Postpartum screening results in Ontario, Canada before and after the COVID-19 pandemic: An interrupted time-series analysis

Aims: This study examined the impact of the COVID-19 pandemic on mothers or childbearing parents using ongoing, systematic screening of a representative Ontario sample. Method(s): An interrupted time series analysis was conducted on data captured in the Healthy Babies Healthy Children (HBHC) screening tool to determine effects of the pandemic on relationships, support, mental health, and related clinical outcomes at the time of postpartum discharge from hospital. The ability to parent or care for the baby/child and other psychosocial and behavioural outcomes were assessed. Result(s): The co-primary outcomes of inability to parent or care for the baby/child were infrequently observed in both the pre -pandemic (March 9, 2019-March 15, 2020) and initial pandemic periods (March 16, 2020-March 23, 2021) ((parent 209/63,006 (0.33%) to 177/56,117 (0.32%), care 537/62,955 (0.85%) to 324/56,086 (0.58%)). Changes following pandemic onset were not observed for either outcome although a significant (beta = 1.013, 95% CI 1.002-1.025, p = 0.02) increase in slope was observed for inability to parent (with questionable clinical significance). For secondary outcomes, worsening was only seen for complications during labour/delivery. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time. Conclusion(s): Despite more complications during labour/delivery, there were no substantive changes in concerns about ability to parent or care for children. Adverse impacts of the pandemic may have been mitigated by accommodations for remote work and social safety net policies.Copyright © 2023

COVID-19 Infection and Medicines in Pregnancy in Canada

Background: Although over 100 million pregnant women worldwide are at risk of infection with SARS-CoV-2, little data exists on the impact of COVID-19 and related treatments on maternal/neonatal health. Objective(s): (1) To quantify the prevalence of medication use in pregnancy to treat COVID-19, and (2) To quantify and compare the risk of adverse pregnancy/neonatal outcomes in those with and without COVID-19. Method(s): In the Canadian Mother-Child population-based cohort (CAMCCO), two sub-cohorts were identified using prospective data collection of medical services, prescription drugs, hospitalization archives data, and COVID-19 surveillance testing program (02/28/2020- 2021). The first cohort included all pregnant women during the study period regardless of pregnancy status (delivery, induced/planned or spontaneous abortion);this cohort was further stratified on COVID-19 status. The second cohort included all nonpregnant women (aged 15-45) with a positive COVID-19 test. COVID-19 in pregnant or nonpregnant women was assessed using COVID-19 test results or ICD-10CM code U07.1 from hospital data. COVID-19 severity was categorized based on hospital admission. Women were considered exposed to COVID-19 medications if they filled at least one prescription for a medicine included in the WHO list in the 30 days pre- or 30 days post-COVID-19 positive test/diagnosis. Considering potential confounders, association between COVID-19 during pregnancy, treated vs not, and perinatal outcomes were quantified using log-binomial regression models. Result(s): 150,345 pregnant women (3,464 (2.3%) had COVID-19), and 112,073 nonpregnant women with COVID-19 diagnoses were included. Pregnant women with COVID-19 were more likely to have severe infections compared to nonpregnant women with COVID-19 (11.4% vs 1.6%, p<0.001). The most frequent medications used in pregnancy to treat COVID-19 were antibacterials (13.96%), psychoanaleptics (7.35%), and medicines for obstructive airway disease (3.20%). In pregnancy COVID-19 was associated with spontaneous abortions (adjRR 1.76, 95%CI 1.37, 2.25), gestational diabetes (adjRR 1.52, 95%CI 1.18, 1.97), prematurity (adjRR 1.30, 95%CI 1.01, 1.67), NICU admissions (adjRR 1.32, 95%CI 1.10, 1.59);COVID-19 severity was increasing these risks but exposures to COVID-19 medications reduced all risks. Conclusion(s): COVID-19 severity was higher in pregnancy. Antibacterials, psychoanaleptics, and medicines for obstructive airway disease were the most used overall. COVID-19 was associated with adverse outcomes for mothers and newborns.

The COVID-19 pandemic and parental substance use: a cross-sectional survey of substance use among pregnant and post-partum individuals and their partners

Background: This study was designed to investigate patterns and risk factors for substance use among obstetrical patients who gave birth during the early period of the pandemic, and their partners. Method(s): Cross-sectional survey of obstetrical patients between March 17th and June 16th, 2020, at The Ottawa Hospital, Ottawa, Canada. Substance use was a composite measure of any alcohol, tobacco, or cannabis use since COVID-19 began. Four outcomes included: any participant substance use or increase in substance use, any partner substance use or increase in substance use. Adjusted risk ratios (ARR) and 95% confidence intervals (CI) are presented. Finding(s): Of 216 participants, 113 (52.3%) and 15 (6.9%) obstetrical patients reported substance use and increased use, respectively. Those born in Canada (ARR: 2.03;95% CI: 1.27-3.23) and those with lower household income (ARR: 1.38;95% CI: 1.04-1.85) had higher risk of substance use. Those with postpartum depression (ARR: 5.78;95%CI: 2.22-15.05) had the highest risk of increased substance use. Families affected by school/daycare closure reported a higher risk of increased partner substance use (ARR: 2.46;95% CI:1.38-4.39). Conclusion(s): This study found that risk factors for substance use included demographics (i.e., being born in Canada, income), mental health (postpartum depression), and school/childcare closures.Copyright © 2023 Taylor & Francis Group, LLC.

Patient and provider experiences with virtual care during the COVID-19 pandemic: A mixed methods study

The COVID-19 pandemic prompted the rapid uptake of Virtual Care (VC). Positive patient outcomes with VC are previously reported but little is known about the experiences of patients and providers using VC during the pandemic. We aimed to describe patient and primary care provider experiences, satisfaction, perceptions, and attitudes to VC during the COVID-19 pandemic that might explain adoption of VC across the continuum of care and inform sustained uptake. We conducted a sequential explanatory mixed methods study using online surveys and virtual interviews with a convenience sample of primary care providers and patients in a Canadian province (July – December 2020). Eligible participants included patients and primary care providers using VC during the COVID-19 pandemic. Survey responses and interviews were analyzed using descriptive statistics and thematic analysis, respectively. Overall satisfaction was compared using the Mann-Whitney U test. Eighty-five patients and 94 primary care providers responded to the surveys. Patients reported higher overall satisfaction with VC than primary care providers (median [interquartile range]: 4.4 [4.0-4.7] and 3.7 [3.4-3.9] p < 0.001). Ten patients and 11 primary care providers were interviewed. Both groups strongly appreciated VC’s increased access and convenience, identified the lack of compensation as a pre-pandemic barrier to providing VC, and reported willingness to continue VC post-COVID-19 pandemic. The COVID-19 pandemic provided an opportunity for patients and primary care providers to rapidly adopt VC with high satisfaction. Patients and primary care providers viewed VC positively due to its convenience and accessibility;both intend to continue using VC post-pandemic. © The Author(s), 2022.

Responses and Learning from Covid-19: Integrating Chaos and Complexity Theories in the Event and Tourism Sector in Iran

COVID-19 has impacted the events, tourism, and hospitality industries throughout most parts of the world, prompting the need for empirical work to explore the perspectives and responses of indus-try stakeholders towards the pandemic. To characterize how managers in this space evaluated the impacts of the pandemic and the associated response system(s) and learning stories, in-depth inter-views with N = 24 senior event and tourism managers in Iran were conducted. The findings revealed that COVID-19 was a complex external crisis that significantly fueled other internal crises, impact-ing the complex event and tourism system. The data revealed that understanding the full effects of the pandemic depends on how sufficiently Iranian stakeholders acquired knowledge of the virus and the scope of its outcomes on the layered event and tourism system. The profound structural and transformational changes to this system necessitate the call for a uniform, coevolving responses from multiple events, tourism, sport, and associated management/industrial sectors. Adaption to the new normal and transformational opportunities were recommended by interviewees as influential strate-gies extracted from crisis lessons learned.

Reduction of Blood Donor Vasovagal Syncope Reactions Post-Implementation of Non- Invasive Hemoglobin Determination in a Blood Donor Setting

Background/Case Studies: Determining donor eligibility during registration is the first step in the process of donating blood. The donor's psychological and physiological stress levels increase during the donor eligibility registration process, which then carries on to the phlebotomy process and can potentially result in a vasovagal reaction (VVR). One of the major causes of increased anxiety and stress amongst blood donors during registration is the fingerstick performed to collect a sample of blood to ensure the donor has an adequate hemoglobin level or hematocrit value to assure donor safety and product potency. In 2016 our collection facility performed a study to determine the accuracy of a noninvasive hemoglobin methodology and discovered during the study that not only did the results of the non-invasive hemoglobin device correlate better with venous sample data, but also the onset of donor anxiety in the registration process decreased. In September of 2021, our collection facility implemented the OrSense NBM-200 noninvasive occlusion spectroscopy device used to determine the donor's hemoglobin level. We anticipated an increase in donor satisfaction and a reduction of VVRs due to the elimination of the fingerstick. Study Design/Methods: Donor VVR rates were analyzed pre and post-implementation of the non-invasive device. The analysis was performed to determine if the VVR rate decreased in blood donors from the removal of the fingerstick. A 6 months of data prior to the implementation of the non-invasive device (09/11/2019 to 03/10/2020) were compared to 6 months of data postimplementation of the non-invasive device (09/11/2021 to 03/10/2022). The data used prior to the implementation of the non-invasive device was pulled from the previous year to reflect the same group sets that included young donors (16 years old to 19 years old). The same 6-month date set pre-implementation 2021 was not included due to the 2021 COVID-19 shutdown of high schools because it did not include young donor data that tend to have a higher VVR rate. Results/Findings: A 70,724 blood donors' preimplementation of the non-invasive device were compared to 66,265 blood donors' post-implementation of the non-invasive device. The blood donor VVR rate decreased by 15% post-implementation of the non-invasive hemoglobin determination methodology device. Conclusion(s): Since eliminating the fingerstick in the donor screening process, our collection facility saw a decrease in the overall donor vasovagal reaction by rate by 15% and an improvement in our overall donor satisfaction with a safe and painless methodology to determine donor eligibility.

CHARACTERISTICS OF A COVID-19 COHORT WITH LARGE VESSEL OCCLUSION: A MULTICENTER INTERNATIONAL STUDY

Background The mechanisms and outcomes in COVID-19- associated stroke are unique from those of non-COVID-19 stroke. Objectives The purpose of this study is to describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort. Methods We conducted an international multicenter retrospective study of consecutively admitted COVID-19 patients with concomitant acute large vessel occlusion (LVO) across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a MT between January 2018 to December 2020.Results: The total cohort was 575 patients with acute LVO, 194 had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs. 71.2;p<0.001), and lacked vascular risk factors (49, 25.3% vs. 54, 14.2%;p =0.001). mTICI 3 revascularization was less common in the COVID-19 group (74, 39.2% vs. 252, 67.2%;p < 0.001). Poor functional outcome at discharge (defined as mRS 3-6) was more common in the COVID-19 group (150, 79.8% vs.132, 66.7%;p =0.004). COVID-19 was independently associated with a lower likelihood of achieving mTICI 3 (OR: 0.4, 95% CI: 0.2 -0.7;p<0.001), and unfavorable outcomes (OR: 2.5, 95% CI: 1.4 - 4.5;p=0.002). Conclusion COVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. COVID-19 patients with LVO patients were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates. (Figure Presented).

Peripartum Outcomes Following COVID-19 Vaccination in Late Pregnancy: Findings from a Population-Based Retrospective Cohort Study in Ontario, Canada

Objectives: Evaluate peripartum outcomes following COVID-19 vaccination during pregnancy. Methods: Ontario population-based retrospective cohort between December 14, 2020 and September 30, 2021 using linkage of provincial birth registry and COVID-19 immunization databases. Poisson regression was used to generate risk ratios (RR) and 95% confidence intervals (CI), adjusted for temporal, socio-demographic, and clinical factors using propensity scores. Obstetric (postpartum hemorrhage, chorioamnionitis, cesarean birth) and newborn (NICU admission and 5-minute Apgar<7) outcomes were compared for those who received ≥1 dose of COVID-19 vaccine during pregnancy with 2 unexposed groups—Group 1: individuals vaccinated postpartum, Group 2: never vaccinated. Results: Among 97 590 individuals, 22 660 (23%) received ≥1 dose of vaccine during pregnancy (64% received dose 1 in 3rd trimester). Compared with those vaccinated postpartum, we found no increased risks of postpartum hemorrhage (aRR 0.91, 95% CI 0.82–1.02);chorioamnionitis (aRR 0.92, 95% CI 0.70–1.21);or cesarean (aRR 0.92, 95% CI 0.89–0.95) following COVID-19 vaccination, nor any increased risk of NICU admission or 5-minute Apgar <7. All findings were similar when compared with individuals who did not receive COVID-19 vaccination at any point. We did not observe any difference according to vaccine product, number of doses received during pregnancy, or trimester of dose 1. Conclusions: As of late 2021, there is limited evidence from comparative studies in large populations on outcomes following COVID-19 vaccination during pregnancy. Our study of births up to September 30, 2021 did not identify any increased adverse peripartum outcomes associated with later pregnancy COVID-19 vaccination. Once more individuals vaccinated earlier in pregnancy deliver, we will report on other important obstetric and perinatal outcomes. Keywords: COVID-19 vaccine;pregnancy;epidemiology

Universal SARS-CoV-2 Testing Among Obstetrical Patients (UNIVERSE-OB) in Ottawa, Canada

Objectives: Universal testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within birthing units is an effective strategy to contain infection and estimate community prevalence. Given the high-prevalence of COVID-19 cases in Ontario, the objective of this study was to determine the prevalence of active and recovered SARS-CoV-2 infection among pregnant individuals in Ottawa through universal SARS-CoV-2 and serology testing. Methods: From October 19th to November 27th, 2020, pregnant individuals admitted to triage assessment units at The Ottawa Hospital (TOH) were consented for SARS-CoV-2 testing. Swab and serology samples were analyzed using digital droplet polymerase chain reaction (ddPCR) and enzyme-linked immunosorbent assays, respectively. SARS-CoV-2 seropositivity was defined as a positive result for immunoglobulin (Ig) G, either alone or in combination with IgM and/or IgA. Results: From the 395 enrolled participants, 284 swab and 353 serology samples were collected. We found that 18 of 395 (4.6%) participants had evidence of SARS-CoV-2 exposure: 2/284 (0.70%) were positive for SARS-CoV-2 and 16/353 (4.5%) were positive for anti–SARS-CoV-2 IgG. Seropositive participants were similar to seronegative participants in terms of demographics, clinical characteristics, and pregnancy outcomes. Conclusions: The prevalence of SARS-CoV-2 ddPCR positivity and seropositivity in the obstetrical population at TOH was 0.70% and 4.5%, respectively in the fall of 2020. According to local public health data, the infection rate peaked at 0.6% during the study time period. Universal SARS-CoV-2 testing programs may help approximate community prevalence, however, justification of this strategy depends on testing capabilities and the local context of COVID-19 infection. Keywords: pregnancy;COVID-19;SARS-CoV-2;universal testing;seroprevalence

Understanding the Resiliency of the Muscular Dystrophy Community One-Year into the COVID-19 Pandemic

Objective: To assess the long-term social and health impacts of the COVID-19 pandemic on people with muscular dystrophy (MD). Background: As the COVID-19 pandemic has continued, it has produced lasting impacts on daily life worldwide. People with muscular dystrophy are potentially at a higher risk for complications when infected with COVID-19, but little is known about the continued impact of COVID-19 on the muscular dystrophy population. Design/Methods: We modified our prior COVID-19 Impact Survey (K. Eichinger, et al) to assess impacts from the continuing pandemic using feedback from muscular dystrophy experts, patients, and advocacy group/registry representatives. The survey assessed COVID-19 medical history, and the effects of the pandemic on social aspects, muscle disease, and medical care. We also used the Perceived Stress Scale, a validated 10-item scale. The de-identified, electronic survey was distributed to adults with muscular dystrophy via international patient registries or advocacy group websites from February 8, 2021 to March 22, 2021. Results: Respondents (n=1243: 49% FSHD;43% DM, and 8% LGMD) were slightly more women and middle-aged (range 18-90). COVID-19 infection rates were 8%. Reported recovery times were typically less than 2 weeks with only 9% reporting recovery greater than 8 weeks, and 7% requiring hospitalization. Major challenges reported during the pandemic included stress management (27%) and wearing a mask (24%). The majority reported a slight worsening of their disease. Respondents reported moderate stress levels (average= 15.8;range= 0-39), with higher stress levels reported by women and those under age 30 years. Of the participants who had telemedicine visits, 70% reported satisfaction;however, most preferred in-person visits. Conclusions: People with muscular dystrophy reported moderate stress and challenges during the COVID-19 pandemic. COVID-19 infection rates and medical complications were similar to a general population. Telemedicine visits may have a more permanent role in care, though inperson visits are still preferred.

Antiviral NL-CVX1 Efficiently Blocks Infection of SARS-CoV-2 Viral Variants of Concern (VOC)

Background. Using a computational approach, NL-CVX1 was developed by Neoleukin Therapeutics, Inc. to create a de novo protein that both blocks SARS-CoV-2 infection and is highly resilient to viral escape. In this study we evaluated the efficacy of NL-CVX1 against variants of the original SARS-CoV-2 strain, including important viral variants of concern (VOC) such as B.1.1.7, B.1.351, and P.1. Methods. The relative binding affinity of NL-CVX1 to the SARS-CoV-2 viral spike protein of VOC was measured using biolayer interferometry (Octet). A competitive ELISA measured the ability of NL-CVX1 to compete with hACE2 for binding to the receptor binding domain (RBD) of the SARS-CoV-2 S protein from the original strain and VOC. The activity of NL-CVX1 in preventing viral infection was assessed by evaluating the cytopathic effects (CPE) of SARS-CoV-2 in a transmembrane protease, serine 2-expressing Vero E6 cell line (Vero E6/TMPRSS2) and determining the viral load using quantitative real-time reverse transcriptase polymerase chain reaction in infected cells. A K18hACE2 mouse model of SARS CoV-2 infection was used to study the dose-response of NL-CVX1 anti-viral activity in vivo. Results. NL-CVX1 binds the RBD of different VOC of SARS-CoV-2 at low nanomolar concentrations (Fig 1;Kd < 1-~5 nM). When competing with hACE2, NL-CVX1 achieved 100% inhibition against hACE2 binding to the RBD of different VOC with IC50s values ranging from 0.7-53 nM (Fig 2). NL-CVX1 neutralized the B.1.1.7 variant as efficiently as the original strain in Vero E6/TMPRSS2 cells, with EC50 values of 16 nM and 101. 2 nM, respectively (Fig 3). In mice, we found that a single intranasal dose of 100 μg NL-CVX1 prevented clinically significant SARS-CoV-2 infection and protected mice from succumbing to infection. Results from additional in vitro and in vivo experiments to be conducted this summer will be presented. Figure 1. NL-CVX1 binds the RBD from multiple strains of SARS-CoV-2 at low nanomolar concentrations. Figure 2. NL-CVX1 achieves 100% inhibition against all strains tested, including SARS-CoV-2 VOC. Figure 3. NL-CVX1 neutralizes the B.1.1.7 variant as efficiently as the original SARSCoV-2 strain. Conclusion. In vitro and in vivo data (Fig 4) demonstrate that NL-CVX1 is a promising drug candidate for the prevention and treatment of COVID-19. As a hACE2 mimetic, it is resilient to antibody escape mutations found in SARS-CoV-2 VOC. NL-CVX1 further demonstrates the power and utility of de novo protein design for developing proteins as human therapeutics. Figure 4. NL-CVX1 is effective in preventing clinically significant SARS-CoV-2 viral infection in a K18hACE2 mouse model.

COVID-19 Outcomes Among Participants in the NHLBI Myelodysplastic Syndromes (MDS) Natural History Study

Introduction: The NHLBI MDS Natural History Study (NCT02775383) is an ongoing prospective cohort study conducted across 144 sites in the U.S. and Israel intended to establish a data and biospecimen repository to advance the understanding of MDS. In response to the COVID-19 pandemic, the study also collected data on COVID-19 infection and management. Here, we report a summary of COVID-19 outcomes from participants in this study and the impact of the pandemic on study operations. Methods: This prospective cohort study initiated in June, 2016 is enrolling patients (pts) undergoing diagnostic work up for suspected or newly diagnosed MDS or MDS/myeloproliferative neoplasms (MPNs) in the setting of cytopenia. Study enrollment was paused from Mar. 27, 2020 to May 18, 2020 due to COVID-19. Previously untreated pts underwent a bone marrow assessment with a centralized histopathology review at enrollment for assignment to a longitudinal cohort (MDS, MDS/MPN overlap, idiopathic cytopenia of undetermined significance (ICUS), acute myeloid leukemia (AML) with <30% blasts, or “At-Risk” (pts with sub-threshold dysplasia, select karyotype, or select genetic mutations) for follow-up every six months;or a cross-sectional cohort (other cytopenia or cancers) with no further follow-up. COVID-19 outcomes, including tests, status, hospitalizations and treatments for COVID-19, were collected for all eligible pts. Protocol deviations related to COVID-19 were also collected. Fisher's exact test was used for comparing the proportions of pts tested or positive between groups. Results: Of 758 eligible pts with available COVID-19 data, 507 (67%) were assigned to the longitudinal cohort and 251 (33%) to the cross-sectional cohort or are pending assignment. Among longitudinal pts, 74 (15%) had ICUS, 240 (47%) MDS, 47 (9%) MDS/MPN overlap, 11 (2%) AML with <30% blasts, and 135 (27%) At-Risk for MDS. The median age over all pts was 72 years (range=21-95) and 66% were male, 92% White, 4% Black, 2% Asian, and 2% other. Among 244 pts (32%) tested for COVID-19 (Table 1), 23 (9%) were positive. Twelve (>50% of the positive pts) were in Wisconsin, California (CA), and Missouri (Figure 1), with 8 identified from Sep. to Dec. 2020, which overlaps with third waves of COVID-19 reported in CA and in the Midwest. Tests from 17 (74%) of the 23 pts were based on a polymerase chain reaction (PCR) assay. The proportion of pts positive were similar between pooled disease (ICUS, MDS, MDS/MPN, AML <30%), At-Risk, and cross-sectional groups (8%, 8%, 16%, respectively;Table 2) but the proportions tested differed significantly (39%, 28%, and 25%, respectively, p=0.004). Among all positive pts, 21 (91%) are recovering or have recovered (16 with sequelae), 1 (4%) died, and 1 outcome is unknown (Table 1). The one participant who died had MDS with excess blasts-1 (MDS-EB1, 5-9% blasts). Eight pts (35% of positive pts) required hospitalization (median duration of 7 days (range=2-17)) or treatment (tx) in response to COVID-19, 7 of whom required both. In the 8 pts who required tx for COVID-19, 4 reported Remdesivir-use, 3 of whom were diagnosed with MDS or MDS/MPN overlap. The study monthly accrual rates were similar when compared pre- vs. post-study pause (23 vs. 22 pts, respectively) but the rate of missed follow-up visits increased from 5% to 11% post-pause. About half (49%) of the 144 COVID-19-related study deviations occurred during the months the study was paused. Conclusions: In this analysis of 758 pts with MDS and related conditions, the largest reported for these diagnoses, the COVID-19 mortality rate (13%) in MDS was lower than has been reported in a smaller (n=61) case study (39%, Feld et al Blood 2020) but is similar to the rates for MDS observed annually each year prior to study pause (range=11-19%) and to the rate reported in a larger (n=2186) observational study of cancer patients (16%, Rivera et al Cancer Discov 2020). Infection rates were similar across disease groups. The pandemic also resulted in substantial study-specific challenges, including incre sed rate of deviations, the study being paused, and difficulty sourcing material for biospecimen processing. Data on vaccine efficacy and rates of pts with long-haul symptoms post-COVID may be of interest in future work. [Formula presented] Disclosures: Padron: BMS: Research Funding;Kura: Research Funding;Taiho: Honoraria;Stemline: Honoraria;Blueprint: Honoraria;Incyte: Research Funding. Komrokji: Novartis: Honoraria;Geron: Honoraria;Acceleron: Honoraria;Agios: Honoraria, Speakers Bureau;Abbvie: Honoraria, Speakers Bureau;JAZZ: Honoraria, Speakers Bureau;BMS: Honoraria, Speakers Bureau. Saber: Govt. COI: Other. Al Baghdadi: Bristol-Myers Squibb: Current holder of individual stocks in a privately-held company, Membership on an entity's Board of Directors or advisory committees;AstraZeneca: Current holder of individual stocks in a privately-held company;Epizyme: Current holder of individual stocks in a privately-held company;Heron Therapeutics: Current holder of individual stocks in a privately-held company;Morphosys: Membership on an entity's Board of Directors or advisory committees;Karyopharm: Membership on an entity's Board of Directors or advisory committees;Cardinal Health: Membership on an entity's Board of Directors or advisory committees. DeZern: Taiho: Consultancy, Membership on an entity's Board of Directors or advisory committees;Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees;Bristol-Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees;Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees. Sekeres: Novartis: Membership on an entity's Board of Directors or advisory committees;Takeda/Millenium: Membership on an entity's Board of Directors or advisory committees;BMS: Membership on an entity's Board of Directors or advisory committees.

A patient-focused survey to assess the effects of the COVID-19 pandemic and social policies on people with muscular dystrophy

Objective: To examine the social and health impacts of the pandemic and social policies on people with muscular dystrophies. Background: The COVID-19 pandemic and social policies have disrupted all aspects of community life in the United States, but the impact on people with progressive muscular dystrophies is unknown. Design/Methods: The COVID-19 and Social Policy Impact Survey was developed by muscular dystrophy experts in association with patient collaborators and advocacy groups. The survey assesses social impact;impact on disease;exercise;use of telemedicine;and effect on research. Overall stress was measured using the Perceived Stress Scale, a validated 10-item inventory of stress. We conducted a prospective de-identified electronic survey of people with muscular dystrophy residing in the US from May 8, 2020 to May 28, 2020. An IRB-approved information letter with an embedded link to the survey was emailed to registry participants who had agreed to be contacted by email, or posted as notifications on advocacy websites. Results: Respondents (n=774: 56% FSHD;35% DM, and 9% LGMD) were mostly women and middle-aged (range 19-87 years). Rates of COVID-19 infections were low (<1%) and compliance with social distancing policies high (98%). Major challenges reported during the pandemic included: obtaining treatment (40%), managing stress (37%), social distancing (36%), and obtaining essentials (34%). Of those who reported a change in their disease, the majority reported slight worsening. Respondents reported moderate stress levels (stress score= 15.4;range= 0-35), with higher stress levels reported by women and those under age 30 years. Threequarters of participants who participated in telemedicine visits were satisfied with the encounters;however, most reported a preference for in-person visits. Conclusions: People with muscular dystrophy reported multiple challenges due to COVID-19 social policies, and moderate levels of stress. Future interventions like exercise and stress-coping strategies, including strategies specific to women or individuals < 30 years, may be important.

Management practices impacting on the rostering of medical scientists in the Australian healthcare sector

Purpose This study examines the management rostering systems that inform the ways medical scientists are allocated their work in the public healthcare sector in Australia. Promoting the contributions of medical scientists should be a priority given the important roles they are performing in relation to COVID-19 and the demand for medical testing doubling their workloads (COVID-19 National Incident Room Surveillance Team, 2020). This study examines the impact of work on medical scientists and rostering in a context of uncertain work conditions, budget restraints and technological change that ultimately affect the quality of patient care. This study utilises the Job-Demands-Resources theoretical framework (JD-R) to examine the various job demands on medical scientists and the resources available to them. Design/methodology/approach Using a qualitative methodological approach, this study conducted 23 semi-structured interviews with managers and trade union officials and 9 focus groups with 53 medical scientists, making a total 76 participants from four large public hospitals. Findings Due to increasing demands for pathology services, this study demonstrates that a lack of job resources, staff shortages, poor rostering practices such as increased workloads that lead to absenteeism, often illegible handwritten changes to rosters and ineffectual management lead to detrimental consequences for medical scientists' job stress and well-being. Moreover, medical science work is hidden and not fully understood and often not respected by other clinicians, hospital management or the public. These factors have contributed to medical scientists' lack of control over their work and causes job stress and burnout. Despite this, medical scientists use their personal resources to buffer the effects of excessive workloads and deliver high quality of patient care. Originality/value Findings suggest that developing mechanisms to promote sustainable employment practices for medical scientists are critical for the escalating demands in pathology.