Medicine and Health Sciences Commons^™

Impact Of The Covid-19 Pandemic On Daily Life, Mood, And Behavior Of Adults With Down Syndrome, Sigan L. Hartley, Victoria Fleming, Brianna Piro-Gambetti, Annie Cohen, Beau M. Ances, Michael A. Yassa, Adam M. Brickman, Benjamin L. Handen, Elizabeth Head, Mark Mapstone, Bradley T. Christian, Ira T. Lott, Eric Doran, Shahid Zaman, Sharon Krinsky-Mchale, Frederick A. Schmitt, Christy L. Hom, Nicole Schupf

Sanders-Brown Center on Aging Faculty Publications

Background: The Down syndrome population has been disproportionately affected by Coronavirus 2019 (COVID-19) in terms of experiencing severe illness and death. Societal efforts to curb the spread of COVID-19 may also have taken a heavy toll on the daily lives of individuals with Down syndrome.

Objective/hypothesis: The goal of the study was to understand how the COVID-19 pandemic has altered daily life (including residence, employment, and participation in adult disability day programs) and influenced the mood and behavior of adults with Down syndrome.

Methods: Between September 2020 and February 2021, caregivers of 171 adults with Down syndrome (aged …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

• A cover feature on negotiating reimbursement rates with PPO contracts.
• A cover feature on guarding against employee embezzlement.
• A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
• A Back Page look at the 2022 MDA award winners.
• News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …

Impact Of Covid-19 On Otolaryngology Literature, Yeshwant R. Chillakuru, Eleanor F. Gerhard, Timothy Shim, Samuel H. Selesnick, Lawrence R. Lustig, John H. Krouse, Ehab Y. Hanna, Timothy L. Smith, Edward W. Fisher, Joseph E. Kerschner, Ashkan Monfared

School of Medicine Publications

Objective

To understand the effect of the COVID-19 pandemic on the volume, quality, and impact of otolaryngology publications.

Methods

Fifteen of the top peer-reviewed otolaryngology journals were queried on PubMed for COVID and non-COVID related articles from April 1, 2020 - March 31, 2021 (pandemic period) and pre-COVID articles from the year prior. Information on total number of submissions and rate of acceptance were collected from seven top-ranked journals.

Results

Our PubMed query returned 759 COVID articles, 4885 non-COVID articles, and 4200 pre-COVID articles, corresponding to a 34% increase in ENT publications during the pandemic period. Meta-analysis/reviews and miscellaneous publication …

Association Between The Covid-19 Pandemic And Insurance-Based Disparities In Mortality After Major Surgery Among Us Adults, Laurent G Glance, Andrew W Dick, Ernie Shippey, Patrick J Mccormick, Richard Dutton, Patricia W Stone, Jingjing Shang, Stewart J Lustik, Heather L Lander, Igor Gosev, Karen E Joynt Maddox

2020-Current year OA Pubs

Importance: The COVID-19 pandemic caused significant disruptions in surgical care. Whether these disruptions disproportionately impacted economically disadvantaged individuals is unknown.

Objective: To evaluate the association between the COVID-19 pandemic and mortality after major surgery among patients with Medicaid insurance or without insurance compared with patients with commercial insurance.

Design, Setting, and Participants: This cross-sectional study used data from the Vizient Clinical Database for patients who underwent major surgery at hospitals in the US between January 1, 2018, and May 31, 2020.

Exposures: The hospital proportion of patients with COVID-19 during the first wave of COVID-19 cases between March 1 and …

Health Inequities As Measured By The Eq-5d-5l During Covid-19: Results From New York In Healthy And Diseased Persons, Erica I. Lubetkin, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, Gouke J. Bonsel

Publications and Research

Introduction: The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

Methods: Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to …

Vaccine Hesitancy And Betrayal Aversion, Abdelaziz Alsharawy, Esha Dwibedi, Jason Aimone, Sheryl Ball

Faculty, Staff and Student Publications

The determinants of vaccine hesitancy remain complex and context specific. Betrayal aversion occurs when an individual is hesitant to risk being betrayed in an environment involving trust. In this pre-registered vignette experiment, we show that betrayal aversion is not captured by current vaccine hesitancy measures despite representing a significant source of unwillingness to be vaccinated. Our survey instrument was administered to 888 United States residents via Amazon Mechanical Turk in March 2021. We find that over a third of participants have betrayal averse preferences, resulting in an 8-26% decline in vaccine acceptance, depending on the betrayal source. Interestingly, attributing betrayal …

Covid-Associated Avascular Necrosis Of The Maxilla-A Rare, New Side Effect Of Covid-19, Victoria A Mañón, Steven Balandran, Simon Young, Mark Wong, James C Melville

Faculty, Staff and Student Publications

Purpose: The purpose of this article is to present an interesting, rare case of a patient who experienced avascular necrosis of the maxilla associated with COVID-19 infection.

Methods and results: Our team retrospectively evaluated this patient's chart after completion of surgical management. The patient is a 72-year-old male who presented to the University of Texas Health Science Center at Houston for surgical management of his infarcted maxilla, which developed as a sequela of infection with COVID-19. A literature review was completed using PubMed. Twenty-five articles are reviewed and discussed.

Conclusions: Infection with COVID-19 confers a hypercoagulable state in patients, leading …

“Into The Lion’S Den”: Covid-19 Experiences Of Black Adults With Sickle Cell Disease, Nadine Matthie, Dora L. Clayton-Jones, Coretta Jenerette

College of Nursing Faculty Research and Publications

Adults living with sickle cell disease are at risk for experiencing severe illness from coronavirus disease 2019 (COVID-19) due to the complexity of their disease. Additionally, self-management and navigating the healthcare system may be challenging during the COVID-19 pandemic. Therefore, we conducted telephone interviews with 25 participants to explore the experiences of Black adults living with sickle cell disease during the early months of the pandemic in the United States. Three overarching themes characterize their experiences: management of sickle cell disease was further complicated by the pandemic, fear of the virus contributed to physical and social isolation, and employment and …

Prognostic Serum Biomarkers In Cancer Patients With Covid-19: A Systematic Review, Te-An Lee, Shih-Han Wang, Chun-Tse Kuo, Chia-Wei Li, Louise D Mccullough, Dhimiter Bello, Yun-Ju Lai

Faculty, Staff and Student Publications

Purpose: Cancer patients with COVID-19 likely express biomarker changes in circulation. However, the biomarkers used in SARS-CoV-2 infected cancer patients for COVID-19 severity and prognosis are largely unclear. Therefore, this systematic review aims to determine what biomarkers were measured in cancer patients with COVID-19 and their prognostic utility.

Methods: A systematic literature review in PubMed, Embase, and Scopus was performed on June 16th, 2021. The search keywords coronavirus, neoplasm, biomarkers, and disease progression were used to filter out 17 eligible studies, which were then carefully evaluated.

Results: A total of 4,168 patients, 16 types of cancer, and 60 biomarkers were …

Michigan Plan For Appropriate Tailored Healthcare In Pregnancy Prenatal Care Recommendations: A Practical Guide For Maternity Care Clinicians, Alex Friedman Peahl, Mark Turrentine, Wanda Barfield, Sean C Blackwell, Christopher M Zahn

Faculty, Staff and Student Publications

Prenatal care is an important preventive service designed to improve the health of pregnant patients and their infants. Prenatal care delivery recommendations have remained unchanged since 1930, when the 12-14 in-person visit schedule was first established to detect preeclampsia. In 2020, the American College of Obstetricians and Gynecologists, in collaboration with the University of Michigan, convened a panel of maternity care experts to determine new prenatal care delivery recommendations. The panel recognized the need to include emerging evidence and experience, including significant changes in prenatal care delivery during the COVID-19 pandemic, pre-existing knowledge of the importance of individualized care plans, …

Telerounding: A Scoping Review And Implications For Future Healthcare Practice, Natasha N Ludwig, Amanda E Child, Dasal Tenzin Jashar, Allison J Mostow, Ericka L Wodka

Faculty, Staff and Student Publications

A diagnosis of autism spectrum disorder (ASD) provides access to interventions that are important for fostering development and improving quality of life. Thus, the timeliness of a diagnosis should not be limited by social-distancing limitations whenever possible. Despite this, clear guidance for transitioning autism diagnostic services to a telehealth model of care in the era of the COVID-19 pandemic is lacking. At our Institute, we have adapted our approach to ASD evaluation to promote continued access to evaluation services during this unprecedented time. The purpose of this case series is to provide examples of three different approaches to ASD differential …

Third Year Medical Student Knowledge Gaps After A Virtual Surgical Rotation, Sophia Hernandez, Siyou Song, Ogonna N Nnamani Silva, Chelsie Anderson, Alexander S Kim, Andre R Campbell, Edward H Kim, Adnan Alseidi, Elizabeth C Wick, Julie Ann Sosa, Jessica Gosnell, Matthew Y C Lin, Sanziana A Roman

Faculty, Staff and Student Publications

INTRODUCTION: This study describes perceived knowledge gaps of third-year medical students after participating in a virtual surgical didactic rotation (EMLR) and shortened in-person surgery rotation during the COVID-19 Pandemic.

METHODS: Open-ended and Likert questions were administered at the end of the virtual rotation and inperson-surgical rotation to medical students. Three blinded coders identified themes by semantic analysis.

RESULTS: 82 students (51% of all MS3s) participated in the EMLR. Semantic analysis revealed gaps in perioperative management (Post-EMLR:18.4%, Post-Inpatient:26.5%), anatomy (Post-EMLR:8.2%, PostInpatient:26.5%). and surgical skills (Post-EMLR: 43.0%, Post-Inpatient: 44.1%). Students also described gaps related to OR etiquette (Post-EMLR: 12.2%, Post-Inpatient: 8.8%) and …

Institute For Global Health And Development : Issue 4 - July - Sept 2022, Institute For Global Health And Development

IGHD Newsletters

• Research Highlights
• Key Publications
• News
• Reflections from IGHD’s Associate Faculty
• Reflections from IGHD’s Summer Interns
• Webinars and Dialogues
• Mark your Calendars: Upcoming Event
• Obituary
• Collaborate With Us

The Covid-19 Pandemic And Associated Increases In Experiences Of Assault Violence Among Black Men With Low Socioeconomic Status Living In Louisiana, Kaylin Beiter, Denise Danos, Erich Conrad, Stephanie Broyles, Jovanny Zabaleta, Jason Mussell, Stephen Phillippi

School of Public Health Faculty Publications

Background: The COVID-19 pandemic has had mental health, social, and economic implications among communities with high levels of social disadvantage; this may have impacted community violence rates. The objective of this study was to characterize overall trends in assault and social disadvantage of patients experiencing assault before and during the COVID-19 pandemic. Methods: All trauma activations at a level one trauma center serving the entire southeast Louisiana region were included during March–August pre-COVID (2018–2019) and during COVID (2020). ICD-10 E-codes were used to identify trauma intent (assault vs. other). Assaults in this context are defined as physical injuries caused by …

Long Covid After Breakthrough Sars-Cov-2 Infection, Ziyad Al-Aly, Benjamin Bowe, Yan Xie

2020-Current year OA Pubs

The post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-also referred to as Long COVID-have been described, but whether breakthrough SARS-CoV-2 infection (BTI) in vaccinated people results in post-acute sequelae is not clear. In this study, we used the US Department of Veterans Affairs national healthcare databases to build a cohort of 33,940 individuals with BTI and several controls of people without evidence of SARS-CoV-2 infection, including contemporary (n = 4,983,491), historical (n = 5,785,273) and vaccinated (n = 2,566,369) controls. At 6 months after infection, we show that, beyond the first 30 days of illness, compared to …

Understanding The Impact Of Emotional Support On Mental Health Resilience Of The Community In The Social Media In Covid-19 Pandemic, Xuan Hu, Yanqing Song, Ruilin Zhu, Shuang He, Bowen Zhou, Xuelian Li, Han Bao, Shan Shen, Bingsheng Liu

Research Collection Lee Kong Chian School Of Business

Background: Emotional support in social media can act as a buffer against the negative impact of affective disorders. However, empirical evidence relating to emotional support in social media and how it influences the wider public remains scanty. The objective of this study is therefore to conduct a prototype investigation into the translation mechanism of emotional support in social media, providing empirical evidence for practitioners to use to tackle mental health issues for the wider public. Methods: A regression model is proposed to examine the relationship between perceived and received emotional support. Received emotional support is set as the dependent variable …

Provider Perceptions Of Telehealth And In-Person Exposure And Response Prevention For Obsessive-Compulsive Disorder, Andrew D Wiese, Kendall N Drummond, Madeleine N Fuselier, Jessica C Sheu, Gary Liu, Andrew G Guzick, Wayne K Goodman, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Until recently, psychotherapies, including exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD), have primarily been delivered in-person. The COVID-19 pandemic required OCD providers delivering ERP to quickly transition to telehealth services. While evidence supports telehealth ERP delivery, limited research has examined OCD provider perceptions about patient characteristics that are most appropriate for this modality, as well as provider abilities to identify and address factors interfering with effective telehealth ERP. In the present study, OCD therapists (N = 113) rated the feasibility of delivering telehealth ERP relative to in-person for different (1) patient age-groups, (2) levels of OCD severity, and …

Breast Cancer Diagnosis And Treatment During The Covid-19 Pandemic In A Nationwide, Insured Population, Jennifer L Caswell-Jin, Maryam N Shafaee, Lan Xiao, Mina Liu, Esther M John, Melissa L Bondy, Allison W Kurian

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The early months of the COVID-19 pandemic led to reduced cancer screenings and delayed cancer surgeries. We used insurance claims data to understand how breast cancer incidence and treatment after diagnosis changed nationwide over the course of the pandemic.

Methods: Using the Optum Research Database from January 2017 to March 2021, including approximately 19 million US adults with commercial health insurance, we identified new breast cancer diagnoses and first treatment after diagnosis. We compared breast cancer incidence and proportion of newly diagnosed patients receiving pre-operative systemic therapy pre-COVID, in the first 2 months of the COVID pandemic and in …

Impact Of Coronavirus Disease 2019 Restrictions On Retinal Detachment: A Multicenter Experience, Jesse J Jung, Jonathan S Chang, Patrick R Oellers, Mohsin H Ali, Brian K Do, Joseph J Tseng, Roberto Roizenblatt, Rajeev H Muni, Christina Y Weng, Zackery B Oakey, Sean W Tsao, Soraya Rofagha, Xavier Chan, Quan V Hoang

Faculty, Staff and Students Publications

In this retrospective, multicenter study of 261 eyes (259 patients), patients who underwent rhegmatogenous retinal detachment repair during the coronavirus disease 2019 (COVID-19) post-lockdown period experienced an additional 22-day delay, leading to significantly more epiretinal membrane and proliferative vitreoretinopathy and lower single-surgery anatomic success rates. During lockdown, perfluoropropane gas was used more commonly, and pneumatic retinopexy was used more commonly in COVID-19-positive patients.

Pilot Phase Results Of A Prospective, Randomized Controlled Trial Of Narrowband Ultraviolet B Phototherapy In Hospitalized Covid-19 Patients, Frank H Lau, Catherine E Powell, Giacomo Adonecchi, Denise M Danos, Andrew R Dinardo, Robert J Chugden, Peter Wolf, Carmen F Castilla

Faculty, Staff and Students Publications

COVID-19 morbidity and mortality are driven by poor immune regulation. Narrowband ultraviolet B (NB-UVB) phototherapy is standard of care in a number of immune-dysregulated diseases. To assess the efficacy of NB-UVB phototherapy for improving COVID-19 outcomes in high-risk, hospitalized, we developed the Adaptive Photo-Protection Trial. This is a multi-center, prospective, double-blinded, randomized, placebo-controlled trial. The pilot phase results are reported here. Consecutive patients admitted with a positive COVID-19 PCR were screened for eligibility. Enrolled subjects were computer randomized 1:1 to NB-UVB or placebo phototherapy. Subjects were treated daily with escalating doses on 27% of their body surface area for up …

Innovation And Missed Opportunities In Internal Medicine Undergraduate Education During Covid-19: Results From A National Survey, Irene Alexandraki, Katherine J Walsh, Temple Ratcliffe, Chavon Onumah, Karen Szauter, Camilla Curren, Nora Osman, Cindy J Lai, Deborah Dewaay, Nicholas S Duca, Amy Weinstein, Nadia Ismail, Jackcy Jacob, Michael Kisielewski, Amber T Pincavage

Faculty, Staff and Students Publications

BACKGROUND: COVID-19 disrupted undergraduate clinical education when medical schools removed students from clinical rotations following AAMC recommendations. Clerkship directors (CDs) had to adapt rapidly and modify clerkship curricula. However, the scope and effects of these modifications are unknown.

OBJECTIVE: To examine the effects of the initial phase of COVID-19 on the internal medicine (IM) undergraduate clinical education.

DESIGN: A nationally representative web survey.

PARTICIPANTS: IM CDs from 137 LCME-accredited US medical schools in 2020.

MAIN MEASURES: Items (80) assessed clerkship structure and curriculum, assessment in clerkships, post-clerkship IM clinical experiences, and CD roles and support. The framework of Understanding Crisis …

Universities In And Beyond A Pandemic, Lily Kong, Sovan Patra

Research Collection School of Social Sciences

The impact of the COVID pandemic, and concomitant public health interventions, on university operations and finances is unprecedented in its scope and scale. This chapter provides, firstly, a panorama of the challenges of tertiary teaching and learning in a socially distanced world as well as of the fiscal impact of the pandemic on universities. Secondly, it is an experience-informed personal reflection on the lessons that university instructors, researchers, and leaders can learn from the events of the past year to be more effective in sub-optimal environments, both as individuals and as members of the larger society. Finally, it presents an …

Impact Of The Covid-19 Pandemic On Daily Life, Mood, And Behavior Of Adults With Down Syndrome, Sigan L Hartley, Beau M Ances, Et Al.

2020-Current year OA Pubs

BACKGROUND: The Down syndrome population has been disproportionately affected by Coronavirus 2019 (COVID-19) in terms of experiencing severe illness and death. Societal efforts to curb the spread of COVID-19 may also have taken a heavy toll on the daily lives of individuals with Down syndrome.

OBJECTIVE/HYPOTHESIS: The goal of the study was to understand how the COVID-19 pandemic has altered daily life (including residence, employment, and participation in adult disability day programs) and influenced the mood and behavior of adults with Down syndrome.

METHODS: Between September 2020 and February 2021, caregivers of 171 adults with Down syndrome (aged 22-66 years) …

Covid: Health Inequities Exposed And How We Can Do Better, Timothy Mcnamara, Kara Mann, Josephin Mathai

HCA Healthcare Journal of Medicine

If a fair and just healthcare system is the goal, then the COVID-19 pandemic proves America still has a long way to go in its effort to achieve health equity for all. Inequalities in the healthcare landscape have been amassing for decades. Lack of access to quality care, underfunded public health programs, and the rising cost of treatment are just a few of the proposed origins of systemic inequity—all of which were apparent long before COVID-19’s arrival. Will observing these deep-seated issues under the lens of an ongoing pandemic shine a brighter light on these enduring disparities? More importantly, what …

Covid-19 And Mental Health Disparities In The Black American Population, Israel Taylor

HCA Healthcare Journal of Medicine

The current COVID-19 pandemic has amplified health disparities that have long existed for minoritized groups in the United States. There have been disproportionate effects on the mental and physical health of the Black American population, specifically because of longstanding racial, social, and economic injustices. To fully understand the current state of Black mental health and the extent to which COVID-19 has impacted it, we examine historical examples of unjust mental health practices throughout generations. We then explore why depression, suicidality, and other mental illnesses may have a profound effect on a community that has been made vulnerable to socioeconomic shifts. …

The Impact Of Covid-19 In The Latinx Community, Laura Pedraza, Ricardo Villela, Vikki Kamatgi, Kaitlyn Cocuzzo, Ricardo Correa, Miriam Zylberglait Lisigurski

HCA Healthcare Journal of Medicine

The COVID-19 pandemic has intensified the existing health and social disparities that affect minority groups in the United States (US), including the Latinx community. This situation has been reflected in many aspects of health, including increased morbi-mortality and reduced adherence to medical and scientific recommendations. Limited access to health care, financial challenges, migrant status, and health literacy, or lack thereof, have all hampered the Latinx community's ability to seek aid quickly and to be tested or treated effectively for this disease. This pandemic has shown that the Latinx community's socioeconomic status correlates with greater mortality rates when compared to other …

Conscious And Unconscious Bias: The Hidden Pandemic Of Biases In Healthcare Exacerbated By Covid-19, Ibtisam Rauf, Abigail Hartmann, Alexandre Koumtchev, Syed Anjum Khan, Rahul Kashyap

HCA Healthcare Journal of Medicine

Background

There are limited data on unconscious bias in healthcare, but there is consistent evidence that it alters clinical decision-making. COVID-19 exacerbated many pre-existing disparities, and this paper seeks to identify, deconstruct, and propose mitigation strategies for a few of them.

Discussion

Five of the largest disparities amplified by the pandemic are discussed in this paper. Older people, Black people, uninsured people, rural communities, and people with lower education levels have been disproportionally affected in both morbidity and mortality.

Conclusions

The disparities discussed above did not occur in a vacuum but are the result of systemic issues. Equity starts with …

2022-06-30_Michiganoverview_Misc, Michigan Department Of Health & Human Services

Michigan COVID-19 MIS-C Data

The MIS-C Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/mis-c-reporting.

This report is created by the Michigan Department of Health & Human Services from data self-reported by health care providers and local health departments. Data is updated on the first and third Thursdays of the month.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition in children and adolescents under 21 years of age where multiple organ systems become inflamed or dysfunctional which occurs in association with illness. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, …

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

Clinical Profile Of Covid-19 Older Patients Hospitalized In Immanuel Teaching Hospital Bandung, Vera Vera, Yossie Guventri Eka Suprana

Jurnal Penyakit Dalam Indonesia

Introduction. It was reported that 11.2% out of the 78,572 confirmed cases of COVID-19 in Indonesia was foundinolder people with a high mortality rate. There is no available data regarding functional and frailty status of these COVID-19 older patients. This study aimed to describe clinical profile of older COVID-19 patients in terms of geriatric aspect, in order to design better hospital policy for older patients in the COVID-19 isolation ward.Methods. This was a retrospective cohort study of confirmed COVID-19 patients aged >60 years which were admitted to Immanuel Teaching Hospital Bandung during the period of October 2020 - January 2021. …