CONCLUSIONS: Social media was an effective means to inform applicants, and generally positively impacted applicants' perception of programs. Thus, residency programs should consider investing time and resources toward building a social media presence to improve resident recruitment.

Changes in dental and medical visits before and during the COVID-19 pandemic among U.S. children aged 1-17 years.

OBJECTIVES: The COVID-19 pandemic has tremendously impacted the U.S. healthcare system, but no study has examined the impact of the pandemic on utilization of dental care among U.S. children. Changes in past-year dental versus medical visits and perceived unmet health needs between 2019 and 2020 among U.S. children aged 1-17 years were examined. METHODS: National and state representative, cross-sectional data from the National Survey of Children's Health conducted during June 2019-January 2020 (i.e. pre-pandemic, n = 28 500) and July 2020-January 2021 (i.e. intra-pandemic, n = 41 380) were analysed. Any past-year visit and perceived unmet needs (i.e. delay or inability to receive needed care) were reported by the parent proxy. Weighted prevalence estimates were compared using two-tailed chi-squared tests at p < .05. Poisson regression analyses were used to explore the relationship between having dental and/or medical unmet needs during the pandemic and indicators of poor health and social wellbeing. RESULTS: Between 2019 and 2020, a significantly reduced prevalence of past-year medical (87.2%-81.3%) and dental visits (82.6%-78.2%) among U.S. children aged 1-17 years (all p < .05) were observed. Correspondingly, perceived unmet needs increased by half for dental care (from 2.9% in 2019 to 4.4% in 2020) and almost one-third for medical care (from 3.2% to 4.2% in 2020). Subgroups with the highest prevalence of unmet dental need included those with low socio-economic status, living with their grandparents, uninsured and living with a smoker. CONCLUSIONS: Unmet health needs increased in general but increased more for dental than for medical care among U.S. children aged 1-17 years. Enhanced and sustained efforts will be needed to deliver targeted services towards disadvantaged segments of the population to narrow existing disparities.

Impact of telehealth versus traditional visits on pain management patients utilizing medical cannabis during the COVID-19 pandemic

Alternatives to traditional office visits have become a necessity with the recent COVID-19 outbreak, resulting in an unmatched surge in telehealth adoption. The present study was an investigation of the impact of telehealth versus traditional office visits in medical cannabis clinics treating patients for chronic pain. With 50,000,000 American adults experiencing pain and over 750,000 overdoses attributed to opioid usage, collecting research-driven evidence to increase the availability of safe, effective, and nonopioid treatment options will create positive social change. The Donabedian model was applied to measure the quality of care, focusing on structure (cannabis clinics), process (telehealth vs. traditional office visits), and outcome (visual analog scale [VAS]). The study utilized a quasi-experimental, retrospective analysis of data using multiple linear regression comparing the impact of telemedicine visits versus traditional office visits on treating five pain types in a medical cannabis clinic during a pandemic. The main finding of this study indicated that telemedicine visits were as effective as traditional office visits in treating pain. However, there was not statistically significant data to suggest that cannabis-derived medicines resulted in improved outcomes in the five pain types studied (general, back, arthritic, cancer, and migraine). Across all pain types and subjects there was an overall decrease in pain from initial visit (7.44) to follow-up visit (6.29) a decrease of 15.4% on the VAS. Expanding healthcare service treatment options that are safe, effective, and accessible in caring for chronic pain will prevent disease, improve health outcomes, and improve quality of care all leading to positive social change. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Patient Perspectives on Telemedicine During the COVID-19 Pandemic.

BACKGROUND: Patients received care over telemedicine during the COVID-19 pandemic, and their perspective is useful for hand surgeons. METHODS: Online surveys were sent October-November 2020 to 497 patients who received telemedicine care. Questions were free-response and multi-item Likert scales asking about telehealth in general, limitations, benefits, comparisons to in-person visits, and opinions on future use. RESULTS: The response rate was 26% (n = 130). Prior to the pandemic, 55% had not used telemedicine for hand surgery consultation. Patients liked their telemedicine visit and felt their provider spent enough time with them (means = 9/10). In all, 48% would have preferred in-person visits despite the pandemic, and 69% would prefer in-person visits once the pandemic concludes. While 43% had no concerns with telemedicine, 36% had difficulties explaining their symptoms. Telemedicine was easy to access and navigate (M = 9/10). However, 23% saw telemedicine of limited value due to the need for an in-person visit soon afterward. Of these patients, 46% needed an in-person visit due to inadequate physical examination. Factors that make telemedicine more favorable to patients included convenience, lack of travel, scheduling ease, and time saved. Factors making telemedicine less favorable included need for in-person examination or procedure, pain assessment, and poor connectivity. There was no specific appointment time the cohort preferred. Patient recommendations to improve telemedicine included decreasing wait times and showing patient queue, wait time, or physician status online. CONCLUSIONS: Telemedicine was strongly liked by patients during the COVID-19 pandemic. However, nearly 70% of patients still preferred in-person visits for the future.

The Evolution of Primary Care Telehealth Disparities During COVID-19: Retrospective Cohort Study.

BACKGROUND: Telehealth has become widely used as a novel way to provide outpatient care during the COVID-19 pandemic, but data about telehealth use in primary care remain limited. Studies in other specialties raise concerns that telehealth may be widening existing health care disparities, requiring further scrutiny of trends in telehealth use. OBJECTIVE: Our study aims to further characterize sociodemographic differences in primary care via telehealth compared to in-person office visits before and during the COVID-19 pandemic and determine if these disparities changed throughout 2020. METHODS: We conducted a retrospective cohort study in a large US academic center with 46 primary care practices from April-December 2019 to April-December 2020. Data were subdivided into calendar quarters and compared to determine evolving disparities throughout the year. We queried and compared billed outpatient encounters in General Internal Medicine and Family Medicine via binary logic mixed effects regression model and estimated odds ratios (ORs) with 95% CIs. We used sex, race, and ethnicity of the patient attending each encounter as fixed effects. We analyzed socioeconomic status of patients in the institution's primary county based on the patient's residence zip code. RESULTS: A total of 81,822 encounters in the pre-COVID-19 time frame and 47,994 encounters in the intra-COVID-19 time frame were analyzed; in the intra-COVID-19 time frame, a total of 5322 (11.1%) of encounters were telehealth encounters. Patients living in zip code areas with high utilization rate of supplemental nutrition assistance were less likely to use primary care in the intra-COVID-19 time frame (OR 0.94, 95% CI 0.90-0.98; P=.006). Encounters with the following patients were less likely to be via telehealth compared to in-person office visits: patients who self-identified as Asian (OR 0.74, 95% CI 0.63-0.86) and Nepali (OR 0.37, 95% CI 0.19-0.72), patients insured by Medicare (OR 0.77, 95% CI 0.68-0.88), and patients living in zip code areas with high utilization rate of supplemental nutrition assistance (OR 0.84, 95% CI 0.71-0.99). Many of these disparities persisted throughout the year. Although there was no statistically significant difference in telehealth use for patients insured by Medicaid throughout the whole year, subanalysis of quarter 4 found encounters with patients insured by Medicaid were less likely to be via telehealth (OR 0.73, 95% CI 0.55-0.97; P=.03). CONCLUSIONS: Telehealth was not used equally by all patients within primary care throughout the first year of the COVID-19 pandemic, specifically by patients who self-identified as Asian and Nepali, insured by Medicare, and living in zip code areas with low socioeconomic status. As the COVID-19 pandemic and telehealth infrastructure change, it is critical we continue to reassess the use of telehealth. Institutions should continue to monitor disparities in telehealth access and advocate for policy changes that may improve equity.

Use telehealth as needed: telehealth substitutes in-person primary care and associates with the changes in unplanned events and follow-up visits.

BACKGROUND: Telehealth rapidly expanded since the outbreak of the COVID-19 pandemic. This study aims to understand how telehealth can substitute in-person services by 1) estimating the changes in non-COVID emergency department (ED) visits, hospitalizations, and care costs among US Medicare beneficiaries by visit modality (telehealth vs. in-person) during the COVID-19 pandemic relative to the previous year; 2) comparing the follow-up time and patterns between telehealth and in-person care. METHODS: A retrospective and longitudinal study design using US Medicare patients 65 years or older from an Accountable Care Organization (ACO). The study period was April-December 2020, and the baseline period was March 2019 - February 2020. The sample included 16,222 patients, 338,872 patient-month records and 134,375 outpatient encounters. Patients were categorized as non-users, telehealth only, in-person care only and users of both types. Outcomes included the number of unplanned events and costs per month at the patient level; number of days until the next visit and whether the next visit happened within 3-, 7-, 14- and 30-days at the encounter level. All analyses were adjusted for patient characteristics and seasonal trends. RESULTS: Beneficiaries who used only telehealth or in-person care had comparable baseline health conditions but were healthier than those who used both types of services. During the study period, the telehealth only group had significantly fewer ED visits/hospitalizations and lower Medicare payments than the baseline (ED 13.2, 95% CI [11.6, 14.7] vs. 24.6 per 1,000 patients per month and hospitalization 8.1 [6.7, 9.4] vs. 12.7); the in-person only group had significantly fewer ED visits (21.9 [20.3, 23.5] vs. 26.1) and lower Medicare payments, but not hospitalizations; the both-types group had significantly more hospitalizations (23.0 [21.4, 24.6] vs. 17.8). Telehealth was not significantly different from in-person encounters in number of days until the next visit (33.4 vs. 31.2 days) or the probabilities of 3- and 7-day follow-up visits (9.2 vs. 9.3% and 21.8 vs.23.5%). CONCLUSIONS: Patients and providers treated telehealth and in-person visits as substitutes and used either depending on medical needs and availability. Telehealth did not lead to sooner or more follow-up visits than in-person services.

Impact of COVID-19 pandemic on health care system, work, and mental well-being of people with cystic fibrosis.

BACKGROUND: COVID-19 pandemic has been challenging for all, particularly for high-risk groups including people with cystic fibrosis (PWCF). AIM: This study aims to examine impact of COVID-19 pandemic on the lives of PWCF in relation to hospital visits, use of telemedicine, employment, and mental well-being. METHODS: A cross-sectional online survey was developed by the Cystic Fibrosis (CF) Ireland research team and uploaded on SmartSurvey UK. The survey was advertised by CF Ireland via their website and social media in October 2020. The University College Dublin research partner team conducted the analysis. Logistic regression was used for the analysis, using IBM SPSS Version 26. RESULTS: One hundred nineteen PWCF responded. 47.5% deferred their hospital visits, with delays ranging from 1 to 6 months. Deferrals impacted rehabilitation therapies, medical care at hospital, and diagnostic tests. For many, online consultation was a new experience (51.7%), and 87.8% were satisfied with this method. Among those who worked during lockdown (47.8%), 87.2% (n = 48) worked at home. PWCF aged < 35 years (9.6%) were more likely to work onsite as compared to those > 35 years (1.9%). When adjusted for gender and employment, PWCF aged < 35 years were more likely to feel "nervous" (OR: 3.28; P = 0.02), "nothing could cheer them up" (OR: 3.24; P = 0.04), and "tired" (OR: 2.76; P = 0.02) as compared to those > 35 years. CONCLUSION: COVID 19 pandemic has greatly impacted PWCF in terms of hospital visits, access to tests, CF care, and psychological well-being. Younger PWCF reported greater impact on psychological health. Online consultation and electronic prescription were welcomed and could have a role post-pandemic.