BACKGROUND: There have been over 772 million confirmed cases of COVID-19 worldwide. A significant portion of these infections will lead to long COVID (post-COVID-19 condition) and its attendant morbidities and costs. Numerous life-altering complications have already been associated with the development of long COVID, including chronic fatigue, brain fog, and dangerous heart rhythms.
OBJECTIVE: We aim to derive an actionable long COVID case definition consisting of significantly increased signs, symptoms, and diagnoses to support pandemic-related clinical, public health, research, and policy initiatives.
METHODS: This research employs a case-crossover population-based study using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) data generated at Veterans Affairs medical centers nationwide between January 1, 2020, and August 18, 2022. In total, 367,148 individuals with ICD-10-CM data both before and after a positive COVID-19 test were selected for analysis. We compared ICD-10-CM codes assigned 1 to 7 months following each patient\'s positive test with those assigned up to 6 months prior. Further, 350,315 patients had novel codes assigned during this window of time. We defined signs, symptoms, and diagnoses as being associated with long COVID if they had a novel case frequency of ≥1:1000, and they significantly increased in our entire cohort after a positive test. We present odds ratios with CIs for long COVID signs, symptoms, and diagnoses, organized by ICD-10-CM functional groups and medical specialty. We used our definition to assess long COVID risk based on a patient\'s demographics, Elixhauser score, vaccination status, and COVID-19 disease severity.
RESULTS: We developed a long COVID definition consisting of 323 ICD-10-CM diagnosis codes grouped into 143 ICD-10-CM functional groups that were significantly increased in our 367,148 patient post-COVID-19 population. We defined 17 medical-specialty long COVID subtypes such as cardiology long COVID. Patients who were COVID-19-positive developed signs, symptoms, or diagnoses included in our long COVID definition at a proportion of at least 59.7% (268,320/449,450, based on a denominator of all patients who were COVID-19-positive). The long COVID cohort was 8 years older with more comorbidities (2-year Elixhauser score 7.97 in the patients with long COVID vs 4.21 in the patients with non-long COVID). Patients who had a more severe bout of COVID-19, as judged by their minimum oxygen saturation level, were also more likely to develop long COVID.
CONCLUSIONS: An actionable, data-driven definition of long COVID can help clinicians screen for and diagnose long COVID, allowing identified patients to be admitted into appropriate monitoring and treatment programs. This long COVID definition can also support public health, research, and policy initiatives. Patients with COVID-19 who are older or have low oxygen saturation levels during their bout of COVID-19, or those who have multiple comorbidities should be preferentially watched for the development of long COVID.

Law enforcement officers (LEOs) often encounter rapidly changing and uncontrolled situations that expose them to various hazards. A law enforcement agency requested an evaluation by the National Institute for Occupational Safety and Health (NIOSH) when multiple LEOs reported illness after executing a search warrant and taking a suspect into custody. NIOSH investigators interviewed LEOs and reviewed medical records, forensic laboratory results for collected evidence, and environmental testing results of samples taken after the operation. Two-thirds (25 of 38) of LEOs who participated in the operation reported ≥1 symptom. Eleven LEOs met a case definition for influenza-like illness (ILI). Members of one unit were more likely to have ILI than non-members (prevalence ratio (PR), 4.1; 95% confidence interval (CI): 1.3-13.0; p = 0.01). Influenza vaccination was associated with a lower prevalence of ILI (PR, 0.2; 95% CI, 0.1-0.9; p = 0.02). Preventing employees from working while ill and annual influenza vaccination might prevent similar occurrences.

During public emergencies, the level of public safety will be resilient and follow a process from decline to rise. Regarding the concept and influencing factors of public safety resilience, a three-level public safety resilience framework that includes personal, community, and government levels was proposed in this study. It provided the overall metrics that used the resistance and recovery ability to describe the dynamic characteristics of public safety resilience as well as the resilience assessment indexes on three levels. In the context of the Coronavirus Disease 2019 (COVID-19) pandemic, this study applied the proposed framework in a case study on public safety resilience at the Beihang community, Beijing, China through descriptive statistics, structural equation model, and principal component regression analysis of questionnaire data. The data analysis results showed that community resilience was the most important of the three levels of public safety resilience. In addition, community resilience could improve personal resilience, and government resilience had a positive effect on community and personal resilience. Compared with the resistance ability, the recovery ability was influenced more by the operation and improvement of the community. This study is conducive to understanding and improving public safety resilience on the personal, community, and government levels and can help relevant parties improve their ability to respond to the COVID-19 pandemic. Furthermore, the methods used in this study can be extended to other studies on public emergencies.

There has been vigorous debate on how different countries responded to the COVID-19 pandemic. To secure public safety, South Korea actively used personal information at the risk of personal privacy whereas France encouraged voluntary cooperation at the risk of public safety. In this article, after a brief comparison of contextual differences with France, we focus on South Korea\'s approaches to epidemiological investigations. To evaluate the issues pertaining to personal privacy and public health, we examine the usage patterns of original data, de-identification data, and encrypted data. Our specific proposal discusses the COVID index, which considers collective infection, outbreak intensity, availability of medical infrastructure, and the death rate. Finally, we summarize the findings and lessons for future research and the policy implications.

Electric scooter (e-scooter) companies are growing in popularity across the United States looking to take advantage of the rideshare economy by providing an independent alternative to cars and bicycles. While e-scooter transportation could reduce emissions, and automobile congestion in local areas, powered two-wheeler drivers are extremely vulnerable to road risks. News reports of e-scooter crashes and fatalities have started to accumulate. Earlier research has demonstrated that the ways in which companies promote and demonstrate use of their product or service through social media influences consumer behavior. In the U.S. in 2018, this study examined the official Instagram account of Bird, the e-scooter market share leader with over 66,000 followers, to determine how much it emphasized safety in its posts. All posts to Bird\'s official Instagram account were collected from 22 September 2017 to 9 November 2018 (n = 324) and rules for coding content were developed. Among all posts, 69.14% contained a person visible with a Bird e-scooter, 6.17% contained persons wearing protective gear, 6.79% had protective gear somewhere in the post, and 1.54% of posts mentioned protective gear in the comment box. About 69.44% of the posts were reposts, and among reposts, 7.11% had persons wearing protective gear. Posts to Bird\'s official Instagram rarely showed e-scooters being used with protective gear. Photos of customers\' experiences with Bird, via reposts, rarely featured protective gear potentially normalizing these behaviors among customers. Public health practitioners may need to establish interventions to promote use of protective gear while operating escooters.