Project description:PurposeTo investigate the effect of home quarantine during the COVID-19 pandemic on myopia progression in children and its associated factors.MethodsMyopic children aged 7 to 12 years with regular follow-up visits every half a year from April 2019 to May 2020 were included. Cycloplegic refraction was measured at baseline and at two follow-up visits. The first follow-up visit (visit 1) was conducted before the COVID-19 home quarantine, whereas the second (visit 2) was four months after the home quarantine. Myopia progression at visits 1 and 2 were compared. Factors associated with changes in myopia progression were tested with a multiple regression analysis.ResultsIn total, 201 myopic children were enrolled. There was a significantly greater change in spherical equivalent at visit 2 (-0.98 ± 0.52 D) than at visit 1 (-0.39 ± 0.58 D; P < 0.001). Students were reported to have spent more time on digital devices for online learning (P < 0.001) and less time on outdoor activities (P < 0.001) at visit 2 than at visit 1. Children using television and projectors had significantly less myopic shift than those using tablets and mobile phones (P < 0.001). More time spent on digital screens (β = 0.211, P < 0.001), but not less time on outdoor activities (β = -0.106, P = 0.110), was associated with greater myopia progression at visit 2.ConclusionsChanges in behavior and myopic progression were found during the COVID-19 home quarantine. Myopic progression was associated with digital screen use for online learning, but not time spent on outdoor activities. The projector and television could be better choices for online learning.
Project description:BackgroundOutdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data.MethodsThe literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic.ResultsAmong 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI -0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was - 0.46 D (95% CI -0.59 to -0.34, p<0.001). Over the mean follow-up time during the COVID-19 pandemic, the SER mean difference was -0.55 D (95% CI -0.78 to -0.32, p<0.001), showing that the mean SER had decreased significantly during the COVID-19 pandemic. The mean SER differences in myopic patients before COVID-19 compared with during the pandemic follow-up was -0.49 D (95% CI -0.53 to -0.45, p=0.00). So the prior pandemic myopic patients became more myopic during the pandemic follow-up time.ConclusionDuring home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.
Project description:ImportanceTime spent in outdoor activities has decreased owing to home confinement for the coronavirus disease 2019 (COVID-19) pandemic. Concerns have been raised about whether home confinement may have worsened the burden of myopia owing to substantially decreased time spent outdoors and increased screen time at home.ObjectiveTo investigate the refractive changes and prevalence of myopia in school-aged children during the COVID-19 home confinement.Design, setting, and participantsA prospective cross-sectional study using school-based photoscreenings in 123 535 children aged 6 to 13 years from 10 elementary schools in Feicheng, China, was conducted. The study was performed during 6 consecutive years (2015-2020). Data were analyzed in July 2020.ExposuresNoncycloplegic photorefraction was examined using a photoscreener device.Main outcomes and measuresThe spherical equivalent refraction was recorded for each child and the prevalence of myopia for each age group during each year was calculated. The mean spherical equivalent refraction and prevalence of myopia were compared between 2020 (after home confinement) and the previous 5 years for each age group.ResultsOf the 123 535 children included in the study, 64 335 (52.1%) were boys. A total of 194 904 test results (389 808 eyes) were included in the analysis. A substantial myopic shift (approximately -0.3 diopters [D]) was found in the 2020 school-based photoscreenings compared with previous years (2015-2019) for younger children aged 6 (-0.32 D), 7 (-0.28 D), and 8 (-0.29 D) years. The prevalence of myopia in the 2020 photoscreenings was higher than the highest prevalence of myopia within 2015-2019 for children aged 6 (21.5% vs 5.7%), 7 (26.2% vs 16.2%), and 8 (37.2% vs 27.7%) years. The differences in spherical equivalent refraction and the prevalence of myopia between 2020 and previous years were minimal in children aged 9 to 13 years.Conclusions and relevanceHome confinement during the COVID-19 pandemic appeared to be associated with a significant myopic shift for children aged 6 to 8 years according to 2020 school-based photoscreenings. However, numerous limitations warrant caution in the interpretation of these associations, including use of noncycloplegic refractions and lack of orthokeratology history or ocular biometry data. Younger children's refractive status may be more sensitive to environmental changes than older ages, given the younger children are in a critical period for the development of myopia.
Project description:This study aims at identifying the tools necessary for COVID-19 health emergency management, with particular reference to the period following the first lockdown, a crucial phase in which it was important to favor the maintenance of protective behaviors. It also aims at identifying the messages and sources that were most effective in managing communication correctly in such a crucial phase that is likely characterized by a fall in perceived health risk (due to the flattening of the epidemic curve) and a simultaneous rise in perceived economic and social risks (due to the enduring calamity). Knowing what source will be most effective to convey a specific message is fundamental in enabling individuals to focus on and comply with the rules. At the same time, it is necessary to understand how the message should be presented, and the relationships between messages, sources and targets. To meet these goals, data were collected through a self-administered online questionnaire submitted to a sample of undergraduate students from a University in Lombardy-the region most affected by the pandemic in the first wave- (Study 1), and to a national sample composed of Italian citizens (Study 2). Through our first manipulation which explored the effectiveness of social norms in relation to different sources, we found that, in the national sample, the injunctive norm conveyed by the government was the most effective in promoting behavioral intentions. By contrast, among the students, results showed that for the critical group with a lower risk perception (less inclined to adopt prevention behavior) descriptive norms, which implicitly convey the risk perception of peers, were as effective as the government injunctive norm. Our second manipulation, identical in Study 1 and 2, compared four types of communication (emotional, exponential growth, both of them, or neutral). The neutral condition was the most memorable, but no condition was more effective than the others. Across all message types there was a high intention to adopt protective behaviors. The results indicate possible applicative implications of the adopted communicative tools.
Project description:Background In March 2020, the COVID-19 pandemic led to a national lockdown and quarantine in Italy. The aim of this study was to assess the perceived change in anxiety levels and its predictors in a non-clinical, non-infected, home-quarantined Italian sample in the very first weeks of the lockdown. Methods Online survey data on perceived change in anxiety symptoms since the beginning of the lockdown, health anxiety, social anxiety, depression, and obsessive-compulsive symptomatology before the lockdown, and background information were anonymously collected between March 26 and April 9 2020 on 660 Italian participants. Results Overall, participants reported a substantial increase of anxiety levels. Women reported more increased levels of anxiety symptoms than men. Increase of anxiety was also predicted by higher pre-existing levels of health anxiety and lower socio-economic status. Having lost the job was not associated with a perceived change in anxiety levels. Limitations Crosssectional design; sample of mostly female, young, highly educated, and not infected participants; use of self-report measures. Conclusions The results suggest the need to address mental health issues as a core element of the response to a pandemic, in order to prevent long-term social, psychological, and economic costs to society.
Project description:As economic woes of the COVID-19 pandemic deepen, strategies are being formulated to avoid the need for prolonged stay-at-home orders, while implementing risk-based quarantine, testing, contact tracing and surveillance protocols. Given limited resources and the significant economic, public health, and operational challenges of the current 14-day quarantine recommendation, it is vital to understand if shorter but equally effective quarantine and testing strategies can be deployed. To quantify the probability of post-quarantine transmission upon isolation of a positive test, we developed a mathematical model in which we varied quarantine duration and the timing of molecular tests for three scenarios of entry into quarantine. Specifically, we consider travel quarantine, quarantine of traced contacts with an unknown time if infection, and quarantine of cases with a known time of exposure. With a one-day delay between test and result, we found that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortened quarantine by at most one day. Testing on exit more effectively reduces post-quarantine transmission than testing upon entry. Furthermore, we identified the optimal testing date within quarantines of varying duration, finding that testing on exit was most effective for quarantines lasting up to seven days. As a real-world validation of these principles, we analyzed the results of 4,040 SARS CoV-2 RT-PCR tests administered to offshore oil rig employees. Among the 47 positives obtained with a testing on entry and exit strategy, 16 cases that previously tested negative at entry were identified, with no further cases detected among employees following quarantine exit. Moreover, this strategy successfully prevented an expected nine offshore transmission events stemming from cases who had tested negative on the entry test, each one a serious concern for initiating rapid spread and a disabling outbreak in the close quarters of an offshore rig. This successful outcome highlights that appropriately timed testing can make shorter quarantines more effective, thereby minimizing economic impacts, disruptions to operational integrity, and COVID-related public health risks.
Project description:Initial COVID-19 containment in the United States focused on limiting mobility, including school and workplace closures. However, these interventions have had enormous societal and economic costs. Here, we demonstrate the feasibility of an alternative control strategy, test-trace-quarantine: routine testing of primarily symptomatic individuals, tracing and testing their known contacts, and placing their contacts in quarantine. We perform this analysis using Covasim, an open-source agent-based model, which has been calibrated to detailed demographic, mobility, and epidemiological data for the Seattle region from January through June 2020. With current levels of mask use and schools remaining closed, we find that high but achievable levels of testing and tracing are sufficient to maintain epidemic control even under a return to full workplace and community mobility and with low vaccine coverage. The easing of mobility restrictions in June 2020 and subsequent scale-up of testing and tracing programs through September provided real-world validation of our predictions. Although we show that test-trace-quarantine can control the epidemic in both theory and practice, its success is contingent on high testing and tracing rates, high quarantine compliance, relatively short testing and tracing delays, and moderate to high mask use. Thus, in order for test-trace-quarantine to control transmission with a return to high mobility, strong performance in all aspects of the program is required.
Project description:For COVID-19, it is vital to understand if quarantines shorter than 14 days can be equally effective with judiciously deployed testing. Here, we develop a mathematical model that quantifies the probability of post-quarantine transmission incorporating testing into travel quarantine, quarantine of traced contacts with an unknown time of infection, and quarantine of cases with a known time of exposure. We find that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortens quarantine by at most one day. In a real-world test of our theory applied to offshore oil rig employees, 47 positives were obtained with testing on entry and exit to quarantine, of which 16 had tested negative at entry; preventing an expected nine offshore transmission events that each could have led to outbreaks. We show that appropriately timed testing can make shorter quarantines effective.
Project description:BackgroundIn the recent outbreak of COVID-19, many countries have enacted various kinds of quarantine measures to slow down the explosive spread of COVID-19. Although these measures were proven to be successful in stopping the outbreak in China, the potential adverse effects of countrywide quarantine have not been thoroughly investigated.MethodsIn this study, we performed an online survey to evaluate the psychological effects of quarantine using the Zung Self-rating Anxiety Scale in February 2020 when the outbreak had nearly peaked in China. Along with the anxiety scores, limited personal information, such as age, gender, region, education, occupation, and specifically, the type and duration of quarantine, was collected for analysis.ResultsFrom a total of 992 valid questionnaires from 23 provinces in China, clinically significant anxiety symptoms were observed in 9.58% of respondents according to clinical diagnostic standards in China. The specific groups of people showing higher levels of anxiety were (a) adolescents (<18 years); (b) respondents with education lower than junior high school; (c) people with chronic diseases; and (d) frontline medical personnel. Other characteristics, such as gender, marital status, region, and acquaintance with suspected or confirmed cases of COVID-19, did not affect anxiety levels significantly. Respondents who experienced different forms of quarantine showed different anxiety levels. People undergoing centralized quarantine have higher levels of anxiety. Unexpectedly, longer durations of quarantine did not lead to a significant increase in anxiety level.ConclusionsOur results suggest a rather mild psychological influence caused by the countrywide quarantine during the COVID-19 outbreak in China and provide a reference for other countries and regions battling COVID-19.