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Objectives: This study aims to evaluate the impact of the stay-at-home orders, especially closing and reopening bars and other drinking establishments, on binge drinking patterns in US populations in Metropolitan Statistical Areas (MSAs). Method(s): Data on binge drinking and heavy binge drinking for this study was extracted from the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS). Data on regulations were collected by National Academy for State Health Policy. We used two staggered differences-in-differences strategies to account for monthly variations in bar regulations. We implemented a strategy that used never treated states as controls via the Stata package CSDID and a strategy that directly imputed counterfactuals for treated states via the Stata package FECT. The outcomes were measured by the number of binge drinkers or heavy binge drinkers per 1000 population. The treatment effect was estimated while controlling for age, income level, race, chronic conditions, gender, MSA fixed effects, and month fixed effects. Stay-at-home orders were coded as 1 in the first full month of implementation and were assumed to impact the entire state equally. Bars were assumed to reopen if the indoor service has been reactivated at any capacity. Result(s): For heavy binge drinking, the average treatment effect on the treated group was 4.86 per 1000 population (p=0.027) using FECT package and 6.74 per 1000 population (p = 0.025) using CSDID package. No significant effect was found for binge drinking. Conclusion(s): We provide suggestive evidence that stay-at-home orders may have increased heavy binge drinking in metropolitan areas. We estimated this led to a 3.38% (FECT) or 4.68% (CSDID) increase in heavy binge drinking during the pandemic. Future work will assess the characteristics of areas that saw the greatest increase in heavy binge drinking, and explore why heavy binge drinkers were more vulnerable than binge drinkers during the Covid.Copyright © 2023
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Background: The COVID-19 pandemic is a major health crisis affecting several nations. Such widespread outbreaks are associated with adverse mental health consequences. Objective(s): To conduct a survey-based assessment of mental health among medical students during the COVID-19 pandemic. Aimed at identifying severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress. Method(s): An analytical cross-sectional study was chosen as the study design for this research to study the association between demographic social and mental health among medical students during the pandemic COVID-19. Result(s): The results of this study were collected by respondents through questionnaires as the respondents were needed to answer about 16 questions and the main question was asked mostly about their mental health condition during the pandemic COVID-19. 101 respondents participated in the study. Discussion(s): the impact of COVID-19 on mental health among medical students has been studied. Due to the long-lasting pandemic situation and numerous measures such as lockdown and stay-at-home orders, COVID-19 brings negative impacts on higher education of medical students, self and social isolation, disconnection from friends and teachers resulting in more medical students than ever experiencing feelings of helplessness, isolation, grief, anxiety and depression. The issue of mental health is not only relevant but crucial. Demand for health support services has increased exponentially as a result. Conclusion(s): In this study, severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress have increased due to many factors such as social isolation, own health and the health of loved ones, financial difficulties, suicidal thoughts, depressive thoughts, class workload, changes in living environment, eating patterns and sleeping habits.Copyright © RJPT. All right reserved.
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BACKGROUND: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. METHODS: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. RESULTS: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. CONCLUSION: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners.
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BACKGROUND: Changes in injury patterns during the COVID pandemic have been reported in other states. The objective was to explore changes to trauma service volume and admission characteristics at a trauma center in northeast Ohio during a stay-at-home order (SAHO) and compare the 2020 data to historic trauma census data. METHODS: Retrospective chart review of adult trauma patients admitted to a level I trauma center in northeast Ohio. Trauma admissions from January 21 to July 21, 2020 (COVID period) were compared to date-matched cohorts of trauma admissions from 2018 to 2019 (historic period). The COVID period was further categorized as pre-SAHO, active-SAHO, and post-SAHO. RESULTS: The SAHO was associated with a reduction in trauma center admissions that increased after the SAHO (P = .0033). Only outdoor recreational vehicle (ORV) injuries (P = .0221) and self-inflicted hanging (P = .0028) mechanisms were increased during the COVID period and had substantial effect sizes. Glasgow Coma Scores were lower during the COVID period (P = .0286) with a negligible effect size. Violence-related injuries, injury severity, mortality, and admission characteristics including alcohol and drug testing and positivity were similar in the COVID and historic periods. DISCUSSION: The SAHO resulted in a temporary decrease in trauma center admissions. Although ORV and hanging mechanisms were increased, other mechanisms such as alcohol and toxicology proportions, injury severity, length of stay, and mortality were unchanged.
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Intro: Tuberculosis (TB) is an ancient disease in Malaysia and the arrival of COVID-19 has driven TB into an unknown that possibly creates hidden threats to public health. Recently, TB is identified as a socially influenced disease transmitted through people that are easily mobile and dynamically connected. It is critical to develop a data-driven geospatial-based modelling to map tuberculosis (TB) cases in Malaysia for boosting early detection. Method(s): We conducted a retrospective review of TB notified cases in Kuala Lumpur, Malaysia, between the years 2020 and 2021. The data was retrieved from the MyTB database and TB cases trends were examined against the five main series of 2020-2021 Malaysia Movement Control Order (MCO). The examination was extended to the study of social demographic and disease profiles. Locality, sub-locality, and housing type were investigated to measure hotspots in Kuala Lumpur. Finding(s): The number of patients with pulmonary TB (PTB) was high where 51% of them are smear positive and contributed majorly by male dominants. Cases with diabetes tend to be dominated by positive smear PTB that is close to 80%. There is a relatively strong trend that cases diagnosed with diabetes are in the non-smokers group and almost equally distributed between men and women, although the remaining cases are succeeded by men at the rate of 98% as opposed to women. Conclusion(s): The review of Kuala Lumpur TB notification between 2020 and 2021 is presented in this study providing a glance at a retrospective view of TB case notification in the era of the pandemic COVID-19. There are 188 cases per 100,000 population within the area of Kuala Lumpur and several important examinations were conducted to understand the underlying insights of notified TB cases. Several areas have been identified as hotspots according to geospatial modelling to allow targeted TB prevention activities at the community level.Copyright © 2023
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Introduction: In March 2020, Malaysia initiated the first Movement Control Order (MCO) to curb the spread of COVID-19 infections. While healthcare services remained operational, fears of contracting COVID-19 may have impacted health seeking behaviours and healthcare access. A survey was conducted to investigate how the first MCO impacted actions of individuals experiencing upper respiratory tract infection versus other symptoms, routine follow-up visits, and refill prescription practices. Method(s): A cross-sectional survey among adult Malaysians was conducted from November to December 2020. A selfadministered questionnaire was developed, validated, and disseminated on social media and communication platforms. Result(s): 3001 participants responded to the survey. 486 (16.0%) of them reported being unwell during the MCO. Regardless of symptoms, actions taken to seek medical care were similar. The most common action on average was visiting a medical doctor (55.0%), followed by self-medicating at home (38.0%). 588 participants had a scheduled appointment for their medical condition during the MCO. 253 of them had their appointments affected by the lockdown, for examples, 85.0% postponed, 12% cancelled, 9.0% referred. Only 42.3% of these affected participants saw a doctor within 3 months after the first MCO. Out of 487 participants who regularly collected medications from the pharmacy, 69.0% had a prescription refill appointment during the lockdown. Only 15.0% of them did not collect their medications on the scheduled date. Conclusion(s): The first MCO did not severely affect health seeking behaviour and prescription refill practices. However, there are concerns over timely access to follow-up appointments due to extensive rescheduling and backlogs triggered by the pandemic.
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The Covid-19 stay-at-home restrictions put in place in New York City were followed by an abrupt shift in movement away from public spaces and into the home. This study used interrupted time series analysis to estimate the impact of these changes by crime type and location (public space vs. residential setting), while adjusting for underlying trends, seasonality, temperature, population, and possible confounding from the subsequent protests against police brutality in response to the police-involved the killing of George Floyd. Consistent with routine activity theory, we found that the SAH restrictions were associated with decreases in residential burglary, felony assault, grand larceny, rape, and robbery; increases in non-residential burglary and residential grand larceny motor vehicle; and no change in murder and shooting incidents. We also found that the protests were associated with increases in several crime types: felony assault, grand larceny, robbery, and shooting incidents. Future research on Covid-19's impact on crime will need to account for these potentially confounding events.
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The emergence of COVID-19 had affected people in terms of their physical activity and nutritional changes which may increase the risk of various non-communicable diseases (NCD) among them. This study aimed to identify the physical activity level, nutritional changes, and perceived barriers to engage physical activity among students of UiTM Selangor, Puncak Alam Campus during the Movement Control Order (MCO) in Malaysia. A total of 234 students aged 18-24 years old were chosen to participate in this study by using convenience sampling. The International Physical Activity Questionnaire (IPAQ), Physical Activity Resource Assessment (PARA), and adapted questionnaire from the Ministry of Health (MOH) Malaysia were used in this study. Findings reveal that students were able to engage in physical activity level during the pandemic period which required them to be quarantined. Moreover, there was an increase in the frequency of healthy eating behaviour as well as unhealthy eating behaviour during MCO.Copyright © 2023 The Authors.
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Introduction: Early in the pandemic various lockdown measures were implemented to decrease spreading of Covid-19. This resulted in many clinics and hospitals observing a decrease in the usual numbers of patients accessing care. Patients have also expressed fears and challenges with accessing care at health clinics and hospitals during this time. Since May 2020, there has been a gradual decrease in the restrictions and stay at home orders for Covid-19 by the government in Jamaica and more persons have begun to access care again at health facilities. The impact of the Covid-19 pandemic in patients with chronic kidney disease especially those who were not admitted with Covid-19 is limited. This study seeks to determine why patients were not accessing care early in the pandemic and the possible longer-term impact of the Covid-19 pandemic on the care and prognosis of patients with chronic kidney disease. Method(s): All patients who attended Renal clinic, Kingston Public Hospital (KPH) from April 20th to July 14th 2021 were eligible for inclusion in the study. Those who consented to participate in the study had an interview with the researcher at the Renal clinic where a questionnaire was administered. Demographic data was collected as well as whether they were a new or follow-up patient and number of appointments missed was noted. Their renal diagnosis and labs were obtained from their dockets by the researchers. The data was analysed using Microsoft excel and Epi info software Results: There were 185 participants. 45.7% of the participants were 51 to 70 years old. 61.1% were females and 38.9% were males. Follow-up patients accounted for 76.2% of the participants whilst 23.8% were new patients. 92.2% of the follow-up patients reported attending clinic in the past year. 15.1% of the participants reported missing at least one appointment in the past year. Most common reasons given for missing appointments were forgot date of appointment, afraid of coming to hospital, was sick at home or admitted to hospital. 2.7% of the participants reported having had Covid-19. Only 7.0% of the study participants were on dialysis. 76.9% of those receiving dialysis were started on haemodialysis since March 2020. 93.0% reported receiving all or most of their medications through the free public health care system during the pandemic. 44.3% of the participants reported working in the past year. Most common reasons given for not working in the past year were medical condition, receiving family support or retired. Only 3.6% reported being sent home by an employer due to the pandemic. The most common renal diagnoses were diabetic nephropathy and hypertensive nephrosclerosis followed by lupus nephritis and sickle cell nephropathy. 49.2% were CKD stage 3b to Stage 5. 14.6% of those who were CKD stage 3 near to March 2020 progressed to CKD stage 4 or 5 by a year later. Conclusion(s): During the pandemic, attendance of patients at Renal clinic, Kingston Public Hospital and their access to medications remained high. Approximately 15% of those with CKD stage 3 near the onset of the pandemic progressed to CKD stage 4 or 5 by a year later. This warrants further study. No conflict of interestCopyright © 2023
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Countries around the world have resorted to issuing stay-at-home orders to slow viral transmission since the COVID-19 pandemic. During the lockdown, access to public park plays a central role in the public health of surrounding communities. However, we know little about how such an unprecedented policy may exacerbate the preexisting unequal access to green space (i.e., green space justice). To address this research void, we used difference-in-difference models to examine socioeconomic disparities, urban-rural disparities, and mobility disparities in terms of public park access in the United States. Our national analysis using the weekly mobile phone movement data robustly suggests the following three key findings during COVID-19: (1) The elderly, non-college-educated people, poor people, and blacks are less likely to visit public parks frequently, while unemployed people appear to be the opposite. (2) Compared to rural areas, populations in urban neighborhoods appear to visit public parks more frequently and they generally go to larger parks to minimize the risk of infection. (3) Populations in neighborhoods with higher private vehicle ownership or those with a higher density of transit stops would more frequently visit and travel a longer distance to public parks during the stay-at-home order. Our results imply that conventional inequality in green space access may still exist and even become worse during COVID-19, which could negatively impact people's health during isolation. We suggest that special attention should be paid to park-poor neighborhoods during the pandemic and in the post-pandemic recovery phase.
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COVID-19 , Humans , United States , Aged , Parks, Recreational , Pandemics , Communicable Disease Control , Social JusticeABSTRACT
BACKGROUND: After COVID-19 was declared a Public Health Emergency of International Concern by WHO, several non-pharmaceutical interventions were adopted for containing the virus. Success to which largely depend upon citizens' compliance to these measures. There is growing body of evidence linking social support with health promoting behaviour. Hence, this research aimed to study the effects on compliance with stay-at-home order in relation to their perceived social support. METHODS: A web-based cross-sectional study was conducted among adult participants aged 18 years and above residing in Bagmati Province, Nepal. A convenient non-probability sampling method was adopted to select the required number of samples. The questionnaire was developed through an extensive review of literature, and consultations with the research advisor, subject experts, as well as peers and converted to online survey form using Google Forms. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS) scale whereas compliance was assessed using a single screening question. Statistical analysis was performed using SPSS version 20 involving both the descriptive and inferential statistics. RESULTS: Two fifth (40.2%) of the participants reported poor compliance with stay-at-home order which was found higher among participants who were not vaccinated against COVID-19 compared to those vaccinated (p value < 0.05). A significant difference was observed between sex and perceived support (p value < 0.05) with higher proportion (80.8%) of female participants reporting perceived support from family, friends, and significant others in comparison to male participants. CONCLUSION: Overall, the results of this study suggest that the perceived support from family is higher compared to others. Further evidence might be helpful to understand contextual factors on compliance with public health measures. Tailoring behaviour change messages as per the community needs would help the response in such emergencies. The findings from this study might be useful as one of the evidence base for formulating plans and policy during emergencies of similar nature.
Subject(s)
COVID-19 , Adult , Humans , Male , Female , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , SARS-CoV-2 , Nepal/epidemiology , Emergencies , Social Support , InternetABSTRACT
Initial research on the effect of pandemic related stay-at-home orders (SAHO) on subsequent US state unemployment rates found inconclusive results regarding the magnitude of the effect. This research helps to clarify the debate, finding that while own-state SAHOs affected unemployment outcomes, it was actually the national level of SAHO implementation across the country that had an even greater impact. While these results do not offer direct guidance on when or whether SAHOs should have been issued in any given state, they do help to clarify the impact of SAHOs on various measures of US unemployment. Supplementary Information: The online version contains supplementary material available at 10.1057/s41302-023-00243-4.
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Background: The human papillomavirus (HPV) vaccine is a cancer prevention tool, yet vaccination coverage among adolescents remains suboptimal in the United States. Research shows significant disparate incidence and mortality rates of HPV-related cancers in Puerto Rico (PR). In 2018, the PR Department of Health (DOH) enacted an HPV vaccine school-entry requirement for adolescents 11 to 12 years old, and on August 2020 extended the requirement to include adolescents up to 16 years old. Amid the COVID-19 pandemic in the US, during March-August 2020, national data showed that HPV vaccine uptake rates decreased about 75%. Public health measures, such as stay-at-home orders, may have caused this decline by limiting access to preventive services. Our study explored, using a qualitative assessment, the impact of the COVID-19 pandemic on the implementation of the HPV vaccine school-entry requirement in PR. Method(s): We conducted 26 interviews with stakeholders from schools, DOH employees, Department of education staff, health providers, and community-based organizations from 08/2021-03/2022. Interviews were recorded and transcribed in Spanish. Data were analyzed using applied thematic techniques by two trained coders using Atlas-ti 8. We discussed eight of these interviews among the team to identify major barriers related to the HPV school-entry implementation during the pandemic. Result(s): Our analysis identified the following preliminary emergent themes including: (1) lockdown limitations and access barriers to the vaccine and (2) shifting immunization priorities. Most participants noted that the March 2020 lockdown limited parents' ability to get their kids vaccinated and for schools to monitor the vaccine requirements;however, as vaccination centers and schools re-opened, gradually, vaccination processes increased. Participants described how during the pandemic, public health agencies prioritized the COVID-19 vaccine missing other vaccines that are required for school-entry, including the HPV vaccine. Discussion(s): Continuation of the implementation of the HPV vaccine school-entry requirement was challenging during early stages of the pandemic due to public health measures enacted to stop the spread of COVID-19. Moreover, once the COVID-19 vaccine was available, public heath vaccination priorities shifted. Nonetheless these barriers, efforts to increase HPV vaccine to pre-pandemic rates should continue, including providing educational support to parents, increase vaccine promotion, and creating community collaborations. As new guidelines recommend COVID-19 boosters, for everyone ages 5 years and older, this opportunity could serve to vaccinate against HPV as part of the bundling implementation of the HPV vaccine school-entry requirement.
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At the Universiti Sains Malaysia (USM), Pharmacoinformatics is a second-year undergraduate Bachelor of Pharmaceutical Sciences course designed to introduce students on how to use technology to improve pharmaceutical care services. Until the outbreak of COVID-19, teaching, learning, and assessments for this course were predominantly conducted face-to-face. The unannounced arrival of the pandemic with its unprecedented uncertainties meant a drastic change in programme delivery was necessary. Social distancing and movement control orders were imposed to control the transmission of COVID-19 and hence a complete shift to online learning was required. All available tools were therefore deployed to make the transition a successful experience for both students and lecturers. The advantage of the new learning approach was that both synchronous and asynchronous learning experiences were explored. The group assignments were mostly synchronous using video conferencing applications. However, student assessments by the lecturers were predominantly asynchronous. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.
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Introduction: Although surveys are a well-established instrument to capture the population prevalence of mental health at a moment in time, public Twitter is a continuously available data source that can provide a broader window into population mental health. We characterized the relationship between COVID-19 case counts, stay-at-home orders because of COVID-19, and anxiety and depression in 7 major U.S. cities utilizing Twitter data. Methods: We collected 18 million Tweets from January to September 2019 (baseline) and 2020 from 7 U.S. cities with large populations and varied COVID-19 response protocols: Atlanta, Chicago, Houston, Los Angeles, Miami, New York, and Phoenix. We applied machine learningâbased language prediction models for depression and anxiety validated in previous work with Twitter data. As an alternative public big data source, we explored Google Trends data using search query frequencies. A qualitative evaluation of trends is presented. Results: Twitter depression and anxiety scores were consistently elevated above their 2019 baselines across all the 7 locations. Twitter depression scores increased during the early phase of the pandemic, with a peak in early summer and a subsequent decline in late summer. The pattern of depression trends was aligned with national COVID-19 case trends rather than with trends in individual states. Anxiety was consistently and steadily elevated throughout the pandemic. Google search trends data showed noisy and inconsistent results. Conclusions: Our study shows the feasibility of using Twitter to capture trends of depression and anxiety during the COVID-19 public health crisis and suggests that social media data can supplement survey data to monitor long-term mental health trends.
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COVID-19 virus is transmitted from human to human through splashes of saliva when the sufferer coughs, sneezes, or talks and is inhaled by the people around him. The spread of this virus started from the Chinese city of Wuhan in December 2019 which quickly spread to cities outside Wuhan including Jakarta, Indonesia. The same is in other countries, the local government in Jakarta taking some emergency decisions to minimize the virus spreading including the movement control order (MCO). This paper discusses the simulation of COVID-19 spreading in the early stage in Jakarta using a different model of disease spreading available on The Spatiotemporal Epidemiologic Modeler (STEM). The focus of this simulation is to see the effect of MCO on the COVID-19 spreading in the local area in Indonesia. The result shows that the MCO contribute to the decreasing of case number with some certain period of lag time. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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During the COVID-19 pandemic, strict stay-at-home orders have been implemented in many Chinese universities in virus-hit regions. While changes in electricity consumption in the residential sector caused by COVID-19 have been thoroughly analysed, there is a lack of insight into the impact of the stay-at-home order on electricity consumption in university dormitory buildings. Based on questionnaire survey results, this study adopted the statistical Kaplan-Meier survival analysis to analyse the energy-use behaviours of university students in dormitories during the COVID-19 pandemic. The electricity load profiles of the dormitory buildings before and during the implementation of the stay-at-home order were generated and compared to quantitatively analyse the influence of COVID-19 pandemic on the energy-use behaviours of university students, and the proposed load forecasting method was validated by comparing the forecasting results with monitoring data on electricity consumption. The results showed that: 1) during the implementation of the stay-at-home order, electricity consumption in the university dormitory buildings increased by 41.05%; 2) due to the increased use of illuminating lamps, laptops, and public direct drinking machines, the daily electricity consumption increased most significantly from 13:00 to 18:00, with an increase rate of 97.15%; and 3) the morning peak shifted backward and the evening peak shifted forward, demonstrating the effect of implementing the stay-at-home order on reshaping load profiles.
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Covid-19 is an emerging respiratory infection and pandemic disease that caused by a virus called the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the WHO rename as Covid-19. The government of Malaysia implemented Movement Control Order (MCO) to control the spreading of the disease. The citizens play an important role to curb Covid-19 by giving cooperation and compliant to Standard Operating Procedure (SOP) implemented by the government. Therefore, this study is to determine the knowledge, attitude and practices towards Covid-19 among UOC (University of Cyberjaya) MBBS students during the rapid rise period during the Covid-19 outbreak. A cross sectional study was conducted. The respondents that took part in this study were medical students from University of Cyberjaya. Our result shows that 143 out of 150 participants (95.3%) had good knowledge. 3 questions were asked to evaluate attitude towards COVID-19. For the first question, 58% of the participants had positive attitude, second question 83.3% and third question 33.3% executively. In terms of practice, 79.3% of the participants reported they avoided crowded places in the week before MCO was implemented, 76.7% of them wear face masks when they leave home and 88.0% practiced proper hand hygiene. Lastly, our findings confirmed that there is no significant association between sociodemographic factors and knowledge. Copyright © 2022, Anka Publishers. All rights reserved.
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BACKGROUND: There is limited data regarding the rates and severity of child maltreatment in medical settings during the COVID-19 pandemic, and the reports are somewhat contradictory. OBJECTIVE: To examine the rates of emergency department (ED) child maltreatment (CM) diagnosis before and after the California statewide stay-at-home order, as well as potential disparities by age, gender, race/ethnicity, and Medicaid status. METHODS: A retrospective pre-post interrupted time series was conducted using data from the electronic health records of children (<18 years) with at least one emergency department visit between January 1, 2019 and September 30, 2021. Enactment of the stay-at-home order in California, March 2020 was used to determine a change in trend of rates of diagnosis of CM in the ED. RESULTS: Overall the study included 407,228 pediatric ED visits. There was a significant change in the percentage of CM visits immediately after the stay-at-home order, followed by small month to month decreases returning to near pre-stay-at-home order levels. This significant increase was driven by higher risk for children <4 years old. The increased rate of CM in the first month after the stay-at-home order was also elevated for female, Black, and Hispanic children. CONCLUSIONS: Our results indicated the rates of CM diagnoses in the ED doubled after the March 2020 stay-at-home order in California. Additionally, our findings suggest that some children may be at higher risk than others, which supports the importance of social safety nets for children in times of national emergency.