Emotional risk work during the pandemic: Healthcare professionals' perceptions from a COVID-19 ward

In March 2020, COVID-19 wards were established in hospitals in Denmark. Healthcare professionals from a variety of specialities and wards were transferred to these new wards to care for patients admitted with severe COVID-19 infections. Based on ethnographic fieldwork in a COVID-19 ward at a hospital in Copenhagen, Denmark, including focus group interviews with nursing staff, we intended to explore practices in a COVID-19 ward by seeking insight into the relation between the work carried out and the professionals' ways of talking about it. We used a performative approach of studying how the institutional ways of handling pandemic risk work comes into being and relates to the health professionals' emerging responses. The empirical analysis pointed at emotional responses by the nursing staff providing COVID-19 care as central. To explore these emotional responses we draw on the work of Mary Douglas and Deborah Lupton's concept of the ‘emotion-risk-assemblage'. Our analysis provides insight into how emotions are contextually produced and linked to institutional risk understandings. We show that work in the COVID-19 ward was based on an institutional order that was disrupted during the pandemic, producing significant emotions of insecurity. Although these emotions are structurally produced, they are simultaneously internalised as feelings of incompetence and shame.

The impact of Covid-19 pandemic on acute burn admissions at the University College Hospital Ibadan, Nigeria.

The coronavirus disease and the subsequent pandemic that followed drastically changed human civilization with disruptive effects on health and overall wellbeing of mankind. This disruptive effect has been shown to include changes in epidemiology of burn injuries. This study therefore aimed to determine the impact of COVID-19 on acute burn presentation at the University College Hospital, Ibadan. This was a retrospective study carried out between April 1st 2019 and March 31st 2021. The period was divided into two: April 1st 2019 to March 31st 2020 and April 1st 2020 to March 31st 2021. Data obtained from the burn unit registry was analyzed using the scientific package for social sciences (SPSS) version 25. The only statistically significant finding from this study was the marked reduction in burn ICU admission during the pandemic (p<0.001). A total of 144 patients presented to the burn intensive care unit at UCH Ibadan during the period under review with 92 patients in the pre-pandemic year, and 52 patients in the pandemic year. 0-9 years representing 42% in pre-pandemic, and 30.8% in the pandemic period was the most affected age group. Scald was predominantly among the pediatric age group in both groups. Males were more likely to suffer flame burn in both study periods with a near gender equilibration during the pandemic. Burn injury during the pandemic resulted in more total body surface area burned. Conclusion: The lockdown effect of the pandemic resulted in a significant reduction in acute burn admissions at the University College Hospital, Ibadan.

Predicting Success: An Examination of the Predictive Validity of a Measure of Motivational-Developmental Dimensions in College Admissions.

Amid the COVID-19 pandemic, an unprecedented number of higher education institutions adopted test-optional admissions policies. The proliferation of these policies and the criticism of standardized admissions tests as unreliable predictors of applicants' postsecondary educational promise have prompted the reimagining of evaluative methodologies in college admissions. However, few institutions have designed and implemented new measures of applicants' potential for success, rather opting to redistribute the weight given to other variables such as high school course grades and high school GPA. We use multiple regression to investigate the predictive validity of a measure of non-cognitive, motivational-developmental dimensions implemented as part of a test-optional admissions policy at a large urban research university in the United States. The measure, composed of four short-answer essay questions, was developed based on the social-cognitive motivational and developmental-constructivist perspectives. Our findings suggest that scores derived from the measure make a statistically significant but small contribution to the prediction of undergraduate GPA and 4-year bachelor's degree completion. We also find that the measure does not make a statistically significant nor practical contribution to the prediction of 5-year graduation.

Effectiveness of the booster dose of COVID-19 vaccine in the Basque Country during the sixth wave: A nationwide cohort study.

The aim of the study was to assess the effect of a booster dose of COVID-19 vaccine on the rates of hospital ward and intensive care unit (ICU) admissions around the time of emergence of the Omicron variant in the Basque Country. A retrospective cohort population-based study was conducted. The population with any records related to COVID-19 vaccination up to 28 February 2022 was classified into four cohorts by vaccination status. For every cohort, the hospital ward and ICU admission rates were calculated for each day between November 2021 and February 2022. Generalized linear models with a negative binomial distribution were used to estimate the age-adjusted hospitalization rate ratio of the cohort of individuals who had received a booster compared to the other cohorts. The age-adjusted rates of hospital ward and ICU admissions were 70.4 % and 72.0 % lower, respectively, in the fully vaccinated plus booster group compared to the fully vaccinated but no booster group. Analysing changes in the 14-day admission incidence rates showed that as the prevalence of the Omicron variant increased, the corresponding rate ratios decreased. The immunity acquired with the booster dose allowed the hospital network to meet all the demand for hospitalization during a period of high incidence of COVID-19, despite the fact that vaccine protection decreased as the prevalence of the Omicron variant increased.

Competition in american social work education during times of COVID-19: a midwestern case study

Competition to attract students for enrollment in American social work degree programs is intense. Program attributes (e.g. minimum grade point average, maximum transfer credits permitted, institutional tuition rate, and rankings) distinguish social work education programs in the United States. Determining which program attributes appeal to potential students could help increase a program's competitiveness in a crowded education marketplace. The COVID-19 pandemic is further intensifying recruitment of students to BSW programs. This research used a case study approach to compare admission attributes of 21 bachelor of social work programs (BSW) offered at 11 public and 10 private institutions located in one state that could be viewed as representative of American BSW programs. This paper compared attributes that differentiated these undergraduate social work programs, while exploring the potential impact of the pandemic on BSW student recruitment. Implications for social work education are discussed, including lessons learned that may be helpful to BSW faculty and staff responsible for student recruitment activities and related operations. Social work education program administrators and faculty could use this information to review recruitment and application processes and raise awareness of the burgeoning influence of reputational ranking services.

Psychiatric ward admissions during the COVID-19 pandemic in Canton of Ticino (Swiss Confederation) and the province of Como (Italy): a comparison between two different systems of care and outbreak response strategies

The aim of the study was to estimate the effect of the COVID-19 pandemic and response policies on the psychiatric ward admissions in the hospitals referring to the ASST Lariana (province of Como, Italy) and the Hospital of Mendrisio (Canton of Ticino, Switzerland), two similar territories that belong to countries that dealt differently with the pandemic. We compared the two territories for type of admission (voluntary vs. compulsory), the Stringency Index (SI) and the country's number of admission in Intensive Care Units (ICU). We found a significant reduction in the psychiatric ward admission in the lockdown period in both territories, even in periods with milder lockdown measures. The admission rate's reduction in the ASST Lariana was significantly associated with the ICU admissions (p<0.001). In the Hospital of Mendrisio, admissions included a weekly seasonality, were significantly correlated with SI (p=0.001) and period (pre-pandemic and pandemic;p<0.001) and we observed also a significant reduction of compulsory admission that is influenced both by the stringency index (p<0.001) and period (p<0.001). The differences between the two territories seem influenced by the different mental health systems. r. © the Author(s), 2023 Licensee PAGEPress, Italy.

Comparing inpatient management of chronic pelvic pain flares before and after the COVID-19 pandemic.

Abstract: Patients with chronic pelvic pain (CPP) may experience pain exacerbations requiring hospital admissions. Due to the effects of backlogged elective surgeries and outpatient gynaecology appointments resulting from the COVID-19 pandemic, we hypothesised that there would be an increased number of women admitted with CPP flares. We conducted a retrospective review of all acute gynaecology admissions at the Royal Infirmary of Edinburgh from July to December 2018 (pre-COVID) and 2021 (post-COVID lockdown). We collected information on the proportion of emergency admissions due to CPP, inpatient investigations and subsequent management. Average total indicative hospital inpatient costs for women with CPP were calculated using NHS National Cost Collection data guidance. There was no significant difference in the number of emergency admissions due to pelvic pain before (153/507) and after (160/461) the COVID-19 pandemic. As high as 33 and 31% had a background history of CPP, respectively. Across both timepoints, investigations in women with CPP had low diagnostic yield: <25% had abnormal imaging findings and 0% had positive vaginal swab cultures. Women with CPP received significantly more inpatient morphine, pain team reviews and were more likely to be discharged with strong opioids. Total yearly inpatient costs were £170,104 and £179,156 in 2018 and 2021, respectively. Overall, emergency admission rates for managing CPP flares was similar before and after the COVID-19 pandemic. Inpatient resource use for women with CPP remains high, investigations have low diagnostic yield and frequent instigation of opiates on discharge may risk dependence. Improved community care of CPP is needed to reduce emergency gynaecology resource utilisation. Lay summary: Existing treatments for chronic pelvic pain (CPP) and endometriosis focus on surgery or hormone medication, but these are often ineffective or associated with unacceptable side-effects. As a result, women continue to experience chronic pain and often have 'flares' of worsening pain that may lead to hospital admission. The COVID-19 pandemic resulted in backlogged gynaecology clinics and surgeries. The aim of this study was to compare the management of emergency pelvic pain admissions for women with CPP before and after COVID-19. We also aimed to better understand their in-hospital management and estimate their hospital length of stay costs. We did not find an increase in CPP patients admitted for pelvic pain flares after the COVID-19 lockdown. Women with CPP often undergo multiple hospital tests and are often prescribed with strong pain medications which can cause long-term problems. Efforts are needed to improve long-term pain management for women with CPP.

Decrease of visits and hospital admissions for cancer patients during the COVID-19 pandemic. A systematic review and meta-analysis.

Background: During the COVID-19 pandemic, many nonurgent oncologic services were postponed. The aim of the present study was to estimate the impact of the pandemic on visits and hospital admissions for cancer patients worldwide. Methods: In our systematic review and meta-analysis, databases such as Pubmed, Proquest, and Scopus were searched comprehensively for articles published between January 1, 2020, and December 12, 2021. We included articles reporting data comparing the number of visits and hospital admissions for oncologic patients performed before and during the pandemic. Two pairs of independent reviewers extracted data from the selected studies. The weighted average of the percentage change was calculated and compared between pandemic and pre-pandemic periods. Stratified analysis was performed by geographic area, time interval, and study setting. Findings: We found a mean relative change throughout January-October 2020 of -37.8% (95% CI -42.6; -32.9) and -26.3% (95% CI -31.4; -21.1) compared to pre-pandemic periods for oncologic visits and hospital admission, respectively. The temporal trend showed a U-shaped curve with nadir in April for cancer visits and in May 2020 for hospital admissions. All geographic areas showed a similar pattern and the same was observed when stratifying the studies as clinic-based and population-based. Interpretation: Our results showed a decrease in the number of visits and hospital admission during the January-October 2020 period after the outbreak of the COVID-19 pandemic. The postponement or cancellation of these oncologic services may negatively affect the patient's outcome and the future burden of disease. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01857-w.

Escalation to intensive care for the older patient. An exploratory qualitative study of patients aged 65 years and older and their next of kin during the COVID-19 pandemic: the ESCALATE study.

BACKGROUND: older people comprise the majority of hospital medical inpatients so decision-making regarding admission of this cohort to the intensive care unit (ICU) is important. ICU can be perceived by clinicians as overly burdensome for patients and loved ones, and long-term impact on quality of life considered unacceptable, effecting potential bias against admitting older people to ICU. The COVID-19 pandemic highlighted the challenge of selecting those who could most benefit from ICU. OBJECTIVE: this qualitative study aimed to explore the views and recollections of escalation to ICU from older patients (aged ≥ 65 years) and next of kin (NoK) who experienced a COVID-19 ICU admission. SETTING: the main site was a large NHS Trust in London, which experienced a high burden of COVID-19 cases. SUBJECTS: 30 participants, comprising 12 patients, 7 NoK of survivor and 11 NoK of deceased. METHODS: semi-structured interviews with thematic analysis using a framework approach. RESULTS: there were five major themes: inevitability, disconnect, acceptance, implications for future decision-making and unique impact of the COVID-19 pandemic. Life was highly valued and ICU perceived to be the only option. Prior understanding of ICU and admission decision-making explanations were limited. Despite benefit of hindsight, having experienced an ICU admission and its consequences, most could not conceptualise thresholds for future acceptable treatment outcomes. CONCLUSIONS: in this study of patients ≥65 years and their NoK experiencing an acute ICU admission, survival was prioritised. Despite the ordeal of an ICU stay and its aftermath, the decision to admit and sequelae were considered acceptable.

Long-term evaluation of the COVID-19 pandemic impact on acute stroke management: an analysis of the 21-month data from a medical facility in Tokyo.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has caused a global public health crisis and profoundly impacted acute treatment delivery. This study conducted long-term evaluations of the impact of the pandemic on acute stroke management. METHODS: Data from a university-owned medical facility in Tokyo, Japan, were retrospectively analyzed. The number of hospital admissions for stroke and time metrics in the management of patients with acute ischemic stroke were evaluated. A year-over-year comparison was conducted using data from April 2019 to December 2021 to assess the impact of the pandemic. RESULTS: The year-over-year comparison demonstrated that the number of admissions of patients with stroke and patients who underwent magnetic resonance imaging (MRI), intravenous recombinant tissue plasminogen activator (rt-PA), and thrombectomy during the pandemic remained comparable to the pre-COVID data. However, we found a decrease in the number of admissions of patients with stroke alerts and stroke when hospital cluster infection occurred at this facility and when the region hosted the Tokyo Olympics games during the surge of infection. The door-to-computed tomography time in 2021 was affected. This is plausibly due to the reorganization of in-hospital stroke care pathways after hospital cluster infection. However, no significant difference was observed in the onset-to-door, door-to-MRI, door-to-needle, or door-to-groin puncture times. CONCLUSIONS: We did not observe long-term detrimental effects of the pandemic at this site. Prevention of hospital cluster infections remains critical to provide safe and timely acute stroke management during the pandemic.

Trends in Cases, Hospitalization and Mortality Related to the Omicron BA.4/BA.5 Sub-Variants in South Africa.

BACKGROUND: This study compared admission incidence risk across waves, and the risk of mortality in the Omicron BA.4/BA.5 wave, to the Omicron BA.1/BA.2 and Delta waves. METHODS: Data from South Africa's national hospital surveillance system, SARS-CoV-2 case linelist and Electronic Vaccine Data System were linked and analysed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100,000 people. In-hospital case fatality ratios (CFR) in the Delta, Omicron BA.1/BA.2 and Omicron BA.4/BA.5 wave periods were compared by post-imputation random effect multivariable logistic regression models. RESULTS: The CFR was 25.9% (N = 37,538/144,778), 10.9% (N = 6,123/56,384) and 8.2% (N = 1,212/14,879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves respectively. After adjusting for age, sex, race, comorbidities, health sector and province, compared to the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR] 1.3; 95% confidence interval [CI] 1.2-1.4) and Delta (aOR 3.0; 95% CI 2.8-3.2) wave. Being partially vaccinated (aOR 0.9, CI 0.9-0.9), fully vaccinated (aOR 0.6, CI 0.6-0.7) and boosted (aOR 0.4, CI 0.4-0.5); and prior laboratory-confirmed infection (aOR 0.4, CI 0.3-0.4) were associated with reduced risks of mortality. CONCLUSION: Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa's first three waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased.

College Admissions Policy in Post-pandemic America

The COVID-19 pandemic has exposed the systemic racism problems in the United States. Minorities, with rights and opportunities taken away from them, face inequities in education, medical care, work, economy and many more aspects. Income disparity and social class barriers have continued to widen in the past decades. Education is supposed to drive social mobility, yet class reproduction continues to be the reality. Issues of inequitable distribution of education resources and unequal higher education opportunity caused by family resources have been discussed over and over. College admissions have long used standardized test scores to screen students, yet these tests have been criticized of their predictive validity and their manifestation of race and class discrimination. The global pandemic led to a largescale adoption of test-optional policy, allowing college applicants to choose whether they want to submit standardized test scores, while colleges and universities analyze institutional data for a more extensive examination of their admissions policy. It remains to be seen whether inequities can be eased and social justice can be achieved.

The Effect of CoViD-19 Pandemic on the Hospitalization of a Department of Oncology of an Italian Hospital

In the last years, the entire world has been affected by the SARS-COV-2 pandemic, that represents the etiologic agent of Coronavirus disease 2019 (CoViD-19), which degenerated into a global pandemic in 2020. CoViD-19 has also had a strong impact on cancer patients. Our analysis has been performed at the Department of Oncology of the AORN "Cardarelli” in Naples, collecting data from all patients who had access in 2019–2020. We aim to understand how CoViD-19 affected hospital admissions. The statistical analysis showed that between 2019 and 2020 there was an increase in urgent hospitalizations and a decrease in scheduled hospitalization, probably to decrease the risk of infection, particularly in this category of susceptible patients. Indeed, as recommended by the European Society of Medical Oncology, during the pandemic, it was necessary to reorganize healthcare activities, ensure adequate care for patients infected with CoViD-19. Therefore telemedicine services were implemented and clinic visits were reduced. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Analysis of Hospital Admissions of Neurological Patients in the COVID-19 Era: Comparison Between Hospitals

In the last few years, the COVID-19 pandemic has strongly affected different hospital departments, revealing their major weaknesses. For this reason, this emergency has been a driver for healthcare transformation in a very short interval of time in order to optimize the resources, minimize costs and simultaneously increase the caring services, also limiting over-occupancy in wards, especially emergency ones. One of the main factors for assessing the efficiency of a department is associated with how long a patient stays in the facility (LOS). This bicentric study investigated how COVID-19 has modified the activity of the Complex Operative Unit (C.O.U.) of Neurology and Stroke of the University Hospital "San Giovanni di Dio e Ruggi d'Aragona” of Salerno (Italy) and the hospital A.O.R.N. "Antonio Cardarelli” of Naples (Italy). In the work data for the year 2019 (in the absence of Covid-19) and in the year of Covid-19 pandemic 2020 were considered. This work used the logistic regression technique to study the following variables: age, gender, length of stay (LOS), relative weight of DRG and mode of discharge. The analysis shows that in 2020 there was a greater adequacy of admissions, with an increase in the relative weight of DRG. And the statistical analysis obtained the following significant variables: gender, age, relative weight of DRG and discharge mode. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Impact of COVID-19 in a Surgery Department: Comparison Between Two Italian Hospitals

The main phenomenon that impacted people's lives was the COVID-19 pandemic, having strong consequences on national health systems. Since the beginning of the Covid-19 pandemic, hospital admissions dropped precipitously in 2020. Our aim concerns the analysis about how the COVID-19 affects the activity of the Department of General Surgery, Day Surgery and Breast Unit in the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the hospital "A.O.R.N. Antonio Cardarelli” of Naples (Italy). In the work data for the year 2019 (in the absence of pandemic) and in the year of pandemic 2020 were considered. This work used the logistic regression technique to study the following variables: age, gender, length of stay (LOS), relative weight of DRG, admission procedure, mode of discharge and the results about both hospitals were used to make a comparison. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

P158 A nurse-led model for tuberculosis services delivers safe and effective care

P158 Table 1 2018–2019 2020–2021 No: of patients 33 38 Disease site Pulmonary Extra-pulmonary Pulmonary Extra-pulmonary 45.5% 55.5% 23.6% 76.4% Single site Multi-Site Single Site Multi-Site 87.9% 12.1% 78.9% 21.1% Sensitivity Sensitive Drug Resistant Sensitive Drug Resistant 62.5% 37.5% 81.2% 18.8% Treatment started by: Doctor Nurse Doctor Nurse Inpatient Outpatient Inpatient Outpatient 24.1% 75.9% 0% 7.9% 71.1% 21% Days from symptom onset to treatment(median) 73 65 Total clinic appointments Face to face Virtual Face to face Virtual 503 1 339 11 Clinic appointments per patient (median) 13 13 Follow-up appointments led by Doctor Nurse Doctor Nurse 52% 48% 28% 72% Patients lost to follow-up 3 1 Hospital admissions 7 1 Patient deaths 0 1 ConclusionA nurse-led model for TB services provides safe, effective, and timely care.An expanded TBSN role with the support of a proactive, easily-accessible consultant may present a good model for TB service provision going forward.Further research is needed to test this model outside of the pandemic context.ReferencesBritish Thoracic society. Tuberculosis services during the Covid-19 pandemic. Available at https://www.brit-thoracic.org.uk/covid-19/covid-19-information-for-the-respiratory-community/

A Curious Case of New-Onset Diabetes

New-onset type 1 diabetes most frequently presents with diabetic ketoacidosis in young patients. A subset of patients with autoimmune type 1 diabetes may present with a slower progression to insulin deficiency and are frequently misdiagnosed with type 2 diabetes. Clinicians should screen for type 1 diabetes in patients who present with hyperglycemia and do not have obvious signs of insulin resistance or obesity. This case report presents an adult patient with hyperglycemia after a hospital admission for coronavirus disease 2019 and the evidence used to diagnose type 1 diabetes with atypical presentation.

Examining the predictive validity of the Duolingo English Test: Evidence from a major UK university

The COVID-19 pandemic has changed the university admissions and proficiency testing landscape. One change has been the meteoric rise in use of the fully automated Duolingo English Test (DET) for university entrance purposes, offering test-takers a cheaper, shorter, accessible alternative. This rapid response study is the first to investigate the predictive value of DET test scores in relation to university students' academic attainment, taking into account students' degree level, academic discipline, and nationality. We also compared DET test-takers' academic performance with that of students admitted using traditional proficiency tests. Credit-weighted first-year academic grades of 1881 DET test-takers (1389 postgraduate, 492 undergraduate) enrolled at a large, research-intensive London university in Autumn 2020 were positively associated with DET Overall scores for postgraduate students (adj. r = .195) but not undergraduate students (adj. r = −.112). This result was mirrored in correlational patterns for students admitted through IELTS (n = 2651) and TOEFL iBT (n = 436), contributing to criterion-related validity evidence. Students admitted with DET enjoyed lower academic success than the IELTS and TOEFL iBT test-takers, although sample characteristics may have shaped this finding. We discuss implications for establishing cut scores and harnessing test-takers' academic language development through pre-sessional and in-sessional support. [ FROM AUTHOR] Copyright of Language Testing is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Quantifying changes in respiratory syncytial virus-associated hospitalizations among children in Texas during COVID-19 pandemic using records from 2006 to 2021.

Aim: To quantify changes on RSV- associated hospitalizations during COVID-19 pandemic, among children four years of age or younger at the state and county levels of Texas using routinely acquired hospital admission records. Methods: We used the Texas Public Use Data Files (PUDF) of the Department of State Human Services (DSHS) to obtain hospital admissions and healthcare outcomes from 2006 to 2021. We used the 2006-2019 period to estimate a long-term temporal trend and predict expected values for 2020-2021. Actual and predicted values were used to quantify changes in seasonal trends of the number of hospital admissions and mean length of hospital stay. Additionally, we calculated hospitalization rates and assessed their similarity to rates reported in the RSV Hospitalization Surveillance Network (RSV-NET). Results: An unusually low number of hospitalizations in 2020 was followed by an unusual peak in the third quarter of 2021. Hospital admissions in 2021 were approximately twice those in a typical year. The mean length of hospital stay typically followed a seasonal trend before COVID-19, but increased by a factor of ∼6.5 during the pandemic. Spatial distribution of hospitalization rates revealed localized healthcare infrastructure overburdens during COVID-19. RSV associated hospitalization rates were, on average, two times higher than those of RSV-NET. Conclusion: Hospital admission data can be used to estimate long-term temporal and spatial trends and quantify changes during events that exacerbate healthcare systems, such as pandemics. Using the mean difference between hospital rates calculated with hospital admissions and hospital rates obtained from RSV-NET, we speculate that state-level hospitalization rates for 2022 could be at least twice those observed in the two previous years, and the highest in the last 17 years.