Measuring voluntary and policy-induced social distancing behavior during the COVID-19 pandemic.

Staying home and avoiding unnecessary contact is an important part of the effort to contain COVID-19 and limit deaths. Every state in the United States enacted policies to encourage distancing and some mandated staying home. Understanding how these policies interact with individuals' voluntary responses to the COVID-19 epidemic is a critical initial step in understanding the role of these nonpharmaceutical interventions in transmission dynamics and assessing policy impacts. We use variation in policy responses along with smart device data that measures the amount of time Americans stayed home to disentangle the extent that observed shifts in staying home behavior are induced by policy. We find evidence that stay-at-home orders and voluntary response to locally reported COVID-19 cases and deaths led to behavioral change. For the median county, which implemented a stay-at-home order with about two cases, we find that the response to stay-at-home orders increased time at home as if the county had experienced 29 additional local cases. However, the relative effect of stay-at-home orders was much greater in select counties. On the one hand, the mandate can be viewed as displacing a voluntary response to this rise in cases. On the other hand, policy accelerated the response, which likely helped reduce spread in the early phase of the pandemic. It is important to be able to attribute the relative role of self-interested behavior or policy mandates to understand the limits and opportunities for relying on voluntary behavior as opposed to imposing stay-at-home orders.

Perceived social support and compliance on stay-at-home order during COVID-19 emergency in Nepal: an evidence from web-based cross-sectional study.

BACKGROUND: After COVID-19 was declared a Public Health Emergency of International Concern by WHO, several non-pharmaceutical interventions were adopted for containing the virus. Success to which largely depend upon citizens' compliance to these measures. There is growing body of evidence linking social support with health promoting behaviour. Hence, this research aimed to study the effects on compliance with stay-at-home order in relation to their perceived social support. METHODS: A web-based cross-sectional study was conducted among adult participants aged 18 years and above residing in Bagmati Province, Nepal. A convenient non-probability sampling method was adopted to select the required number of samples. The questionnaire was developed through an extensive review of literature, and consultations with the research advisor, subject experts, as well as peers and converted to online survey form using Google Forms. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS) scale whereas compliance was assessed using a single screening question. Statistical analysis was performed using SPSS version 20 involving both the descriptive and inferential statistics. RESULTS: Two fifth (40.2%) of the participants reported poor compliance with stay-at-home order which was found higher among participants who were not vaccinated against COVID-19 compared to those vaccinated (p value < 0.05). A significant difference was observed between sex and perceived support (p value < 0.05) with higher proportion (80.8%) of female participants reporting perceived support from family, friends, and significant others in comparison to male participants. CONCLUSION: Overall, the results of this study suggest that the perceived support from family is higher compared to others. Further evidence might be helpful to understand contextual factors on compliance with public health measures. Tailoring behaviour change messages as per the community needs would help the response in such emergencies. The findings from this study might be useful as one of the evidence base for formulating plans and policy during emergencies of similar nature.

State containment measures, living arrangements, and mental health of U.S. older adults during the COVID-19 pandemic.

OBJECTIVES: Early in the coronavirus pandemic, U.S. states implemented several different types of containment measures to slow the disease's spread. Early evidence indicates containment measures were associated with changes in individuals' mental health. This study explores the associations between U.S. state containment measures and older adults' mental health and importantly, whether the associations vary by living arrangement and gender. METHODS: The study analyzed national sample of adults aged 50 or older from 12 waves (April-July 2020) of the U.S. Household Pulse Survey (N = 394,934). State fixed-effects models linked four state containment measures (stay-at-home order, restaurant closure, bar closure, and movie theater closure) to levels of depression and anxiety across different types of living arrangements, net of controls. Men and women were analyzed separately. RESULTS: Stay-at-home order and restaurant and bar closure, but not movie theater closure, were associated with higher levels of depression and anxiety in older adults. Living arrangements moderated the associations for women but not men. For women, compared to living alone, living with a spouse or intergenerational family was associated with higher levels of anxiety and depression during stay-at-home order and restaurant closure. CONCLUSION: The associations between containment measures and mental health vary by type of living arrangement and were gendered, likely because household situations create different demands and supports that men and woman experience differently. Although containment measures are necessary to protect public health, paying attention to these underlying dynamics can inform policymakers' efforts to implement policies that balance harms and benefits for older adults.

Analysis of the influence of the stay-at-home order on the electricity consumption in Chinese university dormitory buildings during the COVID-19 pandemic.

During the COVID-19 pandemic, strict stay-at-home orders have been implemented in many Chinese universities in virus-hit regions. While changes in electricity consumption in the residential sector caused by COVID-19 have been thoroughly analysed, there is a lack of insight into the impact of the stay-at-home order on electricity consumption in university dormitory buildings. Based on questionnaire survey results, this study adopted the statistical Kaplan-Meier survival analysis to analyse the energy-use behaviours of university students in dormitories during the COVID-19 pandemic. The electricity load profiles of the dormitory buildings before and during the implementation of the stay-at-home order were generated and compared to quantitatively analyse the influence of COVID-19 pandemic on the energy-use behaviours of university students, and the proposed load forecasting method was validated by comparing the forecasting results with monitoring data on electricity consumption. The results showed that: 1) during the implementation of the stay-at-home order, electricity consumption in the university dormitory buildings increased by 41.05%; 2) due to the increased use of illuminating lamps, laptops, and public direct drinking machines, the daily electricity consumption increased most significantly from 13:00 to 18:00, with an increase rate of 97.15%; and 3) the morning peak shifted backward and the evening peak shifted forward, demonstrating the effect of implementing the stay-at-home order on reshaping load profiles.

Work from home during the COVID-19 pandemic: An observational study based on a large geo-tagged COVID-19 Twitter dataset (UsaGeoCov19).

As COVID-19 swept over the world, people discussed facts, expressed opinions, and shared sentiments about the pandemic on social media. Since policies such as travel restriction and lockdown in reaction to COVID-19 were made at different levels of the society (e.g., schools and employers) and the government, we build a large geo-tagged Twitter dataset titled UsaGeoCov19 and perform an exploratory analysis by geographic location. Specifically, we collect 650,563 unique geo-tagged tweets across the United States covering the date range from January 25 to May 10, 2020. Tweet locations enable us to conduct region-specific studies such as tweeting volumes and sentiment, sometimes in response to local regulations and reported COVID-19 cases. During this period, many people started working from home. The gap between workdays and weekends in hourly tweet volumes inspire us to propose algorithms to estimate work engagement during the COVID-19 crisis. This paper also summarizes themes and topics of tweets in our dataset using both social media exclusive tools (i.e., #hashtags, @mentions) and the latent Dirichlet allocation model. We welcome requests for data sharing and conversations for more insights. UsaGeoCov19 link:http://yunhefeng.me/geo-tagged_twitter_datasets/.

Working from home: small business performance and the COVID-19 pandemic.

Abstract: During the COVID-19 pandemic, many firms began operating in a working-from-home environment (WFH). This study focuses on the relationship between WFH and small business performance during the pandemic. We built a theoretical framework based on firm profit maximization, compiled an up-to-date (March through November) real-time daily and weekly multifaceted data set, and empirically estimated fixed-effect panel data, fractional logit, and multilevel mixed effects models to test our hypotheses. We find that in states with higher WFH rates, small businesses performed better overall with industry variations, controlling for the local pandemic, economic, demographic, and policy factors. We also find that WFH rates increased even after stay-at-home orders (SHOs) were rescinded. With the ready technology and practice of WFH in the pandemic, our robust empirics confirm our theory and hypotheses and demonstrate WFH as a potential force that may expedite "creative destruction" instance and permanently impact industrial structure and peoples' work lives. Plain English summary: The Rise of Working from Home (WFH) as a Silver Lining and "Creative Destruction" in the Pandemic: WFH Helps Small Businesses Perform Better with Industry Variations and Continues to Shine after Stay-at-Home Orders Ended. This study focuses on the role of working from home (WFH) for small business performance during the COVID-19 pandemic. We built a theoretical framework based on firm profit maximization and identified WFH as a rational business choice. We then compiled a real-time multifaceted data set, estimated panel fixed-effect, fractional logit, and multilevel mixed effects models, and find that (1) small businesses in states with higher WFH rates performed better with industry variations, controlling for local pandemic and socioeconomic factors; and (2) WFH rates increased after stay-at-home orders were rescinded. Our study demonstrates WFH as a potential "creative destruction" force that may expedite our technologically ready WFH adoption and permanently impact industrial structure and peoples' work lives.

Differential impact of mitigation policies and socioeconomic status on COVID-19 prevalence and social distancing in the United States.

BACKGROUND: The spread of COVID-19 has highlighted the long-standing health inequalities across the U.S. as neighborhoods with fewer resources were associated with higher rates of COVID-19 transmission. Although the stay-at-home order was one of the most effective methods to contain its spread, residents in lower-income neighborhoods faced barriers to practicing social distancing. We aimed to quantify the differential impact of stay-at-home policy on COVID-19 transmission and residents' mobility across neighborhoods of different levels of socioeconomic disadvantage. METHODS: This was a comparative interrupted time-series analysis at the county level. We included 2087 counties from 38 states which both implemented and lifted the state-wide stay-at-home order. Every county was assigned to one of four equally-sized groups based on its levels of disadvantage, represented by the Area Deprivation Index. Prevalence of COVID-19 was calculated by dividing the daily number of cumulative confirmed COVID-19 cases by the number of residents from the 2010 Census. We used the Social Distancing Index (SDI), derived from the COVID-19 Impact Analysis Platform, to measure the mobility. For the evaluation of implementation, the observation started from Mar 1st 2020 to 1 day before lifting; and, for lifting, it ranged from 1 day after implementation to Jul 5th 2020. We calculated a comparative change of daily trends in COVID-19 prevalence and Social Distancing Index between counties with three highest disadvantage levels and those with the least level before and after the implementation and lifting of the stay-at-home order, separately. RESULTS: On both stay-at-home implementation and lifting dates, COVID-19 prevalence was much higher among counties with the highest or lowest disadvantage level, while mobility decreased as the disadvantage level increased. Mobility of the most disadvantaged counties was least impacted by stay-at-home implementation and relaxation compared to counties with the most resources; however, disadvantaged counties experienced the largest relative increase in COVID-19 infection after both stay-at-home implementation and relaxation. CONCLUSIONS: Neighborhoods with varying levels of socioeconomic disadvantage reacted differently to the implementation and relaxation of COVID-19 mitigation policies. Policymakers should consider investing more resources in disadvantaged counties as the pandemic may not stop until most neighborhoods have it under control.

Impact of COVID-19 on Pediatric Clinical Research.

PURPOSE: Many public institutions and settings have taken action to limit exposure to and slow the spread of the novel coronavirus (COVID-19). We sought to characterize the impact of stay-at-home orders on our study of cerebral autoregulation and its association with developmental delays in infants with congenital heart disease compared with healthy controls. DESIGN AND METHODS: We calculated the number of participants recruited (i.e., not enrolled in the study) and assessed (i.e., currently enrolled) before March 2020 (pre-COVID-19) and the number of participants that we could not recruit or assess between March and July 2020 (missed due to COVID-19), separately for congenital heart disease and healthy control infants, in reference to the impacts of COVID-19. We used negative binomial regressions to determine incidence rate ratios which compared participants recruited and assessed pre-COVID-19 and missed due to COVID-19. RESULTS: Recruitment and assessments significantly decreased following the pandemic, i.e., participants were more likely to be recruited or be assessed pre-COVID-19 compared to during the pandemic. Study participants were 3.3 times as likely to have assessments performed pre-COVID-19 compared to during the COVID-19 pandemic (p < 0.001). CLINICAL IMPLICATIONS: Clinical research teams may consider making protocol modifications such as virtual visits or video recordings explaining the study, for example, to adjust to the restrictions caused by COVID-19. CONCLUSION: The COVID-19 pandemic drastically reduced recruitment and assessments completed in our study. Study teams will need to continue to modify procedures for recruitment and assessments that align with COVID-19 regulations to facilitate research progress during the pandemic.

Association between state stay-at-home orders and risk reduction behaviors and mental distress amid the COVID-19 pandemic.

The 2019 Coronavirus Disease (COVID-19) pandemic has triggered stay-at-home orders in 43 states since March 19, 2020. Evidence is limited on how these orders affect peoples' behaviors and mental distress. We used a nationally representative survey of 1094 American adults collected between March 19 and March 31, 2020 to compare risk-reduction behaviors and mental distress in states with and without orders. Risk reduction behaviors included hand washing, wearing face mask and social distancing, and the mental distress was assessed by the four-item version of the Patient Health Questionnaire (PHQ-4). We predicted the probability of a person adopting risk reduction behaviors and the mental distress status using the number of days since their state issued the order relative to those in the non-order states, controlling for COVID-19 prevalence in the state, self-reported symptoms and demographic characteristics. The analysis was conducted in April 2020. Results show that the probability of adopting risk reduction behaviors increased between 8 (avoidance of people with high risk, 87% to 95%) and 27 (use of face mask, 18% to 45%) percentage points in the response period. Mental distress increased by 1.0 point on the PHQ-4 score (from 2.4 to 3.5 point) in the first week and started to drop afterwards. In summary, stay-at-home orders were associated with a differential increase in risk-reduction behaviors. People's mental distress rose in the first week under order and dropped afterwards. While in need for confirmation in longitudinal data, these results suggest that residents are responsive to orders.

Are stay-at-home orders more difficult to follow for low-income groups?

In response to the COVID-19 pandemic, a growing number of states, counties and cities in the United States issued mandatory stay-at-home orders as part of their efforts to slow down the spread of the virus. We argue that the consequences of this one-size-fits-all order will be differentially distributed among economic groups. In this paper, we examine social distance behavior changes for lower income populations. We conduct a comparative analysis of responses between lower-income and upper-income groups and assess their relative exposure to COVID-19 risks. Using a difference-in-difference-in-differences analysis of 3140 counties, we find social distance policy effect on the lower-income group is smaller than that of the upper-income group, by as much as 46% to 54%. Our explorations of the mechanisms behind the disparate effects suggest that for the work-related trips the stay-at-home orders do not significantly reduce low income work trips and this result is statistically significant. That is, the share of essential business defined by stay-at-home orders is significantly negatively correlated with income at county level. In the non-work-related trips, we find that both the lower-income and upper-income groups reduced visits to retail, recreation, grocery, and pharmacy visits after the stay-at-home order, with the upper-income group reducing trips more compared to lower-income group.

Changes in Obesity Prevalence Among U.S. Adults After the COVID-19 Pandemic by State and Territorial Stay-at-Home Order Level and Sociodemographic Characteristics.

PURPOSE: To examine changes in obesity prevalence among US adults after the COVID-19 pandemic by level of stay-at-home order and sociodemographic characteristics. DESIGN: Quasi-experimental study using repeated cross-sectional data. SETTING: Behavioral Risk Factor Surveillance System (BRFSS). SAMPLE: Pooled data for US adults ages ≥26 years (n = 1,107,673) from BRFSS (2018-2021). MEASURES: States/territories were classified into three levels of stay-at-home order: none, advisory/only for persons at risk, or mandatory for all. Individual-level sociodemographic characteristics were self-reported. ANALYSIS: The difference-in-differences method was conducted with weighted multiple logistic regression analysis to examine obesity (body mass index ≥30 kg/m2) prevalence by stay-at-home order level and sociodemographic characteristics before/after the COVID-19 pandemic (January 2018-February 2020 vs March 2020-February 2022). RESULTS: After adjusting for a secular trend and multiple covariates, adults in states/territories with mandatory stay-at-home orders experienced a larger increase in obesity prevalence (adjusted odds ratio: 1.05; 95% confidence interval: 1.01, 1.11) than adults in states/territories with no stay-at-home order. Younger adults (vs ≥65 years) and individuals with

Depression and Anxiety on Twitter During the COVID-19 Stay-At-Home Period in 7 Major U.S. Cities.

Introduction: Although surveys are a well-established instrument to capture the population prevalence of mental health at a moment in time, public Twitter is a continuously available data source that can provide a broader window into population mental health. We characterized the relationship between COVID-19 case counts, stay-at-home orders because of COVID-19, and anxiety and depression in 7 major U.S. cities utilizing Twitter data. Methods: We collected 18 million Tweets from January to September 2019 (baseline) and 2020 from 7 U.S. cities with large populations and varied COVID-19 response protocols: Atlanta, Chicago, Houston, Los Angeles, Miami, New York, and Phoenix. We applied machine learning‒based language prediction models for depression and anxiety validated in previous work with Twitter data. As an alternative public big data source, we explored Google Trends data using search query frequencies. A qualitative evaluation of trends is presented. Results: Twitter depression and anxiety scores were consistently elevated above their 2019 baselines across all the 7 locations. Twitter depression scores increased during the early phase of the pandemic, with a peak in early summer and a subsequent decline in late summer. The pattern of depression trends was aligned with national COVID-19 case trends rather than with trends in individual states. Anxiety was consistently and steadily elevated throughout the pandemic. Google search trends data showed noisy and inconsistent results. Conclusions: Our study shows the feasibility of using Twitter to capture trends of depression and anxiety during the COVID-19 public health crisis and suggests that social media data can supplement survey data to monitor long-term mental health trends.

The Local and Aggregated Impacts of Stay-at-Home Orders on State Level Unemployment Outcomes.

Initial research on the effect of pandemic related stay-at-home orders (SAHO) on subsequent US state unemployment rates found inconclusive results regarding the magnitude of the effect. This research helps to clarify the debate, finding that while own-state SAHOs affected unemployment outcomes, it was actually the national level of SAHO implementation across the country that had an even greater impact. While these results do not offer direct guidance on when or whether SAHOs should have been issued in any given state, they do help to clarify the impact of SAHOs on various measures of US unemployment. Supplementary Information: The online version contains supplementary material available at 10.1057/s41302-023-00243-4.

Influence of a Stay-At-Home Order on Trauma Volume and Injury Patterns at a Level I Trauma Center in Ohio.

BACKGROUND: Changes in injury patterns during the COVID pandemic have been reported in other states. The objective was to explore changes to trauma service volume and admission characteristics at a trauma center in northeast Ohio during a stay-at-home order (SAHO) and compare the 2020 data to historic trauma census data. METHODS: Retrospective chart review of adult trauma patients admitted to a level I trauma center in northeast Ohio. Trauma admissions from January 21 to July 21, 2020 (COVID period) were compared to date-matched cohorts of trauma admissions from 2018 to 2019 (historic period). The COVID period was further categorized as pre-SAHO, active-SAHO, and post-SAHO. RESULTS: The SAHO was associated with a reduction in trauma center admissions that increased after the SAHO (P = .0033). Only outdoor recreational vehicle (ORV) injuries (P = .0221) and self-inflicted hanging (P = .0028) mechanisms were increased during the COVID period and had substantial effect sizes. Glasgow Coma Scores were lower during the COVID period (P = .0286) with a negligible effect size. Violence-related injuries, injury severity, mortality, and admission characteristics including alcohol and drug testing and positivity were similar in the COVID and historic periods. DISCUSSION: The SAHO resulted in a temporary decrease in trauma center admissions. Although ORV and hanging mechanisms were increased, other mechanisms such as alcohol and toxicology proportions, injury severity, length of stay, and mortality were unchanged.

Green space justice amid COVID-19: Unequal access to public green space across American neighborhoods.

Countries around the world have resorted to issuing stay-at-home orders to slow viral transmission since the COVID-19 pandemic. During the lockdown, access to public park plays a central role in the public health of surrounding communities. However, we know little about how such an unprecedented policy may exacerbate the preexisting unequal access to green space (i.e., green space justice). To address this research void, we used difference-in-difference models to examine socioeconomic disparities, urban-rural disparities, and mobility disparities in terms of public park access in the United States. Our national analysis using the weekly mobile phone movement data robustly suggests the following three key findings during COVID-19: (1) The elderly, non-college-educated people, poor people, and blacks are less likely to visit public parks frequently, while unemployed people appear to be the opposite. (2) Compared to rural areas, populations in urban neighborhoods appear to visit public parks more frequently and they generally go to larger parks to minimize the risk of infection. (3) Populations in neighborhoods with higher private vehicle ownership or those with a higher density of transit stops would more frequently visit and travel a longer distance to public parks during the stay-at-home order. Our results imply that conventional inequality in green space access may still exist and even become worse during COVID-19, which could negatively impact people's health during isolation. We suggest that special attention should be paid to park-poor neighborhoods during the pandemic and in the post-pandemic recovery phase.

Disentangling the Impact of Covid-19: An Interrupted Time Series Analysis of Crime in New York City.

The Covid-19 stay-at-home restrictions put in place in New York City were followed by an abrupt shift in movement away from public spaces and into the home. This study used interrupted time series analysis to estimate the impact of these changes by crime type and location (public space vs. residential setting), while adjusting for underlying trends, seasonality, temperature, population, and possible confounding from the subsequent protests against police brutality in response to the police-involved the killing of George Floyd. Consistent with routine activity theory, we found that the SAH restrictions were associated with decreases in residential burglary, felony assault, grand larceny, rape, and robbery; increases in non-residential burglary and residential grand larceny motor vehicle; and no change in murder and shooting incidents. We also found that the protests were associated with increases in several crime types: felony assault, grand larceny, robbery, and shooting incidents. Future research on Covid-19's impact on crime will need to account for these potentially confounding events.

Sexual Behavior Change Among Gay and Bisexual Men During the First COVID-19 Pandemic Wave in the United States.

Background: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. Methods: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. Results: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. Conclusion: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners.

Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

BACKGROUND: The COVID-19 pandemic has impacted timely access to care for children, including patients with appendicitis. This study aimed to evaluate the effect of the COVID-19 pandemic on management of appendicitis and patient outcomes. METHODS: A multicenter retrospective study was performed including 19 children's hospitals from April 2019-October 2020 of children (age≤18 years) diagnosed with appendicitis. Groups were defined by each hospital's city/state stay-at-home orders (SAHO), designating patients as Pre-COVID (Pre-SAHO) or COVID (Post-SAHO). Demographic, treatment, and outcome data were obtained, and univariate and multivariable analysis was performed. RESULTS: Of 6,014 patients, 2,413 (40.1%) presented during the COVID-19 pandemic. More patients were managed non-operatively during the COVID-19 pandemic compared to before the pandemic (147 (6.1%) vs 144 (4.0%), p < 0.001). Despite this change, there was no difference in the proportion of complicated appendicitis between groups (1,247 (34.6%) vs 849 (35.2%), p = 0.12). COVID era non-operative patients received fewer additional procedures, including interventional radiology (IR) drain placements, compared to pre-COVID non-operative patients (29 (19.7%) vs 69 (47.9%), p < 0.001). On adjusted analysis, factors associated with increased odds of receiving non-operative management included: increasing duration of symptoms (OR=1.01, 95% CI: 1.01-1.012), African American race (OR=2.4, 95% CI: 1.3-4.6), and testing positive for COVID-19 (OR=10.8, 95% CI: 5.4-21.6). CONCLUSION: Non-operative management of appendicitis increased during the COVID-19 pandemic. Additionally, fewer COVID era cases required IR procedures. These changes in the management of pediatric appendicitis during the COVID pandemic demonstrates the potential for future utilization of non-operative management.

Visiting parents in times of COVID-19: The impact of parent-adult child contacts on the psychological health of the elderly.

Using the 8th wave of the SHARE and the SHARE Corona Survey, we investigated whether the disruption of parent-adult child contacts due to social distancing restrictions increased the symptoms of depression among old age individuals during the first wave of the COVID-19 pandemic. We model the relationship between the disruption of parent-adult child contacts and the mental health of the elderly using a recursive simultaneous equation model for binary variables. Our findings show that the likelihood of disruption of parent-adult child contacts was higher with adult children who do not live with or close to their parents (i.e., in the same household or in the same building) for whom contact disruption increases about 15 %. The duration of restrictions to movement and lockdowns also has a positive and significant effect on parent-child contact disruption: an additional week of lockdown significantly increases the probability of parent-child contact disruption, by about 1.5 %. The interventions deemed essential to reduce the spread of the pandemic, such as the "stay-at-home" order, necessarily disrupted personal parent-child contacts and the social processes that facilitate psychological well-being, increasing the probability of suffering from a deepening depressed mood by about 17 % for elderly parents.

Perceived physical activity during stay-at-home COVID-19 pandemic lockdown March-April 2020 in Polish adults.

BACKGROUND: Lockdowns amid the COVID-19 pandemic drastically reduced the possibility of undertaking physical activity (PA) in gyms, swimming pools, or work-related PA, e.g., active commuting. However, the stay-at-home order could have reduced PA the most, i.e., the ban of unnecessary outdoor activities. It affected free walking, running, skiing, active tourism, etc. It is, therefore, crucial to estimate how the stay-at-home order affected PA. We estimated how the stay-at-home order affected perceived PA and sedentary behavior compared to the pre-pandemic time in Poland. METHODS: We used a self-reported International Physical Activity Questionnaire-Long Form (IPAQ-LF) to estimate the time (minutes per day) of vigorous and moderate PA and walking and sitting time. RESULTS: We gathered data from 320 Polish participants. Bayesian approaches, including t-test and Bayesian correlations, were used to find differences and correlations between PA before and during the stay-at-home lockdown. Our data supported the hypotheses that vigorous PA, as well as walking, declined during the lockdown. Surprisingly, our data did not support the hypothesis that moderate physical activity was reduced. We found that moderate PA during lockdown increased compared to the pre-lockdown PA. As hypothesized, our data strongly evinced that sitting time inclined during the lockdown. PA decline was not correlated with the available living space. People who had access to gardens did not demonstrate a higher PA level than those without. DISCUSSION: Walking and sitting time have drastically changed during the stay-at-home lockdown, decreasing and increasing, respectively. Given results from studies focusing on lockdowns without the stay-at-home restriction, it may be assumed that letting people go outside is crucial in keeping them more active and less sedentary. Authorities should take into account the effect the stay-at-home order may have on PA and sedentary behavior and as a result, on health. Stay-at-home orders should be the last considered restriction, given its detrimental consequences.