Vivek Goel

This study identifies trends in abusive discourse towards public health professionals (PHPs) during the COVID-19 pandemic and explores associations between abusive digital content, case numbers, deaths, and major policy announcements. Natural language processing (NLP) and large language model (LLM) techniques were used to develop a computational model to detect abusive content on X (formerly Twitter). This model was applied to abusive posts targeting PHPs during COVID-19 by examining over 1.7 million posts from January 2020 to May 2021. Associations between spikes in abuse and the number of COVID-19 cases, deaths, and government monitoring updates were explored. Pronounced surges in abusive posts coincided with rising case and death counts and the imposition of major federal COVID-19 policies, particularly during the pandemic's initial emergency response. Digital aggression increased at times of public health statements related to restrictions in social gatherings, testing criteria, vaccinations, and masking. However, during high-case periods, even statements providing case updates, expressing compassion, or urging collective responsibility coincided with higher numbers of abusive posts. This work provides insights into the pressures faced by health officials online and offers implications for designing resilient public communication during future crises.

Objectives: To evaluate whether loneliness was associated with transition rates to and between healthcare settings and death in older adults and to examine whether associations were modified by sex. Design: Retrospective cohort study. Setting: Ontario, Canada, from December 2008 to February 2020. Participants: Community-dwelling, Ontario respondents (≥65 years) to the 2008/2009 Canadian Community Health Survey—Healthy Aging (CCHS-HA). Exposure: Baseline loneliness was measured with the Three-Item Loneliness Scale in the CCHS-HA. Respondents were classified as not lonely, moderately lonely or severely lonely. Primary outcome measures: Healthcare transitions were assessed over a 12-year period through linkage to health administrative records. Relative rates of transition to and between community, inpatient hospitalisation, home care and long-term care (LTC) settings, as well as death, were estimated using a continuous-time multistate transition framework. Adjusted models were weighted and tested for sex interactions. Results: Of 2671 respondents (weighted n=1 398 180), 20.9% were moderately lonely and 12.0% were severely lonely. Compared with those who were not lonely, moderately lonely respondents transitioned at a faster rate from the community to home care, and severely lonely respondents transitioned at a faster rate from the community to LTC; although, both associations were attenuated with adjustment (RR _ML 1.37; 95% CI 1.00 to 1.85 and RR _SL 1.96; 95% CI 0.99 to 4.12, respectively). Female and male respondents had mostly similar transition patterns. Conclusions: Our findings suggest that loneliness may hasten transitions from the community to home care and LTC settings in older adults, although these transitions are mostly driven by related health and social factors.

Background: Digital technologies have enabled social connection during prolonged periods of physical distancing and travel restrictions throughout the COVID-19 pandemic. These solutions may exclude older adults, who are at higher risk for social isolation, loneliness, and severe outcomes if infected with SARS-CoV-2. Objective: This study investigated factors associated with nonuse of social media or video communications to connect with friends and family among older adults during the pandemic’s first wave. Methods: A web-based, cross-sectional survey was administered to members of a national retired educators’ organization based in Ontario, Canada, between May 6 and 19, 2020. Respondents (N=4879) were asked about their use of social networking websites or apps to communicate with friends and family, their internet connection and smartphone access, loneliness, and sociodemographic characteristics. Factors associated with nonuse were evaluated using multivariable logistic regression. A thematic analysis was performed on open-ended survey responses that described experiences with technology and virtual connection. Results: Overall, 15.4% (751/4868) of respondents did not use social networking websites or apps. After adjustment, male gender (odds ratio [OR] 1.60, 95% CI 1.33-1.92), advanced age (OR 1.88, 95% CI 1.38-2.55), living alone (OR 1.68, 95% CI 1.39-2.02), poorer health (OR 1.33, 95% CI 1.04-1.71), and lower social support (OR 1.44, 95% CI 1.20-1.71) increased the odds of nonuse. The reliability of internet connection and access to a smartphone also predicted nonuse. Many respondents viewed these technologies as beneficial, especially for maintaining pre–COVID-19 social contacts and routines, despite preferences for in-person connection. Conclusions: Several factors including advanced age, living alone, and low social support increased the odds of nonuse of social media in older adults to communicate with friends and family during COVID-19’s first wave. Our findings identified socially vulnerable subgroups who may benefit from intervention (eg, improved access, digital literacy, and telephone outreach) to improve social connection.

Objective To investigate the prospective association between life satisfaction and future mental health service use in: (1) hospital/emergency department, and (2) outpatient settings. Design and setting Population-based cohort study of adults from Ontario, Canada. Baseline data were captured through pooled cycles of the Canadian Community Health Survey (CCHS 2005–2014) and linked to health administrative data for up to 5 years of follow-up. Participants 131 809 Ontarians aged 18 years and older. Main outcome measure The number of mental health-related visits in (1) hospitals/emergency department and (2) outpatient settings within 5 years of follow-up. Results Poisson regression models were used to estimate rate ratios in each setting, adjusting for sociodemographic measures, history of mental health-related visits, and health behaviours. In the hospital/emergency setting, compared to those most satisfied with life, those with the poorest satisfaction exhibited a rate ratio of 3.71 (95% CI 2.14 to 6.45) for future visits. In the outpatient setting, this same comparison group exhibited a rate ratio of 1.83 (95% CI 1.42 to 2.37). When the joint effects of household income were considered, compared with the highest income and most satisfied individuals, the least satisfied and lowest income individuals exhibited the highest rate ratio in the hospital/emergency setting at 11.25 (95% CI 5.32 to 23.80) whereas in the outpatient setting, the least satisfied and highest income individuals exhibited the highest rate ratio at 3.33 (95% CI 1.65 to 6.70). Conclusion The findings suggest that life satisfaction is a risk factor for future mental health visits. This study contributes to an evidence base connecting positive well-being with health system outcomes.

BACKGROUND Digital technologies have enabled social connection during prolonged periods of physical distancing and travel restrictions throughout the COVID-19 pandemic. These solutions may exclude older adults, who are at higher risk for social isolation, loneliness, and severe outcomes if infected with SARS-CoV-2. OBJECTIVE This study investigated factors associated with nonuse of social media or video communications to connect with friends and family among older adults during the pandemic’s first wave. METHODS A web-based, cross-sectional survey was administered to members of a national retired educators’ organization based in Ontario, Canada, between May 6 and 19, 2020. Respondents (N=4879) were asked about their use of social networking websites or apps to communicate with friends and family, their internet connection and smartphone access, loneliness, and sociodemographic characteristics. Factors associated with nonuse were evaluated using multivariable logistic regression. A thematic analysis was performed on open-ended survey responses that described experiences with technology and virtual connection. RESULTS Overall, 15.4% (751/4868) of respondents did not use social networking websites or apps. After adjustment, male gender (odds ratio [OR] 1.60, 95% CI 1.33-1.92), advanced age (OR 1.88, 95% CI 1.38-2.55), living alone (OR 1.68, 95% CI 1.39-2.02), poorer health (OR 1.33, 95% CI 1.04-1.71), and lower social support (OR 1.44, 95% CI 1.20-1.71) increased the odds of nonuse. The reliability of internet connection and access to a smartphone also predicted nonuse. Many respondents viewed these technologies as beneficial, especially for maintaining pre–COVID-19 social contacts and routines, despite preferences for in-person connection. CONCLUSIONS Several factors including advanced age, living alone, and low social support increased the odds of nonuse of social media in older adults to communicate with friends and family during COVID-19’s first wave. Our findings identified socially vulnerable subgroups who may benefit from intervention (eg, improved access, digital literacy, and telephone outreach) to improve social connection.

Objectives The primary objective was to estimate the positivity rate of air travellers coming to Toronto, Canada in September and October 2020, on arrival and on day 7 and day 14. The secondary objectives were to estimate the degree of risk based on country of origin and to assess knowledge and attitudes towards COVID-19 control measures and subjective well-being during the quarantine period. Design Prospective cohort of arriving international travellers. Setting Toronto Pearson Airport Terminal 1, Toronto, Canada. Participants Participants of this study were passengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport, spoke English or French, and provided consent. Excluded were those taking a connecting flight, had no internet access, exhibited symptoms of COVID-19 on arrival or were exempted from quarantine. Main outcome measures Positive for SARS-CoV-2 virus on reverse transcription PCR with self-administered oral-nasal swab and general well-being using the WHO-5 Well-being Index. Results Of 16 361 passengers enrolled, 248 (1.5%, 95% CI 1.3% to 1.7%) tested positive. Of these, 167 (67%) were identified on arrival, 67 (27%) on day 7, and 14 (6%) on day 14. The positivity rate increased from 1% in September to 2% in October. Average well-being score declined from 19.8 (out of a maximum of 25) to 15.5 between arrival and day 7 (pConclusions A single arrival test will pick up two-thirds of individuals who will become positive by day 14, with most of the rest detected on the second test on day 7. These results support strategies identified through mathematical models that a reduced quarantine combined with testing can be as effective as a 14-day quarantine.