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Introduction: Effective spinal anaesthesia for caesarean delivery (CD) is assumed to cause bilateral sympathetic blockade with increased feet skin temperature due to vasodilatation [1]. There has been no published study of peripheral skin temperature measurements during spinal anaesthesia for CD. Our study investigated foot skin temperature changes as spinal anaesthesia was established. Method(s): A single centre, prospective observational study with ethics committee approval (IRAS No. 263967). With informed consent, 60 healthy parturients, 37-42 weeks' gestation with singleton pregnancy scheduled for category 4 CD with spinal anaesthesia were recruited. Standard spinal anaesthesia used 0.5% hyperbaric bupivacaine and diamorphine with IV Phenylephrine and fluids. Skin temperature was measured on the dorsum of both feet with Covidien Mon-a-Therm© skin thermistor sensors prior to intrathecal injection and every minute after until completion of surgery. Theatre room temperature and ambient temperature under surgical drapes were recorded. Two controls were recruited. Result(s): All participants had successful spinal anaesthesia. The Figure shows mean (95% CI) skin temperature changes of both feet of participants during spinal anaesthesia and for controls. The maximum rate of skin temperature increase occurred 5-12 minutes after spinal injection with temperature change plateauing after 30 mins. The mean temperature range was 5.54degreeC (min = 29.7degreeC;max = 35.2degreeC). Discussion(s): This study characterises for the first time the peripheral temperature changes in the feet that occur with sympathetic block after spinal anaesthesia in parturients. Increased bilateral foot skin temperatures occur within 10 minutes of spinal injection. This may be useful for determining successful spinal anaesthesia for CD in addition to other assessments [2]. The insights may be useful for assessing epidural analgesia. The study was supported by an OAA research grant. Data collected by ROAR group.Copyright © 2023 Elsevier Ltd
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The additional impact of emission-reduction measures in North China (NC) during autumn and winter on the air quality of downwind regions is an interesting but less addressed topic. The mass concentrations of routine air pollutants, the chemical compositions, and sources of fine particles (PM2.5) for January 2018, 2019, and 2020 at a megacity of Central China were identified, and meteorology-isolated by a machine-learning technique. Their variations were classified according to air mass direction. An unexpectedly sharp increase in emission-related PM2.5 by 22.7% (18.0 mug m-3) and 25.7% (19.4 mug m-3) for air masses from local and NC in 2019 was observed compared to those of 2018. Organic materials exhibited the highest increase in PM2.5 compositions by 6.90 mug m-3 and 6.23 mug m-3 for the air masses from local and NC. PM2.5 source contributions related to emission showed an upsurge from 1.39 mug m-3 (biomass burning) to 24.9 mug m-3 (secondary inorganic aerosol) in 2019 except for industrial processes, while all reduced in 2020. From 2018 to 2020, the emission-related contribution of coal combustion to PM2.5 increased from 10.0% to 19.0% for air masses from the local area. To support the priority natural gas quotas in northern China, additional coal in cities of southern China was consumed, raising related emissions from transportation activities and road dust in urban regions, as well as additional biofuel consumption in suburban or rural regions. All these activities could explain the increased primary PM2.5 and related precursor NO2. This study gave substantial evidence of air pollution control measures impacting the downwind regions and promote the necessity of air pollution joint control across the administration.Copyright © 2023 Elsevier Ltd
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Introduction: Miliaria crystallina occurring during neonatal period is one of the differential diagnosis for vesiculopustular lesions in that age group. Congenital miliaria crystallina is a rare condition developing due to various causes. Case Report: An otherwise well, term female neonate born by caesarean section presented with generalised clear fluid filled vesicles over the trunk, upper limbs, face and scalp at birth. Mother was COVID-19 positive with fever and cough for 1 week. Otherwise she had an unremarkable antenatal, sexual history and examination. The vesicles were located on normal looking skin and ruptured easily on rubbing. Palms, soles and mucosae were normal. Tzanck smear from the vesicles showed a few deformed keratinocytes only. Venereal Disease Research Laboratory test in dilution for both mother and child was non-reactive. Baby's RT-PCR came negative. She fared well on follow up, the vesicles started to desquamate on the second day and completely disappeared on the third day. Mother's COVID-19 symptoms also subsided after child birth. A final diagnosis of congenital miliaria crystallina was made based on the characteristics of the vesicles. Discussion(s): Miliaria crystallina is triggered by environmental temperature and humidity. Congenital cases are associated with maternal febrile illnesses. However, there are reports of it occurring in newborns of mothers without fever in whom other factors are involved. This is the first report of congenital miliaria crystallina occurring in a neonate born to a COVID-19 positive mother. Conclusion(s): This case report highlights the importance of recognizing this benign self-limiting condition so as to avoid unnecessary investigations to find an alternative cause.
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Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is spreading rapidly around the world and has become a global pandemic. Meteorological factors have been recognized as one of the critical factors that influence the epidemiology and transmission of infectious diseases. In this context, the World Meteorological Organization and scholars at home and abroad have paid extensive attention to the relationships of environment and meteorology with COVID-19. This paper systematically collected and sorted out relevant domestic and foreign studies, and reviewed the latest research progress on the impact of environmental and meteorological factors on COVID-19, classifying them into typical meteorological factors (such as temperature, humidity, and wind speed), local environmental factors (such as indoor enclosed environment, ventilation, disinfection, and air conditioning), and air pollution. Current research evidence suggests that typical meteorological factors, local environmental factors, and air pollutants are closely related to the transmission of COVID-19. However, the results of different studies are still divergent due to uncertainty about the influencing mechanism, and differences in research areas and methods. This review elucidated the importance of environmental and meteorological factors to the spread of COVID-19, and provided useful implications for the control of further large-scale transmission of COVID-19 and the development of prevention and control strategies under different environmental and meteorological conditions.Copyright © 2022, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Intro: Surface and environment disinfection is an important part of infection control strategies, especially in the ongoing COVID-19 pandemic. Ozone, a highly reactive oxidant, is a widely used disinfectant in many industries including food, healthcare and water treatment. It has a broad-spectrum activity and leaves no harmful residues. However, most demonstrated efficacy has been at high ozone levels (>1ppm) which can be harmful to humans in case of exposure. Here, we undertook a study to evaluate if exposure to ozone is effective in inactivating SARS-CoV-2 and feline coronavirus (FCoV) even at low concentrations. Method(s): Ozone at 0.07, 0.1 and 1.2 ppm were evaluated for its virucidal activity against SARS-CoV-2 and FCoV. An ozone gas generator (Medklinn Air + Surface Sterilizer (CerafusionTM Technology), Medklinn, Malaysia) supplied controlled levels of ozone to a custom-built chamber of 1.5 ft3 (1.5ft x 1ft x 1ft) where dry virus films containing 1 x 104 PFU of test virus were exposed to ozone gas for 0.5h, 1h, 3h, 5h, and 8h. The experiment was performed at ambient temperature (23-24oC) and relative humidity (RH) of 55% (FCoV only) and 85% (SARS-CoV-2 and FCoV). Finding(s): At low level of ozone of 0.1ppm, >90% reduction of both viruses was achieved after 3h exposure at 85% and 55% humidity. At 1.2ppm, >90% reduction of both viruses was achieved after 0.5h exposure at 85% humidity. Ozone at 0.07ppm, however, did not show good efficacy as reduction not exceeding 90% was achieved only after 8h exposure at 85% and 55% humidity. Conclusion(s): The study demonstrated that low concentration of ozone of at least 0.1 ppm reduced SARS-CoV-2 and FCoV by >90% when used at 85% humidity. The use of low level ozone presents a safer alternative for disinfecting enclosed spaces and greatly reduces any potential harmful health effects in case of accidental exposure.Copyright © 2023
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Background: COVID-19 has emerged as a serious pandemic that emerged during since the end of 2019. The dissemination and survival of coronaviruses have been demonstrated to be affected by ambient temperature in epidemiological and laboratory research. The goal of this investigation was to see if temperature plays a role in the infection produced by this novel coronavirus. Methods: Between March 29, 2020, and September 29, 2020, daily confirmed cases and meteoro-logical parameters in many Gulf countries were collected. Using a generalized additive model, we investigated the nonlinear relationship between mean temperature and COVID-19 confirmed cases.. To further investigate the association, we employed a piecewise linear regression. Results: According to the exposure-response curves, the association between mean temperature and COVID-19 cases was nearly linear in the window of 21 - 30C while it is almost flat beyond that window. When the number was below 21C (lag 0-14), each 1C increase was associated with a 4.861 percent (95 percent CI: 3.209 - 6.513) increase in mean temperature (lag 0-14). Our sensitiv-ity analysis confirmed these conclusions. Conclusions: Our findings show a positive linear association between mean temperature and the number of COVID-19 cases with a threshold of 21C. There is little evidence that COVID-19 case numbers would rise as the weather becomes colder, which has important consequences for making health strategy and decision.
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This special issue comprises 8 articles that explore various aspects of the COVID-19 pandemic from mathematical, statistical, and biological perspectives. The two articles in the mathematics category discuss optimal control strategies to limit the spread of COVID-19 in Italy and Jakarta, Indonesia, using quarantine, testing, and medical treatment. The statistics category features 4 articles that investigate the impact of temperature on the spread of COVID-19 in Gulf countries, the development of novel hybrid models for predicting COVID-19 in Kuwait, forecasting using basic reproduction number dynamics to analyze the pandemic's data, and a comparison of the multi-state models to assess the effect of antiviral treatment on SARS-CoV-2 infectious disease progression. The final 2 articles in the biology category focus on the bioinformatic analysis of antiviral medicinal compounds against SARS-CoV-2 proteases and the filtration efficiency of face masks and veils as protective measures during the COVID-19 pandemic.
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To treat mild to moderate COVID-19, an investigational drug called nirmatrelvir in combination with ritonavir is being researched for which the potential hazards with this are still unknown. Nirmatrelvir has been approved for immediate use by the US Food and drug intake in conjunction with the drug ritonavir for the treatment of mild to medium COVID-19 in grown ups and individuals of more than 12 years who test positive for the virus and are at a high risk to develop severe COVID-19.To quantify the drugs simultaneously in tablet dosage forms, a novel, sensitive and reproducible reverse phase liquid chromatography method has been developed. Thechromatographic separation was performed using Phenomenex (250x4.6mm,5micro particle size) column. The separation and elution were carried out at an ambient temperature using a mobile phase consisting of 0.1% trifluoro acetic acid &acetonitrile in the ratio of 50:50%v/v. The maximum absorbance by UV spectrophotometer shown at wavelength 258.3nm& 271.4nm for nirmatrelvir and ritonavir. Also, 266nm was selected as detector wavelength by a photodiode array detector for the HPLC chromatrographic method.Beer lambert's law obeyed in the linear range of 37.5-225microg/mL(R2=0.9998) for nirmatrelvir and 25-150 microg/mL(R2=0.9994) for ritonavir. The method shows method and system precision with % RSD less than 1%.The percentage mean recovery was found to be 99.9-100.2%& 100.0-100.2%. The LOD 1.5 microg/mL &1 microg/mL values indicates the method sensitivity. The proposed stability indicating method was validated for precision,accuracy, specificity, selectivity, robustness and stability studies according to ICH guidelines.Copyright © 2022, Anka Publishers. All rights reserved.
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Introduction: The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. Objective(s): To determine knowledge regarding heat stress and practice of PPE among HCWs during the COVID-19 pandemic. Material(s) and Method(s): A cross-sectional observational study was done among 115 HCWs using a self-designed questionnaire to identify their thoughts on heat stress caused by PPE wear during the COVID-19 pandemic. The ambient temperature, relative humidity (RH), and dew point in their respective locations were recorded using data loggers (EL-USB-2-LCD+, Lascar Electronics, Salisbury, UK). R version 3.6.2 was used to examine the frequency and descriptive statistics from the survey findings. Pearson's chi-square was used to determine associations. A p value of <0.05 was considered statistically significant. Result(s): The average wet bulb globe temperature (WBG) reported was 30.0oC (IQR 29.1-31.8oC) according to the heat exposure data. The majority of the 115 HCWs were involved in medical consulting (39%), followed by nursing (29%). The researchers discovered that 50% of the workers (n=57) were wearing 5-6 PPEs and had a fourteen-fold increased risk of developing an undesirable thermal health symptom (95 % CI: 0.77 to 280.24;p=0.0737). In addition, 36% of the participants (n=42) worked between 8 and 10 hours every shift with little or no rest. It was also important to note that 76% (n=88) of them worked in non-air-conditioned environments, and 33% (n=38) of them had excessive workloads, which could add to the employees' heat burden. More than half of them agreed that wearing PPE is extremely inconvenient, and they avoided taking breaks to maintain infection control. The impression of thermal stress was reported by 96% of the participants (n=111), and it was found to be substantially linked with the job they were engaged [OR 0.0654 (95% CI: 0.003- 1.246) P=0.001]. More than half of the participants strongly agreed that appropriate rest and hydration before work could help them lower their thermal stress. Conclusion(s): HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Ice slurry ingestion could be a practical and effective method for promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.
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Particle size distribution is a major factor in the health and climate effects of ambient aerosols, and it shows a large variation depending on the prevailing atmospheric emission sources. In this work, the particle number size distributions of ambient air were investigated at a suburban detached housing area in northern Helsinki, Finland, during a half-year period from winter to summer of 2020. The measurements were conducted with a scanning mobility particle sizer (SMPS) with a particle size range of 16–698 nm (mobility diameter), and the events with a dominant particle source were identified systematically from the data based on the time of the day and different particle physical and chemical properties. During the measurement period, four different types of events with a dominant contribution from either wood-burning (WB), traffic (TRA), secondary biogenic (BIO), or long-range transported (LRT) aerosol were observed. The particle size was the largest for the LRT events followed by BIO, WB, and TRA events with the geometric mean diameters of 72, 62, 57, and 41 nm, respectively. BIO and LRT produced the largest particle mode sizes followed by WB, and TRA with the modes of 69, 69, 46, and 25 nm, respectively. Each event type had also a noticeably different shape of the average number size distribution (NSD). In addition to the evaluation of NSDs representing different particle sources, also the effects of COVID-19 lockdown on specific aerosol properties were studied as during the measurement period the COVID-19 restrictions took place greatly reducing the traffic volumes in the Helsinki area in the spring of 2020. These restrictions had a significant contribution to reducing the concentrations of NOx and black carbon originating from fossil fuel combustion concentration, but insignificant effects on other studied variables such as number concentration and size distribution or particle mass concentrations (PM1, PM2.5, or PM10). © 2022 The Authors
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In the Covid-19 disaster, fever detection using infrared thermography became widespread. A person with fever is detected based on the facial skin temperature measured in a non-invasive and free-of-restraint method. Recent studies have pointed out that the facial whole skin temperature, when measured immediately after entering a moderately moderate environment from a cold environment, is not practical for detecting persons with fever because it is greatly affected by the environmental temperature. On the other hand, the effect of cold and hot temperatures on the details of the entire face has not been evaluated. In this study, we compared the cold and hot environments and the acclimation to moderate temperatures to The effects of cold and hot environments on the whole face skin temperature distribution was evaluated in detail.The results showed that the periorbital area and side of the nose were least affected in the cold environment, and the side of the the nose was least affected in the hot environment. And, These parts are suggested to be suitable for core temperature estimation considering the environmental temperature. © 2022 IEEE.
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It can be argued that there are three colliding pandemics that are currently affecting the planet and its people: COVID-19, global inequities and climate change. Regrettably, these are all the result of human action or inaction and are preventable. The United Nations Conference of the Parties (COP26), held in November 2021 in Glasgow, addressed some of these issues.1 Prince Charles called this meeting the 'last chance saloon to save the planet.' The main objective of COP26 was to reduce global heating and limit global warming to the target maximum temperature of 1.5-degree Celsius above pre-industrial levels. According to the National Aeronautics and Space Administration (NASA), since the late 19th century, the earth surface temperature rose by 1.18 degrees Celsius, caused by increased carbon dioxide and other emissions into the atmosphere, with the years 2016 and 2020 being tied as the warmest years on record.2 However, many, including a group of scientists called 'Scientist Rebellion' were not convinced that COP26 would make any difference to the warming of the planet.3 President of COP26, Alok Sharma admitted that the objective of the conference was not reached but remained cautiously optimistic: "We can now say with credibility that we have kept 1.5 degrees alive. But its pulse is weak and it will only survive if we keep our promises and translate commitments into rapid action".
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Since the outbreak of COVID-19, various regions have introduced their own TCM prevention and treatment methods. However, there are two opposing views on the nature of coldness and warmness. With advanced social development, the thought of the unification of coldness and warmness has developed rapidly, and many doctors gradually have realized the importance and practicability of the unification of coldness and warmness, and began to advocate the unification of coldness and warmness syndrome. The prevention and treatment of COVID-19 in Jiangxi was developed by Professor Wu Bingcai,a master of Chinese medicine, based on the unified idea of cold and temperature, according to the characteristics of humid climate in Jiangxi, and in combination with the characteristics of COVID-19, the anti-toxin prescription for dispelling cold and desiccating dampness and the anti-toxin prescription for clearing heat and dehumidifying, which achieved exact and satisfactory results in clinical application.
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Respiratory viral infections are related to environmental parameters, especially Influenza viruses. There are no studies on this subject in Argentina. The objective of the study is to investigate the relationship between the presence of COVID19 cases and environmental parameters in 4 departments of the province of Catamarca, from March 2 to June 31, 2021, to establish the importance of the environment in the spread of viral infection. A descriptive cross-sectional study was conducted in Ambato, Capital, Paclín, and Andalgalá. A total of 17,142 positive cases were taken, in a temperature range (T) between -3.1°C and 39.6°C, and relative humidity of 75%. The data treatment was carried out with the Infostat statistical software, through a linear regression for the numerical variables. The results showed that the average ambient temperature has an indirect relationship with the number of cases in Capital where the average temperature decreased from 28.3 to 5°C, increasing from 13 to 345 cases;in Ambato, the average temperature decreased from 22.2 to 0.9°C with an increase from 0 to 16 cases, in Paclín the average temperature decreased from 22.3 to 1.5°C with an increase from 0 to 9 cases, and Andalgalá, where the ambient temperature has a direct relationship with the number of cases, where the number of cases increased from 0 to 70. Relative humidity did not vary in any of the departments studied. In conclusion, preliminary results suggest that the number of COVID19 cases is related to environmental temperature but not to average humidity. Further study of environmental parameters to virosis is relevant for our region and the rest of the country.
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Background: National Blood Centre is an institution under the Ministry of Health Malaysia responsible for ensuring adequate and safe blood supply is always available for hospitals in Malaysia. Prior to COVID-19 pandemic, collection from the blood donation campaign was 80% of the total collection. However, during the pandemic collection from blood donation campaigns has reduced to almost only 60%. Identifying the issues is important because tackling these issues reduce barriers that impede people from becoming blood donors and increase the likelihood of blood donation campaigns organizers to continue supporting blood donation campaigns which are important for the sustainability of donations from regular blood donors. Aims: The purpose of this study is to better understand the issues faced at blood donation campaigns specifically related to location, equipment, and staff-related issues in view of paving the way to solving the issues later for the betterment of the service in terms of future intervention. Methods: This was a cross-sectional prospective study using a feedback form filled out by Blood Donation Campaign managers to give their input on the issues encountered during blood donation campaigns. The duration of this study was 4 months from 1st of September 2021 to 31st of December 2021 involving 711 blood donation campaigns organized by the National Blood Centre with blood donation campaign organizers using the purposive sampling method. These feedbacks were mainly categorized into three main categories involving location, equipment, and staff-related issues. The feedback form is given to Blood Donation Campaign managers on the day of the blood donation campaigns, with the feedback to be filled during campaign progress and to be returned at the end of the blood donation campaign on the same day. The outcome of this feedback is calculated by pointer system-where 0 = no issues, 1 = issue exist. Results: A total of 240 issues were highlighted involving 123 of the 711 blood donation campaigns between the 1 September 2021 to the 31 December 2021. 81.25% of the issues were due to blood donation campaign location and environment, 13.75% of the issues were due to staff issues and 5.0% of the issues were due to equipment issues. 24.62% of the issues were related to the lack of the locations' visibility and accessibility to potential blood donors. 22.05% of the issues related to the blood donation campaign locations were due to unsuitable environment temperature, which is vital for preserving the blood cold chain. 13.33% of the issues were due to staff issues such as failure to be prepared for departure on time. Unexpectedly high number of donors turn up contributed to 4.49% of issues related to inadequate equipment (blood bag and rations). Summary/Conclusions: This cross-sectional prospective study analysis has helped in identifying issues encountered at blood donation campaigns and pave the way for further intervention for the betterment of services needed. Choosing a proper location and adequate promotional materials may be useful in addressing visibility issues in recruiting potential donors. Unsuitable environment temperature can be overcome by bringing additional fans or air humidifiers to bring down the temperature around the campaign location. A possible solution to inadequate blood bags and ration is by bringing additional blood bags to blood donation campaigns that are going to be held in high population areas.
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Objectives: To report a rare case of extensive congenital miliaria crystallina. Results: A male infant was born at term by Caesarian section due to warning signs of fetal distress. The pregnancy had been uneventful. However, a maternal SARS-CoV2-infection occurred 2 days before birth. Immediately at birth, the newborn presented with a striking appearance of disseminated pinpoint-sized vesicles filled with clear fluid. Preemptive antibiotic treatment was initiated On dermatology consult, a diagnosis of congenital miliaria crystallina was made due to the typical clinical presentation. Investigations for congenital infections (Herpes, Varicella) were negative as well as repeat sampling for SARSCoV2. Antibiotic treatment was stopped. Treatment included reduction of ambient temperature/humidity and disinfectant dressings leading to a quick resolution of miliaria within 2-3 days. Clinical follow-up on DOL 20 revealed normal skin with areas of flaky desquamation. Discussion: Miliaria is a benign, transient disorder caused by occlusion and disruption of eccrine sweat ducts and occasionally occurs in infants. Congenital presentation of extensive miliaria crystallina however is exceptional with only sporadic reports in the medical literature. The role of SARS-CoV2 in our case remains unclear as fetal infection was excluded. However, a few cases of congenital miliaria were reported in the context of other maternal infections, suggesting a role of maternal fever and increased temperature of amniotic fluid in the pathogenesis of congenital miliaria. Clinicians should be aware of this striking yet harmless congenital presentation, which may mimic a congenital disorder of cornification or another severe skin disease, causing unnecessary anxiety.
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Vaccination rates have a statistically significant downward effect on the Covid-19 death rate across US counties, as of August 12, 2021. Controlling for poverty rates, age, and temperature lowers the magnitude of the estimate a little. Using the Biden-Trump vote in the 2020 election as an instrument for vaccination rates raises the magnitude of the estimate. Presumably it corrects for a positive effect of observed local Covid deaths on the decision to get vaccinated. Overall, the estimated beneficial effect holds up and has risen over time.