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The Effectiveness Of Disinfection Protocols In Medical School Osteopathic Manipulative Medicine Labs., Harrison A. Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: In light of the COVID-19 pandemic, healthcare-associated infections have taken center stage. Healthcare has adjusted workflows to accommodate for more robust disinfecting regiments to help protect the community. This has resulted in the need for medical institutions to reevaluate the current disinfection protocols down to the student level. The osteopathic manipulative medicine (OMM) laboratory provides an optimal avenue for assessing the effectiveness of medical students' ability to clean examination tables. With OMM laboratories having a high level of interaction, adequate disinfection is important for the health and safety of students and teaching faculties.

OBJECTIVES: This study will evaluate the …

Literature Review—Transthoracic Echocardiography, Computed Tomography Angiography, And Their Value In Clinical Decision Making And Outcome Predictions In Patients With Covid-19 Associated Cardiovascular Complications, Jędrzej Warpechowski, Adam Olichwier, Aleksandra Golonko, Marcin Warpechowski, Robert Milewski

Department of Nutrition and Health Sciences: Faculty Publications

The sudden outbreak of the COVID-19 pandemic posed a great threat to the world’s healthcare systems. It resulted in the development of new methods and algorithms for the diagnosis and treatment of both COVID-19 and its complications. Diagnostic imaging played a crucial role in both cases. Among the most widely used examinations are transthoracic echocardiography (TTE) and computed tomography angiography (CTA). Cardiovascular complications in COVID-19 are frequently associated with a severe inflammatory response, which results in acute respiratory failure, further leading to severe complications of the cardiovascular system. Our review aims to discuss the value of TTE and CTA in …

Implementation Of A Virtual Interprofessional Icu Learning Collaborative: Successes, Challenges, And Initial Reactions From The Structured Team- Based Optimal Patient-Centered Care For Virus Covid-19 Collaborators, Simon Zec, Nika Zorko Garbajs, Yue Dong, Ognjen Gajic, Christina Kordik, Lori Harmon, Marija Bogojevic, Romil Singh, Yuqiang Sun, Vikas Bansal, Linh Vu, Kelly Cawcutt, John M. Litell, Sarah Redmond, Elly Fitzpatrick, Kirstin J. Kooda, Michelle Biehl, Neha S. Dangayach, Viren Kaul, June M. Chae, Aaron Leppin, Mathew Siuba, Rahul Kashyap, Allan J. Walkey, Alexander S. Niven

Jefferson Hospital Staff Papers and Presentations

IMPORTANCE: Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes. OBJECTIVES: The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices. DESIGN, SETTING, AND PARTICIPANTS: This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method …

Innovative Strategy To Improve Enteral Nutrition In Prone Positioning With Patients With Covid-19., Jan Powers Phd, Rn, Ccrn, Janette Richardson, Jennifer Rechter Msn, Rn-Bc, Agcns-Bc

Nursing Publications, Posters, & Presentations

BACKGROUND: Enteral nutrition is essential to improve outcomes in patients who are critically ill. Patients in the prone position, including those diagnosed with coronavirus disease 2019 (COVID-19) present additional challenges for enteral nutrition initiation.

METHODS: A novel technique for placing feeding tubes while in the prone position was developed using an electromagnetic placement device and specialty trained clinical nurse specialists. Data were assessed retrospectively to determine effectiveness of this new practice.

RESULTS: Sixty-eight patients had feeding tubes placed while in the prone position; 75% were able to be placed through the postpyloric route, 22% were placed through the gastric route, …

Hospital-Acquired Pressure Injuries In Adults With Prone Positioning Using Manual Method Versus Specialty Bed: A Retrospective Comparison Cohort Study, Jacqueline M. Demellow, Harbir Dhillon, Mouchumi Bhattacharyya, Daniel Pacitto, Teri M. Kozik

Pacific Faculty Work

Purpose: The purpose of this study was to compare the incidence of hospital-acquired pressure injuries (HAPIs) in patients with acute respiratory distress syndrome (ARDS) and placed in a prone position manually or using a specialty bed designed to facilitate prone positioning. A secondary aim was to compare mortality rates between these groups. Design: Retrospective review of electronic medical records. SUBJECTS AND SETTING: The sample comprised 160 patients with ARDS managed by prone positioning. Their mean age was 61.08 years (SD = 12.73); 58% (n = 96) were male. The study setting was a 355-bed community hospital in the Western United …

Comparison Of Female Ovarian Reserve Before Vs After Covid-19 Vaccination, Liubin Yang, Samantha Neal, Tiffany Lee, Andrew Chou, Amy K Schutt, William Gibbons

Children’s Nutrition Research Center Staff Publications

This cohort study examines the association of COVID-19 vaccination with levels of anti-Mullerian hormone and antral follicle count in women seeking fertility treatment.

Association Of Area Deprivation Index With Severity Of Covid-19 In Pediatric Patients: A Multisite Study Of Racially And Ethnically Diverse Children, Sebastian Acosta, Srinivasan Suresh, Anna K Ettinger, Fabio Savorgnan, Ananth Annapragada, Nirupama Kannikeswaran, Usha Sethuraman

Faculty, Staff and Students Publications

Area deprivation index (ADI) is associated with the risk of severe COVID-19 in adults. However, this association has not been established in children. Information on ADI, demographics, clinical features, disease severity, and outcomes was analyzed for 3434 children with COVID-19. A multivariate logistic regression revealed that non-Hispanic Asians, extremes of weight, and higher ADI were associated with severe disease.

Dietary Changes Among Normal And High Blood Pressure Adolescents During The Covid-19 Pandemic, Bernadette Victoria, Ratu Ayu Dewi Sartika, Rizti Millva Putri

Kesmas

The COVID-19 pandemic has significantly impacted adolescents' unhealthy eating habits and sedentary lifestyles, leading to an increase in blood pressure and obesity rate. High blood pressure among adolescents is an early indicator of adult hypertension, but this condition has received less attention recently. Therefore, this study aimed to determine the differences in dietary changes among high school students with normal and high blood pressure before and during the COVID-19 pandemic in West Lampung District, Indonesia. A cross-sectional design was used, and the sample population consisted of 167 students aged 14-19 years. The results showed that 43 participants had elevated blood …

The Vitamin D Serum Levels In Pregnant Women Affected By Covid-19: A Systematic Review And Meta-Analysis, Luiza Szarpak, Stepan Feduniw, Michal Pruc, Michal Ciebiera, Basar Cander, Mansur Rahnama-Hezavah, Łukasz Szarpak

Faculty, Staff and Students Publications

Vitamin D can modulate immune responses, and its deficiency is linked to increased autoimmunity and susceptibility to infection. In the general population, it has been observed that serum vitamin D levels are connected with the risk of COVID-19 and its severity. Our study aims to examine reported findings on the effect of vitamin D serum levels on infection of COVID-19 during pregnancy. PubMed, Web of Science, Embase, and Cochrane Library were searched for relevant studies. Serum vitamin D serum levels in COVID-19-positive and COVID-19-negative pregnant women were 24.61 ± 20.86 ng/mL and 24.12 ± 17.33 ng/mL, respectively. In mild vs. …

Nutrition In Times Of Crisis: A Qualitative Study In Siargao Island, Philippines, During The Covid-19 Pandemic, Gideon Lasco, Vincen Gregory Yu, Julie Madelo Compra, Phetdavanh Leuangvilay, Rapeepong Suphanchaimat, Yunting Zhang, Charina Javier

Development Studies Faculty Publications

Objectives

Despite the public-health significance of both malnutrition and crises, little has been done to explore the convergence of the two domains and develop ways to improve policies and practices, especially in rural communities. This article remedies that knowledge gap by focusing on nutrition-related changes, responses, and practices during crisis situations in Siargao Island, Philippines, using the COVID-19 pandemic as a backdrop.

Methods

Forty-six (46) semi-structured interviews were conducted among parents, caregivers, local health workers, and local officials of Del Carmen, Siargao Island. Principles of thematic analysis were applied to data analysis using NVivo 12. Afterwards, the preliminary data were …

Binge Drinking Alcohol And Circadian Misalignment In Night Shift Nurses Is Associated With Decreased Resiliency To Covid-19 Infection, Garth R. Swanson, Benjamin A. Schwartz, Cara Joyce, Ali Keshavarzian

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in …

Balancing The Drinking Act: A Grounded Theory Of Youth Drinking, Policy And Covid-19 In Botswana, Tebogo Sebeelo

The Qualitative Report

Stakeholder and consumer participation is generally seen as a critical part of effective alcohol policy making as it has a direct impact on policy implementation. In the advent of COVID-19, the views and experiences of stakeholders and consumers were integral to how countries responded to the virus. The involvement of alcohol stakeholders and consumers raises critical questions about policy making practices. Using Grounded Theory (GT) methods amongst 20 drinkers and six alcohol stakeholders, I examined the views and experiences of stakeholders and alcohol consumers in Botswana during COVID-19. I identified two interrelated core categories of Balancing the Drinking Act and …

Improving Patient Safety For Surgical Clearance: A Preop One Stop Shop, Anna Benedictos

Doctor of Nursing Practice (DNP) Projects

Problem: Medical clearance is required for patients scheduled for surgery, also known as “patient optimization.” Ineffective and inefficient patient optimization is a major contributor to surgery postponements, procedure cancellations, and patient dissatisfaction.

Context: Ambulatory care clinics often lack resources to medically clear patients prior to scheduled surgery. Poor surgical optimization continues to occur on the same day of surgery, resulting in case cancellation or delay in a suburban, 169 bed community hospital with 9 operating rooms and approximately 500 surgical procedures per month.

Interventions: A nurse-led PreOp One Stop Shop (POSS) utilized a standardized checklist to perform preoperative surgical assessment. …

The Evolution Of Primary Care Telehealth Disparities During Covid-19: Retrospective Cohort Study, Rachel D'Amico, Patrick M Schnell, Randi Foraker, J Nwando Olayiwola, Daniel E Jonas, Seuli Bose Brill

2020-Current year OA Pubs

BACKGROUND: Telehealth has become widely used as a novel way to provide outpatient care during the COVID-19 pandemic, but data about telehealth use in primary care remain limited. Studies in other specialties raise concerns that telehealth may be widening existing health care disparities, requiring further scrutiny of trends in telehealth use.

OBJECTIVE: Our study aims to further characterize sociodemographic differences in primary care via telehealth compared to in-person office visits before and during the COVID-19 pandemic and determine if these disparities changed throughout 2020.

METHODS: We conducted a retrospective cohort study in a large US academic center with 46 primary …

Experiences Of School Administrators And Teachers: Challenges And Promising Practices During The Covid-19 Pandemic, Helen Teresa Hyde Carter

Theses and Dissertations

This study examined the lived experiences of teachers and administrators as reflected in their responses regarding instructional materials, instructional delivery, social and emotional well-being of students, and access to critical school services during the COVID-19 pandemic. Participants shared their experiences about how the instructional materials and delivery modes were selected as well as the guidance and support given by school administrators. Major challenges and concerns along with promising practices related to student engagement, social and emotional well-being of students, and access to critical school services were identified.

The Impact Of Covid-19 On Para-Athletes: A Case Study On Motivation And Psychological Training For The 2020 Paralympic Games, Irina Perfilova

Masters Theses, 2020-current

In the 61-year history of the Paralympic Games, the Games have never been canceled for any public health reasons. In order to participate in the Paralympic Games, the preparation process for professional athletes is planned at least four years in advance. Interruptions to this schedule can present significant challenges for elite athletes. Such was the case in 2020 with widespread cancellations of many athletic events due to the COVID-19 pandemic. The impact of in-home isolation can potentially cause athletes to experience different psychological conditions, including depression and anxiety as well as losing motivation. The purpose of this study was to …

Lifestyle And Dietary Habits Change Before And During Quarantine And Subsequent Weight Gain, Adnan Gulzar, Anosh Javed, Amna Liaquat, Daniyal Javed, Maham Zahid, Hassan Mumtaz

Journal of Community Hospital Internal Medicine Perspectives

Background: Pandemics greatly affected human health due to changes in dietary habits and lifestyle Methods: A multi-centric comparative cross-sectional study was conducted online using a structured questionnaire with 323 respondents from two medical colleges of Lahore, Pakistan. The collected data was analyzed including various variables of dietary habits, lifestyle changes and were compared by using paired sample t-test. Chi-square test was applied to measure the relation of weight gain with lifestyle and dietary habits changes. Result: Out of 323 participants, 64.5% of them observed an increase in their weights and 64.1% of respondents noticed an increase in caloric intake. An …

Physical Activity In Managing Stress Among Managers During The Covid-19 Pandemic – A Systematic Review, Anna Hryniewicz, Anna Gmiąt, Magdalena Jaroch-Lidzbarska, Mariusz Lipowski

Baltic Journal of Health and Physical Activity

Introduction: During the COVID-19 pandemic managers experienced additional stress connected with taking responsibility for workers at the time of a worldwide crisis. Maintaining a high level of physical activity in this specific group possibly could have contributed to keeping both management skills and health condition at a high required standard. The purpose of this review is to verify the range of scientific interest on the subject of physical activity among managers as a stress coping strategy during the pandemic. Materials and Methods: For this systematic review six studies were chosen (two of them are qualitative descriptive, three are cross-sectional, one …

Outcomes In Type Ii Diabetes Patients Through The Covid 19 Pandemic A Retrospective Chart Review, Zurwa Nishat, Tara Pellegrino, Robert Steer

Rowan-Virtua Research Day

Context: The COVID-19 pandemic provided a unique opportunity for urgent expansion of telemedicine services as providers continued to supply longitudinal care to patients. Patients with type II diabetes were vulnerable to serious infection with COVID-19 as well as disruption in management of their chronic disease.

Objective: To delineate the outcomes in type II diabetes patients through the COVID-19 pandemic by a retrospective chart review in which disease management was evaluated through HbA1c levels and BMI.

Methods: This retrospective chart review included adult T2DM patients receiving care from five university family medicine offices in NJ. HbA1c levels and BMI values were …

Review Of Telemedicine Use As It Expands Since The Covid-19 Pandemic, Michael P. Perra, Frederick J. Goldstein

Research Day

INTRODUCTION: As new technology advances and the world becomes increasingly connected, medical care and physician-patient interactions have changed. Telemedicine, though present in different forms for many decades, has grown, and its use is changing at a faster-than-ever pace. The COVID-19 pandemic highlighted the utility of different telemedicine platforms and has led to an expansion in its capabilities.

OBJECTIVES: To explore the evolution of telemedicine, its multiple functions, and how this technology has continued to develop since the COVID-19 pandemic in various medical specialties.

METHODS: PubMed was used to assess published studies that either incorporated telehealth resources in their research or …

A Mixed Methods Study On Urban Educators’ Feelings Of Preparedness To Implement Practices That Impact Social And Emotional Learning In A Mid-Pandemic Environment, Emily Dittmer

Dissertations

The purpose of the mixed methods study was to evaluate urban educators’ perceptions of their preparedness to implement social and emotional learning strategies in their classrooms/workspaces as well as to understand what the educators’ experiences were as their students returned to a five day a week school schedule after a year and a half of disruptions due to the COVID-19 pandemic. Those involved in the study included educators from four K-8 public charter schools located in an urban Midwestern environment. Quantitative data was obtained through the administration of two identical surveys that were completed by volunteer participants at two different …

Pandemic Produce: Impacts Of Covid-19 On Florida's Fruit And Vegetable Industries, Christa D. Court, David Outerbridge, Lauri Baker, Laura Birou, Catherine Campbell, Gigi Digiacomo, Sebastian Galindo, John Lai, Alexandre Magnier, Michelle Miller, Gustavo De L.T. Oliveira, Eyrika Orlando, Hikaru Hanawa Peterson, Xiaohui Qiao, Fritz Roka, Andrew Ropicki, Bijeta Bijen Saha, Andrew W. Stevens, Li Zhang

Geography

Florida has one of the most diverse agricultural economies in the United States, producing several dozen types of fruits and vegetables that are consumed within the state, across the country, and around the world. The COVID-19 pandemic and resulting policy responses occurred during the peak of spring harvest season for many crops in Florida, abruptly removing market demand from the food service industry and shifting consumer purchasing habits, which enabled insights into several aspects of the fruit and vegetable supply chain. This article examines how the COVID-19 pandemic impacted fruit and vegetable industries in Florida, how these industries responded to …

Patterns In Use And Transplant Outcomes Among Adult Recipients Of Kidneys From Deceased Donors With Covid-19, Mengmeng Ji, Amanda J Vinson, Su-Hsin Chang, Massini Merzkani, Krista L Lentine, Yasar Caliskan, Kristin Progar, Nicole Nesselhauf, Casey Dubrawka, Tarek Alhamad

2020-Current year OA Pubs

IMPORTANCE: While the COVID-19 pandemic enters a new phase and the proportion of individuals with a previous COVID-19 diagnosis increases, the national patterns in kidney use and medium-term kidney transplant (KT) outcomes among patients receiving kidneys from active or resolved COVID-19-positive donors remain unknown.

OBJECTIVE: To evaluate the patterns in kidney use and KT outcomes among adult recipients of kidneys from deceased donors with active or resolved COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was conducted using national US transplant registry data from 35 851 deceased donors (71 334 kidneys) and 45 912 adult patients who received KTs …

Adapting Elements Of Cleft Care Protocols In Low- And Middle-Income Countries During And After Covid-19: A Process-Driven Review With Recommendations, Matthew Fell, Michael Goldwasser, B S Jayanth, Rui Manuel Rodrigues Pereira, Christian Tshisuz Nawej, Rachel Winer, Neeti Daftari, Hugh Brewster, Karen Goldschmied, Collaborators Fernando Almas, Mekonen Eshete, George W Galiwango, Larry H Hollier, Akhter Hussain, Lun-Jou Lo, Paul Salins, Debbie Sell, Amanuel Tafase, Ronald M Zuker

Faculty, Staff and Students Publications

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery …

Anxio-Depressive Disorders In A Pandemic Context: A Comparative Analysis: Year 2019 Versus 2020, Andreea Roxana Droahnă, Lavinia-Alexandra Moroianu, Valeria-Anca Pietroșel, Cristina Ioana Bica, Teodor Salmen, Cecilia Curis, Emanuele Maria Merlo, Roxana Adriana Stoica, Marius Moroianu

Journal of Mind and Medical Sciences

The outbreak of SARS-CoV-2 pandemic has resulted in increased rates of anxiety and depression worldwide. Objective. To comparatively evaluate factors associated with the psychological impact of Coronavirus disease between 2019 and the pandemic year 2020. Materials and Methods. The study was performed on a group of 3224 patients, of which 197 were hospitalized, selected from Jan 1st 2019 until 30th Dec 2020 in a tertiary care center for psychiatric disorders. Data were collected from the observation charts. Results. The incidence of anxiety disorders is higher in the age range 40-70 years with an average value of 53 years old. In …

Opportunistic Retrospective Assessment Of Huac, Bone Density, Sft And Breast Density On Ct Images And Relationship With Severity Of Covid-19, Mahmut Subasi, Mustafa Duger, Cengiz Erol, Irmak Durur-Subasi

Journal of Mind and Medical Sciences

Aim. To evaluate mean Hounsfield unit calculation (HUAC), bone density, subcutaneous fat thickness (SFT), breast density (constitutional imaging biomarkers) and age in symptomatic patients with COVID-19, to assess their correlation with pneumonia severity. Materials and Methods. Between 11 March and 30 May 2020, 272 consecutive symptomatic female patients with COVID-19 who underwent chest CT imaging at baseline were reviewed. HUAC, bone density, SFT and breast density were evaluated retrospectively and statistically compared in cases with negative/positive PCR test results, with/without pneumonia and with mild/moderate-severe pneumonia. Univariate/multivariate logistic regression analyses were applied for estimation of moderate/severe pneumonia. Results. The parameters of …

Virtual Visits In Routine Prenatal Care, Katrina K. Wu

MUSC Theses and Dissertations

Problem

One million pregnant persons in the United States do not receive early prenatal care or the recommended number of prenatal visits each year, and this gap in care access disproportionately affects people of color, those with lower incomes, and those living in rural communities. Telemedicine was widely utilized in prenatal care during the COVID-19 pandemic, and optimizing prenatal telemedicine has the potential to improve prenatal care access beyond the pandemic.

Purpose

This dissertation focused on examining the integration of virtual visits in routine prenatal care during the COVID-19 pandemic. The purpose of this dissertation was to:

Aim 1. Explore …

Mixed Depression In The Post-Covid-19 Syndrome: Correlation Between Excitatory Symptoms In Depression And Physical Burden After Covid-19, Alessio Simonetti, Evelina Bernardi, Stella Margoni, Antonello Catinari, Antonio Restaino, Valentina Ieritano, Marta Palazzetti, Federico Mastrantonio, Delfina Janiri, Matteo Tosato, Francesco Landi, Gabriele Sani

Faculty, Staff and Students Publications

The relationship between depression and post-COVID-19 disease syndrome (post-COVID-19 syndrome) is established. Nevertheless, few studies have investigated the association between post-COVID-19 syndrome and mixed depression, i.e., a specific sub-form of depression characterized by high level of excitatory symptoms. Aims of the present study are: (a) to compare the post-COVID-19 syndrome's burden in depressed and non-depressed patients, and (b) to investigate the correlation between post-COVID-19 syndrome's burden and the severity of mixed depression. One thousand and forty six (n = 1460) subjects with post-COVID-19 syndrome were assessed. Subjects were divided into those with (DEP) or without (CONT) depression. Sociodemographically, post-COVID-19 syndrome's …

The Compound Risk Of Heat And Covid-19 In New York City: Riskscapes, Physical And Social Factors, And Interventions, Janelle Knox-Hayes, Juan Camilo Osorio, Natasha Stamler, Maria Dombrov, Rose Winer, Mary Hannah Smith, Reginald Blake, Cynthia Rosenzweig

Publications and Research

Climate change is disrupting the fundamental conditions of human life and exacerbating existing inequity by placing further burdens on communities that are already vulnerable. Risk exposure varies by where people live and work. In this article, we examine the spatial overlap of the compound risks of COVID-19 and extreme heat in New York City. We assess the relationship between socio-demographic and natural, built and social environmental characteristics, and the spatial correspondence of COVID-19 daily case rates across three pandemic waves. We use these data to create a compound risk index combining heat, COVID-19, density and social vulnerability. Our findings demonstrate …

Liberating Legal Aid: Reducing Covid-19'S Justice Gap And Promoting Health By Removing The Legal Services Corporation's Class Action And Advocacy Restrictions, Molly C. Schmidt

Cleveland State Law Review

The Legal Services Corporation (LSC) is the single-largest funder of civil legal services, or legal aid, in the United States. The COVID-19 pandemic underscored a longstanding and growing problem faced by ow-income Americans served by LSC-funded legal aid organizations: the growing "justice gap." The justice gap represents the unmet civil legal needs of low-income Americans. The justice gap perpetuates poverty, conceals health-harming legal problems, and furthers racial disparities. Despite the LSC’s essential role in reducing the justice gap and promoting “equal access to justice,” Congress consistently underfunded the LSC before and during COVID-19. Congress has also prohibited the LSC-funded legal …