Early COVID-19 Interventions Failed to Replicate St. Louis vs. Philadelphia Outcomes in the United States

The Coronavirus disease 2019 (COVID-19) pandemic has elicited an abrupt pause in the United States in multiple sectors of commerce and social activity. As the US faces this health crisis, the magnitude, and rigor of their initial public health response was unprecedented. As a response, the entire nation shutdown at the state-level for the duration of approximately one to three months. These public health interventions, however, were not arbitrarily decided, but rather, implemented as a result of evidence-based practices. These practices were a result of lessons learned during the 1918 influenza pandemic and the city-level non-pharmaceutical interventions (NPIs) taken across the US. During the 1918 pandemic, two model cities, St. Louis, MO, and Philadelphia, PA, carried out two different approaches to address the spreading disease, which resulted in two distinctly different outcomes. Our group has evaluated the state-level public health response adopted by states across the US, with a focus on New York, California, Florida, and Texas, and compared the effectiveness of reducing the spread of COVID-19. Our assessments show that while the states mentioned above benefited from the implementations of early preventative measures, they inadequately replicated the desired outcomes observed in St. Louis during the 1918 crisis. Our study indicates that there are other factors, including health disparities that may influence the effectiveness of public health interventions applied. Identifying more specific health determinants may help implement targeted interventions aimed at preventing the spread of COVID-19 and improving health equity

Does COVID-19 Spread through Droplets Alone?

The world has been in the midst of a swiftly unfolding public health crisis that has turned deadly. The novel coronavirus disease 2019 (COVID-19), has turned out to be a rapidly expanding pandemic affecting the nations of the world. Most governments and their public health authorities worldwide have taken drastic measures to strictly contain the spread of this coronavirus. However, despite the aggressive preventative measures in place, COVID-19 has propagated exponentially across the world. Currently, the accepted mode of disease transmission is by droplets containing the virus. Here we provide epidemiological data in conjunction with biochemical molecular mechanisms of this Severe Acute Respiratory Syndrome- Coronavirus-2 (SARS-CoV-2) and explain the possible alternative modes of disease transmission. Our observed data, biochemical mechanisms, and inferences indicate that COVID-19 has a high probability of transmission through other routes as well, such as indirect routes; viz, fomites and aeros

Comparison of Gastrocnemius Shear Wave Elastography Stiffness Over 5 Different Zones

A few studies report that shear wave elastography (SWE) is a reliable method of measuring gastrocnemius muscle stiffness. To date there are no studies assessing variance in stiffness measures at different locations on the muscle. This led us to ask whether the spot at which gastrocnemius stiffness is measured matters. PURPOSE: To determine if measurement site on the medial and lateral gastrocnemius affects SWE stiffness values. METHODS: Twelve subjects (3 men, 9 women) completed this study (Mean age is 23.0 (SD = 1.0) for men and 21.7 (SD = 2.0) for women (t p = 0.3035). Mean height (cm) is 179.5 (SD = 2.9) for men and 167.1 (SD = 7.8) for women (t p = 0.0256). Mean weight (kg) is 74.9 (SD =10.4) for men and 62.5 (SD = 9.7) for women (t p = 0.0892). Subjects wore shorts and lay prone on a treatment table with their bare feet hanging off the edge of the table. Ultrasound images to confirm borders of the medial and lateral gastrocnemius were confirmed and marked. SWE of both the Medial head (MG) and lateral head (LG) were taken with each head area divided into 4 zones (1=superior medial, 2=superior lateral, 3=inferior medial, 4= inferior lateral). A fifth zone was collected at the center of the muscle at 70% of the length of the lateral malleolus to lateral femoral epicondyle. All 5 points were assessed for SWE in both a relaxed and neutral (900) ankle joint position. Three separate elastogram frames were used to calculate muscle stiffness using both the velocity (m/s) and young’s modulus model (kPa) utilizing an overall area analysis for each. RESULTS: MG velocity and kPa values were significantly greater than LG in the relaxed and neutral positions (pCONCLUSION: MG stiffness is greater than LG regardless of position while intrinsic stiffness of MG increases more relative to LG when placed in neutral. Measurement of stiffness is best represented at the center of the muscle belly in the neutral position, but zones 2,3 and 5 produce similar stiffness values in the relaxed position

Mental Health, Substance Use, and the Importance of Religion during the COVID-19 Pandemic

COVID-19 impacted multiple facets of life, with implications on physical, mental, and societal health. Specifically, long COVID and related losses have exacerbated complex and prolonged grief responses and mental disorders including depression and anxiety. These mental health concerns are in turn associated with increased detrimental coping strategies including substance use disorders (SUD). The social and interpersonal implications of SUD are varied. Secondary data analyses from the National Survey on Drug Use and Health (NSDUH) collected during the COVID-19 pandemic revealed an increase in substance use behaviors and mental health problems. Self-reported religious activities had a positive meditating effect on reducing substance use behaviors. Accordingly, we explored the importance of one\u27s religion and faith in coping with stress, grief, and mental health challenges during the COVID-19 pandemic, highlighting the impact of religion and faith in bringing hope and purpose during periods of loss, grief, mental health challenges, and SUD

Biopsychosocial and Spiritual Implications of Patients with COVID-19 Dying in Isolation

Critically ill patients with the Coronavirus disease 2019 (COVID-19) are dying in isolation without the comfort of their family or other social support in unprecedented numbers. Recently, healthcare teams at COVID-19 epicenters have been inundated with critically ill patients. Patients isolated for COVID-19 have had no contact with their family or loved ones and may have likely experienced death without closure. This situation highlights concerns about the psychological and spiritual well-being of patients with COVID-19 and their families, as they permanently part ways. While palliative care has advanced to address these patients\u27 needs adequately, the COVID-19 pandemic presents several barriers that force healthcare teams to deprioritize these essential aspects of patient care. The severe acute respiratory syndrome (SARS) outbreak in 2003 gave us a glimpse of these challenges as these patients were also isolated in hospitals. Here, we discuss the importance of the biopsychosocial spiritual model in end-of-life care and its implications on patients dying with COVID-19. Furthermore, we outline an integrative approach to address the unique and holistic needs of critically ill patients dying with COVID-19. These include intentional and increased coordination with trained palliative care staff, early and frequent goals of care including discussion of end-of-life plans, broader use of technology to improve connectedness and shared decision making with patients’ families

Acute Stretching Effect on Hamstring Muscle Stiffness using Elastography

Having first been introduced in the 1990s, shear wave elastography (SWE) has more recently been used to investigate intrinsic muscle stiffness. While studies have shown SWE to be an effective way of determining muscle stiffness, few have been conducted to measure the effects of stretching on the hamstring muscles. PURPOSE: to determine if there is a measurable difference of hamstring muscle stiffness with acute stretching using ultrasound elastography. METHODS: 16 subjects participated in this study (11 men and 5 women). Mean age 23.4 ± 2.6yrs for men and 21.2 ±1.5 for women. Mean height (cm) is 180.3± 4.7 for men and 172.7±2.5 for women. Mean weight (kg) is 76.8±9.7 for men and 70.0±14.9 for women. Participants lay supine and positioned to 90° hip and 90° knee flexion. Each participant came in for two sessions that consisted of (1) static stretching and (2) PNF stretching protocols. Maximum ROM of the knee joint, force, and muscle stiffness of the biceps femoris (BF), semimembranosus (SM) and semitendinosus (ST) were recorded both before and 1 minute after stretching. RESULTS: After accounting for age, weight and height, there was no significant difference between the use of static and PNF stretching techniques on either velocity (p= 0.4805) or kPa (p=0.5423) stiffness values. Both static and PNF stretching resulted in significant reductions in both velocity and kPa stiffness (pCONCLUSION: Stiffness as measured using SWE decreases following an acute stretching session for both static and PNF stretching techniques. This suggests alterations to intrinsic muscle characteristics beyond just “stretch tolerance” as suggested in previous literature. Changes in both ROM and force also support this claim. Further research on retention of decreased stiffness are needed as acute stretching has previously been shown to be temporary. Longer term stretching studies to determine if intrinsic muscle stiffness changes models plastic deformation are also needed and may help better elucidate duration and stretch technique differences

Delayed Interventions, Low Compliance, and Health Disparities Amplified the Early Spread of COVID-19

The United States (US) public health interventions were rigorous and rapid, yet failed to arrest the spread of the Coronavirus Disease 2019 (COVID-19) pandemic as infections spread throughout the US. Many factors have contributed to the spread of COVID-19, and the success of public health interventions depends on the level of community adherence to preventative measures. Public health professionals must also understand regional demographic variation in health disparities and determinants to target interventions more effectively. In this study, a systematic evaluation of three significant interventions employed in the US, and their effectiveness in slowing the early spread of COVID-19 was conducted. Next, community-level compliance with a state-level stay at home orders was assessed to determine COVID-19 spread behavior. Finally, health disparities that may have contributed to the disproportionate acceleration of early COVID-19 spread between certain counties were characterized. The contribution of these factors for the disproportionate spread of the disease was analyzed using both univariate and multivariate statistical analyses. Results of this investigation show that delayed implementation of public health interventions, a low level of compliance with the stay at home orders, in conjunction with health disparities, significantly contributed to the early spread of the COVID-19 pandemic

Massage Gun Use at a Lower Frequency Does Not Alter Blood Flow

Data has shown that whole body vibration can affect blood flow velocity in arteries and improves cutaneous blood flow. However, there is very limited information available on therapeutic localized vibration. Massage guns have become very popular with little to no research validating their efficacy. It is currently unknown if massages guns can affect arterial blood flow. PURPOSE: To determine if massage gun treatment at 30Hz improves and retains blood flow in the popliteal artery as compared to a control condition. METHODS: There were 12 participants in this study (8 males and 4 females). The mean age was 22.7±1.6 yrs, the mean height was 181.1± 11.8 cm, and the mean weight was 78.2±16.2 kg. Participants wore shorts that allowed us to access their popliteal artery using ultrasound imaging. Participants wore electrodes to control the measurement of blood flow from widest artery diameter. Participants lay prone with a foam roller under their ankles to slightly elevate their feet. After ten minutes of rest, ultrasound imaging was used to find the participant’s popliteal artery behind the knee and took two baseline measurements. We measured the mean velocity of blood flow (TAmean) and volume flow (VolF). We measured subjects on 4 different days (30Hz at 5 minutes, 30Hz 10 minutes, Control 5 minutes, Control 10 minutes). Measurements of TAmean and VolF were measured at multiple time points after treatment. RESULTS: A two-factor repeated measures analysis was performed. Each subject was measured under all levels of condition (1=30hz 5 min, 4=Control 5 mi, 5=30hz 10 min, 8=Control 10 min) and time (baseline, post, post1-5, 7, 9, 11, 13, 15, 17, 19). TA mean is significantly greater in 30Hz versus control (p=0.0349). TAmean varies across time, and the effect of the condition on TAmean is related to time (p=0.0104). There is not a significant difference in flow between 30Hz and control (p=0.2425). Blood flow varies across time (pCONCLUSION: Use of a massage gun at a lower frequency setting of 30Hz may cause slight increases in velocity but does not increase mean blood flow as compared to control. Lower frequency settings on massage guns may not be benefit blood flow in the massaged muscle group

Effect of Localized Vibration Using Massage Gun at 40hz and 50hz on Blood Flow

Data has shown that whole body vibration can positively affect blood flow, however, there are very few studies on the effect of localized therapeutic vibration on arterial blood flow. Occupational studies looking at localized vibration effects on skin blood flow normally include high frequency settings. In the last few years, massage guns have become popular, but they operate at lower frequencies. Currently, there is no data on the effects of localized vibration from massage guns on arterial blood flow. PURPOSE: To compare the effects of two different frequencies of localized vibration on blood flow in the popliteal artery. METHODS: 12 subjects participated in this study (8 males and 4 females). Mean age was 22.7±1.6 years; mean height was 181.1±11.8 cm; mean weight was 78.2±16.2 kg. Participants wore shorts to give access to the popliteal artery. Participants were hooked to ECG leads to control measurement of artery diameter and then laid on a treatment table in a prone position with a foam roller under their ankles. Once at resting heart rate, baseline blood flow readings were taken using ultrasound, which measured TA Mean and Volume Flow. The participants were then randomly given a 5-minute treatment of control with no vibration or vibration at 40hz or 50hz. Blood flow readings were taken immediately post-treatment and then every minute for 5 minutes after. RESULTS: A two-factor repeated measures analysis was performed. Each subject was measured under all levels of condition (Control 5 min, 40hz 5 min, and 50hz 5 min) and time (baseline, post, post1-5). TA Mean and Volume Flow for both 40hz and 50hz were significantly greater than control (p=0.0020 and p=0.0110 respectively). The effect of time was significant (

The DEHVILS Survey Overview and Initial Data Release: High-Quality Near-Infrared Type Ia Supernova Light Curves at Low Redshift

While the sample of optical Type Ia Supernova (SN Ia) light curves (LCs) usable for cosmological parameter measurements surpasses 2000, the sample of published, cosmologically viable near-infrared (NIR) SN Ia LCs, which have been shown to be good "standard candles," is still $\lesssim$ 200. Here, we present high-quality NIR LCs for 83 SNe Ia ranging from $0.002 < z < 0.09$ as a part of the Dark Energy, H$_0$, and peculiar Velocities using Infrared Light from Supernovae (DEHVILS) survey. Observations are taken using UKIRT's WFCAM, where the median depth of the images is 20.7, 20.1, and 19.3 mag (Vega) for $Y$, $J$, and $H$-bands, respectively. The median number of epochs per SN Ia is 18 for all three bands ($YJH$) combined and 6 for each band individually. We fit 47 SN Ia LCs that pass strict quality cuts using three LC models, SALT3, SNooPy, and BayeSN and find scatter on the Hubble diagram to be comparable to or better than scatter from optical-only fits in the literature. Fitting NIR-only LCs, we obtain standard deviations ranging from 0.128-0.135 mag. Additionally, we present a refined calibration method for transforming 2MASS magnitudes to WFCAM magnitudes using HST CALSPEC stars that results in a 0.03 mag shift in the WFCAM $Y$-band magnitudes.Comment: 24 pages, 9 figures. Accepted by MNRA