The Impact of Age-Based COVID-19 Pandemic Regulations on Older People in Turkey: A Capability Approach.

Older adults all around the world encountered numerous challenges during the COVID-19 pandemic. Some of these challenges were pertinent to biological factors, like the risk of infection, while others resulted from social factors, like ageism and government regulations. Employing a capability approach, this study examined how age-based pandemic regulations that were imposed in Turkey affected the freedom and social environment of older adults. We used Bachhi's What is the Problem Represented to Be? (WPR) approach to analyze the memorandums issued by the central government between March 11, 2020, and June 30, 2021. Our analysis revealed that the problem is represented in these memorandums as older people's increased vulnerability to health risks, which resulted in violations of their mobility and health capabilities, as well as (mis)recognition of diversity within the older population. These findings provide vital insight into how age-based pandemic regulations define the problem based exclusively on chronological age, thereby creating circumstances that compromise older people's capabilities beyond simply maintaining health. Thus, we recommend that policymakers pay closer attention to both the intended and unintended consequences of any proposed regulations, and account for individuals' capabilities rather than merely their functionings.

The Impacts of COVID-19 Lockdowns on Road Transport Air Pollution in London: A State-Space Modelling Approach.

The emergence of the COVID-19 pandemic in 2020 led to the implementation of legal restrictions on individual activities, significantly impacting traffic and air pollution levels in urban areas. This study employs a state-space intervention method to investigate the effects of three major COVID-19 lockdowns in March 2020, November 2020, and January 2021 on London's air quality. Data were collected from 20 monitoring stations across London (central, ultra-low emission zone, and greater London), with daily measurements of NOx, PM10, and PM2.5 for four years (January 2019-December 2022). Furthermore, the developed model was adjusted for seasonal effects, ambient temperature, and relative humidity. This study found significant reductions in the NOx levels during the first lockdown: 49% in central London, 33% in the ultra-low emission zone (ULEZ), and 37% in greater London. Although reductions in NOx were also observed during the second and third lockdowns, they were less than the first lockdown. In contrast, PM10 and PM2.5 increased by 12% and 1%, respectively, during the first lockdown, possibly due to higher residential energy consumption. However, during the second lockdown, PM10 and PM2.5 levels decreased by 11% and 13%, respectively, and remained unchanged during the third lockdown. These findings highlight the complex dynamics of urban air quality and underscore the need for targeted interventions to address specific pollution sources, particularly those related to road transport. The study provides valuable insights into the effectiveness of lockdown measures and informs future air quality management strategies.

What aspects of the pandemic had the greatest impact on adolescent mental health: duration of lockdown or subjective experience?

BACKGROUND: The COVID-19 pandemic negatively impacted global mental health, with adolescents experiencing disproportionate effects. Limited research has explored the impact of different pandemic restrictions on adolescent mental health, and only a few studies have examined the longer-term impacts of the pandemic on adolescent mental health. These investigations are crucial for informing public health policies, particularly the integration of mental health care in future public health emergencies. METHODS: This study aimed to investigate the impact of lockdown duration and the impact of adolescents' subjective experiences of the pandemic on their wellbeing, internalising symptoms, and externalising symptoms. Australian adolescents (N = 1,001, mean age = 14.2 years) completed a baseline survey in 2021, shortly after pandemic lockdowns were lifted (Time 1), and a follow-up survey approximately 12 months later (Time 2). Predictors of interest were the total duration of COVID-19 lockdowns across 2020-2021, and adolescents' subjective experiences of the pandemic on their social connections, learning, technology use and family relationships. A range of covariates were included in analyses to examine subgroup differences. RESULTS: Linear mixed-effects models indicated that total duration of the lockdown was not associated with any of the outcomes at Time 1 or Time 2 (all ps > 0.017). Negative subjective experience of the pandemic on learning was associated with greater externalising symptoms at both Time 1 (t = 5.17, df = 980, p <.001) and Time 2 (t = 2.72, df = 708, p =.007). Negative subjective experience of the pandemic on social connection was associated with greater internalising symptoms at Time 2 only (t = 3.20, df = 709, p =.001). Negative subjective experience of the pandemic on family relationships or technology use was not associated with any of the outcomes at Time 1 or Time 2 (all ps > 0.017). CONCLUSIONS: Adolescents' negative subjective experience of the pandemic on learning and social connections was associated with greater internalising and externalising symptoms after the lockdown had been lifted. Duration of lockdowns was not associated with any of the primary outcomes. During future public health emergencies, mental health interventions should be tailored to assist adolescents to adapt to new learning environments, and to build and maintain social connections.

The COVID-19 pandemic "anthropause" decreased plastic ingestion in neotropic cormorants Nannopterum brasilianus in Lima, Peru.

Background: The anthropause during the recent COVID-19 pandemic provided a unique opportunity to examine the impact of human activity on seabirds. Lockdowns in Peru prevented people from visiting coastal areas, thereby reducing garbage disposal on beaches and the movement of microplastics into the ocean. This cessation of activities likely led to a temporary decrease in plastic pollution in coastal regions. We aimed to investigate this phenomenon in inshore-feeding neotropic cormorants (Nannopterum brasilianus) along the Circuito de Playas Costa Verde (CPCV), situated on the coastal strip of Lima, Peru (∼ 11 million people). Methods: We collected and analyzed fresh pellets along the CPCV before (over 11 months) and during the pandemic lockdowns (over 8 months). Results: Our findings revealed a significant reduction in the occurrence of plastic in pellets during the pandemic period (% Oc = 2.47, n = 647 pellets) compared to pre-pandemic conditions (% Oc = 7.13, n = 800 pellets). The most common plastic debris item found in the pellets was threadlike microplastic. Additionally, our study highlights the direct correlation between human presence on beaches and the quantity of microplastics (mainly threadlike) found in cormorant pellets. We suggest that the reintroduction of these materials into the sea, previously accumulated on the coast, is likely facilitated by the movement and activity of beachgoers toward the ocean.

COVID-19, lockdowns, and the mental wellbeing of LGBTQ people in Australia.

LGBTQ communities around the world entered the COVID-19 pandemic with generally high rates of poor mental health and faced additional challenges including stigma, discrimination, and barriers to care. This study sample was drawn from a survey of 3135 LGBTQ adults residing in Australia during the pandemic. Regression analysis was used to explore individual differences in psychological distress and perceived change in mental wellbeing since the onset of the pandemic as well as the impact of lockdowns, by taking advantage of a natural experiment comparing the states that experienced more extensive lockdowns (Victoria and New South Wales) to the rest of Australia. The burden of mental health was found to vary across gender, sexual orientation, age, and area of residence. While no impact of lockdowns on psychological distress was observed, participants living in the states of Victoria (ß = -0.15; 95% CI = -0.23, -0.07) and New South Wales (ß = -0.13; 95% CI = -0.21, -0.05) self-reported a more negative impact of the pandemic on their mental wellbeing compared to the rest of the country. The findings suggest that the COVID-19 pandemic had a negative impact on the mental wellbeing of LGBTQ populations, particularly among those who experienced extensive lockdowns and highlight the need for increased efforts to enable access to mental health supports during times of crisis.

Is COVID-19 as Lethal as the Spanish Flu? The Australian Experience in 1919 and 2020 and the Role of Nonpharmaceutical Interventions (NPIs).

We conducted a comparative historical study to interrogate Professor Peter Doherty's warning to Australians in April 2020 that 'COVID-19 is just as lethal as the Spanish flu'. We identified the epicentres of both pandemics, namely, metropolitan Sydney in 1919 and metropolitan Melbourne in 2020 and compared the lethality of the Spanish Flu and COVID-19 in these two cities. Lethality was measured by the number and rate of hospital admissions, death rates, age-specific death rates and age-standardised mortality rates (ASMRs). Using these measures, we demonstrated the strikingly different waves of infection, their severity at various points in time and the cumulative impact of the viruses by the end of our study period, i.e., 30 September in 1919 and 2020. Hospital admissions and deaths from the Spanish Flu in 1919 were more than 30 times higher than those for COVID-19 in 2020. The ASMR per 100,000 population for the Spanish Flu was 383 compared to 7 for COVID-19: The former was about 55 times higher than the latter. These results suggest that the Spanish Flu was more lethal than COVID-19. Professor Doherty's warning was perhaps taken seriously and that partly explains the findings of this study. Containing infection in 1919 and 2020 threw the burden on nonpharmaceutical interventions (NPIs) such as 'protective sequestration' (quarantine), contact tracing, lockdowns and masks. It is likely that the persistent and detailed contact tracing scheme provides the best possible explanation for why NPIs in 2020 were more effective than in 1919 and therefore contributed to the lower lethality of the COVID-19 pandemic in its first year.

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait.

Introduction: Investigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors. Methods: We used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants' characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties. Results: We inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values < 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns. Conclusions: Our findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics.

Exploring the Infectious Contribution to Intussusception Causality Using the Effects of COVID-19 Lockdowns in Australia: An Ecological Study.

BACKGROUND: Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases <2 years of age are classed as idiopathic, with viral infection implicated as one of the causes. Coronavirus disease 2019 (COVID-19) public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were greater than would be expected with our previous understanding of its infectious etiology. METHODS: We conducted a retrospective, multistate, ecological study over a 12-year period. Monthly case numbers of "intussusception"-coded admissions (code K56.1; International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) were acquired from state-wide admissions data sets from New South Wales, Victoria, and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared with non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods. RESULTS: We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the <2-year age groups, with Victoria experiencing a 62.7% reduction (rate ratio, 0.37; P < .001) and New South Wales a 40.1% reduction (0.599; P = .006) during lockdown times. Controls for variations in lockdown restrictions between both regional and metropolitan areas also showed expected decreases. CONCLUSIONS: Our ecological study demonstrates significant decreases in the frequency of pediatric intussusception admissions during the COVID-19 lockdown periods. The unexpected magnitude of the reductions suggests that the true proportion of infectious disease-caused idiopathic intussusception is greatly underestimated.

Baby Bump or Baby Slump? COVID-19, Lockdowns, and their Effects on Births in Australia.

This study examines changes in birth rates in Australia during the COVID-19 pandemic and the extent to which such changes were influenced by lockdowns. We use natality data at State and small regional area levels spanning the period from 2011 to 2022. In our empirical approach, we first take advantage of a unique quasi-experimental setting that arose in Victoria, Australia's second most populous State, during the first year of the pandemic. Victoria imposed a 111-day stay-at-home lockdown while other States and Territories enforced milder restrictions on social and economic activities. We then exploit lockdowns that lasted more than three months in Victoria and New South Wales in the second year of the pandemic. Within these quasi-experimental settings, our empirical approach was to first use monthly data at the State-level and estimate birth rate deviations from secular trends for the months affected by COVID-19 policies. We also estimate separate models to examine variations in births across regional areas with different compositions of Indigenous population, unemployment, low-income, and non-English speaking residents. Our findings reveal a nationwide fertility increase in 2021, but Victoria exhibited slower growth, especially in areas with higher unemployment, lower income, and more non-English speaking residents. In 2022, we find evidence of a gradual return of birth rates to pre-pandemic trends, though this is mainly concentrated in the major cities. While the second-year lockdowns had limited impacts, language-diverse areas still mostly experienced lower rates of growth in birth rates.

The Exercise Right for Active Ageing Study: Participation in Community-Based Exercise Classes by Older Australians During the COVID-19 Pandemic.

The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65 years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns.

Protective factors for children with autism spectrum disorder during COVID-19-related strict lockdowns: a Shanghai autism early developmental cohort study.

BACKGROUND: COVID-19 lockdowns increased the risk of mental health problems, especially for children with autism spectrum disorder (ASD). However, despite its importance, little is known about the protective factors for ASD children during the lockdowns. METHODS: Based on the Shanghai Autism Early Developmental Cohort, 188 ASD children with two visits before and after the strict Omicron lockdown were included; 85 children were lockdown-free, while 52 and 51 children were under the longer and the shorter durations of strict lockdown, respectively. We tested the association of the lockdown group with the clinical improvement and also the modulation effects of parent/family-related factors on this association by linear regression/mixed-effect models. Within the social brain structures, we examined the voxel-wise interaction between the grey matter volume and the identified modulation effects. RESULTS: Compared with the lockdown-free group, the ASD children experienced the longer duration of strict lockdown had less clinical improvement (ß = 0.49, 95% confidence interval (CI) [0.19-0.79], p = 0.001) and this difference was greatest for social cognition (2.62 [0.94-4.30], p = 0.002). We found that this association was modulated by parental agreeableness in a protective way (-0.11 [-0.17 to -0.05], p = 0.002). This protective effect was enhanced in the ASD children with larger grey matter volumes in the brain's mentalizing network, including the temporal pole, the medial superior frontal gyrus, and the superior temporal gyrus. CONCLUSIONS: This longitudinal neuroimaging cohort study identified that the parental agreeableness interacting with the ASD children's social brain development reduced the negative impact on clinical symptoms during the strict lockdown.

COVID-19's death transfer to Sub-Saharan Africa.

The COVID-19 spread very quickly around the world following its discovery in China, in December 2019. Lockdowns implemented in China and the Global North to control the propagation of the virus and to save human lives have resulted in a global recession. The transmission of the recessionary effects from the Global North to the Global South is reflected in the decline in sub-Saharan Africa's (SSA) GDP and the associated increase in poverty. The purpose of this paper is to illustrate how the recession induced in China and the Global North by COVID-19 lockdowns may have had indirect effects on SSA mortality that are higher than those directly attributed to the pandemic itself. Our methodology relies on a three-step relationship: (i) the impact of lockdowns on the recession in the North, (ii) the impact of the recession in the North on income in SSA countries, and (iii) the impact of a decline in income on mortality in SSA. We show that COVID-19-induced lockdowns in the Global North, through the severe recessions they induced in the Global South, resulted in the transfer of between 538,000 and 679,000 deaths in one year to SSA, including the deaths of 140,000 to 177,000 children aged 0-5 years. This corresponds to a 6-7% increase in the crude death rate and a 5-6% increase in under-5 mortality. These figures are much higher than the number of deaths directly attributable to COVID-19 in SSA. Thus, policymakers must not lose sight of the indirect excess mortality caused by global economic recession triggered by the pandemic. Our results reveal the need to increase the resilience of SSA countries to exogenous shocks, including COVID-19, which, in addition to increasing poverty, may induce excessive mortality due to the high sensitivity of mortality in SSA countries to economic recession.

A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria.

BACKGROUND: Coercive measures such as involuntary psychiatric admission are considered a last resort in the treatment of people with psychiatric disorders. So far, numerous factors have been identified that influence their use. However, the link between a pandemic - in particular, restrictions such as lockdowns - and the use of involuntary psychiatric admission is unclear. AIM: To examine the association between COVID-19 lockdowns and involuntary psychiatric admissions in Austria. METHOD: This retrospective exploratory study assessed all involuntary psychiatric admissions and use of mechanical restraint in Austria, except for the federal state of Vorarlberg, between 1 January 2018 and 31 December 2020. Descriptive statistics and regression models were used. RESULTS: During the 3-year study period, 40 012 individuals (45.9% females, mean age 51.3 years) had 66 124 involuntary psychiatric admissions for an average of 10.9 days. Mechanical restraint was used during 33.9% of these admissions. In weeks of nationwide COVID-19 lockdowns (2020 v. 2018/2019), involuntary psychiatric admissions were significantly fewer (odds ratio = 0.93, P = 0.0001) but longer (11.6 (s.d.: 16) v. 10.9 (s.d.: 15.8) days). The likelihood of involuntary admission during lockdowns was associated with year (2020 v. 2018-2019; adjusted odds ratio = 0.92; P = 0.0002) but not with sex (P = 0.814), age (P = 0.310), use of mechanical restraint (P = 0.653) or type of ward (P = 0.843). CONCLUSIONS: Restrictions such as lockdowns affect coercive measures and resulted in fewer but longer involuntary psychiatric admissions during weeks of lockdown in Austria. These results strengthen previous findings that showed the dependence of coercive measures on external factors, highlighting the need to further clarify causality and desired prevention effects when using coercive measures.

Gender in the disclosure of loneliness on Twitter during COVID-19 lockdowns.

Introduction: Loneliness has been shown to affect both mental and physical health, and was a major concern even before the COVID-19 pandemic. During the COVID-19 distancing measures, millions of people took to social media to express their feelings and seek social support. Methods: In this mixed-methods study, we examine the self-disclosure of loneliness by users identifying as male or female (via self-disclosed naming conventions) on Twitter before and during the COVID-19 "lockdowns." Results: We show that in the first two months of COVID-19 restrictions, self-disclosure of loneliness on this platform rose dramatically, and also have changed qualitatively. We find that female accounts tend to post more loneliness self-disclosures compared to male ones, even before COVID. Female disclosures more often center around pregnancy, family, and close relationships, whereas those posted by the male ones are more related to leadership, video gaming and sex. During COVID lockdowns, female accounts turn to online messaging apps and hobbies, and male become increasingly vocal in seeking partners. Discussion: The insights of this study have important implications for the design of interventions for lessening the burden of loneliness in the current digitized world.

"Keeping our distance": Older adults' experiences during year one of the COVID-19 pandemic and lockdown in Australia.

The first year of the COVID-19 pandemic had a profound impact on everyday life in Australia despite relatively low infection rates. Lockdown restrictions were among the harshest in the world, while older adults were portrayed as especially vulnerable by politicians and the media. This study examines the perceptions and experiences of the pandemic and lockdowns among 31 older Australians. We investigated how participants perceived their own vulnerability, their attitudes towards lockdowns and protective behaviors, and how the pandemic affected everyday life. We found that participants were cautious about COVID-19 and vigilant observers of physical distancing. Despite approving of public health guidelines and lockdowns, participants raised concerns about weakening social ties and prolonged social isolation. Those living alone or lacking strong family ties were most likely to report increased loneliness. Most participants nonetheless regarded themselves as "fortunate": they perceived older age as affording them financial, emotional, and relational stability, which insulated them from the worst impacts of the coronavirus pandemic. In their views, financial independence and post-retirement lifestyles helped them adapt to isolation and the disruption of lockdowns.

Pediatric injury attendances in different population groups in Israel before, during, and after COVID-19 lockdowns: a descriptive study, 2018-2022.

BACKGROUND: Lockdowns and quarantines during the COVID-19 pandemic influenced healthcare services' usage patterns such as emergency department (ED) attendance. During the pandemic, Israel issued three lockdowns (March-May 2020, September-October 2020, and December 2020-February 2021) to mitigate the spread of COVID-19. Little is known about the impact of these lockdowns on ED attendance for injuries in the diverse population of Northern Israel. METHODS: We described patterns of ED attendance before, during, and after COVID-19 lockdowns. We extracted data from medical records of all northern Israeli children aged 0-17 years old who attended Ziv Medical Center (ZMC) emergency department (ED) due to injury, between 01/01/2018 and 10/02/2022. We compared the volume and characteristics of ED attendance during lockdown periods to the same time periods in the 2 years before the pandemic and 1 year after the lockdowns, using chi-square tests. RESULTS: Seven thousand six hundred nineteen northern children attended ZMC ED during the time periods of the study for injuries and were analyzed. Mean attendance numbers during lockdowns decreased compared to previous years, with an increase in injuries proportion (67.8% (1502/2216) vs. 52.7% (2038/3868) p < 0.001). The proportion of 0-4-year-olds attending for injuries during the lockdown increased compared to pre-pandemic (39.68% vs. 30.7%, p < 0.0001). Minority population attendance decreased (27.47% vs. 30.71% p = 0.02). Hospitalization rates increased (13.21% vs. 10.65% p = 0.01). Post-lockdown periods saw a return to the pre-pandemic age and ethnicity distribution. CONCLUSIONS: Compared to previous years, the volume of injuries was lower during lockdowns for all ages, with a relative increase in the proportion of injuries among younger children attending the ED. A lower proportion of attendance from minority groups suggests different health-seeking behavior patterns during emergencies compared to the general population. Understanding these differences will help better plan for future emergencies.

Civil Liberties in a Lockdown: The Case of COVID-19.

In response to the spread of COVID-19, governments across the world, with very few exceptions, have enacted sweeping restrictive lockdown policies that impede citizens' freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support worldwide should be justified by uncontroversial moral principles. We argue that the virtually unanimous support in favor of restrictive lockdowns is not adequately justified by the arguments given in favor of them. Importantly, this is not to say that states ought not impose restrictive lockdown measures, but rather that the extent of the acceptance of these measures is not proportionate to the strength of the arguments for lockdowns.

Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis.

Australia experienced some of the world's longest and most stringent lockdowns during the COVID-19 pandemic. While lockdown measures had consequences for mental health, investigation is lacking on the potential for green and blue space coverage within people's local environments to ameliorate the impact of lockdowns with varied lengths using longitudinal cohorts. This study examined the impact of lockdown durations on population mental health and tests the effect modification of neighbourhood green and inland and coastal blue space coverage in metropolitan areas. We merged population-based longitudinal data on more than 11,000 individuals collected over a ten-year period from 2012 to 2021 with national land use data describing green and blue space coverage. We used fixed effect models to estimate the relationship between lockdowns (with different durations and staggered introduction) and mental health, controlling for sociodemographic, health, and geographical confounders, and tested the significance of effect modification of green and blue space. Results show that extended lockdowns led to considerably larger decreases in mental health (COVID-y1: -2.66, 95%CI: -3.43, -1.89; COVID-y2: -2.65, 95%CI: -3.33, -1.97) relative to short lockdowns. The mental health effect of lockdowns was smaller where green spaces and inland and coastal blue spaces were available. Effect modification was statistically significant for green space, with smaller negative mental health effects observed where there was sizeable green space coverage, particularly during long lockdowns (COVID-y1: -2.69, 95%CI: -3.63, -1.76 for coverage <5%; -3.27, 95%CI: -4.70, -1.84 for coverage 5%-10%; -0.60, 95%CI: -2.03, 0.83 for coverage ≥30%; COVID-y2: -2.74, 95%CI: -3.62, -1.87 for coverage <5%, -2.95, 95%CI: -3.98, -1.92 for coverage 5%-10%; -2.08, 95%CI: -3.28, -0.88 for coverage ≥30%). Findings support the consideration of nature exposure to improve people's mental wellbeing and resilience when designing lockdown measures in response to future public health emergencies.

Rethinking the Ethics of the Covid-19 Pandemic Lockdowns.

Public health responses to the Covid-19 pandemic included various measures to mitigate the spread of the virus. Among these, the most restrictive was a broad category referred to as "lockdowns." We argue that the reasoning offered in favor of extended lockdowns-those lasting several months or longer-did not adequately account for a host of countervailing considerations, including the impact on mental illness, education, employment, and marginalized communities as well as health, educational, and economic inequities. Furthermore, justifications offered for extended lockdowns set aside a basic tenet of public health ethics: restrictions on liberty and autonomy should be the least intrusive means of achieving the desired end. Since it is now clear that extended lockdowns cause severe harm to many vulnerable populations, the burden of proof is on those who would advocate for them, and there must be a much higher bar to implement an extended lockdown, with high-quality evidence that the benefit would substantially exceed its harm.