"My brain feels like a browser with 100 tabs open": A longitudinal study of teachers' mental health and well-being during the COVID-19 pandemic.

BACKGROUND: Teaching and caring for pupils during the COVID-19 pandemic has been a challenge for many teachers, and its impact on teachers' mental health and well-being (MHWB) should be of great national and international concern. AIM AND PARTICIPANTS: This study examines 24 primary and secondary school teachers' MHWB experiences across three time points (April, July, and November 2020) using longitudinal qualitative trajectory analysis. METHOD: We used a mixture of inductive and deductive coding, based on the Job Demands-Resources Model, to identify the job demands (aspects of the job that can be physically or psychologically costly) and job resources (aspects of the job that can buffer the effects of job demands and promote achievement and growth) teachers reported experiencing across the three time points. RESULTS: Generally, teachers' MHWB seemed to have declined throughout the pandemic, especially for primary school leaders. Six job demands contributed negatively to teachers' MHWB (i.e., uncertainty, workload, negative perception of the profession, concern for others' well-being, health struggles, and multiple roles) and three job resources contributed positively to their MHWB (i.e., social support, work autonomy, and coping strategies). CONCLUSIONS: Policymakers and practitioners can support teachers' MHWB by engaging in more collaborative communication and ensuring greater accessibility to sources of social support. These discussions and provisions will be crucial in supporting teachers, and thereby the educational system, both during and after the pandemic.

The Clinical Course of Coronavirus Disease 2019 in a US Hospital System: A Multistate Analysis.

There are limited data on longitudinal outcomes for coronavirus disease 2019 (COVID-19) hospitalizations that account for transitions between clinical states over time. Using electronic health record data from a hospital network in the St. Louis, Missouri, region, we performed multistate analyses to examine longitudinal transitions and outcomes among hospitalized adults with laboratory-confirmed COVID-19 with respect to 15 mutually exclusive clinical states. Between March 15 and July 25, 2020, a total of 1,577 patients in the network were hospitalized with COVID-19 (49.9% male; median age, 63 years (interquartile range, 50-75); 58.8% Black). Overall, 34.1% (95% confidence interval (CI): 26.4, 41.8) had an intensive care unit admission and 12.3% (95% CI: 8.5, 16.1) received invasive mechanical ventilation (IMV). The risk of decompensation peaked immediately after admission; discharges peaked around days 3-5, and deaths plateaued between days 7 and 16. At 28 days, 12.6% (95% CI: 9.6, 15.6) of patients had died (4.2% (95% CI: 3.2, 5.2) had received IMV) and 80.8% (95% CI: 75.4, 86.1) had been discharged. Among those receiving IMV, 35.1% (95% CI: 28.2, 42.0) remained intubated after 14 days; after 28 days, 37.6% (95% CI: 30.4, 44.7) had died and only 37.7% (95% CI: 30.6, 44.7) had been discharged. Multistate methods offer granular characterizations of the clinical course of COVID-19 and provide essential information for guiding both clinical decision-making and public health planning.