Trends in vaping and smoking behavior before and during the COVID-19 pandemic in Canada: Beneficial and potentially detrimental changes.

INTRODUCTION: E-cigarette and cigarette use may have changed during the COVID-19 pandemic, however, there is no consensus in existing literature, and current Canadian studies have not used representative samples. Thus, there is a need for robust national estimates. OBJECTIVE AND METHODS: The primary objective was to describe the 30-day period prevalence of smoking and vaping before and during the COVID-19 pandemic in Canada. This study analyzed three years of the cross-sectional Canadian Tobacco and Nicotine Survey: 2019 (pre-pandemic), 2020 (9 months into the pandemic) and 2021 (21 months into pandemic). RESULTS: Thirty-day period prevalence of vaping over the 2019, 2020, and 2021 study periods were 4.8 (95%CI: 4.2-5.3), 4.6% (95%CI: 4.1-5.2), and 5.2% (95%CI: 4.7-5.7), respectively. The 30-day period prevalence of smoking over the 2019, 2020, and 2021 study periods were 11.9% (95%CI: 10.9-12.7), 10.3% (95%CI: 9.4-11.2), and 10.3% (95%CI: 9.4-11.1), respectively. Notably, estimates of smoking for females decreased considerably from 2019 (11.0%; 95%CI: 9.9--12.2%) to 2020 (8.6%; 95%CI: 7.5-9.7). Estimates of vaping in those aged 20-24 increased substantially from 2020 (13.0%; 95%CI: 10.9-15.1) to 2021 (17.2%; 95%CI: 15.4-18.9). CONCLUSIONS: Changes to smoking and vaping were restricted to subsets within the population. In those aged 20-24, there was a modest increase in vaping from 2020 to 2021. In females, there was a decrease in smoking from 2019 to 2020, which persisted in 2021.

A Decade of Tweets: Visualizing Racial Sentiments Towards Minoritized Groups in the United States Between 2011 and 2021.

BACKGROUND: Research has demonstrated the negative impact of racism on health, yet the measurement of racial sentiment remains challenging. This article provides practical guidance on using social media data for measuring public sentiment. METHODS: We describe the main steps of such research, including data collection, data cleaning, binary sentiment analysis, and visualization of findings. We randomly sampled 55,844,310 publicly available tweets from 1 January 2011 to 31 December 2021 using Twitter's Application Programming Interface. We restricted analyses to US tweets in English using one or more 90 race-related keywords. We used a Support Vector Machine, a supervised machine learning model, for sentiment analysis. RESULTS: The proportion of tweets referencing racially minoritized groups that were negative increased at the county, state, and national levels, with a 16.5% increase at the national level from 2011 to 2021. Tweets referencing Black and Middle Eastern people consistently had the highest proportion of negative sentiment compared with all other groups. Stratifying temporal trends by racial and ethnic groups revealed unique patterns reflecting historical events specific to each group, such as the killing of George Floyd regarding sentiment of posts referencing Black people, discussions of the border crisis near the 2018 midterm elections and anti-Latinx sentiment, and the emergence of COVID-19 and anti-Asian sentiment. CONCLUSIONS: This study demonstrates the utility of social media data as a quantitative means to measure racial sentiment over time and place. This approach can be extended to a range of public health topics to investigate how changes in social and cultural norms impact behaviors and policy.A supplemental digital video is available at http://links.lww.com/EDE/C91.

Tools and methods for evaluating the change to health service delivery due to pandemics or other similar emergencies: A rapid evidence review.

The novel coronavirus, SARS-CoV-2 and its associated disease COVID-19, were declared a pandemic in March 2020. Countries developed rapid response activities within their health services to prevent spread of the virus and protect their populations. Evaluating health service delivery change is vital to assess how adapted practices worked, particularly during times of crisis. This review examined tools and methods that are used to evaluate health service delivery change during pandemics and similar emergencies. Five databases were searched, including PubMed, CENTRAL, Embase, CINAHL, and PsycINFO. The SPIDER tool informed the inclusion criteria for the articles. Articles in English and published from 2002 to 2020 were included. Risk of bias was assessed using the Mixed-Methods Appraisal Tool (MMAT). A narrative synthesis approach was used to analyse the studies. Eleven articles met the inclusion criteria. Many evaluation tools, methods, and frameworks were identified in the literature. Only one established tool was specific to a particular disease outbreak. Others, including rapid-cycle improvement and PDSA cycles were implemented across various disease outbreaks. Novel evaluation strategies were common across the literature and included checklists, QI frameworks, questionnaires, and surveys. Adherence practices, experience with telehealth, patient/healthcare staff safety, and clinical competencies were some areas evaluated by the tools and methods. Several domains, including patient/practitioner safety and patient/practitioner experience with telemedicine were also identified in the studies.

A descriptive study on the potential transmission of COVID-19 to hospitalized patients from a nursery school affiliated with it.

INTRODUCTION: During the epidemic of the Omicron variant of SARS-CoV-2, nosocomial transmissions from healthcare workers (HCWs) to patients occur frequently. The influence of COVID-19 on hospitalized patients from nursing schools affiliated with the hospitals is a concern but it had not been well studied. METHODS: We here describe COVID-19 outbreaks at the nursery school affiliated with an acute-care hospital, during the surges of the Omicron variants on the transmission of SARS-CoV-2 children as well as for the patients who were judged to be the close contacts of patients of COVID-19 by contact investigation by PCR testing. RESULTS: A total of 36 children and five caregivers were diagnosed with COVID-19 during the study period. Of the 206 preschoolers who had close contact with the infected persons, only 16 became positive (7.6%). Secondary transmission from the 36 preschool children to the parents as HCWs occurred in 19 (61%) out of 31 parents. Three hospitalized patients were judged to have unsafe contact with the infected HCWs but this did not result in their infections, making a total of zero transmission from the nursery school to the hospital. CONCLUSIONS: Children at the nursery school are potential reservoirs for nosocomial transmissions at the affiliated hospital, but multiple practical measures might have prevented them to occur.

Differences in COVID-19 treatment across Japan: Analysis of the COVID-19 Registry Japan (COVIREGI-JP).

BACKGROUND: This study investigated the differences between metropolitan and non-metropolitan areas in the treatment of hospitalized patients with COVID-19 using data from the nationwide COVID-19 Registry Japan (COVIREGI-JP). METHODS: Data of patients hospitalized for COVID-19 during waves 2-4 (June 1, 2020-June 30, 2021) treated in one of the 800 medical institutions participating in the Registry were extracted. Treatment and treatment outcomes were evaluated in inpatients with moderate 2 and severe disease using propensity score matching performed between metropolitan and non-metropolitan areas. RESULTS: A total of 32797 patients were identified during epidemic waves 2-4. After matching (wave 2, n = 307; wave 3, n = 913; wave 4, n = 479), the population comprised mostly elderly patients with a median age of ≥65 years (IQR: 52-81 years) and median SpO2 of 93/94 (IQR: 91%-96%), and the proportion of patients with moderate 2 (SpO2≤93%/require oxygenation) vs severe disease (ICU admission) ranged from 82.7% to 89.8% vs 10.2% to 17.3% in metropolitan areas vs non-metropolitan areas, respectively, across all epidemic waves. Noninvasive mechanical ventilation was used significantly more in waves 2 and 3 and invasive mechanical ventilation in wave 4 in metropolitan vs non-metropolitan areas, compared with other waves. In wave 2, death as an outcome was significantly higher in metropolitan vs non-metropolitan areas compared with patient discharge to home/transfer. CONCLUSION: During the COVID-19 epidemic, starting from wave 2 up until and through wave 4, no clear differences in mortality rates and no regional differences in treatment provision patterns were observed between metropolitan and non-metropolitan areas in Japan.

Risk factors for progressing to severe COVID-19 among people living with HIV in Japan: A hospital claims database study.

INTRODUCTION: Risk factors for severe COVID-19 associated with people living with HIV (PLWH) have not been well studied in Japan. In this study, we aim to reveal how having AIDS and comorbidities affect adverse COVID-19 outcomes. METHODS: This observational, retrospective study examined the clinical outcomes for PLWH hospitalized as COVID-19 inpatients in Japan, using data extracted from hospitals with the Diagnosis Procedure Combination (DPC) system between January 2020 and December 2021. From 4672 records of HIV patients receiving antiretroviral therapy, 85 adult PLWH became hospitalized with COVID-19. The associations between patients' AIDS diagnosis, comorbidities, and their adverse COVID-19 outcomes (mild/moderate and severe/death) were analyzed. RESULTS: Among 85 studied patients, 78 were male (91.8%) with mean (SD) age of 48 (14.4) years. 75 (88.2%) were found to be COVID-19 mild/moderate; 9 (10.6%) were severe; 1 (1.2%) died. Older age (p = 0.002) and hypertension (p = 0.032) were significantly associated with progressing to severe COVID-19 or death. AIDS and other AIDS-defining illnesses were not found to be significant risk factors in this study. CONCLUSIONS: While interpretation of the results from this hospital claim database study warrants caution, we found that among PLWH hospitalized as COVID-19 inpatients in Japan, those who are older or with hypertension have a higher risk for progression to severe COVID-19 outcomes, suggesting a careful monitoring of clinical course for these patients.

Influence of the coronavirus infectious disease 2019 pandemic on infectious disease practice and infection control in Japan: A web questionnaire survey.

INTRODUCTION: Infection and mortality rates caused by the coronavirus infectious disease 2019 (COVID-19) pandemic were high. However, the influence of the COVID-19 pandemic on the clinical burden in medical facilities remains to be clarified in Japan. MATERIALS AND METHODS: This study used a questionnaire-based web survey to clarify how the COVID-19 pandemic affected infectious disease practice and infection control. The questionnaire was sent to healthcare professionals at nationwide medical facilities between January 13, 2023, and February 15, 2023. RESULTS: Responses were obtained from 1784 healthcare professionals throughout Japan. Hospital management of COVID-19 patients was the responsibility of 96.5% of respondents. Furthermore, 75.1% had experienced nosocomial spread of COVID-19. Manuals and infection control measures for COVID-19 have been arranged in most facilities. In many facilities, the timing of an infected employee's return to work was determined in accordance with the isolation period for coronavirus-positive patients with symptoms established by the Ministry of Health, Labor and Welfare in Japan. Approximately 30% of respondents reported that caring for COVID-19 patients, including the use of personal protective equipment, was their most stressful job. Approximately 50% of the respondents reported an increase in overtime hours. Approximately 90% of facilities are now capable of performing COVID-19 testing onsite. CONCLUSION: Infection control for COVID-19 has been improved, and testing equipment for SARS-CoV-2 has been prepared. Patient care-related burdens and burdens caused by having to compensate for vacancies due to infected staff members have increased. In the future, a reduction in workload and role sharing should be considered.

The effect of the urban exposome on COVID-19 health outcomes: A systematic review and meta-analysis.

BACKGROUND: The global severity of SARS-CoV-2 illness has been associated with various urban characteristics, including exposure to ambient air pollutants. This systematic review and meta-analysis aims to synthesize findings from ecological and non-ecological studies to investigate the impact of multiple urban-related features on a variety of COVID-19 health outcomes. METHODS: On December 5, 2022, PubMed was searched to identify all types of observational studies that examined one or more urban exposome characteristics in relation to various COVID-19 health outcomes such as infection severity, the need for hospitalization, ICU admission, COVID pneumonia, and mortality. RESULTS: A total of 38 non-ecological and 241 ecological studies were included in this review. Non-ecological studies highlighted the significant effects of population density, urbanization, and exposure to ambient air pollutants, particularly PM2.5. The meta-analyses revealed that a 1 µg/m3 increase in PM2.5 was associated with a higher likelihood of COVID-19 hospitalization (pooled OR 1.08 (95% CI:1.02-1.14)) and death (pooled OR 1.06 (95% CI:1.03-1.09)). Ecological studies, in addition to confirming the findings of non-ecological studies, also indicated that higher exposure to nitrogen dioxide (NO2), ozone (O3), sulphur dioxide (SO2), and carbon monoxide (CO), as well as lower ambient temperature, humidity, ultraviolet (UV) radiation, and less green and blue space exposure, were associated with increased COVID-19 morbidity and mortality. CONCLUSION: This systematic review has identified several key vulnerability features related to urban areas in the context of the recent COVID-19 pandemic. The findings underscore the importance of improving policies related to urban exposures and implementing measures to protect individuals from these harmful environmental stressors.

Characterization of summertime single aerosol particles in Chengdu (China): Interannual evolution and impact of COVID-19 lockdown.

To investigate the interannual evolution of air pollution in summer and the impact of the COVID-19 lockdown on local pollution in Chengdu, China, single aerosol particles were continuously measured in three summer periods: the regular period in 2020 (RP2020); the regular period in 2022 (RP2022); and the lockdown period in 2022 (LP2022). It was found that, from RP2020 to RP2022, the mass concentrations of PM2.5, PM10, SO2 and NO2 decreased by 25.6 %, 24.7 %, 28.8 % and 38.5 %, respectively, while the concentration of O3 increased by 11.0 %. Affected by regional transport, there was no significant decrease in the concentrations of various pollutants during LP2022. All single aerosol particles could be classified into seven categories: vehicle emissions (VE), dust, biomass burning (BB), coal combustion (CC), K mixed with sulfate (KSO4), K mixed with nitrate (KNO3) and K mixed with sulfate and nitrate (KSN) particles. From RP2020 to RP2022, the contributions of BB and CC particles decreased by 12.1 % and 0.9 %, respectively, while VE and dust particles increased by 3.6 % and 2.5 %, respectively; and compared to RP2022, the contributions of VE, dust and CC particles in LP2022 decreased by 22.2 %, 11.0 % and 12.7 %, respectively. The high PM2.5 pollution events in RP2020 and RP2022 were mainly caused by combustion sources (BB and CC, 51.6 %) and VE (38.3 %) particles, respectively, while the pollution event in LP2022 was contributed by BB (27.0 %) and secondary inorganic (KSO4, KNO3 and KSN, 60.2 %) particles. The formation mechanisms of different pollution events were further validated by WRF-Chem results. Although the potential source areas of particles showed a shrinking trend from RP2020 to RP2022, regional transport still caused high PM2.5 pollution events during LP2022. Photochemical processes dominated the formation of KSO4 particles, while the KNO3 and KSN particles were mainly generated by liquid-phase reactions, and this effect increased year by year.

Pollution characteristics and source differences of VOCs before and after COVID-19 in Beijing.

During the outbreak of the COVID-19, the change in the way of people's living and production provided the opportunity to study the influence of human activity on Volatile organic compounds (VOCs) in the atmosphere. Therefore, this study analyzed VOCs concentration and composition characteristics in urban area of Beijing from 2019 to 2020. The results showed that the concentration of VOCs in Chaoyang district in 2020 was 73.1ppbv, lower than that in 2019 (92.8ppbv), and alkanes (45 % and 47 %) were the most dominant components. The concentrations of isopentane, n-pentane, n-hexane, and OVOCs significantly increased in 2020. According to the results of the PMF model, the contribution of VOCs from vehicle and pharmaceutical-related emissions increased to 45.8 % and 27.1 % in 2020, while coal combustion decreased by 23.7 %. This is likely linked to the strict implementation of the coal conversion policy, as well as the increment in individual travel and pharmaceutical production during the pandemic. The calculation results of OFP and SOAFP indicated that toluene had an increased impact on the formation of O3 and SOA in the Chaoyang district in 2020. Notably, VOCs emitted by vehicles have the highest potential for secondary generation. In addition, VOCs from vehicles and industries pose the greatest health risks, together accounting for 77.4 % and 79.31 % of the total carcinogenic risk in 2019 and 2020. Although industrial emission with the high proportions of halocarbons was controlled to some extent during the pandemic, the carcinogenic risk in 2020 was 3.74 × 10-6, which still exceeded the acceptable level, and more attention and governance efforts should be given to.

Development of highly sensitive one-step reverse transcription-quantitative PCR for SARS-CoV-2 detection in wastewater.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is a major public health concern that has highlighted the need to monitor circulating strains to better understand the coronavirus disease 2019 (COVID-19) pandemic. This study was carried out to monitor SARS-CoV-2 RNA and its variant-specific mutations in wastewater using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). One-step RT-qPCR using the SARS-CoV-2 Detection RT-qPCR Kit for Wastewater (Takara Bio), which amplified two N-gene regions simultaneously using CDC N1 and N2 assays with a single fluorescence dye, demonstrated better performance in detecting SARS-CoV-2 RNA (positive ratio, 66 %) compared to two-step RT-qPCR using CDC N1 or N2 assay (40 % each, and 52 % when combined), with significantly lower Ct values. The one-step RT-qPCR assay detected SARS-CoV-2 RNA in 59 % (38/64) of influent samples collected from a wastewater treatment plant in Japan between January 2021 and March 2022. The correlation between the concentration of SARS-CoV-2 RNA in the wastewater and the number of COVID-19 cases reported each day for 7 days pre- and post-sampling was significant (p < 0.05, r = 0.76 ± 0.03). Thirty-one influent samples which showed two-well positive for SARS-CoV-2 RNA were further tested by six mutations site-specific one-step RT-qPCR (E484K, L452R, N501Y, T478K, G339D, and E484A mutations). The N501Y mutation was detected between March and June 2021 but was replaced by the L452R and T478K mutations between July and October 2021, reflecting the shift from Alpha to Delta variants in the study region. The G339D and E484A mutations were identified in January 2022 and later when the incidence of the Omicron variant peaked. These findings indicate that wastewater-based epidemiology has the epidemiological potential to complement clinical tests to track the spread of COVID-19 and monitor variants circulating in communities.

Medication Safety Event Reporting: Factors That Contribute to Safety Events During Times of Organizational Stress.

BACKGROUND: Incident reports submitted during times of organizational stress may reveal unique insights. PURPOSE: To understand the insights conveyed in hospital incident reports about how work system factors affected medication safety during a coronavirus disease-2019 (COVID-19) surge. METHODS: We randomly selected 100 medication safety incident reports from an academic medical center (December 2020 to January 2021), identified near misses and errors, and classified contributing work system factors using the Human Factors Analysis and Classification System-Healthcare. RESULTS: Among 35 near misses/errors, incident reports described contributing factors (mean 1.3/report) involving skill-based errors (n = 20), communication (n = 8), and tools/technology (n = 4). Reporters linked 7 events to COVID-19. CONCLUSIONS: Skill-based errors were the most common contributing factors for medication safety events during a COVID-19 surge. Reporters rarely deemed events to be related to COVID-19, despite the tremendous strain of the surge on nurses. Future efforts to improve the utility of incident reports should emphasize the importance of describing work system factors.

Assessing the Great Resignation phenomenon: voluntary resignation of young Italian workers during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has determined a radical change in workplace dynamics, with a reported increase in voluntary resignation from employment at a global level, especially among the young-est workers. The aim of this study is to investigate the social, demographic, and cultural characteristics of young people aged between 25 and 45 years who voluntarily resigned from their previous jobs during the COVID-19 pandemic. Methods: This is a cross-sectional observational study; an ad hoc questionnaire was designed and admin-istered via an online link. Descriptive analyses were performed to describe the sample, and the Pearson analysis was performed to investigate statistically significant correlations; p values ≤ 0.05 were considered statistically significant. Results: A total of 72 valid responses were gathered. Mean age was 32.6 years; 43.1% participants were males, 54.2% were married, and 80.6% had no children; most participants (68.1%) had a college level education. The most reported cause of job resignation was work dissatisfaction (38.9%), followed by inadequate remuneration (27.8%). The most reported perspective for people who had resigned or were planning on resigning, was a better salary (27.8%), followed by the pursuit of a higher work-life balance (25.0%). The perception that having resigned was the right choice was significantly correlated with the timeframe of resignation (p<0.01), with having suffered from COVID-19 (p<0.05), and with a close relative having suffered from COVID-19 (p<0.01). Conclusion: This study highlighted that voluntarily resigning was significantly correlated to having suffered from COVID-19, or a close relative having suffered from it; 84.9% of participants who had resigned thought that it had been the right choice. The COVID-19 pandemic could have changed workplace perception, making employees feel more at risk; the indirect impact of the pandemic should be further investigated, and prevention strategies should be implemented to ensure the safety and wellbeing of employees.

Burnout symptoms, work motivation and their relationships among Italian ICU's nurses after COVID-19 emergency. A multicenter study.

Background: Despite the end of the health emergency, healthcare professionals are at risk of developing long-term mental health problems. The aim of this study was to observe Burnout symptoms and work motivation among Intensive Care Nurses, one year after admission to the Intensive Care Unit of the last positive SARS-CoV-2 swab patients. Study design: A multicenter cross-sectional study design was carried out and a national web-based survey was conducted between April, 2023 and May, 2023 among 21 Italian Intensive Care Units. Methods: The survey consisted of single- and multiple-choice questions structured into 3 sections: demographic sample data, Maslach Burnout Inventory Scale for the assessment of Burnout-symptoms and Multidimensional Work Motivation Scale for the assessment of work motivation. Results: Four hundred-nine surveyed and questionnaires were included in the study. Of these 272 were male (66.5%). Burnout-related symptoms were identified in at least 79% of ICU nurses. Symptoms of severe Burnout was observed in 169 nurses analysed (41.3%) and they are significantly among nurses who had COVID-19 or positive SARS-COV-2 swab during the pandemic (RR= 1.55; CI= 1.24-1.95, p= .0004) and among nurses with at least one child (RR= 1.37; CI= 1.07-1.76; p= .011). Motivated nurses for the intrinsic motivation's level have been 281 (68.7%). The risk of being intrinsically demotivated is significantly greater among nurses with 5-10 years of work experience (RR= 2.44; CI= 1.48-4.02; p= .0002). Emotional exhaustion was associated in increase in demotivation and introjected estrinsic motivation. Depersonalization was associated with demotivation. Personal accomplishment was associated with increase in external estrinsic motivation and amotivation. Conclusions: High level of Burnout has been observed among Italian ICU nurses associated with low work motivation after COVID-19 emergency. Interventions and strategies should be adopted to prevent burnout and improve work motivation.

Modeling long COVID dynamics: Impact of underlying health conditions.

We propose a new mathematical model to investigate the population dynamics of long COVID, with a focus on the impact of chronic health conditions. Our model connects long COVID with the transmission of COVID-19 so as to accurately predict the prevalence of long COVID from the progression of the infection in the host population. The model additionally incorporates the effects of COVID-19 vaccination. We implement the model with data from both the US and the UK to demonstrate the real-world applications of this modeling framework.

Safety and timeliness of telemedicine initiation of continuous kidney replacement therapy.

BACKGROUND: During the COVID-19 pandemic, some continuous kidney replacement therapy (CKRT) initiations were transitioned to telemedicine to improve the timeliness of initiation, and minimize COVID-19 transmission. While telemedicine would appear acceptable for many clinical settings, safety and timeliness of telemedicine CKRT initiation is undescribed. METHODS: We conducted a single-center retrospective cohort study of pediatric patients on CKRT from January 2021-September 2022. Information on patient characteristics and CKRT therapy was extracted from the electronic health record. Multidisciplinary team provider attitudes and perspectives were assessed using survey. RESULTS: During the study period, there were 101 CKRT circuit initiations in patients not previously receiving CKRT, with 33% (33/101) initiated by telemedicine. There were no differences in patient characteristics, including age, weight at initiation, severity of illness, nor degree of fluid overload between the in-person and telemedicine initiation cohorts. CKRT telemedicine initiations were timelier, occurring on average 3.0 h after decision to initiate therapy compared to 5.8 h for all in-person CKRT starts (p < 0.001) and 5.5 h for night and weekend in-person starts (p < 0.001). Complications did not differ between telemedicine and in-person starts (15% vs. 15%, p = 0.99) and initial circuit life was similar. There were no differences in likelihood of death or duration of CKRT therapy. Telemedicine initiations were widely acceptable to multidisciplinary providers. CONCLUSION: In appropriately selected patients, telemedicine initiation of CKRT is a timely and safe option. Further standardization of telemedicine initiation of CKRT should be considered to improve the timely delivery of CKRT and may improve nephrology workforce wellness. A higher resolution version of the Graphical abstract is available as Supplementary information.

Domestic Violence in the Context of the COVID-19 Pandemic: A Synthesis of Systematic Reviews.

The current systematic meta-review aimed to map out, characterize, analyze, and synthesize the overarching findings of systematic reviews on domestic violence (DV) in the context of COVID-19. Specifically, a systematic meta-review was conducted with three main objectives: (1) to identify what types and aspects of DV during COVID-19 have been reviewed systematically to date (research trends), (2) to synthesize the findings from recent systematic reviews of the theoretical and empirical literature (main findings), and (3) to discuss what systematic reviewers have proposed about implications for policy and practice as well as for future primary research (implications). We identified, appraised, and synthesized the evidence contained in systematic reviews by means of a so-called systematic meta-review. In all, 15 systematic reviews were found to be eligible for inclusion in the current review. Thematic codes were applied to each finding or implication in accordance with a set of predetermined categories informed by the DV literature. The findings of this review provide clear insight into current knowledge of prevalence, incidence, and contributing factors, which could help to develop evidence-informed DV prevention and intervention strategies during COVID-19 and future extreme events. This systematic meta-review does offer a first comprehensive overview of the research landscape on this subject. It allows scholars, practitioners, and policymakers to recognize initial patterns in DV during COVID-19, identify overlooked areas that need to be investigated and understood further, and adjust research methods that will lead to more robust studies.

Incomplete sanitation in the Metropolitan Region of São Paulo results in detection of SARS-CoV-2 in headwater streams.

Among the largest metropolitan regions in the world, the Metropolitan Region of São Paulo (MRSP) represents an important case study for the COVID-19 respiratory disease pandemic because it is home to >20 million people, making it one of the largest metropolitan regions in the global south. Besides the high population density, the MRSP has several problems related to social and economic aspects, which may reflect in the dynamics of SARS-CoV-2 virus, such as low income, lack of sanitation and social vulnerability in the peripheral regions of MRSP. In these regions, the input of untreated sewage on the streams and rivers can be frequently observed, which may represent an indicator of poor sewer system. Therefore, this study aimed to identify if streams draining urbanized regions without appropriate sanitation are prone to receive higher loads of detectable SARS-CoV-2 in its waters. For this, we collected water samples from 45 headwater streams distributed across an urbanization gradient (0-100 % of urbanization) in the MRSP, with three replicates in each stream and analyzed the concentrations of SARS-CoV-2 RNA targeting the nucleocapsid N1 and N2 genomic regions. In addition, we analyzed the relationship between the concentrations of SARS-CoV-2 RNA and sanitation and social variables. Our results showed that the concentrations of SARS-CoV-2 RNA were higher in the streams draining medium to high urbanized catchments, especially because of the lack of sanitation and the higher probabilities to detect SARS-CoV-2 RNA in the stream water was associated with households without a septic tank or sewage system within the catchment, followed by per capita household income. These results reflect the lack of urbanization planning and the lack of sanitation, especially in the poor regions from the MRSP, adding another risk for the already vulnerable population in a metropolitan region from the global south during a pandemic disease.

Systematic review and meta-analysis on the impact of COVID-19 related restrictions on air quality in low- and middle-income countries.

BACKGROUND: Low- and middle-income countries (LMIC) are disproportionately affected by air pollution and its health burden, representing a global inequity. The COVID-19 pandemic provided a unique opportunity to investigate the impact of unprecedented lockdown measures on air pollutant concentrations globally. We aim to quantify air pollutant concentration changes across LMIC settings as a result of COVID-19 restrictions. METHODS: Searches for this systematic review and meta-analysis were carried out across five databases on 30th March 2022; MEDLINE, Embase, Web of Science, Scopus and Transport Research Information Documentation. Modelling and observational studies were included, as long as the estimates reflected city or town level data and were taken exclusively in pre-lockdown and lockdown periods. Mean percentage changes per pollutant were calculated and meta-analyses were carried out to calculate mean difference in measured ground-level observed concentrations for each pollutant (PROSPERO CRD42022326924). FINDINGS: Of the 2982 manuscripts from initial searches, 256 manuscripts were included providing 3818 percentage changes of all pollutants. No studies included any countries from Sub-Saharan Africa and 34 % and 39.4 % of studies were from China and India, respectively. There was a mean percentage change of -37.4 %, -21.7 %, -54.6 %, -39.1 %, -48.9 %, 16.9 %, -34.9 %, -30.6 % and - 14.7 % for black carbon (BC), carbon monoxide (CO), nitric oxide (NO), nitrogen dioxide (NO2), oxides of nitrogen (NOx), ozone (O3), particulate matter 10 (PM10) and 2.5 (PM2.5) and sulphur dioxide (SO2), respectively. Meta-analysis included 100 manuscripts, providing 908 mean concentration differences, which showed significant reduction in mean concentration in all study settings for BC (-0.46 µg/m3, PI -0.85; -0.08), CO (-0.25 mg/m3, PI -0.44; -0.03), NO2 (-19.41 µg/m3, PI -31.14; -7.68) and NOx (-22.32 µg/m3, PI -40.94; -3.70). INTERPRETATION: The findings of this systematic review and meta-analysis quantify and confirm the trends reported across the globe in air pollutant concentration, including increases in O3. Despite the majority of global urban growth occurring in LMIC, there are distinct geographical gaps in air pollution data and, where it is available, differing approaches to analysis and reporting.

Zooming in to the neighborhood level: A year-long wastewater-based epidemiology monitoring campaign for COVID-19 in small intraurban catchments.

In recent years, wastewater-based epidemiology (WBE) has emerged as a valuable and cost-effective tool for monitoring the prevalence of COVID-19. Large-scale monitoring efforts have been implemented in numerous countries, primarily focusing on sampling at the entrance of wastewater treatment plants (WWTPs) to cover a large population. However, sampling at a finer spatial scale, such as at the neighborhood level (NGBs), pose new challenges, including the absence of composite sampling infrastructure and increased uncertainty due to the dynamics of small catchments. This study aims to investigate the feasibility and accuracy of WBE when deployed at the neighborhood level (sampling in sewers) compared to the city level (sampling at the entrance of a WWTP). To achieve this, we deployed specific WBE sampling stations at the intraurban scale within three NGBs in Barcelona, Spain. The study period covers the 5th and the 6th waves of COVID-19 in Spain, spanning from March 2021 to March 2022, along with the WWTP downstream from the NGBs. The results showed a strong correlation between the dynamics of COVID-19 clinical cases and wastewater SARS-CoV-2 loads at both the NGB and city levels. Notably, during the 5th wave, which was dominated by the Delta SARS-CoV-2 variant, wastewater loads were higher than during the 6th wave (Omicron variant), despite a lower number of clinical cases recorded during the 5th wave. The correlations between wastewater loads and clinical cases at the NGB level were stronger than at the WWTP level. However, the early warning potential varied across neighborhoods and waves, with some cases showing a one-week early warning and others lacking any significant early warning signal. Interestingly, the prevalence of COVID-19 did not exhibit major differences among NGBs with different socioeconomic statuses.