Quantifying the impact of urban road traffic on air quality: activity pre-pandemic and during partial and full lockdowns.

The impact of partial and full COVID lockdowns in 2020 on vehicle miles traveled (VMT) in Kuwait was estimated using data extracted from the Directions API of Google Maps and a Python script running as a cronjob. This approach was validated by comparing the predictions based on the app to measuring traffic flows for 1 week across four road segments considered in this study. VMT during lockdown periods were compared to VMT for the same calendar weeks before the pandemic. NOx emissions were estimated based on VMT and were used to simulate the spatial patterns of NOx concentrations using an air quality model (AERMOD). Compared to pre-pandemic periods, VMT was reduced by up to 25.5% and 42.6% during the 2-week partial and full lockdown episodes, respectively. The largest reduction in the traffic flow rate occurred during the middle of these 2-week periods, when the traffic flow rate decreased by 35% and 49% during the partial and full lockdown periods, respectively. The AERMOD simulation results predicted a reduction in the average maximum concentration of emissions directly related to VMT across the region by up to 38%, with the maximum concentration shifting to less populous residential areas as a result of the lockdown.

Patient Satisfaction and Willingness to Continue with Telemental Health Care During and After the Early Period of SARS-CoV-2 Pandemic: A User Survey.

Objective: The SARS-CoV-2 pandemic and related lockdown periods generated an increase in the use of virtual care for mental health (MH). This study aimed to assess patient satisfaction with Telemental Health services (TMH) during first lockdown and factors related to their willingness to continue using this service. Methods: We conducted a cross-sectional survey of 364 MH outpatients from 9 centers in the Barcelona region (Spain), who received TMH between April 20 and May 22, 2020. We assessed sociodemographic and clinical characteristics, prior experience, and familiarity with technologies and satisfaction with TMH. Willingness to receive TMH after the lockdown was measured separately for telephone and videoconferencing. We performed descriptive statistics and bivariate and multivariate regression models to predict TMH willingness. Results: From 450 patients contacted, 364 were interviewed. Satisfaction with TMH was high (mean 9.24, standard deviation 0.07); 2.47% preferred only TMH visits after lockdown, 23.08% preferred mostly TMH visits, 50.82% accepted some TMH visits, and 23.63% would prefer in-person consultations. Female patients and those having received TMH during lockdown showed higher odds of willingness to receive TMH in the future, while patients unfamiliar with technologies showed lower odds. Concerning TMH through telephone, willingness was more likely in patients living with more persons. Videoconferencing willingness was more likely for people living with depression. Conclusions: TMH was well accepted during the first lockdown and patients were willing to maintain it after lockdown. Low familiarity with new technologies is an important barrier to TMH willingness, which needs to be addressed for appropriate implementation going forward.

Home-schooling and caring for children during the COVID-19 lockdown in the UK: emotional states, systems of support and coping strategies in working mothers.

Introduction: We examined the experience of the intensification of home-schooling and/or childcare in working mothers in the United Kingdom during the first national COVID-19 lockdown. Our focus was on understanding how mothers dealt with this challenging period both emotionally and practically. Methods: Eligible mothers (n = 47; Mage = 39.6) participated in an anonymous online survey of openended questions. Results: Thematic analysis of responses showed that mothers found home-schooling and/or childcare to be challenging. This was particularly notable in situations where support from partners, schools, and workplaces was limited. For single working mothers, the absence of support resources was especially impactful. Mothers often felt overly stressed trying to balance work and family responsibilities, guilty for not meeting their child's needs, and were worried over their child's well-being and academic progress and over increasing work demands. Common strategies mothers used to cope with the challenges of home-schooling and/or childcare included adopting a positive outlook, implementing flexible family structures, increasing family connectedness, and negotiating alternative partnership models. Discussion: The intensification of home-schooling and/or childcare during the lockdown in the United Kingdom negatively affected maternal well-being, particularly due to limited support. These findings underscore the importance of prioritizing maternal wellbeing in post-pandemic recovery efforts. Additionally, they highlight the social dimension of maternal wellbeing and suggest a comprehensive approach to support it that includes both timely access to intervention for mental health but also implementing family-friendly work policies and offering support with childcare and children's learning as essential measures.

Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience.

BACKGROUND: For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown. METHODS: This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences. RESULTS: Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges. CONCLUSIONS: Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.

Patterns and outcomes of acute toxicological cases before, during, and after COVID-19 lockdown in Sohag University hospitals, Egypt.

Background: Toxicologists manage poisoning by preventing, detecting, and treating it, which requires continuous data collection and analysis of toxicological hazards. Aim of the work: The study aims to report and compare the pattern and outcome of acute toxicological cases admitted to Sohag University Hospitals during the COVID-19 lockdown (2020-2021) with the year before (2019) and the year after (2022). Methods: This comparative study reviewed the sociodemographic and clinical data in the medical records. The study showed that Sohag University Hospitals received 670 toxicological cases between 2019 and 2022; 105 cases in 2019, 347 cases in 2020-2021, and 218 cases in 2022. Results: Most of patients were below seven years with no sex differences. Accidental poisoning was the most frequent toxicity. The oral route was the most common in the three studied periods. During the lockdown, metal phosphide was the most frequent (19.0%), while therapeutic agents were the most reported after the lockdown (23.9%). The delay time showed a significant difference between the studied periods (p-value < 0.001). In the three studied periods, complete recovery was achieved in more than 70% of cases; however, the mortality rate and the rate of complications during the lockdown period (10.4% and 9.5%, respectively) were almost twice those of the year before and the year after the pandemic with significant odds ratio of mortality during pandemic (OR) 0.07 CI 95% (0.02, 0.11). Conclusion: The pandemic had a bad impact on outcomes as showed the highest percentage of mortality compared to before and after COVID-19 periods.

The Prevalence of Anxiety Among University Students in the United Arab Emirates Following the COVID-19 Lockdown.

INTRODUCTION: The COVID-19 pandemic, with its consequential lifestyle changes, is anticipated to contribute to increased anxiety levels, particularly among university students who already contend with significant academic stress. We aim to assess the prevalence of anxiety among university students in the United Arab Emirates (UAE) following the COVID-19 lockdown period. METHODS: We conducted a descriptive cross-sectional study among students enrolled in UAE universities. A self-administered questionnaire was utilized to gather demographic data, assess anxiety levels using the generalized anxiety disorder-7 scale, explore potential factors associated with heightened anxiety, investigate the impact of increased anxiety on academic performance, and identify coping mechanisms employed post-lockdown. RESULTS: Of the 369 participating students, anxiety levels were minimal in 87 (23.6%), mild in 163 (44.2%), and moderate to severe in 119 (32.2%) subjects. Moreover, increased anxiety levels were significantly correlated with poor/fair sleep quality (p=0.002). Importantly, students with moderate to severe anxiety levels exhibited poorer performance in exams and assignments (p=0.001) and encountered difficulties in maintaining focus on studies (p<0.001). The predominant coping mechanisms employed by students included self-distraction, prayer, and maintaining a positive attitude. CONCLUSION: The majority of students in our study experienced mild to severe levels of anxiety following the COVID-19 lockdown period. We hope that our findings will prompt university and government officials to implement effective screening and preventive strategies to adequately support university students in future public health crises.

Emergency Preparedness Drills for Active and Mass Shootings in Schools.

PURPOSE OF REVIEW: There is widespread use of emergency preparedness drills in public K-12 schools across the US, but considerable variability exists in the types of protocols used and how these practices are conducted. This review examines research into both "lockdown drills" and "active shooter drills" as it relates to their impact on participants across different outcomes and evaluations of their procedural integrity. RECENT FINDINGS: A number of studies on lockdown drills yielded largely consistent findings about their impacts, whereas findings related to the effects of active shooter drills are less uniform. The research also demonstrated that lockdown drills, though not active shooter drills, can help participants build skill mastery to be able to successfully deploy the procedure. Differences in how drills impact participants and whether they cultivate skill mastery are largely attributable to the type of drill being conducted. This review suggests that employing clearly defined drill procedures incorporating best practices, coupled with instructional training, can help schools prepare for emergencies without creating trauma for participants.

Air pollution changes due to COVID-19 lockdowns and attributable mortality changes in four countries.

COVID-19 lockdowns reduced nitrogen dioxide (NO2) and fine particulate matter (PM2.5) emissions in many countries. We aim to quantify the changes in these pollutants and to assess the attributable changes in mortality in Jiangsu, China; California, U.S.; Central-southern Italy; and Germany during COVID-19 lockdowns in early 2020. Accounting for meteorological impacts and air pollution time trends, we use a machine learning-based meteorological normalization technique and the difference-in-differences approach to quantify the changes in NO2 and PM2.5 concentrations due to lockdowns. Using region-specific estimates of the association between air pollution and mortality derived from a causal modeling approach using data from 2015 to 2019, we assess the changes in mortality attributable to the air pollution changes caused by the lockdowns in early 2020. During the lockdowns, NO2 reductions avoided 1.41 (95% empirical confidence interval [eCI]: 0.94, 1.88), 0.44 (95% eCI: 0.17, 0.71), and 4.66 (95% eCI: 2.03, 7.44) deaths per 100,000 people in Jiangsu, China; California, U.S.; and Central-southern Italy, respectively. Mortality benefits attributable to PM2.5 reductions were also significant, albeit of a smaller magnitude. For Germany, the mortality benefits attributable to NO2 changes were not significant (0.11; 95% eCI: -0.03, 0.25), and an increase in PM2.5 concentrations was associated with an increase in mortality of 0.35 (95% eCI: 0.22, 0.48) deaths per 100,000 people during the lockdown. COVID-19 lockdowns overall improved air quality and brought attributable health benefits, especially associated with NO2 improvements, with notable heterogeneity across regions. This study underscores the importance of accounting for local characteristics when policymakers adapt successful emission control strategies from other regions.

A traffic-induced shift of ultrafine particle sources under COVID-19 soft lockdown in a subtropical urban area.

During the unprecedented COVID-19 city lockdown, a unique opportunity arose to dissect the intricate dynamics of urban air quality, focusing on ultrafine particles (UFPs) and volatile organic compounds (VOCs). This study delves into the nuanced interplay between traffic patterns and UFP emissions in a subtropical urban setting during the spring-summer transition of 2021. Leveraging meticulous roadside measurements near a traffic nexus, our investigation unravels the intricate relationship between particle number size distribution (PNSD), VOCs mixing ratios, and detailed vehicle activity metrics. The soft lockdown era, marked by a 20-27% dip in overall traffic yet a surprising surge in early morning motorcycle activity, presented a natural experiment. We observed a consequential shift in the urban aerosol regime: the decrease in primary emissions from traffic substantially amplified the role of aged particles and secondary aerosols. This shift was particularly pronounced under stagnant atmospheric conditions, where reduced dilution exacerbated the influence of alternative emission sources, notably solvent evaporation, and was further accentuated with the resumption of normal traffic flows. A distinct seasonal trend emerged as warmer months approached, with aromatic VOCs such as toluene, ethylbenzene, and xylene not only increasing but also significantly contributing to more frequent particle growth events. These findings spotlight the criticality of targeted strategies at traffic hotspots, especially during periods susceptible to weak atmospheric dilution, to curb UFP and precursor emissions effectively. As we stand at the cusp of widespread vehicle electrification, this study underscores the imperative of a holistic approach to urban air quality management, embracing the complexities of primary emission reductions and the resultant shifts in atmospheric chemistry.

Dissecting Drivers of Ozone Pollution during the 2022 Multicity Lockdowns in China Sheds Light on Future Control Direction.

In 2022, many Chinese cities experienced lockdowns and heatwaves. We analyzed ground and satellite data using machine learning to elucidate chemical and meteorological drivers of changes in O3 pollution in 27 major Chinese cities during lockdowns. We found that there was an increase in O3 concentrations in 23 out of 27 cities compared with the corresponding period in 2021. Random forest modeling indicates that emission reductions in transportation and other sectors, as well as the changes in meteorology, increased the level of O3 in most cities. In cities with over 80% transportation reductions and temperature fluctuations within -2 to 2 °C, the increases in O3 concentrations were mainly attributable to reductions in nitrogen oxide (NOx) emissions. In cities that experienced heatwaves and droughts, increases in the O3 concentrations were primarily driven by increases in temperature and volatile organic compound (VOC) emissions, and reductions in NOx concentrations from ground transport were offset by increases in emissions from coal-fired power generation. Despite 3-99% reduction in passenger volume, most cities remained VOC-limited during lockdowns. These findings demonstrate that to alleviate urban O3 pollution, it will be necessary to further reduce industrial emissions along with transportation sources and to take into account the climate penalty and the impact of heatwaves on O3 pollution.

The impact of the COVID-19 pandemic on the mood and family relationships of runners.

Introduction: The aim of this study was to analyze the impact of the COVID-19 lockdown on the mood of amateur runners and on their relationships with their partners and families. Methods: Adult runners 18 years or older (N = 260) completed an online survey that included demographic information, standardized psychological assessments of Exercise Dependence (EDS-R) and mood (POMS), and, to measure relationship functioning, either the Dyadic Adjustment Scale (DAS) if they did not have children, or the Basic Family Evaluation Questionnaire (CERFB), measuring conjugal and parental relationships. Participants also answered questions about their exercise habits and the coping strategies they adopted during lockdown. Results: The results suggest that runners who saw the largest reductions in time spent exercising during lockdown tended to feel significantly less energetic (p < 0.05) and friendly (p < 0.01). In addition, they recorded significantly lower scores in marital satisfaction with their peers (p < 0.05). The runners with a higher degree of dependence on physical exercise registered significantly higher levels of depression, tension and anger than non-dependent runners (p < 0.001). Runners whose partners were physically active and did not have children had significantly higher scores marital satisfaction than runners whose partners were not physically active and had children (p < 0.05). Discussion: These findings seem to indicate that the psychological approach to athletes in the context of crises such as the pandemic should consider not only individual aspects, but also include the family perspective.

Relationship Between Severity and Length of Exposure to COVID-19 Parameters and Resulting Government Responses and the Suicide Crisis Syndrome (SCS).

OBJECTIVE: The COVID-19 pandemic has had a globally devastating psychosocial impact. A detailed understanding of the mental health implications of this worldwide crisis is critical for successful mitigation of and preparation for future pandemics. Using a large international sample, we investigated in the present study the relationship between multiple COVID-19 parameters (both disease characteristics and government responses) and the incidence of the suicide crisis syndrome (SCS), an acute negative affect state associated with near-term suicidal behavior. METHODS: Data were collected from 5528 adults across 10 different countries in an anonymous web-based survey between June 2020 and January 2021. RESULTS: Individuals scoring above the SCS cut-off lived in countries with higher peak daily cases and deaths during the first wave of the pandemic. Additionally, the longer participants had been exposed to markers of pandemic severity (eg, lockdowns), the more likely they were to screen positive for the SCS. Findings reflected both country-to-country comparisons and individual variation within the pooled sample. CONCLUSION: Both the pandemic itself and the government interventions utilized to contain the spread appear to be associated with suicide risk. Public policy should include efforts to mitigate the mental health impact of current and future global disasters.

Machine learning insights into PM2.5 changes during COVID-19 lockdown: LSTM and RF analysis in Mashhad.

This study seeks to investigate the impact of COVID-19 lockdown measures on air quality in the city of Mashhad employing two strategies. We initiated our research using basic statistical methods such as paired sample t-tests to compare hourly PM2.5 data in two scenarios: before and during quarantine, and pre- and post-lockdown. This initial analysis provided a broad understanding of potential changes in air quality. Notably, a low reduction of 2.40% in PM2.5 was recorded when compared to air quality prior to the lockdown period. This finding highlights the wide range of factors that impact the levels of particulate matter in urban settings, with the transportation sector often being widely recognized as one of the principal causes of this issue. Nevertheless, throughout the period after the quarantine, a remarkable decrease in air quality was observed characterized by distinct seasonal patterns, in contrast to previous years. This finding demonstrates a significant correlation between changes in human mobility patterns and their influence on the air quality of urban areas. It also emphasizes the need to use air pollution modeling as a fundamental tool to evaluate and understand these linkages to support long-term plans for reducing air pollution. To obtain a more quantitative understanding, we then employed cutting-edge machine learning methods, such as random forest and long short-term memory algorithms, to accurately determine the effect of the lockdown on PM2.5 levels. Our models' results demonstrated remarkable efficacy in assessing the pollutant concentration in Mashhad during lockdown measures. The test set yielded an R-squared value of 0.82 for the long short-term memory network model, whereas the random forest model showed a calculated cross-validation R-squared of 0.78. The required computational cost for training the LSTM and the RF models across all data was 25 min and 3 s, respectively. In summary, through the integration of statistical methods and machine learning, this research attempts to provide a comprehensive understanding of the impact of human interventions on air quality dynamics.

Effects of SARS-COVID-19 lockdown on menstrual patterns: A transversal large sample survey.

OBJECTIVE: To elucidate the presence, importance, and characteristics of menstrual changes related to stressful circumstances during the COVID-19 lockdown in Spain. STUDY DESIGN: An online survey was administered in Spain to menstruating women aged 15-55 who had not contracted COVID-19. It collected information on activities during the lockdown, sexual activity, perceptions of emotional status, any changes in menstrual characteristics, and impact on quality of life. The analysis of menstrual changes was limited to responders who did not use hormonal contraception. RESULTS: A total of 6449 women answered the survey, and 4989 surveys were valid for the final analysis. 92.3% of women had at least one menstruation period during the lockdown, while 7.7% had amenorrhea. Quality of life (QoL) associated with menstruation worsened in 19% of women, did not change in 71.7%, and improved in 1.6%. For 50.1% of the women, global QoL worsened during the lockdown; 41.3% remained about the same and 8.7% reported improvement. Sexual activity during the lockdown decreased in 49.8% of the respondents, remained unchanged in 40.7%, and increased in 9.5%. As far the menstrual changes are concerned, there were no statistically significant differences in amenorrhea incidence, regularity of the menstrual cycle, or the amount or duration of menstrual bleeding in non-hormonal contraceptive users when evaluated by the length and characteristics of isolation, the perception of exposure to COVID-19 and the economic or employment situation. Conversely, we found statistically significant differences according to the intensity of changes in emotional status due to lockdown stressors and changes in regularity, duration, and heaviness of menstruation. CONCLUSION: Changes in emotional status, but not the length and intensity of the isolation or exposure to the disease, significantly influenced menstrual disturbances during the COVID-19 lockdown.

Lockdown during the COVID-19 pandemic: lessons from a polarized scenario in Brazil.

Introduction: The COVID-19 pandemic led many countries to adopt strict measures aimed at reducing circulation of the virus and mitigating the burden on health services. Among these, the lockdown (social distancing/confinement) was probably the most controversial and most widely debated, since it affected the population's daily life abruptly, with consequences for people's emotional state and the operational logic of various economic sectors. Objective: Analyze the relationship been Brazilians' opinions on lockdown during the pandemic and individual, sociodemographic, and belief characteristics. Methods: We conducted an online survey to evaluate Brazilians' opinions on the lockdown during the COVID-19 pandemic. We prepared a questionnaire with questions on sociodemographic aspects and individuals' points of view toward the lockdown. We sent a link for the survey through social media and encouraged participants to also share the link in their respective social networks, as a snowball sample. Cluster analysis was performed to identify different opinion profiles. Cluster Analysis is a multivariate approach that aims to segment a set of data into distinct groups, using some classification criteria. Results: From April to May 2021, the link received 33,796 free participations via social networks from all over Brazil. We analyzed data from 33,363 participants. Pro-lockdown opinions predominated in most of the sociodemographic strata. Cluster analysis identified two groups: pro-lockdown, aligned with the scientific recommendations, and anti-lockdown, characterized by economic insecurity and denialism. Anti-lockdown participants downplayed the pandemic's seriousness and believed in unproven measures to fight SARS-CoV-2. However, these same participants were afraid of losing their jobs and of being unable to pay their bills. In general, participants did not believe in the feasibility of a lockdown in Brazil or in the efficacy of the prevailing government administration's measures. Conclusion: The study identified a lack of consensus among participants concerning lockdown as a practice. Issues such as disbelief in the pandemic's seriousness, denialism, and economic insecurity were important in the determination of the profiles identified in the study. Denialism is believed to have been a subjective defense against the economic problems resulting from social control measures and the lack of adequate social policies to deal with the pandemic. It was also highlighted that political polarization and the lack of central coordination during social distancing are crucial aspects. The variation in results in different locations highlights the diversity of the Brazilian scenario. By analyzing Brazilians' opinions about the lockdown, considering individual characteristics, the study seeks insights to face the pandemic and prepare for future crises, contributing to more effective public health strategies.

The Impact of the SARS-COVID-19 Lockdowns on the Subjectively Perceived Performance Level of Amateur Athletes after Returning to the Gyms.

Since December 2019, few issues have garnered as much global attention as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-19). The imposed lockdowns in 2020/21, which led to the closure of all gyms, barred people from participating in their favourite sports activities. This study explores athletes' self-evaluations of their performance levels upon return to training facilities post-reopening. Data were collected in May 2021, after the end of the second lockdown, using a national online questionnaire. The study recorded 20 demographic and training-specific parameters to discern the factors influencing self-perceived performance upon resuming gym activities after the 2020/2021 lockdown. A total of 1378 respondents participated in the study. Of the total number of participants, 27.5% (365) reported regaining 100% of their original performance level after reopening their studios, a proportion that comprised 212 males, 150 females, and 3 individuals of unspecified gender. Additionally, 35.7% (474) estimated their performance level to be up to 75%, followed by 30% (398) recording their performance level at 50%, and a minority of 6.8% (90) determining their performance level to be up to 25%. Exercise intensity prior to lockdown, training experience, sex, and concurrent practice of another sport significantly influenced the athletes' self-assessment of their current fitness levels (p > 0.001, p > 0.001, p > 0.001, and 0.006, respectively). We need to understand the factors that shape self-perception, especially in case of another lockdown, in order to provide preventive assistance concerning mental and physical well-being. Positive influences on self-perception include prior athletic experience, intensive training before the lockdown, and continued participation in sports throughout the lockdown. Younger age is also favourable, but this may not necessarily reflect the benefits of youth; rather, it could indicate the current lack of accessible online sports activities for older individuals. Women, however, might have a less favourable perception of their own athletic performance.

Effect of Long-Distance Domestic Travel Ban Policies in Japan on COVID-19 Outbreak Dynamics During Dominance of the Ancestral Strain: Ex Post Facto Retrospective Observation Study.

BACKGROUND: In Japan, long-distance domestic travel was banned while the ancestral SARS-CoV-2 strain was dominant under the first declared state of emergency from March 2020 until the end of May 2020. Subsequently, the "Go To Travel" campaign travel subsidy policy was activated, allowing long-distance domestic travel, until the second state of emergency as of January 7, 2021. The effects of this long-distance domestic travel ban on SARS-CoV-2 infectivity have not been adequately evaluated. OBJECTIVE: We evaluated the effects of the long-distance domestic travel ban in Japan on SARS-CoV-2 infectivity, considering climate conditions, mobility, and countermeasures such as the "Go To Travel" campaign and emergency status. METHODS: We calculated the effective reproduction number R(t), representing infectivity, using the epidemic curve in Kagoshima prefecture based on the empirical distribution of the incubation period and procedurally delayed reporting from an earlier study. Kagoshima prefecture, in southern Japan, has several resorts, with an airport commonly used for transportation to Tokyo or Osaka. We regressed R(t) on the number of long-distance domestic travelers (based on the number of airport limousine bus users provided by the operating company), temperature, humidity, mobility, and countermeasures such as state of emergency declarations and the "Go To Travel" campaign in Kagoshima. The study period was June 20, 2020, through February 2021, before variant strains became dominant. A second state of emergency was not declared in Kagoshima prefecture but was declared in major cities such as Tokyo and Osaka. RESULTS: Estimation results indicated a pattern of declining infectivity with reduced long-distance domestic travel volumes as measured by the number of airport limousine bus users. Moreover, infectivity was lower during the "Go To Travel" campaign and the second state of emergency. Regarding mobility, going to restaurants, shopping malls, and amusement venues was associated with increased infectivity. However, going to grocery stores and pharmacies was associated with decreased infectivity. Climate conditions showed no significant association with infectivity patterns. CONCLUSIONS: The results of this retrospective analysis suggest that the volume of long-distance domestic travel might reduce SARS-CoV-2 infectivity. Infectivity was lower during the "Go To Travel" campaign period, during which long-distance domestic travel was promoted, compared to that outside this campaign period. These findings suggest that policies banning long-distance domestic travel had little legitimacy or rationale. Long-distance domestic travel with appropriate infection control measures might not increase SARS-CoV-2 infectivity in tourist areas. Even though this analysis was performed much later than the study period, if we had performed this study focusing on the period of April or May 2021, it would likely yield the same results. These findings might be helpful for government decision-making in considering restarting a "Go To Travel" campaign in light of evidence-based policy.

The paradoxical influence of the COVID-19 lockdown period on different types of preterm births in Alberta: a provincial study.

Objectives: The objective of this study was to determine if the COVID-19 pandemic impacted different types of preterm birth rates in Alberta, Canada. Methods: A population-based, retrospective, cohort study was conducted from March 15, 2015 to December 31, 2020 using provincial data. The primary exposure was the COVID-19 lockdown period, and the primary outcome was the incidence of preterm birth (<37 weeks gestational age). Multivariable analyses in the complete lockdown and overall lockdown (partial and complete lockdown) periods were performed to test the association between the year of birth and preterm birth status and were adjusted for various independent variables. Preterm birth status was adjusted for various confounding factors. Results: Following the analysis of n = 41,187 mothers and their singleton infants, we found that the lockdown due to COVID-19 had no impact in reducing the overall preterm birth rate. However, a paradoxical influence was observed with an increase of extremely low preterm births in the overall lockdown period, and a decrease in moderate preterm births during the complete lockdown period. Conclusions: The results of this study demonstrated that there was a decrease in moderate and increase in extremely low preterm birth rates as a result of the COVID-19 lockdown. However, the COVID-19 lockdown did not impact the very preterm and late preterm birth rate in Alberta.

When one door closes: a qualitative exploration of women's experiences of access to sexual and reproductive health services during the COVID-19 lockdown in Nigeria.

BACKGROUND: COVID-19 pandemic widely disrupted health services provision, especially during the lockdown period, with females disproportionately affected. Very little is known about alternative healthcare sources used by women when access to conventional health services became challenging. This study examined the experiences of women and adolescent girls regarding access to sexual and reproductive health (SRH) services during the COVID-19 lockdown in Nigeria and their choices of alternative healthcare sources. METHODS: The study sites were two northern states, two southern states, and the Federal Capital Territory. Qualitative data were obtained through 10 focus group discussion sessions held with married adolescents, unmarried adolescents, and older women of reproductive age. The data were transcribed verbatim and analysed using a thematic approach and with the aid of Atlas ti software. RESULTS: Women reported that access to family planning services was the most affected SRH services during the COVID-19 lockdown. Several barriers to accessing SRH services during COVID-19 lockdown were reported, including restriction of vehicular movement, harassment by law enforcement officers, fear of contracting COVID-19 from health facilities, and fear of undergoing compulsory COVID-19 tests when seeking care in health facilities. In the face of constrained access to SRH services in public sector facilities during the COVID-19 lockdown, women sought care from several alternative sources, mostly locally available and informal services, including medicine vendors, traditional birth attendants, and neighbours with some health experience. Women also widely engaged in self-medication, using both orthodox drugs and non-orthodox preparations like herbs. The lockdown negatively impacted on women's SRH, with increased incidence of sexual- and gender-based violence, unplanned pregnancy resulting from lack of access to contraceptives, and early marriage involving adolescents with unplanned pregnancies. CONCLUSION: COVID-19 negatively impacted access to SRH services and forced women to utilise mostly informal service outlets and home remedies as alternatives to conventional health services. There is a need to ensure the continuity of essential SRH services during future lockdowns occasioned by disease outbreaks. Also, community systems strengthening that ensures effective community-based health services, empowered community resource persons, and health-literate populations are imperative for overcoming barriers to healthcare access during future lockdowns.

Understanding the impacts of COVID-19 pandemic on mental health and well-being among university students in Dhaka, Bangladesh: A nested mixed-methods study.

Background: University students are more at risk of mental illness compared with the general population. Declaration of a global COVID-19 pandemic led the Bangladesh government in March 2020 to implement a national lockdown, home quarantining, social distancing measures, and closure of educational institutions. We aimed to explore the impact of lockdown on the mental health and well-being of university students in Bangladesh. Methods: A nested mixed-methods survey design was undertaken using a semi structured questionnaire and in-depth interviews conducted by telephone of 73 university students (mean age of 22 years, range 18 to 26-years-old) attending public and private academic institutions in Dhaka. A questionnaire was developed de-novo and pre-tested. Qualitative, open-ended questions were used to understand experiences regarding students' mental health and well-being, their perceptions of COVID-19, and coping strategies. Results: Fifty nine percent of students reported that lockdown had a significant impact on their mental health and well-being. They described difficulties with social isolation and loneliness, motivation, and interpersonal conflict within families. Students' knowledge of COVID-19 were high with television, newspapers, online, and social media were main sources of information; few relied on government reports. Most pressing concerns were timely graduation and employment (83%), not being able to socialize (46%), being stuck at home (37%), and financial difficulties regarding university fees (29%). Additional underlying stressors included financial insecurity of respondents' households and parental health. Coping strategies included watching television or films, online meetings with friends, social media, as well interactions with family. Conclusion: As a result of Bangladesh's first national lockdown, university students experienced negative effects on their mental health and well-being. There is an urgent need for greater proactive measures within educational settings, such as mental health literacy programmes and diagnosis management that could mitigate and prevent adverse impacts of future lockdowns.