Public parks and the pandemic: How park usage has been affected by COVID-19 policies.

Public parks serve an important societal function as recreational spaces for diverse communities of people, with well documented physical and mental health benefits. As such, parks may be crucial for how people have handled effects of the COVID-19 pandemic, particularly the increasingly limited recreational opportunities, widespread financial uncertainty, and consequent heightened anxiety. Despite the documented benefits of parks, however, many states have instituted park shutdown orders due to fears that public parks could facilitate SARS-CoV-2 transmission. Here we use geotagged social media data from state, county, and local parks throughout New Jersey to examine whether park visitation increased when the COVID-19 pandemic began and whether park shutdown orders were effective at deterring park usage. We compare park usage during four discrete stages of spring 2020: (1) before the pandemic began, (2) during the beginning of the pandemic, (3) during the New Jersey governor's state-wide park shutdown order, and (4) following the lifting of the shutdown. We find that park visitation increased by 63.4% with the onset of the pandemic. The subsequent park shutdown order caused visitation in closed parks to decline by 76.1% while parks that remained open continued to experience elevated visitation levels. Visitation then returned to elevated pre-shutdown levels when closed parks were allowed to reopen. Altogether, our results indicate that parks continue to provide crucial services to society, particularly in stressful times when opportunities for recreation are limited. Furthermore, our results suggest that policies targeting human behavior can be effective and are largely reversible. As such, we should continue to invest in public parks and to explore the role of parks in managing public health and psychological well-being.

Differential Impact of COVID-19 on Cancer Diagnostic Services Based on Body Regions: A Public Facility-Based Study in Hong Kong.

PURPOSE: A reduction in cancer services during the coronavirus disease of 2019 pandemic has affected cancer diagnoses. The purpose of this study is to quantitatively determine the impact on cancer diagnostic service in public facilities across Hong Kong. Quantifying the temporal changes in the number of cancer diagnoses before, during, and after the outbreak is useful to establish the scale of the problem and assess if there has been an adequate level of response. METHODS AND MATERIALS: This is a retrospective cohort study using a territory-wide database in Hong Kong from 2017 to 2020, and consecutive specimens received for pathologic diagnosis in public laboratories in 41 hospitals were retrieved. RESULTS: In 2020, a total of 455,453 pathologic specimens were received, which amounted to a 15.5% reduction compared with the prior 3-year average (P < .001). An analysis of confirmed malignant pathologic diagnoses revealed a statistically significant reduction in colorectal (-10.0%; P < .001) and prostate (-19.7%; P < .001), nonsignificant reduction in lung (-3.0%; P = .0526), and a marginal but nonsignificant increase for breast (0.7%; P = .7592) regions. Based on time series projection data, the estimated missed cancers for the 3 regions with reduced investigations were colorectal (10.0%), lung (3.0%), and prostate (19.7%). CONCLUSIONS: Variable impact on actual malignant pathologic diagnoses based on 4 body regions was observed, with a statistically significant reduction in colorectal, lung, and prostate regions, and marginal but insignificant increase in breast regions. The findings could help public health policy with future planning and intervention.

The Influence of Urban Park Attributes on User Preferences: Evaluation of Virtual Parks in an Online Stated-Choice Experiment.

Urban green areas, such as parks, are becoming increasingly important in densifying cities. Urban parks encourage physical and social activity, recreation and relaxation, and thus eventually promote people's well-being. The aim of the current study is to examine which urban park attributes influence the preferences of park users, in order to offer recommendations regarding how urban parks of quality can be designed. To elicit the preferences of park visitors we designed an online stated-choice experiment. Seven park attributes, in particular the number and composition of trees and the presence of benches, side paths, a playground, litter, and flowers, were manipulated in a virtual park. In an online stated-choice task, videos of these park alternatives were presented and the preferences of 697 participants were measured. It is found that especially the number of trees and the presence of flowerbeds, particularly with a diversity of flowers, influenced participants' preferences. The presence of many benches and a playground were valued as well, but to a lesser extent. The presence of litter was found to be less troublesome than expected. Alternatives with all trees placed in one cluster were disliked. Moreover, significant standard deviations were found for the presence of side paths, a playground, and the absence of litter, which indicates that preference heterogeneity for these attributes exist. In a latent class analysis, two groups were identified, namely a Nature-loving group, who mainly valued the trees and the flowers, and an Amenity-appreciating group, who valued almost all attributes. It can be concluded that natural elements and a variety of flower species are important in an urban park, while facilities are evaluated differently by different groups of people. These findings may support park designers and policymakers in decision-making. Moreover, it illustrates the usefulness of creating a virtual park in environmental preference research.

Preparedness of health facilities providing HIV services during COVID-19 pandemic and assessment of their compliance to COVID-19 prevention measures: findings from the Tanzania Service Provision Assessment (SPA) survey.

INTRODUCTION: the increased demands of health facilities and workers due to coronavirus overwhelm the already burdened Tanzanian health systems. This study evaluates the current capacity of facilities and providers for HIV care and treatment services and their preparedness to adhere to the national and global precaution guidelines for HIV service providers and patients. METHODS: data for this study come from the latest available, Tanzania Service Provision Assessment survey 2014-15. Frequencies and percentages described the readiness and availability of HIV services and providers. Chi-square test compared the distribution of services by facility location and availability and readiness of precaution commodities and HIV services by managing authorities. RESULTS: availability of latex gloves was high (83% at OPD and 95.3% laboratory). Availability of medical masks, alcohol-based hand rub and disinfectants was low. Availability of medical mask at outpatient department (OPD) was 28.7% urban (23.5% public; 33.8% private, p=0.02) and 13.5% rural (10.1% public; 25.4% private, p=0.001) and lower at laboratories. Fewer facilities in rural area (68.4%) had running water in OPD than urban (86.3%). Higher proportions of providers at public than private facilities in urban (82.8% versus 73.1%) and rural (88.2% versus 81.6%) areas provided HIV test counseling and at least two other HIV services. CONCLUSION: availability of commodities such as medical masks, alcohol-based hand rub, and disinfectant was low while the readiness of providers to multitask HIV related services was high. Urgent distribution and re-assessment of these supplies are necessary, to protect HIV patients, their caregivers, and health providers from COVID-19.