Tag: lockdowns

How COVID Transformed Family Dinners for the Better

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While the lockdowns associated with the COVID pandemic led many families to eat more meals at home, they had an additional benefit: an increase in the quality of family time during those dinners, according to research published by the American Psychological Association.

The study, published in the journal Couple and Family Psychology: Research and Practice, found that families who ate together more often during the pandemic also had more positive interactions, shared news and information, and even embraced technology such as videoconferencing to connect with distant family members.

“The predominance of past research on family dinners has focused on frequency as the key predictor of benefits for children and adolescents,” said lead author Anne Fishel, PhD, a clinician and researcher in family therapy at Massachusetts General Hospital. “This study highlights the importance of examining both frequency and quality to understand the full picture of how shared meals can impact families.”

Researchers examined data from a survey of 517 ethnically and socioeconomically diverse parents across the United States, administered in May 2021. Their aim was to investigate changes in family dinner frequency and quality during the COVID pandemic.

Participants were asked about dinner frequency, quality and post-pandemic expectations. The survey included questions about positive and negative interactions, family support and incorporation of the outside world. They were asked questions such as, “During the pandemic, did all or most of the people living in your home eat dinner together less, about the same, or more than compared to before the pandemic?” Participants then provided answers ranging on a scale of 1–5, 1 being “much less” and 5 being “much more.”

Over 60% of respondents reported eating dinner together more often during the pandemic compared with pre-pandemic times. There was also a significant increase in positive interactions (e.g, expressing gratitude, laughing or feeling connected) during family meals.

“Specifically, 56% said they increased talking about their days during dinner, 60% said they increased talking about their identity as a family, 60% said they increased expressing gratitude, 67% said they increased laughing together and 59% said they felt more connected to each other around the dinner table,” said Fishel. This positive association was evident across income levels, education, age, gender and race.

The pandemic introduced new aspects to family dinners, including remote dining with extended family members and more discussions about current events, according to Fishel. Many families turned to videoconferencing to connect with extended family, potentially strengthening a sense of belonging to a larger family unit. Most parents who increased the use of technology for remote dinners during the pandemic reported that they plan to continue this practice as the pandemic subsides.

The researchers also found an increase in families incorporating news and information from the outside world into their dinner conversations, potentially offering a safe space for children to discuss anxieties and questions with their parents.

Overall, this study suggests that the increased frequency of family dinners during the pandemic may have had lasting positive effects on family dynamics, according to Fishel.

Source: American Psychological Association

American Diets got (Briefly) Healthier During the COVID Pandemic

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American diets may have gotten healthier and more diverse in the months following the start of the COVID-19 pandemic, according to a new study led by Penn State researchers.

The study, published in PLOS ONE, found that as states responded to the pandemic with school closures and other lockdown measures, citizens’ diet quality improved by up to 8.5% and food diversity improved by up to 2.6%.

Co-author Edward Jaenicke, professor of agricultural economics in the College of Agricultural Sciences, said the findings provide a snapshot of what Americans’ diet and eating habits might look like in the nearly complete absence of restaurant and cafeteria eating.

“When dine-in restaurants closed, our diets got a little more diverse and a little healthier,” Jaenicke said. “One post-pandemic lesson is that we now have some evidence that any future shifts away from restaurant expenditures, even those not caused by the pandemic, could improve Americans’ food diversity and healthfulness.”

Prior to the pandemic, the researchers said, the average US diet was considered generally unhealthy. According to the Dietary Guidelines for Americans, eating patterns in the US have remained far below the guidelines’ recommendations, with only slight improvements in the population’s average Healthy Eating Index score between 2005 and 2016.

Also, before the pandemic, the research team was in the midst of a grant-funded project that asked how people would feed themselves after a giant global catastrophe, such as an asteroid strike or nuclear war. In particular, Jaenicke’s team was tasked with investigating how consumers and food retailers might behave during such a disaster.

“At first, the most impactful events we could study using actual, real-world data were hurricanes and other natural disasters,” Jaenicke said. “But then, along came the COVID-19 pandemic, and we realised that this event was an opportunity to study the closest thing we had to a true global catastrophe.”

For the study, the researchers analyzed data from the NielsenIQ Homescan Consumer Panel on grocery purchases, which includes 41,570 nationally representative U.S. households. Data consisted of the quantity and price paid for every universal product code each family purchased during the study period.

Data was gathered from both before the pandemic hit and after the pandemic led to schools, restaurants and other establishments temporarily closing. Because states did not respond to the pandemic simultaneously, the researchers designated each household’s post-pandemic period as the weeks following the date that their county of residence closed schools in 2020.

Jaenicke noted that this allowed the team to show a true causal effect of the pandemic school closures, which generally occurred around the same time that restaurants and other eateries also closed.

“To establish causality, an individual household’s pre- and post-pandemic food purchases were first compared to the same household’s food purchases from one year earlier,” Jaenicke said. “This way, we controlled for the food-purchasing habits, preferences and idiosyncrasies of individual households.”

The researchers found that in the two to three months following pandemic-based school closures (roughly March to June 2020) there were modest increases in Americans’ food diversity, defined as how many different categories of food a person eats over a period of time.

They also found larger, temporary increases in diet quality, meaning the foods purchased were healthier. This was measured by how closely a household’s purchases adhered to the U.S. Department of Agriculture’s (USDA) Thrifty Food Plan, which was designed to meet the requirements of the recommended healthy diet according to the Dietary Guidelines for Americans.

These patterns were found across households with many different demographics; however, those households with young children, lower incomes and without a car exhibited smaller increases in these measures.

“During the COVID-19 pandemic, dine-in restaurants closed, schools and school cafeterias closed, and many supermarket shelves were empty,” Jaenicke said. “Since about 50% of Americans’ food dollars are spent on ‘away from home’ food from restaurants and cafeterias, the pandemic was a major shock to the food system.”

The researchers said there are several possible explanations for these findings. First, because other studies have found that food from restaurants is often less healthy than food made at home, the dramatic decrease of meals eaten at and purchased from restaurants during the pandemic could have contributed to an increase of food diversity and healthfulness at home.

Second, they said it was possible that a global pandemic triggered some consumers to become more health conscious and contributed to them buying healthier, more diverse groceries. Third, because the pandemic caused widespread disruptions to the supply chain, it’s possible that when familiar products were sold out, consumers shifted to newer ones that led to increased diversity and healthfulness.

Finally, school and business closures may have led to many households having more time to cook and prepare foods than they had before, while others – like those with small children – may have had less free time than pre-pandemic.

Jaenicke said that in the future, additional studies could continue to explore how different disasters affect purchasing and eating habits.

Douglas Wrenn, associate professor of environmental and resource economics at Penn State, and Daniel Simandjuntak, research associate at Newcastle University, were also co-authors on the study.

Open Philanthropy helped support this research.

Source: University of Pennsylvania

European COVID Lockdowns Cost Heart Attack Patients up to Two Years of Life

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Patients who had heart attacks during the first COVID lockdown in the UK and Spain are predicted to live 1.5 and 2 years less, respectively, than their pre-COVID counterparts. That’s the finding of a study just published in European Heart Journal – Quality of Care and Clinical Outcomes.

“Restrictions to treatment of life-threatening conditions have immediate and long-term negative consequences for individuals and society as a whole,” said study author Professor William Wijns of the Lambe Institute for Translational Medicine, University of Galway, Ireland. “Back-up plans must be in place so that emergency services can be retained even during natural or health catastrophes.”

Research has shown that during the first wave of the pandemic, about 40% fewer heart attack patients went to hospital as governments told people to stay at home, fear of catching the virus, and the stopping of some routine emergency care. Compared to receiving timely treatment, heart attack patients who stayed at home were more than twice as likely to die, while those who delayed going to the hospital were nearly twice as likely to have serious complications that could have been avoided.

Heart attacks require urgent treatment with stents (called percutaneous coronary intervention or PCI) to open the blocked artery and restore blood flow. Delays, and the resulting lack of oxygen, lead to irreversible damage of the heart muscle and can cause heart failure or other complications. When a large amount of heart tissue is damaged, potentially fatal cardiac arrest results.

This study estimated the long-term clinical and economic implications of reduced heart attack treatment during the pandemic in the UK and Spain. The researchers compared the predicted life expectancy of patients who had a heart attack during the first lockdown with those who had a heart attack at the same time in the previous year. The study focused on ST-elevation myocardial infarction (STEMI), where a coronary artery is completely blocked. The researchers also compared the cost of STEMIs during lockdown with the equivalent period the year before.

A model was developed to estimate long-term survival, quality of life and costs related to STEMI. The UK analysis compared the period 23 March (when lockdown began) to 22 April 2020 with the equivalent time in 2019. The Spanish analysis compared March 2019 with March 2020 (lockdown began on 14 March 2020). Survival projections considered age, hospitalisation status and time to treatment using published data for each country. For example, using published data, it was estimated that 77% of STEMI patients in the UK were hospitalised prior to the pandemic compared with 44% during lockdown. The equivalent rates for Spain were 74% and 57%. The researchers also compared how many years in perfect health were lost for patients with a STEMI before versus during the pandemic.

The analysis predicted that patients who had a STEMI during the first UK lockdown would lose an average of 1.55 years of life compared to patients presenting with a STEMI before the pandemic. In addition, while alive, those with a STEMI during lockdown were predicted to lose approximately one year and two months of life in perfect health. The equivalent figures for Spain were 2.03 years of life lost and around one year and seven months of life in perfect health lost.

The cost analysis focused on initial hospitalisation and treatment, follow-up treatment, management of heart failure and productivity loss in patients unable to return to work. For example, the cost applied to a STEMI admission with PCI was £2837 in the UK and €8780 in Spain. Heart failure costs were estimated at £6086 in year one and £3882 in all subsequent years for the UK. The equivalent figures for Spain were €3815 (year one) and €2930 (each subsequent year).

Professor Wijns said: “The findings illustrate the repercussions of delayed or missed care. Patients and societies will pay the price of reduced heart attack treatment during just one month of lockdown for years to come. Health services need a list of lifesaving therapies that should always be delivered, and resilient healthcare systems must be established that can switch to emergency plans without delay. Public awareness campaigns should emphasise the benefits of timely care, even during a pandemic or other crisis.”

Source: European Society of Cardiology

How COVID Skewed The Perception of Time

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Many people can agree that an altered passage of time, known as “temporal disintegration” in psychiatric literature, was a common experience during the COVID pandemic, ranging from difficulty in keeping track of days of the week to feeling that the hours themselves rushed by or slowed down. Prior work linked these distortions to persistent negative mental outcomes such as depression and anxiety following trauma.

A new study, published in Psychological Trauma: Theory, Research, Practice, and Policy, documents how pervasive the experience was in the first six months of the pandemic. Pandemic-related secondary stresses such as daily COVID-related media exposure, school closures, lockdowns and financial difficulties were also found to be predictors of distortions in perceived time.

“Continuity between past experiences, present life and future hopes is critical to one’s well-being, and disruption of that synergy presents mental health challenges,” said corresponding author E. Alison Holman, UCI professor of nursing. “We were able to measure this in a nationally representative sample of Americans as they were experiencing a protracted collective trauma, which has never been done before. This study is the first to document the prevalence and early predictors of these time distortions. There are relatively new therapies that can be used to help people regain a more balanced sense of time, but if we don’t know who is in need of those services, we can’t provide that support.”

Researchers assessed results of responses regarding distorted time perceptions and other pandemic related experiences from a national sample of 5661 participants. Surveys were conducted during March 18-April 18, 2020 and Sept. 26-Oct. 26, 2020 with respondents who had completed a mental and physical health survey prior to the COVID outbreak.

“Given that distortions in time perception are a risk factor for mental health problems, our findings have potential implications for public health. We are now looking at temporal disintegration, loneliness, and mental health outcomes over 18 months into the pandemic,” Prof Holman said. “This will help us gain insight into how these common experiences during the pandemic work together, so we can better understand how to help people struggling with these challenges.”

Source: University of California – Irvine

Activities That Changed During the Pandemic – and Didn’t Change Back

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A new analysis describes how people in the UK shifted the amount of time they spent on various activities over various stages of pandemic restrictions and shifted to online versus in-person settings. The findings were published in the open-access journal PLOS ONE.

When the COVID pandemic began, the U.K. joined many countries in introducing restrictions on people’s movement and social activities to mitigate viral spread. A growing body of research reveals how such restrictions have affected people’s lifestyles worldwide. This study examined how UK residents’ habits changed over time as different restrictions were implemented and lifted.

The researchers conducted six online surveys of UK residents between April 2020 and July 2021 and were ultimately able to follow 203 people who responded to multiple surveys. The surveys included questions about 16 different types of activities respondents participated in during different phases of the pandemic, such as journalling, shopping, and getting active, and whether they participated online or in person.

Statistical analysis of the responses showed that the biggest changes in terms of amount of time spent – as well as the biggest changes in online versus in-person participation – occurred for cultural activities, spending time with others, and travelling. Changes were most pronounced in March to June 2020, corresponding with the first lockdown period, when participation in all 16 activities decreased. The biggest shift from in-person to online participation occurred from March to October 2020, which included the first lockdown followed by relaxation of restrictions.

Cultural activities, such as going to museums, and group activities were the two categories that fell the most, and did not recover to pre-pandemic levels when UK restrictions were lifted on July 19, 2021. During the restrictions, participation was mostly online in these activities. Spending time with family was among the most robust, and remained mostly in-person, though supplemented by online interaction.

These findings could help policymakers understand the impact of their pandemic restrictions. In the future, the researchers plan to investigate how demographic factors, such as age and employment, may have affected the results, as well as long-term mental health implications of the lifestyle changes.

Professor Patty Kostova, leader of the study, added: “This longitudinal research study illustrated citizens’ resilience throughout the stages of the pandemic.”

Lan Li adds: “This longitudinal study determines the frequency and way of people doing activities from Spring 2020 to Summer 2021 during different phases of the COVID pandemic in the UK. The findings provide an invaluable insight into understanding how people in the UK changed their lifestyle, including what activities they do, and how they accessed those activities in light of the COVID pandemic and related public health policy implemented to address the pandemic.”

Source: ScienceDaily

Caesarean and Induced Deliveries Fell During Pandemic

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During the first few months of the COVID pandemic, premature births from caesarean and induced deliveries fell by 6.5% – and remained consistently lower throughout, according to research reported in the journal Pediatrics. This is likely a result of fewer prenatal visits due to lockdown and social distancing rules, the researchers suggested, and call into question how many such interventions are necessary.   

The study, the first to examine pandemic-era birth data at scale, raises questions about medical interventions in pregnancy and whether some decisions by doctors may result in unnecessary preterm deliveries, according to Assistant Professor Daniel Dench, the paper’s lead author.

“While much more research needs to be done, including understanding how these changes affected fetal deaths and how doctors triaged patient care by risk category during the pandemic, these are significant findings that should spark discussion in the medical community,” A/Prof Dench said.

In effect, the study begins to answer a question that never could have been resolved in a traditional experiment: What would happen to the rate of premature C-sections and induced deliveries if women didn’t see doctors as often, especially in person, during pregnancy?

Doing such a study would be unethical, but lockdown had a side effect of reducing prenatal care visits by more than a third, according to one analysis. That gave A/Prof Dench and colleagues an opportunity to evaluate the impacts, after all.

The researchers took records of nearly 39 million US births from 2010 to 2020, and compared them to expected premature births (born before 37 weeks) from March to December 2020. 

The researchers found that in March 2020, when lockdowns began in the US, preterm births from C-sections or induced deliveries immediately fell from the forecasted number by 0.4%. From March 2020 to December 2020, the number remained on average 0.35% below the predicted values. That translates to 350 fewer preterm C-sections and induced deliveries per 100 000 live births, or 10 000 fewer overall.

Before the pandemic, the number of preterm C-sections and induced deliveries had been rising. Spontaneous preterm births also fell by a small percentage in the first months of the pandemic, but much less than births involving those two factors. The number of full-term caesarean and induced deliveries increased.

“If you look at 1000 births in a single hospital, or even at 30 000 births across a hospital system, you wouldn’t be able to see the drop as clearly,” said A/Prof Dench. “The drop we detected is a huge change, but you might miss it in a small sample.”  

The researchers also corrected for seasonality, for example, preterm births are higher on average in February than in March, which helped them get a clearer picture of the data.

The research comes with caveats. Up to half of all preterm C-sections and induced deliveries are due to a ruptured membrane, which is a spontaneous cause. But in the data Dench and his team used, it’s impossible to distinguish these C-sections from the ones caused by doctors’ interventions. So, Dench and co-authors are seeking more detailed data to get a clearer picture of preterm deliveries.

Still, these findings are significant because the causes for preterm births are not always known.

“However, we know for certain that doctors’ interventions cause preterm delivery, and for good reason most of the time,” A/Prof Dench said. “So, when I saw the change in preterm births, I thought, if anything changed preterm delivery, it probably had to be some change in how doctors were treating patients.”

The researchers’ findings raise a critical question: Was the pre-pandemic level of doctor intervention necessary?

“It’s really about, how does this affect foetal health?” said A/Prof Dench. “Did doctors miss some false positives – did they just not deliver the babies that would have survived anyway? Or did they miss some babies that would die in the womb without intervention?”  

A/Prof Dench plans to use foetal death records from March 2020 to December 2020 to answer this question. If he finds no change in foetal deaths at the same time as the drop in preterm births, that could point to “false positives” in doctor intervention that can be avoided in the future. Learning which pregnancies required care during the pandemic and which ones didn’t could help doctors avoid unnecessary interventions in the future.  

“This is just the start of what I think will be an important line of research,” A/Prof Dench said.

Source: Georgia Institute of Technology

Living with COVID: SA’s New Approach

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South Africa’s easing of COVID regulations at the end of 2021 set a new trend in how countries are choosing to manage the pandemic. In an article for The Conversation, Wits University’s Professor Shabir Madhi and colleagues reflect on the boldness – and the risks.

In a significant departure, the government is choosing a new, more pragmatic approach while keeping an eye on severe COVID and threats to health systems. This reflects a willingness to “live with the virus” without causing further damage to the economy and livelihoods, especially in a resource-constrained country.

Prof Madhi and colleagues hope that “the government continues to pursue this approach and doesn’t blindly follow policies that are not feasible in the local context, and ultimately yield nominal benefit.”

This more nuanced approach is a stark contrast to reflexive restrictions in response to rising case rates, suggesting the government has listened to commentary saying that the focus should be on whether health systems are under threat.

A high level of population immunity guides this approach. A sero-survey in Gauteng, just prior to the onset of the Omicron wave indicated that 72% of people had been infected over the course of the first three waves. Sero-positivity was 79% and 93% in COVID unvaccinated and vaccinated people aged over 50: a group that had previously made up a high percentage of hospitalisations and deaths.

The sero-survey data show that immunity against severe COVID in the country has largely evolved through natural infection over the course of the first three waves and prior to the advent of vaccination. This has, however, come at the massive cost of 268 813 deaths based on excess mortality attributable to COVID

Antibody presence is a proxy for underlying T-cell immunity which appears to play an important role in reducing the risk of infection progressing to severe COVID. Current evidence indicates that such T cell immunity, which has multiple targets and even more so when induced by natural infection, is relatively unaffected even by Omicron’s many mutations and likely lasts more than a year. This sort of underpinning T-cell immunity protecting against severe disease should provide breathing space for at least the next 6–12 months, and possibly further.

Despite Omicron’s anti-spike evasion, vaccine and natural infection induced T-cell immunity has been relatively preserved. This could explain the uncoupling of case rate to hospitalisation and death rates. Omicron’s mutations also appear to make it predisposed to infecting the upper rather than the lower airway, reducing the likelihood of progressing to severe disease.

In the meantime, they stress that greater vaccine uptake is ensured, along with boosters for high-risk groups.

Additionally, since low test rates mean only 10% of infections are actually documented in SA , isolation and quarantine are ineffective and a more pragmatic approach is necessary, the authors argued.

As the average person in South Africa could have 20 close contacts per day, contact tracing is of little value, and even symptomatic cases are most infectious in the pre-symptomatic and early symptomatic phase. The fact that three quarters of the SA population were infected over the course of the first three waves demonstrates how ineffective contact tracing and quarantine is.
They recommend that certain non-pharmacological interventions should be gradually dropped, especially hand hygiene and superficial thermal screening, while outdoor events should be allowed. Rather, government focus should remain on masking in poorly ventilated spaces and ensuring proper ventilation.

Mandatory vaccinations are still on the radar, since as well as the added risk to others that unvaccinated pose, there is the greater pressure they place on the health systems when they are hospitalised for COVID.

Attention also needs to be given to the management of incidental COVID infections in hospitals. The Department of Health guidance needs to be adapted to manage these patients with the appropriate level of care for the primary reason they were admitted. And patients with severe COVID disease require additional care and expertise to improve their outcomes.

Finally, an evaluation of both vaccination status and underlying immune deficiency needs to become a key element of the workup of hospitalised patients with severe COVID.

The authors stressed the need to minimise hospitalisations and deaths, without damaging livelihoods. SA’s Omicron wave death rate is about a tenth that of Delta, on par with pre-COVID seasonal influenza deaths – 10 000 to 11 000 per annum. TB caused an estimated 58 000 deaths in 2019.

While future variants are unpredictable, there is a trend towards lower rates of hospitalisation and death, especially if vaccine coverage can be increased to 90%, particularly in the over-50 age group. Omicron’s high infection rate will likely also contribute to future protection against COVID.

They note that while there is a risk of new variants, failure to change the pandemic mindset is another risk, as Omicron signals the end of COVID’s epidemic phase.

Past practices have had little effect, the authors concluded, and it is something that the SA government appears to have realised. Despite all the severe lockdowns, SA still suffered a high COVID death rate of 481 per 100 000.

Source: The Conversation

WHO Criticises Omicron Travel Bans as SA Stays at Level 1

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The emergence of the Omicron SARS-CoV-2 variant which has resulted in renewed lockdowns and travel bans around the world, which have been criticised by the WHO. In contrast, South Africa will stick to an adjusted Level 1 lockdown for the time being, though pushing for mandatory vaccinations. Business and civil society groups had warned that increasing restrictions would have provoked backlash as recent election campaign events had effectively ignored them.

Many nations around the world have reacted quickly to the new variant, which has a large number of mutations compared to the Delta variant. The UK’s decision to suspend flights from South Africa as well as nine other African countries has provoked criticism from a number of quarters, including President Cyril Ramaphosa. The sudden move has caught many travellers by surprise, including a Welsh rugby team which had two members test positive, one of which was for Omicron. They will have to self-isolate before they are able to return, depending on flight availability.

Japan and Israel have taken the more extreme steps of closing their borders to foreigners. The first cases of Omicron that were recorded in Botswana were revealed to be in visiting diplomats, although which country they came from has not been revealed. 

The World Health Organization criticised the imposition of travel restrictions, acknowledging that although they may play a role in slightly reducing the spread of COVID, they still place a heavy burden on lives and livelihoods. It pointed out that if restrictions are implemented, they should not be unnecessarily invasive or intrusive, and should be scientifically based, under international law, the International Health Regulations. It notes South Africa followed International Health Regulations, and informed WHO as soon as its national laboratory identified the Omicron variant. 

“The speed and transparency of the South African and Botswana governments in informing the world of the new variant is to be commended. WHO stands with African countries which had the courage to boldly share life-saving public health information, helping protect the world against the spread of COVID,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “On the eve of a special session on pandemic preparedness I urge all countries to respect their legal obligations and implement scientifically based public health actions. It is critical that countries which are open with their data are supported as this is the only way to ensure we receive important data in a timely manner.”

Although a full picture of the new variant’s severity is still two or three weeks away, Angelique Coetzee, chair of the South African Medical Association, told the AFP she had recently seen around 30 patients at her Pretoria practice who tested positive for COVID but had unfamiliar symptoms.

“What brought them to the surgery was this extreme tiredness,” she said, something she said was unusual for younger patients. Most were men under 40, and just under half were vaccinated. Other symptoms included mild muscle aches, a “scratchy throat” and dry cough, she said. Just a few had a slightly high temperature. These very mild symptoms stand in contrast to other variants, which typically result in more severe symptoms.

1 in 7 Cancer Patients Missed Surgery Due to Lockdowns

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One in seven cancer patients around the world have missed out on potentially life-saving operations during COVID lockdowns, according to a new study led by the University of Birmingham.

Planned cancer surgery was impacted by lockdowns regardless of the local COVID rates at that time, especially in lower income countries.
Though lockdowns have protected the public from COVID, they have had collateral impact on care for other patients and health conditions. Researchers in this study showed that lockdowns resulted in significant delays for cancer surgery and potentially more cancer deaths.

Researchers are calling for major global reorganisation during the pandemic recovery to provide protected elective surgical pathways and critical care beds that will allow surgery to continue safely, as well as investment in ‘surge’ capacity for future public health emergencies.

‘Ring-fenced’ intensive care beds would support patients with other health conditions and those with advanced disease (who are most at risk from delays) to undergo timely surgery. Investment in staffing and infrastructure for emergency care would mitigate against disruption of elective services.

The COVIDSurg Collaborative involved 5000 surgeons and anaesthetists around the world working together as part of the to analyse data from the 15 most common solid cancer types in 20 000 patients in 61 countries. The findings were reported in The Lancet Oncology.

The researchers compared cancellations and delays before cancer surgery during lockdowns to those during times with light restrictions. During full lockdowns, one in seven patients (15%) did not receive their planned operation after a median of 5.3 months from diagnosis – all with a COVID related reason for non-operation. However, during light restriction periods, the non-operation rate was very low (0.6%).

Patients awaiting surgery for longer than six weeks during full lockdown were less likely to have their planned cancer surgery. Frail patients, those with advanced cancer, and those waiting surgery in lower-middle income countries were all less likely to have the cancer operation they urgently needed.

Researchers analysed data from adult patients suffering from cancer types including colorectal, oesophageal, gastric, head and neck, thoracic, liver, pancreatic, prostate, bladder, renal, gynaecological, breast, soft-tissue sarcoma, bony sarcoma, and intracranial malignancies.

Lockdowns directly impact hospital procedures and planning, as health systems change to reflect stringent government policies restricting movement. The researchers found that full and moderate lockdowns independently raised the likelihood of non-operation after adjustment for local COVID case notification rates. They hope that this information will help guide future lockdowns and restrictions by governments.

Source: University of Birmingham

Gender Behavioural Differences Strengthened in Lockdown

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‘Stereotypical’ gender behaviour differences were exaggerated during the COVID lockdown in Austria, according to a recent study published in Scientific Reports

Men and women conducted themselves differently in the wake of the COVD lockdown in Austria, with women spending more time on the phone while men returned to crowded and public areas more quickly.

Using mobile phone data from 1.2 million devices in Austria (representing 15% of the population) across the first phase of the COVID pandemic, researchers quantified gender-specific patterns of communication intensity, mobility, and circadian rhythms. They noted the resilience of behavioural patterns with respect to the shock imposed by a strict nation-wide lock-down that Austria experienced in the beginning of the crisis with severe implications on public and private life. They found significant differences in gender-specific responses during the different phases of the pandemic. They found that following lockdown, gender differences in mobility and communication patterns increased massively, while circadian rhythms tended to synchronise.

In particular, women had fewer but longer phone calls than men during the lock-down. Phone calls involving women lasted significantly longer on average, with big differences depending on who was calling whom. After the first lockdown in Austria was imposed on March 16, calls between women were up to 1.5 times longer than before the crisis (140% increase), while calls from men to women lasted nearly twice as long. Conversely, when women called men, they talked 80 percent longer, while the duration of calls between men rose only by 66 percent.

“Of course, we don’t know the content or purpose of these calls,” says Georg Heiler, a researcher at CSH and TU Wien, who was responsible for data processing. “Yet, literature from the social sciences provides evidence — mostly from small surveys, polls, or interviews — that women tend to choose more active strategies to cope with stress, such as talking with others. Our study would confirm that.”

Mobility declined massively for both genders, however, women tended to restrict their movement stronger than men. Women also showed a stronger tendency to avoid shopping centres and more men frequented recreational areas. 

After the lockdown, males returned back to normal quicker than females; and young and adolescent age-cohorts returned much quicker. An age stratification highlights the role of retirement on behavioural differences. They found that the length of a day for men and women is reduced by one hour. 

Source: Complexity Science Hub Vienna