Equity Implications of Ride-Hail Travel during COVID-19 in California

COVID-19 has shocked every system in the U.S., including transportation. In the first months of the pandemic, driving and transit use fell far below normal levels. Yet people still need to travel for essential purposes like medical appointments, buying groceries, and—for those who cannot work from home—to work. For some, the pandemic may exacerbate extant travel challenges as transit agencies reduce service hours and frequency. As travelers reevaluate modal options, it remains unclear how one mode—ride-hailing—fits into the transportation landscape during COVID-19. In particular, how does the number of ride-hail trips vary across neighborhood characteristics before versus during the pandemic? And how do patterns of essential trips pre-pandemic compare with those during COVID-19? To answer these questions, we analyzed aggregated Uber trip data before and during the first two months of the COVID-19 pandemic across four regions in California. We find that during these first months, ride-hail trips fell at levels commensurate with transit (82%), while trips serving identified essential destinations fell by less (62%). Changes in ride-hail use were unevenly distributed across neighborhoods, with higher-income areas and those with more transit commuters and higher shares of zero-car households showing steeper declines in the number of trips made during the pandemic. Conversely, neighborhoods with more older (aged 45+) residents, and a greater proportion of Black, Hispanic/Latinx, and Asian residents still appear to rely more on ride-hail during the pandemic compared with other neighborhoods. These findings further underscore the need for cities to invest in robust and redundant transportation systems to create a resilient mobility network.

Equity Implications of Ride-Hail Travel during COVID-19 in California.

COVID-19 has shocked every system in the U.S., including transportation. In the first months of the pandemic, driving and transit use fell far below normal levels. Yet people still need to travel for essential purposes like medical appointments, buying groceries, and-for those who cannot work from home-to work. For some, the pandemic may exacerbate extant travel challenges as transit agencies reduce service hours and frequency. As travelers reevaluate modal options, it remains unclear how one mode-ride-hailing-fits into the transportation landscape during COVID-19. In particular, how does the number of ride-hail trips vary across neighborhood characteristics before versus during the pandemic? And how do patterns of essential trips pre-pandemic compare with those during COVID-19? To answer these questions, we analyzed aggregated Uber trip data before and during the first two months of the COVID-19 pandemic across four regions in California. We find that during these first months, ride-hail trips fell at levels commensurate with transit (82%), while trips serving identified essential destinations fell by less (62%). Changes in ride-hail use were unevenly distributed across neighborhoods, with higher-income areas and those with more transit commuters and higher shares of zero-car households showing steeper declines in the number of trips made during the pandemic. Conversely, neighborhoods with more older (aged 45+) residents, and a greater proportion of Black, Hispanic/Latinx, and Asian residents still appear to rely more on ride-hail during the pandemic compared with other neighborhoods. These findings further underscore the need for cities to invest in robust and redundant transportation systems to create a resilient mobility network.

All-cause mortality in cancer patients treated for sepsis in intensive care units: a systematic review and meta-analysis.

PURPOSE: Sepsis is a common complication in patients with cancer, but studies evaluating the outcomes of critically ill cancer patients with sepsis on a global scale are limited. We aimed to summarize the existing evidence on mortality rates in this patient population. METHODS: Prospective and retrospective observational studies evaluating critically ill adult cancer patients with sepsis, severe sepsis, and/or septic shock were included. Studies published from January 2010 to September 2021 that reported at least one mortality outcome were retrieved from MEDLINE (Ovid), Embase (Ovid), and Cochrane databases. Study selection, bias assessment, and data collection were performed independently by two reviewers, and any discrepancies were resolved by a third reviewer. The risk of bias was assessed using the Newcastle-Ottawa scale. We calculated pooled intensive care unit (ICU), hospital, and 28/30-day mortality rates. The heterogeneity of the data was tested using the chi-square test, with a P value < 0.10 indicating significant heterogeneity. RESULTS: A total of 5464 citations were reviewed, of which 10 studies met the inclusion criteria; these studies included 6605 patients. All studies had a Newcastle-Ottawa scale score of 7 or higher. The mean patient age ranged from 51.4 to 64.9 years. The pooled ICU, hospital, and 28/30 day mortality rates were 48% (95% CI, 43- 53%; I2 = 80.6%), 62% (95% CI, 58-67%; I2 = 0%), and 50% (95% CI, 38- 62%; I2 = 98%), respectively. Substantial between-study heterogeneity was observed. CONCLUSION: Critically ill cancer patients with sepsis had poor survival, with a hospital mortality rate of about two-thirds. The substantial observed heterogeneity among studies could be attributed to variability in the criteria used to define sepsis as well as variability in treatment, the severity of illness, and care across settings. Our results are a call to action to identify strategies that improve outcomes for cancer patients with sepsis.

The COVID-19 Pandemic and Transition to Digital Health in Clinical Oncology Care.

BACKGROUND: Clinical oncology care is complex, and new technologies can improve efficiency, contribute to safe treatment delivery, and enhance care for the patient. The COVID-19 pandemic prompted a shift to the use of digital health technologies to provide care. Oncology care providers can ensure that technology is integrated with the patient's plan of care. OBJECTIVES: The aims of this review were to provide a survey of digital health technologies in oncology care and changes in practice resulting from the pandemic, as well as to highlight oncology nurses' and nursing leaders' roles in promoting digital health technology in clinical practice. METHODS: Current and emerging literature, frameworks, and real-world experiences were reviewed to provide an overview of digital health technology in oncology care. FINDINGS: Digital health technology has become an integral tool for the oncology care team and provides opportunities to improve the lives of patients. The pandemic accelerated the adoption of technology to provide safe and effective care. Oncology nurses play a role in identifying patients' needs and developing and implementing care strategies.

A selective sweep in the Spike gene has driven SARS-CoV-2 human adaptation.

The coronavirus disease 2019 (COVID-19) pandemic underscores the need to better understand animal-to-human transmission of coronaviruses and adaptive evolution within new hosts. We scanned more than 182,000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes for selective sweep signatures and found a distinct footprint of positive selection located around a non-synonymous change (A1114G; T372A) within the spike protein receptor-binding domain (RBD), predicted to remove glycosylation and increase binding to human ACE2 (hACE2), the cellular receptor. This change is present in all human SARS-CoV-2 sequences but not in closely related viruses from bats and pangolins. As predicted, T372A RBD bound hACE2 with higher affinity in experimental binding assays. We engineered the reversion mutant (A372T) and found that A372 (wild-type [WT]-SARS-CoV-2) enhanced replication in human lung cells relative to its putative ancestral variant (T372), an effect that was 20 times greater than the well-known D614G mutation. Our findings suggest that this mutation likely contributed to SARS-CoV-2 emergence from animal reservoirs or enabled sustained human-to-human transmission.

Parking Problems: Motor Vehicle Parking Violations Vastly Surpass Scooters and Bikes

Motor vehicle parking violations in the US vastly surpass scooters and bikes. Electric scooters operate in more than 100 cities in the US and many more throughout the globe. And in each of these cities, policymakers, planners, and engineers are grappling with questions about how to regulate their use and parking. In the absence of good data about how and where scooters are parked, many decision-makers may have no other choice but to rely on anecdotes, news accounts, and observations. Here, parking behavior across several cities is examined, inspired by work done by other academic researchers including one by professor Kevin Fang and colleagues at San Jose State who conducted systematic observations in downtown San Jose CA, walking around city streets and observing how shared scooters were parked. They found that only 2 percent of the 530 scooters they observed impeded pedestrian access.