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Background: COVID-19 vaccine booster uptake remains low and preventable COVID-19 deaths continue to occur, making access to oral antivirals for those most at risk of severe COVID-19 outcomes essential. Method(s): We estimated age and gender adjusted prevalence ratios of oral nirmatrelvir-ritonavir (NMV/r) uptake by sociodemographics, clinical characteristics, and prescription eligibility (based on age, underlying medical conditions, body mass index, physical inactivity, pregnancy, or smokers), among participants in a large U.S. national prospective cohort who were infected with SARS-CoV-2 between December 2021 and October 2022. Among participants who reported NMV/r uptake, we also described the proportion who reported (1) taking NMV/r as directed and (2) NMV/r was helpful for reducing COVID-19 symptoms. Result(s): Among 1,594 participants with a SARS-CoV-2 infection as of October 2022, 1,356 were eligible for NMV/r prescription;of whom 209 (15.4% [95%CI:13.5-17.3]) reported receiving NMV/r. NMV/r uptake increased from 2.2% (95%CI:1.0-3.4) between December 2021 and March 2022 to 16.5% (95% CI:13.0-20.0) between April and July 2022 and 28.6% (95%CI:24.4-32.8) between August and October 2022, respectively. Participants >=65 years of age reported the highest uptake of NMV/r (30.2% [95%CI:22.2-38.2]). Black non-Hispanic participants (7.2% [95%CI:2.4-12.0]) and those in the lowest income group (10.6% [95%CI:7.3-13.8]) had lower uptake than white non-Hispanic (15.8% [95%CI:13.6-18.0]) and high-income individuals (18.4% [95%CI:15.2-21.7]), respectively. Participants with type 2 diabetes had greater uptake (28.8% [95%CI:20.4-37.3]), compared to those without it (12.4% [95%CI:4.8-20.0]). Among a subset of 278 participants who had a prior SARSCoV-2 infection, those who had a history of long COVID reported greater uptake (22.0% [95%CI:13.9-30.1]) for a subsequent SARS-CoV-2 infection than those without a history of long COVID (7.9% [95%CI:3.9-11.8]). Among all participants who were prescribed NMV/r (N=216), 89% (95%CI:85-93) reported that they took NMV/r as directed and 63% (95%CI:57-70) stated NMV/r was helpful for reducing COVID-19 symptoms. Conclusion(s): Uptake of NMV/r increased over time coinciding with national efforts to increase awareness and access. However, most individuals who were eligible for NMV/r did not receive it. Lower NMV/r uptake among racial/ethnic minorities and individuals with lower household income suggests a need to improve awareness and address barriers to uptake in these populations.
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Many workers are at risk of contracting COVID-19 through work, and subjective perceptions of COVID-19 risk are important predictors of worker attitudes and behaviours. However, little to no research provides comprehensive examination of objective COVID-19 occupational risk factors and how, or under what conditions, these factors relate to subjective risk perceptions. Using two wave survey data matched with archival data from the Occupational Information Network (O*Net) and county-level COVID-19 case data (N = 295), we examine how objective COVID-19 occupational risk relates to workers' subjective risk of contracting COVID-19 at work. We also examine the moderating roles of financial frailty, adherence to governmental workplace safety recommendations, and local COVID-19 threat. Results indicate that objective COVID-19 occupational risk significantly predicts subjective risk of contracting COVID-19 at work. Moreover, factors representing in-person work conducted in close proximity to others accounted for a large proportion of explained variance in subjective risk. There was no support for moderation;however, financial frailty and workplace safety had independent main effects on subjective risk perceptions. Our results have theoretical implications for the Economic Stress and COVID-19 Occupational Risk model (Sinclair et al., Appl. Psychol., 70, 2021, 85), individual models of subjective risk perceptions, and practical implications for mitigating occupational risk at work. © 2023 The Authors. Journal of Occupational and Organizational Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.
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Sedentary behaviour among school children has been associated with musculoskeletal pain, adverse cardiometabolic disorders and reduced cognitive performance, all of which may be negatively impacted by distance learning during the COVID-19 pandemic. We present the methodology used to design and develop interventions to increase physical activity in 4th graders using a participatory, systems process during distance learning. Formative evaluation of training is being conducted with key stakeholders to facilitate this iterative process. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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During the COVID-19 pandemic, remote work has been adopted by many organizations as a way to reduce the risk of contagion and preserve jobs and companies. This emergency situation led to a sudden and compulsory shift from the office to home, forcing the adoption of teleworking from home by people and organizations who had little or no experience with this type of workstyle modality. Also, important phases such as planning and resourcing workers and managers may have been passed over with minimal or no attention. This paper aims to raise and discuss experiences on the adoption of remote work during COVID-19 and issues that should be addressed to avoid possible negative outcomes. Experiences in the adoption of telework during the pandemic show consequences already discussed by the literature, like work-family conflict, but under specific circumstances, such as the closure of schools and daycare centers. Excess workload and technology invasion are also reported as difficulties of remote work in this scenario. Using a macroergonomic model, we address issues that should be verified to overcome these challenges, at different levels, considering factors related to the organizational, personnel, and technological subsystems, and the external environment. The use of a macroergonomic model intends to consider aspects from diverse areas that could influence individual, group, or organizational desired outcomes. The consequences of sudden and enforced remote work during COVID-19 reinforce the importance of planning and accompanying telework comprehensively. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background: Epidemiologic risk factors for SARS-CoV-2 infection are best characterized via prospective cohort studies, complementing case-based surveillance and cross-sectional seroprevalence studies. Methods: We estimated the cumulative incidence of SARS-CoV-2 infection and incidence rates of seroconversion in a national prospective online cohort of 6745 US adults, enrolled during March-July 2020. A subset (n=4459) underwent serologic testing (Bio-Rad Platelia Total Ab, IgA/IgM/IgG), offered initially during May-Sept. 2020 and again in Nov. 2020-Jan. 2021. Results: A total of 303 of 4459 individuals showed serologic evidence of past SARS-CoV-2 infection (6.8%, 95%CI 6.1-7.6%). Among 3280 initially seronegative participants who had a subsequent serologic test, there were 145 seroconversions over 1562 person years of follow-up (incidence rate=9.3 per 100 person-years [95%CI 7.9-11.0]). Racial/ethnic disparities in crude incidence rates were apparent through Jan. 2021 (rate ratio [RRHispanic v White]=2.1, 95%CI 1.4-3.1;RRnon-Hispanic Black v White=1.8, 95%CI 0.96- 3.1). Incidence was higher in the southern (RRSouth v Northeast=1.7, 95%CI 1.1-2.8) and midwest (RRmidwest v Northeast=1.6, 95%CI 0.98-2.7) regions, in rural v urban areas (RR=1.5, 95%CI 1.0-2.2), and among essential workers (RR=1.7, 95%CI 1.1-2.5). Household crowding (RR=1.6, 95%CI 1.1-2.3), indoor restaurant dining (RR=2.0, 95%CI 1.4-2.8), visiting places of worship (RR=2.0, 95%CI 1.3-2.9), wearing masks sometimes (v always) while grocery shopping (RR=2.5, 95%CI 1.3-4.4), not wearing masks when visiting people outside the household (RRsometimes v always=1.3, 95%CI 0.88-2.1;RRnever v always=2.0, 95%CI 1.2-3.2), gathering in groups of >10 (RRindoors v never=1.74, 95%CI 1.2-2.5;RRoutdoors v never=1.8, 95%CI 1.3-4.3), and recent air travel (RR=1.7, 95%CI 1.1-2.6) were associated with higher incidence. Among 303 seropositive persons, 27.4% had asymptomatic infections and 32% reported a positive SARSCoV- 2 PCR test or provider diagnosis. There were major gaps in the uptake of public health interventions aimed at isolation (31%) and contact tracing (asked about contacts [18%];told about exposure to a case [7.6%]). Conclusion: Modifiable risk factors and low uptake of public health strategies drive SARS-CoV-2 transmission across the US. It is critical to address inequities in incidence, reduce risk factors, and improve the reach of public health strategies.
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The novel coronavirus disease (COVID-19) was identified as the cause of an outbreak of respiratory disease in China at the end of 2019. It then spread with enormous rapidity and by mid-March 2020 was declared a world pandemic. Gilles de la Tourette Syndrome (GTS) is a childhood-onset neurodevelopmental disorder with a worldwide prevalence of about 1% of the population. The clinical symptoms include multiple motor and one or more phonic (vocal) tics. Germane to this communication is that 85% of patients with GTS have associated psychiatric co-morbidities, many of which are being exacerbated in the current global health crisis. In addition, several symptoms of GTS may mimic COVID-19, such as a dry cough and sniffing (phonic tics), while other symptoms such as spitting, inappropriate touching of others and "non-obscene socially inappropriate symptoms" can potentially get patients with GTS into trouble with the law. We suggest that a clear explanation of the COVID-19 illness and GTS is important to enable colleagues of various specialities who tend to patients with GTS. It is important to acknowledge at the outset that the information available on the COVID-19 pandemic changes daily, including cases infected, deaths reported, and how various national health systems are planning and or coping or not. It is fair to say that having read the current medical and lay press we conclude that it is not easy to reassure our patients with absolute certainty. However, notwithstanding that, we hope our documentation is of some assistance.