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1.
N Engl J Med ; 387(21): 1935-1946, 2022 11 24.
Article in English | MEDLINE | ID: covidwho-2106628

ABSTRACT

BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.


Subject(s)
COVID-19 , Health Policy , Masks , School Health Services , Universal Precautions , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Incidence , Poverty/statistics & numerical data , Schools/legislation & jurisprudence , Schools/statistics & numerical data , Students/legislation & jurisprudence , Students/statistics & numerical data , Health Policy/legislation & jurisprudence , Masks/statistics & numerical data , School Health Services/legislation & jurisprudence , School Health Services/statistics & numerical data , Occupational Groups/legislation & jurisprudence , Occupational Groups/statistics & numerical data , Universal Precautions/legislation & jurisprudence , Universal Precautions/statistics & numerical data , Massachusetts/epidemiology , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/statistics & numerical data
2.
Emerg Infect Dis ; 27(2): 404-410, 2021 02.
Article in English | MEDLINE | ID: covidwho-1006425

ABSTRACT

Switzerland began a national lockdown on March 16, 2020, in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed the prevalence of SARS-CoV-2 infection among patients admitted to 4 hospitals in the canton of Zurich, Switzerland, in April 2020. These 4 acute care hospitals screened 2,807 patients, including 2,278 (81.2%) who did not have symptoms of coronavirus disease (COVID-19). Overall, 529 (18.8%) persons had >1 symptom of COVID-19, of whom 60 (11.3%) tested positive for SARS-CoV-2. Eight asymptomatic persons (0.4%) also tested positive for SARS-CoV-2. Our findings indicate that screening on the basis of COVID-19 symptoms, regardless of clinical suspicion, can identify most SARS-CoV-2-positive persons in a low-prevalence setting.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Diagnostic Tests, Routine/statistics & numerical data , Patient Admission/statistics & numerical data , Universal Precautions/statistics & numerical data , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , Diagnostic Tests, Routine/methods , Female , Humans , Incidence , Male , Middle Aged , Prevalence , SARS-CoV-2 , Switzerland/epidemiology , Universal Precautions/methods
3.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Article in English | MEDLINE | ID: covidwho-988749

ABSTRACT

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.


Subject(s)
COVID-19 , Communicable Disease Control , Guideline Adherence/statistics & numerical data , Physical Distancing , Public Health , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/statistics & numerical data , Cross-Sectional Studies , Disease Transmission, Infectious/prevention & control , Female , Humans , Male , Minnesota/epidemiology , Prevalence , Public Health/methods , Public Health/statistics & numerical data , Risk Reduction Behavior , Universal Precautions/methods , Universal Precautions/statistics & numerical data , Virology/methods
4.
Transl Behav Med ; 10(4): 843-849, 2020 10 08.
Article in English | MEDLINE | ID: covidwho-745734

ABSTRACT

Despite early warnings and calls for action, COVID-19 infection rates continue to climb in many areas of the United States. The current study examined participants' reported likelihood of engaging in eight behaviors designated by the Centers for Disease Control and Prevention as critical for the prevention of COVID-19 at the outset of the epidemic. Self-efficacy, perceived threat, and internal and external health locus of control were explored as potential predictors of those behaviors. In addition, demographic and contextual factors, such as age, gender, political identity, and whether or not participants were currently living under a quarantine advisory, were recorded for analysis. Overall, participants reported high engagement with the prevention behaviors. Higher levels of self-efficacy, perceived severity of the illness, and external locus of control in regard to medical professionals were all positively associated with plans to take the recommended precautions. Based on the results, it appears that messaging regarding COVID-19 prevention may be particularly effective when it focuses on the high risk of the illness, the ease with which the prevention behaviors can be taken, and a reassurance that the medical establishment has individuals' best health in mind when it makes its specific recommendations. While numerous countries have succeeded in reducing the spread of COVID-19, the number of new cases in the United States remains high, even relative to other populations also heavily impacted by the disease [1]. Although it would be difficult to pinpoint a single cause or explanation for the epidemic's course in the USA, at the heart of its spread, like the spread of all infectious diseases, is noncompliance with preventative measures. The current research served as a preliminary exploration of the prevalence and predictors of eight COVID-19 prevention behaviors. A brief survey was sent out at the end of March 2020 to 350 U.S. residents in order to assess the likelihood of their engaging in various prevention behaviors recommended at that time and several related psychosocial factors. The psychological factors assessed included health locus of control (HLOC) beliefs, self-efficacy, and perceived threat. In addition, a handful of demographic and contextual factors, such as age, gender, political identity, and whether or not they were working outside the home or were currently living under a quarantine advisory, were recorded for examination.


Subject(s)
Cooperative Behavior , Coronavirus Infections , Health Behavior , Pandemics , Pneumonia, Viral , Self Efficacy , Social Isolation/psychology , Social Perception , Adult , Attitude to Health , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Female , Humans , Intention , Male , Masks , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Prevalence , Psychology , SARS-CoV-2 , Social Control, Formal/methods , Surveys and Questionnaires , United States/epidemiology , Universal Precautions/methods , Universal Precautions/statistics & numerical data
6.
Int J Environ Res Public Health ; 17(14)2020 07 08.
Article in English | MEDLINE | ID: covidwho-639975

ABSTRACT

Effective management of the global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (also known as COVID-19), resulted in the implementation of severe restrictions in movement and enforcement of social distancing measures. This study aimed to understand and characterize the psychosocial effects of the COVID-19 pandemic in the general population and to identify risks and protective factors that predict changes in mental health status. In addition, the study investigated compliance with precautionary measures (PM) to halt the spread of the virus. The online anonymous survey collected information on sociodemographic data, compliance with PM, quality of life (QOL), and mental health via the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). A total of 1642 adult participants (71.6% women, 28.4% men) completed the survey in the European island country, Cyprus. A large percentage (48%) reported significant financial concerns and 66.7% significant changes in their QOL. About 41% reported symptoms associated with mild anxiety; 23.1% reported moderate-severe anxiety symptoms. Concerning depression, 48% reported mild and 9.2% moderate-severe depression symptoms. Women, younger age (18-29), student status, unemployment status, prior psychiatric history, and those reporting greater negative impact on their QOL, were at higher risk for increased anxiety and depression symptoms (p < 0.05). The youngest age group and males also reported lower levels of compliance with PM. Higher compliance with PM predicted lower depression scores (p < 0.001) but higher anxiety for measures related to personal hygiene. The results of this study provide important data on the effects of the COVID-19 outbreak on mental health and QOL and identify a variety of personal and social determinants that serve as risks and protective factors. Furthermore, it has implications for policy makers demonstrating the need for effective mental health programs and guidance for the implementation of PM as a public health strategy.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/psychology , Depression/epidemiology , Pneumonia, Viral/psychology , Universal Precautions/statistics & numerical data , Adolescent , Adult , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cyprus/epidemiology , Female , Humans , Male , Mental Health , Middle Aged , Pandemics/prevention & control , Patient Compliance , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Prevalence , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
7.
Int Nurs Rev ; 67(2): 157-159, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-612617

ABSTRACT

As the world tackles the largest public health event in more than a century, the COVID-19 pandemic, the true value of nursing is being seen by politicians and the public. But while nurses are being praised for the vital work they do, many are being put into high-risk situations, and some have died, because of a shortage of appropriate, high-quality personal protective equipment. The International Council of Nurses has called for governments to make the provision of such equipment their number one priority to prevent further loss of life among the nurses caring for the world's most vulnerable patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Occupational Diseases/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/prevention & control , COVID-19 , Coronavirus Infections/nursing , Humans , International Cooperation , International Council of Nurses , Nurse's Role , Occupational Diseases/nursing , Pneumonia, Viral/nursing , SARS-CoV-2 , Universal Precautions/statistics & numerical data
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