Variations in land surface temperatures in small-scale urban areas in Vietnam during Covid-19 restrictions: Case studies from Da Nang, Hue and Vinh City.

Land surface temperature (LST) is an important variable in urban microclimate research. At the end of 2019, the emergence of Covid-19 pandemic has changed the world in a manner that forced many countries to impose restrictions in human activities. As a measure to prevent the expansion of Covid-19 infections, most of the major cities have entered a prolonged lockdown period and reduction in human activities between the early 2020 and the late 2021. These restrictions were strict in most of the cities in Southeast Asia, particularly in Vietnam. The present study investigated the variations in LST and NDVI observed in three rapidly growing urban areas, namely Da Nang, Hue and Vinh, in Vietnam using Landsat-8 imagery acquired between 2017 and 2022. There has been a slight reduction in LST in the study sites, particularly in Da Nang City, during the lockdown period but not as high as observed in recently conducted studies from big metropolitan cities, including in Vietnam. It is also observed that LST estimated from built-up areas and other impervious surfaces remained relatively stable during the study period which is similar to the results from recent studies.

Mortality in Catalonia during the summer of 2022 and its relation with high temperatures and COVID-19 cases.

Purpose: To analyse the association between the mortality during the summer 2022 and either high temperatures or the COVID-19 wave with data from the Catalan Health Care System (7.8 million people). Methods: We performed a retrospective study using publicly available data of meteorological variables, influenza-like illness (ILI) cases (including COVID-19) and deaths. The study comprises the summer months of the years 2021 and 2022. To compare the curves of mortality, ILI and temperature we calculated the z-score of each series. We assessed the observed lag between curves using the cross-correlation function. Finally, we calculated the correlation between the z-scores using the Pearson correlation coefficient (R2). Results: During the study period, 33,967 deaths were reported in Catalonia (16,416 in the summer of 2021 and 17,551 in the summer of 2022). In 2022, the observed lag and the correlation between the z-scores of temperature and all-cause deaths was 3 days and R2 = 0.86, while between ILI and all-cause deaths was 22 days and R2 = 0.21. This high correlation between temperature and deaths increased up to 0.91 when we excluded those deaths reported as COVID-19 deaths, while the correlation between ILI and non-COVID-19 deaths decreased to -0.19. No correlation was observed between non-COVID deaths and temperature or ILI cases in 2021. Conclusion: Our study suggests that the main cause of the increase in deaths during summer 2022 in Catalonia was the high temperatures and its duration. The contribution of the COVID-19 seems to be limited.

Changes in air pollution, land surface temperature, and urban heat islands during the COVID-19 lockdown in three Chinese urban agglomerations.

COVID-19 has notably impacted the world economy and human activities. However, the strict urban lockdown policies implemented in various countries appear to have positively affected pollution and the thermal environment. In this study, Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) and aerosol optical depth (AOD) data were selected, combined with Sentinel-5P images and meteorological elements, to analyze the changes and associations among air pollution, LST, and urban heat islands (UHIs) in three urban agglomerations in mainland China during the COVID-19 lockdown. The results showed that during the COVID-19 lockdown period (February 2020), the levels of the AOD and atmospheric pollutants (fine particles (PM2.5), NO2, and CO) significantly decreased. Among them, PM2.5 and NO2 decreased the most in all urban agglomerations, by >14 %. Notably, the continued improvement in air pollution attributed to China's strict control policies could lead to overestimation of the enhanced air quality during the lockdown. The surface temperature in all three urban agglomerations increased by >1 °C during the lockdown, which was mainly due to climate factors, but we also showed that the lockdown constrained positive LST anomalies. The decrease in the nighttime urban heat island intensity (UHIInight) in the three urban agglomerations was greater than that in the daytime quantity by >25 %. The reduction in surface UHIs at night was mainly due to the reduced human activities and air pollutant emissions. Although strict restrictions on human activities positively affected air pollution and UHIs, these changes were quickly reverted when lockdown policies were relaxed. Moreover, small-scale lockdowns contributed little to environmental improvement. Our results have implications for assessing the environmental benefits of city-scale lockdowns.

Heat waves accelerate the spread of infectious diseases.

COVID-19 pandemic appeared summer surge in 2022 worldwide and this contradicts its seasonal fluctuations. Even as high temperature and intense ultraviolet radiation can inhibit viral activity, the number of new cases worldwide has increased to >78% in only 1 month since the summer of 2022 under unchanged virus mutation influence and control policies. Using the attribution analysis based on the theoretical infectious diseases model simulation, we found the mechanism of the severe COVID-19 outbreak in the summer of 2022 and identified the amplification effect of heat wave events on its magnitude. The results suggest that approximately 69.3% of COVID-19 cases this summer could have been avoided if there is no heat waves. The collision between the pandemic and the heatwave is not an accident. Climate change is leading to more frequent extreme climate events and an increasing number of infectious diseases, posing an urgent threat to human health and life. Therefore, public health authorities must quickly develop coordinated management plans to deal with the simultaneous occurrence of extreme climate events and infectious diseases.

Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses.

BACKGROUND: Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. METHODS: This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 "asthma" and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled ß2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. RESULTS: Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25-Pc75) since asthma diagnosis was 83.1 months (34.65-131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. CONCLUSIONS: There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control.

High temperature, COVID-19, and mortality excess in the 2022 summer: a cohort study on data from Italian surveillances.

We aimed to assess whether the effect of high temperature on mortality differed in COVID-19 survivors and naive. We used data from the summer mortality and COVID-19 surveillances. We found 3.8 % excess risk in 2022 summer, compared to 2015-2019, while 20 % in the last fortnight of July, the period with the highest temperature. The increase in mortality rates during the second fortnight of July was higher among naïve compared to COVID-19 survivors. The time series analysis confirmed the association between temperatures and mortality in naïve people, showing an 8 % excess (95%CI 2 to 13) for a one-degree increase of Thom Discomfort Index while in COVID-19 survivors the effect was almost null with -1 % (95%CI -9 to 9). Our results suggest that the high fatality rate of COVID-19 in fragile people has decreased the proportion of susceptible people who can be affected by the extremely high temperature.

Personal protective equipment for COVID-19 among healthcare workers in an emergency department: An exploratory survey of workload, thermal discomfort and symptoms of heat strain.

OBJECTIVES: To examine workload, thermal discomfort and heat-related symptoms among healthcare workers (HCWs) in an Australian ED during the COVID-19 pandemic. METHODS: A cross-sectional study design was employed among HCWs in an ED at a metropolitan hospital in Brisbane, Australia. Respondents provided demographic information including their self-reported age, sex, height, weight, role (e.g. doctor, nurse), and whether they wore personal protective equipment (PPE) during their shift, rated as either Full PPE, Partial PPE, or usual uniform or scrubs. The workload of HCWs was assessed with the National Aeronautics and Space Administration's task load index (NASA-TLX). Thermal discomfort was evaluated using scales from the International Organisation for Standardisation. Responders rated their subjective heat illness using the Environmental Symptoms Questionnaire. RESULTS: Fifty-nine HCWs completed the survey (27 male, 31 female, one prefer not to answer). Overall workload from the NASA-TLX was 64.6 (interquartile range [IQR] 56.5-73.3) for doctors, 72.5 (IQR 63.3-83.3) for nurses and 66.7 (IQR 58.3-74.17) for other staff, representing moderate to high ratings. Eighty-one percent reported thermal sensation to be slightly warm, warm, or hot, and 88% reported being uncomfortable, ranging from slightly to extremely. Ninety-seven percent reported at least one heat-strain symptom. More than 50% reported light-headedness or headache and approximately 30% reported feeling dizzy, faint, or weak. CONCLUSIONS: ED HCWs experience thermal discomfort when wearing PPE. Combined with their workloads, HCWs experienced symptoms related to heat strain. Therefore, careful consideration should be given to managing heat strain among HCWs when wearing PPE in an ED.

Water bath is more efficient than hot air oven at thermal inactivation of coronavirus.

BACKGROUND: Thermal inactivation is a conventional and effective method of eliminating the infectivity of pathogens from specimens in clinical and biological laboratories, and reducing the risk of occupational exposure and environmental contamination. During the COVID-19 pandemic, specimens from patients and potentially infected individuals were heat treated and processed under BSL-2 conditions in a safe, cost-effective, and timely manner. The temperature and duration of heat treatment are optimized and standardized in the protocol according to the susceptibility of the pathogen and the impact on the integrity of the specimens, but the heating device is often undefined. Devices and medium transferring the thermal energy vary in heating rate, specific heat capacity, and conductivity, resulting in variations in efficiency and inactivation outcome that may compromise biosafety and downstream biological assays. METHODS: We evaluated the water bath and hot air oven in terms of pathogen inactivation efficiency, which are the most commonly used inactivation devices in hospitals and biological laboratories. By evaluating the temperature equilibrium and viral titer elimination under various conditions, we studied the devices and their inactivation outcomes under identical treatment protocol, and to analyzed the factors, such as energy conductivity, specific heat capacity, and heating rate, underlying the inactivation efficiencies. RESULTS: We compared thermal inactivation of coronavirus using different devices, and have found that the water bath was more efficient at reducing infectivity, with higher heat transfer and thermal equilibration than a forced hot air oven. In addition to the efficiency, the water bath showed relative consistency in temperature equilibration of samples of different volumes, reduced the need for prolonged heating, and eliminated the risk of pathogen spread by forced airflow. CONCLUSIONS: Our data support the proposal to define the heating device in the thermal inactivation protocol and in the specimen management policy.

Did the Covid-19 restrictions influence land surface temperatures in Southeast Asia? A study from Ho Chi Minh City, Vietnam.

There have been a prolonged lockdown period and reduction in human activities in most of the major cities in the world during the Covid-19 pandemic period between the early 2020 and the late 2021. Such a reduction in human activities was believed to have influenced pollution levels and land surface temperatures (LST) in urban areas. This paper describes the variations in LSTs before, during and after the Covid-19 lockdown in Ho Chi Minh City in southern Vietnam, which is the economic hub of the country. For this purpose, Landsat-8 OLI and TIRS images acquired between 2015 and 2022 were used. It is observed that there was a significant reduction of 1 to 1.8 °C in LST in open areas, excepting impervious surfaces and built-up areas, during the strict lockdown period in Ho Chi Minh City, and an increase in LST since then. The observed reduction in LST during the lockdown period in Ho Chi Minh City is in agreement with the reduction in greenhouses gases during the same period in recent studies. Human mobility and industrial activities have been restored in November 2021 in the study area which would explain the regain in LST in the post-lockdown period.

Heatwaves and mortality in Queensland 2010-2019: implications for a homogenous state-wide approach.

Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.

Evaluation of steam heat as a decontamination approach for SARS-CoV-2 when applied to common transit-related materials.

AIMS: The purpose of this study was to evaluate the efficacy of steam heat for inactivation of SARS-CoV-2 when applied to materials common in mass transit installations. METHODS AND RESULTS: SARS CoV-2 (USA-WA1/2020) was resuspended in either cell culture media or synthetic saliva, inoculated (∼1 × 106 TCID50) onto porous and nonporous materials and subjected to steam inactivation efficacy tests as either wet or dried droplets. The inoculated test materials were exposed to steam heat ranging from 70°C to 90°C. The amount of infectious SARS-CoV-2 remaining after various exposure durations ranging from 1 to 60 s was assessed. Higher steam heat application resulted in higher inactivation rates at short contact times. Steam applied at 1-inch distance (∼90°C at the surface) resulted in complete inactivation for dry inoculum within 2 s of exposure (excluding two outliers of 19 test samples at the 5-s duration) and within 2-30 s of exposure for wet droplets. Increasing the distance to 2 inches (∼70°C) also increased the exposure time required to achieve complete inactivation to 15 or 30 s for materials inoculated with saliva or cell culture media, respectively. CONCLUSIONS: Steam heat can provide high levels of decontamination (>3 log reduction) for transit-related materials contaminated with SARS-CoV-2 using a commercially available steam generator with a manageable exposure time of 2-5 s.

Human thermal physiological response of wearing personal protective equipment: An educational building semi-open space experimental investigation.

With the outbreak and spread of the COVID-19 epidemic, HCWs are frequently required to wear personal protective equipment (PPE) for nucleic acid sample collection in semi-open transition spaces. Wearing PPE causes significant psychological and physical stress in HCWs. In this study, operative temperature (Top) and wet-bulb globe temperature (WBGT) were used to assess thermal conditions through field experiments, while multiple physiological parameters were measured in the subjects. The results indicated that the subjects showed statistically significant differences in thermal perception and physiological parameters with and without PPE. Using observed increases in heart rate (HR), auditory canal temperature (Tac), mean skin temperature (MST), and end-tidal CO2 pressure, subjects were shown to have an increased metabolic rate and heat storage while wearing PPE. Additionally, a decrease in oxygen concentration was also observed, and this decrease may be linked to fatigue and cognitive impairment. Moreover, HR, MST, and Tac showed a significant linear relationship, which increased with temperature and operative temperature, and the HR response was stronger with PPE than without PPE. The neutral, preferred, and acceptable temperatures were significantly lower with PPE than without PPE, and the deviations for neutral Top/WBGT were 9.5/7.1 °C and preferred Top/WBGT was 2.2/4.0 °C, respectively. Moreover, the upper limits of acceptable WBGT, 29.4 °C with PPE and 20.4 °C without PPE, differed significantly between the two phases. Furthermore, the recorded physiological parameter responses and thermal perception responses of the subjects while wearing PPE indicated that they were at risk of thermal stress. Overall, these results suggest that people who wear PPE should focus on their health and thermal stress. This study provides a reference for the development of strategies to counteract heat stress and improve thermal comfort.

Effect of extreme temperatures on asthma hospital visits: Modification by event characteristics and healthy behaviors.

Although ambient temperature has been linked to asthma exacerbation, impacts associated with extreme temperature events remain unclear. This study aims to identify the events characteristics that elevate risk of asthma hospital visits, and to assess whether healthy behavior changes due to the COVID-19 prevention and control policy may modify the relationships. Data of asthma hospital visits from all medical facilities in Shenzhen, China during 2016-2020 were assessed in relation to extreme temperature events using a distributed lag model. Stratified analysis was conducted by gender, age and hospital department to identify susceptible populations. Through events defined by various duration days and temperature thresholds, we explored the modification by events intensity, length, occurrence time and healthy behaviors. The cumulative relative risk of asthma during heat waves compared to other days was 1.06 (95%CI: 1.00-1.13) and for cold spells was 1.17 (95%CI: 1.05-1.30), and that of males and school-aged children were generally higher than other sub-groups. There were significant effects of heat waves and cold spells on asthma hospital visits when the mean temperature was above 90th percentile (30 °C) and below 10th percentile (14 °C) respectively, and the relative risks were higher when events lasted longer, became stronger, occurred in daytime and in early summer or winter. During the healthy behaviors maintaining period, the risk of heat waves increased whilst the risk of cold spells reduced. Extreme temperatures may pose considerable impact on asthma and the health effect can be modified by the event characteristics and anti-epidemic healthy behaviors. Strategies of asthma control should consider the heightened threats of the intense and frequent extreme temperature events in the context of climate change.

Heat-Treated Lysozyme Hydrochloride: A Study on Its Structural Modifications and Anti-SARS-CoV-2 Activity.

Lysozyme (E.C. 3.2.1.17), an about 14 kDa protein and pI 11, widely spread in nature, is present in humans mainly in milk, saliva, and intestinal mucus as a part of innate defense mechanisms. It is endowed with antimicrobial activity due to its action as an N-acetylmuramidase, cleaving the 1-4ß glycosidic linkage in the peptidoglycan layer of Gram-positive bacteria. This antimicrobial activity is exerted only against a limited number of Gram-negative bacteria. Different action mechanisms are proposed to explain its activity against Gram-negative bacteria, viruses, and fungi. The antiviral activity prompted the study of a possible application of lysozyme in the treatment of SARS-CoV-2 infections. Among the different sources of lysozyme, the chicken egg albumen was chosen, being the richest source of this protein (c-type lysozyme, 129 amino acids). Interestingly, the activity of lysozyme hydrochloride against SARS-CoV-2 was related to the heating (to about 100 °C) of this molecule. A chemical-physical characterization was required to investigate the possible modifications of native lysozyme hydrochloride by heat treatment. The FTIR analysis of the two preparations of lysozyme hydrochloride showed appreciable differences in the secondary structure of the two protein chains. HPLC and NMR analyses, as well as the enzymatic activity determination, did not show significant modifications.

Impact of COVID lockdowns on spatio-temporal variability in land surface temperature and vegetation index.

In urban areas, industrial and human activities are the prime cause that exacerbates the heating effects, also called the urban heat island (UHI) effect. The land surface temperature (LST), normalized difference vegetation index (NDVI), and the proportion of vegetation (Pv) are indicators of measurement of the heating/urbanization effects. In the present work, we investigated the impact of the COVID-19 lockdown, i.e., restricted human activities. We used Landsat-8 OLI/TIRS (level 1) data to investigate spatial and temporal heterogeneity changes in these urbanization indicators during full and partial lockdown periods in 2020 and 2021, with 2019 as the base year. We have selected three cities in India's eastern coal mining belt, Bokaro, Dhanbad, and Ranchi, for the study. Results showed a significant decrease in LST values over all sites, with a maximum reduction over mining sites, i.e., Bokaro and Dhanbad. The LST value decreased by about 13-19% during the lockdown period. Vegetation indices (i.e., NDVI and Pv) showed a substantial increase of about 15% overall sites. With decreased LST values and increased NDVI values, these quantities' correlations became more negative during the lockdown period. More positive changes are noticed over mining sites than non/less mining sites. This indirectly indicates the reduction in the heat-absorbing particles in the environment and surface of these sites, a possible cause for the reduction in LST values substantially. Reduction in coal particles at the land and vegetation surface likely contributed to decreased LST and enhanced vegetation indices. To check the statistical significance of changes in the UHI indicators in the lockdown period, statistical tests (ANOVA and Tukey's test) are performed. Results indicate that most of the case changes have been significant. The study's finding suggests the lockdown's positive impact on the heating/UHI effects. It emphasizes the need for planned lockdowns as city mitigation strategies to overcome pollution and environmental issues.

Thermophysiological and Perceptual Responses of Amateur Healthcare Workers: Impacts of Ambient Condition, Inner-Garment Insulation and Personal Cooling Strategy.

While personal protective equipment (PPE) protects healthcare workers from viruses, it also increases the risk of heat stress. In this study, the effects of environmental heat stress, the insulation of the PPE inner-garment layer, and the personal cooling strategy on the physiological and perceptual responses of PPE-clad young college students were evaluated. Three levels of wet bulb globe temperatures (WBGT = 15 °C, 28 °C, and 32 °C) and two types of inner garments (0.37 clo and 0.75 clo) were chosen for this study. In an uncompensable heat stress environment (WBGT = 32 °C), the effects of two commercially available personal cooling systems, including a ventilation cooling system (VCS) and an ice pack cooling system (ICS) on the heat strain mitigation of PPE-clad participants were also assessed. At WBGT = 15 °C with 0.75 clo inner garments, mean skin temperatures were stabilized at 31.2 °C, Hskin was 60-65%, and HR was about 75.5 bpm, indicating that the working scenario was on the cooler side. At WBGT = 28 °C, Tskin plateaued at approximately 34.7 °C, and the participants reported "hot" thermal sensations. The insulation reduction in inner garments from 0.75 clo to 0.37 clo did not significantly improve the physiological thermal comfort of the participants. At WBGT = 32 °C, Tskin was maintained at 35.2-35.7 °C, Hskin was nearly 90% RH, Tcore exceeded 37.1 °C, and the mean HR was 91.9 bpm. These conditions indicated that such a working scenario was uncompensable, and personal cooling to mitigate heat stress was required. Relative to that in NCS (no cooling), the mean skin temperatures in ICS and VCS were reduced by 0.61 °C and 0.22 °C, respectively, and the heart rates were decreased by 10.7 and 8.5 bpm, respectively. Perceptual responses in ICS and VCS improved significantly throughout the entire field trials, with VCS outperforming ICS in the individual cooling effect.

Usage of Heat and Moisture Exchange Devices, Virtual Visits, Masking, and Vaccinations Among People With a Laryngectomy During COVID-19.

PURPOSE: This study described the COVID-19 risk mitigation actions of people with a total laryngectomy (TL) during the pandemic. METHOD: An online survey was completed by 215 people with a TL who lived in the United States. The survey was open from December 1, 2021, to January 15, 2022. RESULTS: There was a significant increase in frequency of heat and moisture exchange (HME) device use during the pandemic compared with pre-COVID-19. Frequency of HME use was significantly greater for those who were vaccinated and those who had at least one clinical visit with their speech-language pathologist (SLP). The use of virtual visits increased from 9% pre-COVID-19 to 37% during the pandemic. Seventy percent of respondents were "satisfied" or "very satisfied" with virtual visits and 51% judged them "as good as in-person." Eighty percent were vaccinated for COVID-19 and 75% received a booster. One third reported that they did not wear mask over the face or over the tracheostoma. Twenty percent had tested positive for COVID-19 with 70% of these people requiring hospitalization. CONCLUSIONS: HME use and virtual SLP visits increased during the pandemic and the vaccination rate was high among this group of respondents. Overall, there were still large percentages of people with a TL who were not using an HME, not vaccinated, and did not wear a mask. SLPs should consider reaching out directly to their TL caseload, particularly those not yet seen during the pandemic, to support uptake of COVID-19 mitigation activities specific to people with a TL as the pandemic persists.

The Health Education and Training (HEAT) Corps: A Medical-Community Collaboration Response during the COVID-19 Pandemic.

With the declaration of the COVID-19 pandemic by the World Health Organization in March 2020, many elements of society were faced with attempting to assimilate public health recommendations for infectious control. Vital social organizations had to balance delivering their social services while attempting to stay up to date with COVID-19 information and comply with evolving regulations. In the realm of schools and school systems, guidance on how to best adapt to COVID-19 was often limited. School officials and staff had to assist with multiple public health crises as a consequence of the pandemic, from the pandemic's transmission prevention strategies (e.g., face masks and physical distancing) to the recognition that students would have personal tragedies related to COVID-19. In this review, we highlight the process and feasibility of implementing an international COVID-19 school-based initiative over two years of the pandemic, the Health Education and Training (HEAT) Corps program.

Extreme Heat and COVID-19 in New York City: An Evaluation of a Large Air Conditioner Distribution Program to Address Compounded Public Health Risks in Summer 2020.

In summer 2020, New York City (NYC) implemented a free air conditioner (AC) distribution program in response to the threats of extreme heat and COVID-19. The program distributed and installed ACs in the homes of nearly 73,000 older, low-income residents of public and private housing. To evaluate the program's impact, survey data were collected from October 2020 to February 2021 via mail and online from 1447 program participants and 902 non-participating low-income NYC adults without AC as a comparison group. Data were examined by calculating frequencies, proportions, and logistic regression models. Participants were 3 times more likely to report staying home during hot weather in summer 2020 compared to non-participants (adjusted odds ratio [AOR] = 3.0, 95% confidence interval [CI] = 2.2, 4.1), with no difference between groups in summer 2019 (AOR = 1.0, CI = 0.8, 1.3). Participants were less likely to report that 2020 hot weather made them feel sick in their homes compared to non-participants (AOR = 0.2, CI = 0.2, 0.3). The program helped participants-low-income residents and primarily people of color-stay home safely during hot weather. These results are relevant for climate change health-adaptation efforts and heat-health interventions.

Stability of the COVID-19 At-Home Test after Exposure to Extreme Temperatures.

To ensure sufficient sensitivity and specificity of lateral flow tests for the detection of SARS-CoV-2 antigen, manufacturers recommend appropriate conditions for storage, including a temperature range. However, there is a high likelihood that kits will be exposed to temperatures outside of this range during transit to some regions. In this prospective study, we evaluated the sensitivity and specificity of the COVID-19 At-Home Test kits (manufactured by SD Biosensor/distributed by Roche) currently being delivered through a US Government program, after exposure to a range of hot and cold temperatures. COVID-19 At-Home Test kits were stored at up to 5 different temperatures: frozen (-4.0°F [-20.0°C]), refrigerated (42.8°F [6.0°C]), room temperature (68.0°F [20.0°C]), warm (98.0°F [36.7°C]), and excessive heat (118.0 to 126.0°F [47.8 to 52.2°C]) for 24 h and left at room temperature for 60, 90, or 120 min before use. Test kits were also stored for 48 h, 1 week, or 2 weeks in frozen, warm, and excessive heat conditions, and left for 60 or 120 min before use. In each scenario (storage temperature + time at room temperature), 5 positive and 5 negative control samples were applied, and line intensity was recorded using a color scale (0 to 100%). In every scenario, every positive sample resulted in strong signal intensity (≥26%), and every negative sample returned a negative result. This study suggests that exposure of up to 2 weeks to extreme temperatures, such as those that may occur in transit, does not impact the stability of the COVID-19 At-Home Test. IMPORTANCE COVID-19 At-Home Test kits may be exposed to extreme temperatures in transit, which may impact test sensitivity and specificity. We investigated assay ability to identify SARS-CoV-2 antigen after 24 h to 2 weeks in frozen, refrigerated, room temperature, warm, or excessive heat conditions. The assay correctly identified all positive and negative samples in all scenarios. This study suggests that exposure of up to 2 weeks to extreme temperatures, such as those that may occur in transit, does not impact the stability of the COVID-19 At-Home Test.