• Masking for COVID-19 is Associated with Decreased Emergency Department Utilization for Non-COVID Viral Illnesses and Respiratory Conditions in Maryland

      Dezman, Zachary D W; Stryckman, Benoit; Zachrison, Kori S; Conrad, Ryan M; Marcozzi, David; Pimentel, Laura; Samuels-Kalow, Margaret; Cairns, Charles B (Elsevier Ltd., 2021-07-06)
      Background: Masking, which is known to decrease the transmission of respiratory viruses, was not widely practiced in the United States until the COVID-19 pandemic. This provides a natural experiment to determine whether the percentage of community masking was associated with decreases in emergency department (ED) visits due to non-COVID viral illnesses (NCVI) and related respiratory conditions. Methods: Observational study of ED encounters in a 11-hospital system in BLINDED during 2019-2020. Year-on-year ratios for all complaints were calculated to account for 'lockdowns' and the global drop in ED visits due to the pandemic. Encounters for specific complaints were identified using the International Classification of Diseases, version 10. Encounters with a positive COVID test were excluded. Linear regression was used to determine the association of publicly available masking data with ED visits for NCVI and exacerbations of asthma and chronic obstructive pulmonary disease (COPD), after adjusting for patient age, sex, and medical history. Results: There were 285,967 and 252,598 ED visits across the hospital system in 2019 and 2020, respectively. There was a trend towards an association between the year-on-year ratio for all ED visits and the BLINDED stay-at-home order (parameter estimate=-0.0804, p=0.10). A 10% percent increase in the prevalence of community masking was associated with a 17.0%, 8.8%, and 9.4% decrease in ED visits for non-COVID viral illness and exacerbations of asthma exacerbations and COPD, respectively (p<0.001 for all). Conclusions: These findings may be valuable for future public health responses, particularly in future pandemics with respiratory transmission or in severe influenza seasons.
    • Research on COVID-19 and air pollution: A path towards advancing exposure science.

      Burns, Carol J; LaKind, Judy S; Naiman, Josh; Boon, Denali; Clougherty, Jane Ellen; Rule, Ana M; Zidek, Angelika (Elsevier, 2022-04-04)
      The COVID-19 pandemic has resulted in an extraordinary incidence of morbidity and mortality, with almost 6 million deaths worldwide at the time of this writing (https://covid19.who.int/). There has been a pressing need for research that would shed light on factors - especially modifiable factors - that could reduce risks to human health. At least several hundred studies addressing the complex relationships among transmission of SARS-CoV-2, air pollution, and human health have been published. However, these investigations are limited by available and consistent data. The project goal was to seek input into opportunities to improve and fund exposure research on the confluence of air pollution and infectious agents such as SARS-CoV-2. Thirty-two scientists with expertise in exposure science, epidemiology, risk assessment, infectious diseases, and/or air pollution responded to the outreach for information. Most of the respondents expressed value in developing a set of common definitions regarding the extent and type of public health lockdown. Traffic and smoking ranked high as important sources of air pollution warranting source-specific research (in contrast with assessing overall ambient level exposures). Numerous important socioeconomic factors were also identified. Participants offered a wide array of inputs on what they considered to be essential studies to improve our understanding of exposures. These ranged from detailed mechanistic studies to improved air quality monitoring studies and prospective cohort studies. Overall, many respondents indicated that these issues require more research and better study design. As an exercise to solicit opinions, important concepts were brought forth that provide opportunities for scientific collaboration and for consideration for funding prioritization. Further conversations on these concepts are needed to advance our thinking on how to design research that moves us past the documented limitations in the current body of research and prepares us for the next pandemic.
    • Social capital during the first wave of the covid-19 outbreak: The case of the island of menorca

      Villalonga-Olives, Ester; Kawachi, Ichiro; Hernández-Aguado, Ildefonso (MDPI AG, 2021-12-02)
      The rapidly evolving coronavirus pandemic has drastically altered the economic and social lives of people throughout the world. Our overall goal is to understand the mechanisms through which social capital shaped the community response to the pandemic on the island of Menorca, Spain, which was under a strict lockdown in 2020. Between April and June 2020, we performed qualitative interviews (n = 25) of permanent residents of the island. From the findings, it is evident that social capital is an important resource with the capacity to organize help and support. However, the dark sides of social capital, with lack of social cohesion and lack of trust, also emerged as an important negative issue. We identified sources of tension that were not resolved, as well as important sociodemographic differences that are primary drivers for health inequalities. The investment in social networks and social capital is a long-term need that should consider sociodemographic vulnerability. © 2021 by the authors.