The effects of COVID-19 on New York State's Drug User Health Hubs and syringe service programs: a qualitative study.

BACKGROUND: Syringe service programs (SSPs) deliver critical harm reduction services to people who inject drugs (PWID). Some SSPs in New York State received enhanced funding to provide additional services to combat opioid overdose fatalities. These SSPs, known as Drug User Health Hubs, provide buprenorphine for the treatment of opioid use disorder and other health-related services in addition to their syringe services. While the COVID-19 pandemic posed widespread challenges to the delivery of health services nationwide, the effect of the pandemic on SSPs uniquely impacts PWID. This study examines the impact of COVID-19 on service delivery of Drug User Health Hubs and stand-alone SSPs in New York State. METHODS: Between July 2020 and September 2020, we performed eleven semi-structured virtual interviews with staff from three Health Hub SSPs and three stand-alone SSPs. The interviews explored the effect of the COVID-19 pandemic on SSPs and their clients as well as the changes implemented in response. Interviews were recorded and transcribed. We performed content analysis to identify emerging themes from the data. RESULTS: Due to the COVID-19 pandemic, some SSPs temporarily shut down while others limited their hours of operation. SSPs modified their service delivery to maintain syringe services and naloxone distribution over other services such as STI and HCV testing. They virtualized components of their services, including telemedicine for the provision of buprenorphine. While SSPs found virtualization to be important for maintaining their services, it negatively impacted the intimate nature of client interactions. Participants also described the impact of the pandemic on the well-being of PWID, including isolation, worsened mental health challenges, and increased drug overdoses. CONCLUSIONS: In response to the COVID-19 pandemic, SSPs demonstrated innovation, adaptability, and togetherness. Despite the challenges posed by the pandemic, SSPs continued to be key players in maintaining access to sterile supplies, buprenorphine, and other services for PWID. In addition to adapting to COVID-19 restrictions, they also responded to the dynamic needs of their clients. Sustainable funding and recognition of the critical role of SSPs in supporting PWID can help to improve outcomes for PWID.

Biofouling Mitigation in Forward Osmosis Using Graphene Oxide Functionalized Thin-Film Composite Membranes.

Forward osmosis (FO) is an emerging membrane process with potential applications in the treatment of highly fouling feedwaters. However, biofouling, the adhesion of microorganisms to the membrane and the subsequent formation of biofilms, remains a major limitation since antifouling membrane modifications offer limited protection against biofouling. In this study, we evaluated the use of graphene oxide (GO) for biofouling mitigation in FO. GO functionalization of thin-film composite membranes (GO-TFC) increased the surface hydrophilicity and imparted antimicrobial activity to the membrane without altering its transport properties. After 1 h of contact time, deposition and viability of Pseudomonas aeruginosa cells on GO-TFC were reduced by 36% and 30%, respectively, compared to pristine membranes. When GO-TFC membranes were tested for treatment of an artificial secondary wastewater supplemented with P. aeruginosa, membrane biofouling was reduced by 50% after 24 h of operation. This biofouling resistance is attributed to the reduced accumulation of microbial biomass on GO-TFC compared to pristine membranes. In addition, confocal microscopy demonstrated that cells deposited on the membrane surface are inactivated, resulting in a layer of dead cells on GO-TFC that limit biofilm formation. These findings highlight the potential of GO to be used for biofouling mitigation in FO.