The impact of public demands on local environmental governance performance: Evidence from civil environmental complaints placed on leaders at different government levels in China.

The joint participation of multiple subjects is crucial for environmental governance. Using panel data for 273 Chinese cities during 2013-2019, this study investigates the impact and mechanism of public demands on environmental pollution. The results demonstrate that public demands measured by the number of environmental complaints placed on government leaders significantly reduce environmental pollution. Furthermore, increases in the rate and speed of government responses improve the effect of public demands on environmental governance. Public demands placed on provincial leaders reduce local environmental pollution to a greater extent than public demands placed on prefectural and county leaders. Province-level governments are more willing to consider public opinions and attach more importance to environmental governance; Prefecture-level governments prioritize province-level governments' attention to the environment when implementing environmental governance. Moreover, strong political ties between provincial and prefectural leaders and long tenures among prefectural leaders strengthen the pollution reduction effect of public demands placed on provincial leaders. The reduction effect of environmental complaints on pollution emission is more significant in cities with high level of Internet construction and environmental disclosure. Our results illustrate the role of public demands in environmental governance, offering a reference for developing effective environmental policies.

Learning from COVID-19: government leaders' perspectives to improve emergency risk communication.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic highlighted the challenges of effective emergency risk communication (ERC) to protect public health, including the difficulty in tackling the spread of inaccurate information. This study aimed to understand those challenges and potential solutions by interviewing leading government spokespersons and their advisors from around the world with experience during large scale emergencies. Interviews were conducted with 27 individuals representing governments from 19 countries across five continents. Thematic analysis, using both a deductive and inductive approach, organized and identified salient themes and patterns that emerged from the interview data. RESULTS: The thematic analysis of the interviews' data led to the identification of 9 principles of communication: 1) Timeliness, 2) Transparency, 3) Coordination, 4) Accuracy and Consistency, 5) Accountability and Integrity, 6) Independence from politics, 7) Responsiveness, 8) Equity, 9) Trust and Empathy. We also developed 36 recommendations actionable by government agencies to enhance the practice of the 9 principles. Examples include the need for: proactive communication strategies, permanent communication task forces integrated into preparedness and response efforts, robust processes to enhance open discussion of controversial topics within government agencies, clarification of how various branches of government coordinate to oversee specific aspects of the overall communication, and development of relationships across public and private entities ahead of a crisis. CONCLUSIONS: Our findings suggest key practical recommendations for leaders of government agencies to enhance ERC capabilities going forward. Before a crisis, they must constantly review internal processes and integrate ERC functions into overall communication planning efforts. During a crisis, they must coordinate roles and responsibilities across branches of governments, strive to communicate to a range of populations to uphold equity, maintain transparency by avoiding information voids on controversial issues and build trust by building relationships with a variety of community leaders. After a crisis, government agencies should continue the practice of social listening to hear more about the public's informational needs, strengthen civic participation processes, and understand how an always evolving information environment can best be leveraged during future crises.

The COVID-19 pandemic and the timing of government response: A comparison of four Nordic countries March-June 2020.

OBJECTIVES: The aim is to compare Sweden, Denmark, Finland and Norway regarding government response to the COVID-19 pandemic in mid-March-June 2020 using the Oxford Government Response Tracker. STUDY DESIGN: Descriptive longitudinal ecological study. METHODS: Descriptive analysis of time series data. RESULTS: Sweden displayed a far lower response index in March. By late April indexes were similar. In May-June, response indexes were lower in Finland and Norway than in Sweden. The average response index in mid-March-June was similar in Sweden, Finland and Norway. CONCLUSIONS: The government response in the four countries indicates that timing of response was essential. Sweden's slow and weak initial government response in March-April was followed by less loosening of government response in May-June compared with, especially, Finland and Norway, which resulted in similar average government response in mid-March-June for the three countries. As a comparison, COVID-19 mortality per capita was 10 times higher in Sweden than in Finland and Norway, and five times higher than in Denmark during the same period.

Black fungus outbreak in India - A direct consequence of COVID-19 surge: A myth or reality.

The deadly second wave of COVID-19 has seen an unprecedented surge in mucormycosis associated mortality in India, overwhelming the heath authorities with challenges beyond measure. Also known as black fungus, this life-threatening fungal infection usually manifests in the nose, spreads to the eyes, and in some cases also to the brain. Immune suppression, pre-existing conditions, prolonged and indiscriminate use of steroids, and unhygienic environments are some of the widely recognized risk factors for contracting black fungus in individuals recovered from COVID-19. However, diagnosis of the infection remains insufficient due to the lack a holistic understanding of the possible risks, symptoms, and exposure pathways and therefore no definite protocol exists for managing this fatal infection. Here, we synthesize the current state of knowledge on black fungus outbreak in India and identify key gaps in its understanding with respect to potential risk factors leading to the widespread infection. We looked at 3354 black fungus cases in India, enlisting ailment history (particularly diabetes) and steroid usage in COVID-19 patients as the key factors responsible for exacerbating risks associated with the disease. However, we also press on the possibilities that other less studied non-traditional risk factors may also have a role in causing the infection. Black fungus is therefore a reality of COVID-19, with or without diabetes or steroid use needs to be investigated. We believe such a review is imperative for making informed decisions specially around timely diagnosis and channelizing efforts in controlling the spread of COVID-19 associated mucormycosis.

Complexity of Government response to COVID-19 pandemic: a perspective of coupled dynamics on information heterogeneity and epidemic outbreak.

This study aims at modeling the universal failure in preventing the outbreak of COVID-19 via real-world data from the perspective of complexity and network science. Through formalizing information heterogeneity and government intervention in the coupled dynamics of epidemic and infodemic spreading, first, we find that information heterogeneity and its induced variation in human responses significantly increase the complexity of the government intervention decision. The complexity results in a dilemma between the socially optimal intervention that is risky for the government and the privately optimal intervention that is safer for the government but harmful to the social welfare. Second, via counterfactual analysis against the COVID-19 crisis in Wuhan, 2020, we find that the intervention dilemma becomes even worse if the initial decision time and the decision horizon vary. In the short horizon, both socially and privately optimal interventions agree with each other and require blocking the spread of all COVID-19-related information, leading to a negligible infection ratio 30 days after the initial reporting time. However, if the time horizon is prolonged to 180 days, only the privately optimal intervention requires information blocking, which would induce a catastrophically higher infection ratio than that in the counterfactual world where the socially optimal intervention encourages early-stage information spread. These findings contribute to the literature by revealing the complexity incurred by the coupled infodemic-epidemic dynamics and information heterogeneity to the governmental intervention decision, which also sheds insight into the design of an effective early warning system against the epidemic crisis in the future.

Sociodemographic Factors and Adjustment of Daily Activities During the COVID-19 Pandemic - Findings from the SHARE Corona Survey.

In the wake of the COVID-19 pandemic in 2020, older people across Europe have adjusted their daily activities as personal risk avoidance and as an amendment to policy recommendations and restrictions. In this study, we use multilevel logistic regressions to examine to what extent sociodemographic factors are associated with activity reduction among the older population (50+) in Europe and whether these associations are moderated by governmental policy responses to COVID-19. By combining data for~35,000 respondents from the SHARE Corona Survey on reported changes in daily activities and stringency of restrictions at the national level, we find that older age, poorer health and being female versus male were (consistently) associated with greater activity reduction across all activities both in countries with weak and in those with strong restrictions. Associations between education, employment and living situation, on the one hand, and activity reduction, on the other, were weaker and less consistent. We conclude that differences between sociodemographic groups are rather similar for countries with weak and those with strong restrictions and hence argue that group-specific policy recommendation are relevant independent of stringency recommendations.

Exploring the performance of responsible companies in G20 during the COVID-19 outbreak.

An uphill question of whether Environmental, Social, and Governance (ESG) directly impact firms' financial performance (FP) continues to vacillate between two opponent streams. In the present study, we argue that COVID-19 is an extreme event where the effect of ESG sharply manifests. We rely on cross-sectional data in the context of G20 countries for the year 2020. To avoid biased results due to governments support, we integrate four novel metrics provided by the Oxford Coronavirus Government Response Tracker (OxCGRT). We run sequential regressions (OLS; and quartiles to account for the Ingrained Income Bias (IIB) and ESG scores). We also perform robustness tests and account for the interaction between ESG and cash level. Our models were subsequently replicated for each ESG pillar. Findings indicate that ESG is beneficial during COVID-19, but the reward appears to be closely tied up to specific aspects of ESG, income level, and firm-specific variables. Results contribute to the burgeoning literature on ESG during COVID-19 by reflecting on firms' key attributes and the preponderance of government support.

The price of COVID-19-induced uncertainty in the options market.

This paper investigates the pricing of uncertainty associated with the COVID-19 responses for 28 countries/regions in 2020. We find that such uncertainty is priced in the equity options market. Specifically, there is a price premium for options that provide protection to hedge against price risk, variance risk, and tail risk caused by a variety of World Health Organization (WHO) announcements and the lockdown announcements from governments on COVID-19. Moreover, such options tend to be more expensive when the governments place stricter restrictions.

Scale development and validation for usage of social networking sites during COVID-19.

This research aims to explore the usage of social networking sites in the midst of the COVID-19 pandemic. To achieve the objective, this study develops and validates a scale to measure the usage of social networking sites. Data was collected via a google form link through social networking sites in India viz. Facebook, Instagram, Twitter, Telegram and WhatsApp. A total of 204 responses were found accurate and useable for the study. The population of the study includes people residing in India. Data was analyzed applying SPSS 20 and AMOS 22.0. To design and validate the scale, both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used in conjunction with each other. The EFA results indicate a six-factor structure, explaining 73.43% of the cumulative variance, with all the items loading above 0.70. Thus, all the 20 items of six constructs meet this threshold limit. Therefore, this 20-items questionnaire emerges as an effective tool for assessing social networking usage. This study developed and validated the scale of usage of social networking sites to measure the six constructs informativeness, education, entertainment, shopping, socialization and social cause. Social media developers and analysts can use this scale from a technological standpoint to redesign and refine their websites for a better user interface. Since the research is primarily focused on India, extrapolating the results to other countries is difficult.

Meteorological factors, governmental responses and COVID-19: Evidence from four European countries.

With the global lockdown, meteorological factors are highly discussed for COVID-19 transmission. In this study, national-specific and region-specific data sets from Germany, Italy, Spain and the United Kingdom were used to explore the effect of temperature, absolute humidity and diurnal temperature range (DTR) on COVID-19 transmission. From February 1st to November 1st, a 7-day COVID-19 case doubling time (Td), meteorological factors with cumulative 14-day-lagged, government response index and other factors were fitted in the distributed lag nonlinear models. The overall relative risk (RR) of the 10th and the 25th percentiles temperature compared to the median were 0.0074 (95% CI: 0.0023, 0.0237) and 0.1220 (95% CI: 0.0667, 0.2232), respectively. The pooled RR of lower (10th, 25th) and extremely high (90th) absolute humidity were 0.3266 (95% CI: 0.1379, 0.7734), 0.6018 (95% CI: 0.4693, 0.7718) and 0.3438 (95% CI: 0.2254, 0.5242), respectively. While the DTR did not have a significant effect on Td. The total cumulative effect of temperature (10th) and absolute humidity (10th, 90th) on Td increased with the change of lag days. Similarly, a decline in temperature and absolute humidity at cumulative 14-day-lagged corresponded to the lower RR on Td in pooled region-specific effects. In summary, the government responses are important factors in alleviating the spread of COVID-19. After controlling that, our results indicate that both the cold and the dry environment also likely facilitate the COVID-19 transmission.

Analysis of personal and national factors that influence depression in individuals during the COVID-19 pandemic: a web-based cross-sectional survey.

BACKGROUND: The World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic on March 11, 2020. Previous studies of infectious diseases showed that infectious diseases not only cause physical damage to infected individuals but also damage to the mental health of the public. Therefore this study aims to analyze the factors that affected depression in the public during the COVID-19 pandemic to provide evidence for COVID-19-related mental health policies and to emphasize the need to prepare for mental health issues related to potential infectious disease outbreaks in the future. RESULTS: This study performed the following statistical analyses to analyze the factors that influence depression in the public during the COVID-19 pandemic. First, to confirm the level of depression in the public in each country, the participants' depression was plotted on a Boxplot graph for analysis. Second, to confirm personal and national factors that influence depression in individuals, a multi-level analysis was conducted. As a result, the median Patient Health Questionnaire-9 (PHQ-9) score for all participants was 6. The median was higher than the overall median for the Philippines, Indonesia, and Paraguay, suggesting a higher level of depression. In personal variables, depression was higher in females than in males, and higher in participants who had experienced discrimination due to COVID-19 than those who had not. In contrast, depression was lower in older participants, those with good subjective health, and those who practiced personal hygiene for prevention. In national variables, depression was higher when the Government Response Stringency Index score was higher, when life expectancy was higher, and when social capital was higher. In contrast, depression was lower when literacy rates were higher. CONCLUSIONS: Our study reveals that depression was higher in participants living in countries with higher stringency index scores than in participants living in other countries. Maintaining a high level of vigilance for safety cannot be criticized. However, in the current situation, where coexisting with COVID-19 has become inevitable, inflexible and stringent policies not only increase depression in the public, but may also decrease resilience to COVID-19 and compromise preparations for coexistence with COVID-19. Accordingly, when establishing policies such as social distancing and quarantine, each country should consider the context of their own country.

The detection of the epidemic phase of COVID-19 and the timing of social distancing policies in Korea.

OBJECTIVES: Observing cumulative and new daily confirmed cases of COVID-19, disease control authorities respond to a surge in cases with social distancing measures or economic lockdown. The question in this article is whether we can gather more useful information from a readily available time series data set of day-to-day changes in confirmed cases of COVID-19. STUDY DESIGN: Time-series data analysis was done using a hidden Markov model. METHODS: Day-to-day differences in confirmed cases of COVID-19 in Korea from February 19, 2020, to July 13, 2021, were modeled via a hidden Markov model. The results from the model were compared with the effective reproduction number and the Korean government's response. RESULTS: The model reports that Korea was in an epidemic phase from August 2020 and from mid-November 2020, the second and third epidemic waves. The government's response, represented by the Government Response Stringency Index, was not timely during the epidemic phases. The results from the model may also be more helpful to detect the onset of the epidemic phase of an infectious disease than the effective reproduction number. CONCLUSIONS: The model can reveal a hidden epidemic phase and help disease control authorities to respond more promptly and effectively.

Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study.

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

Determinants of the community mobility during the COVID-19 epidemic: The role of government regulations and information.

This paper studies the dynamics of human mobility during the initial stage of the COVID-19 pandemic in countries around the world. The main goal of the analysis is to empirically separate voluntary reductions in mobility driven by the information about the location-specific pandemic trends from the effects of the government-imposed social distancing mandates. Google human mobility dataset is used to track the dynamics of mobility across a wide range of categories (e.g., workplace, retail and recreational activities, etc.), while information on country-specific counts of COVID-19 cases and deaths is used as a proxy for the information about the spread of the pandemic available to the population. A detailed index of stringency of the government-imposed social distancing policies in around 100 countries is used as a measure of government response. We find that human mobility does respond in a significant way to the information about the spread of the pandemic. This channel can explain about 15 percentage points of the overall reduction in mobility across the affected countries. At the same time, our results imply that government-imposed policies account for the majority of the reduction in the mobility observed during this period.

The immediate and subsequent effects of public health interventions for COVID-19 on the leisure and recreation industry.

Public health interventions to combat COVID-19 can be viewed as an exogenous shock to the economy, especially for industries-such as leisure, recreation, and tourism-that rely heavily on human mobility. This study investigates whether and how exactly the economic impact of government public health policies varies over time. Focusing on the leisure and recreation industry, we use data for 131 countries/regions from February to May 2020 and employ generalized difference-in-differences models to investigate the short- and longer-term effects of public health policies. We find that stricter policies lead, on average, to an immediate 9.2-percentage-point drop in leisure and recreation participation. Even so, that industry recovers in about seven weeks after a COVID-19 outbreak in countries/regions that undertake active interventions. After thirteen weeks, leisure and recreation involvement recovers to 70% of pre-pandemic levels in a place that actively intervened but stagnates at about 40% in one that did not.

Citizens' trust in government as a function of good governance and government agency's provision of quality information on social media during COVID-19.

Evidence from literature reveals that good governance practices influence citizens' attitudes and behaviours towards the government. Therefore, grounded on the good governance theory, the current study aimed to empirically examine how good governance practices promote public trust with the underlying mechanism of perceived government response on COVID-19 (PGRC) and moderating role of government agency's provision of quality information on social media (GQS). The data was collected from 491 followers of the Facebook account, Instagram, and Twitter pages of a government news agency, i.e., Associated Press of Pakistan and were analyzed using measurement and structural model by employing SmartPls 3.3.0. The results revealed a direct and indirect association of good governance practices with the public's trust in government via PGRC as mediator. Likewise, results showed that GQS interacts with PGRC and augments public trust in government. This study tried to contribute to the body of knowledge while addressing the gap related to the dearth of literature regarding government use of ICT during the COVID-19 pandemic to harvest benefits from social media while communicating with citizens on a larger scale. Moreover, the current study offers valuable practical and strategical recommendations to agencies and policymakers.

Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study.

BACKGROUND: Disabled people are particularly exposed to the risks of COVID-19, as well as to the measures taken to address it, and their impact. The aim of the study was to examine the disability-inclusiveness of government responses to COVID-19 in four South American Countries: Argentina, Brazil, Chile, and Peru. METHODS: We conducted documentary research, using framework analysis to analyse reports, legislation, decrees, and other official documents that communicated measures taken in response to the pandemic, published from February 1st until May 22nd, 2020. We included documents reporting measures that affected disabled people either directly (measures specifically designed for disabled people) or indirectly (measures for the general population). We developed an analytical framework based on recommendations for disability-inclusive response to COVID-19 published by the Economic Commission for Latin America and the Carribean, the World Health Organisation, and other international organisations. RESULTS: We analysed 72 documents. The findings highlight that while some positive measures were taken, the needs of disabled people were not fully considered. Several countries published recommendations for a disability-inclusive response to COVID-19, without ensuring their translation to practice. All countries took at least some steps to ensure access to financial support, health, and education for disabled people, but at the same time they also implemented policies that had a detrimental impact on disabled people. The populations that are most exposed to the impacts of COVID-19, including disabled people living in institutional care, were protected in several cases only by recommendations rather by legislation. CONCLUSIONS: This study illustrates how the official government responses taken by four countries in the region - while positive, in several aspects - do not fully address the needs of disabled people, thus further disadvantaging them. In order to ensure response to COVID - 19 is disability inclusive, it is necessary to translate recommendations to practice, consider disabled people both in mainstream policy and in disability-specific measures, and focus on the long-term reconstruction phase.

Government responses to the COVID-19 pandemic of the Gulf Cooperation Council countries: good practices and lessons for future preparedness.

The COVID-19 pandemic has dramatically threatened the Gulf Cooperation Council (GCC) countries which have a large proportion of foreign workers. The governments of GCC countries have proactively implemented a comprehensive set of policy measures, and up to our knowledge, a systematic analysis of qualitative and quantitative evidence on the government response is still lacking. We summarized the GCC countries' government response and quantitatively measured that response using four indexes-the Government Response Index, the Stringency Index, the Vaccine Index, and the Initial Response Index, to analyse their response for future pandemic preparedness. Overall, the government response of all the GCC countries to the COVID-19 pandemic has been comprehensive, stringent, and timely. Notably, the GCC countries have implemented comprehensive vaccine policies. In addition, they have worked actively to protect foreign workers to improve their access to health services and secure their essential living conditions, regardless of their immigrant status. All the GCC countries dynamically adjusted their response to the evolving COVID-19 epidemiological burden and started to relax the stringency of the control policies after the Omicron wave, though the governments had different response magnitudes as measured by the four indexes. These findings have provided several important lessons for future pandemic response and preparedness for countries with similar economic, demographic, and health contexts in (1) prompt actions of containment and closure policies with dynamic adjusting, (2) strengthening health system policies, (3) comprehensive vaccination policies with universal access, (4) equitable and free access to testing, diagnosis, and treatment for all, and (5) strengthening the resilience of health systems.

Experiences of male irregular migrants during their migration process and reception in Spain: lessons learned from the COVID-19 pandemic.

Background: The causes behind migration movements are complex. The COVID-19 pandemic highlighted how several countries failed to respond to the virus adequately, while simultaneously infringing on people's rights. Male irregular migrants fled their countries of origin and embarked on a perilous migration journey to Spain. The highly restrictive COVID-19 measures and border closures affected the mobility of male irregular migrants, whose reception in the host country posed a challenge. It led to the establishment of emergency facilities to accommodate male irregular migrants affected by COVID-19, which had repercussions on their mental health. The aim of this study was to describe and understand the experiences of male irregular migrants throughout their migration process and reception in Spain during the COVID-19 pandemic. Methods: Qualitative descriptive study. Sixteen male irregular migrants participated in this study. Data were collected between January and March 2023 through 16 one-on-one in-depth interviews. Thematic analysis was used to analyze the qualitative data using ATLAS.ti computer software. Results: Three main themes emerged: (1) How the COVID-19 pandemic drove male irregular migrants to leave their countries of origin, (2) How COVID-19 lockdown policies affected the migration journey, and (3) Receiving male irregular migrants in a pandemic: a housing labyrinth marked by isolation and loneliness. Conclusion: The COVID-19 pandemic increased the social, employment and health inequalities experienced by male irregular migrants. Border closures exacerbated the migration journey and the social stigmatization of this group, who were seen as carriers of the virus in both transit and host countries. Strict control measures in emergency and reception facilities had a significant psychological impact on the male irregular migrants due to the social isolation they experienced. Health institutions should develop programs to guarantee the care needs of irregular migrants.

Pediatric suicide attempts lagged during the COVID-19 pandemic: a European multicenter study.

BACKGROUND: Elevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients' profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative. METHODS: We monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients' characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA. RESULTS: The study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods "other than self-poisoning" (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay. CONCLUSIONS: Findings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients' profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention.