The disruptions of the coronavirus disease 2019 (COVID‐19) pandemic impacted the delivery and utilization of healthcare services with potential long‐term implications for population health and the hospital workforce. Using electronic health record data from over 700 US acute care hospitals, we documented changes in admissions to hospital service areas (inpatient, observation, emergency room [ER], and same‐day surgery) during 2019−2020 and examined whether surges of COVID‐19 hospitalizations corresponded with increased inpatient disease severity and death rate. We found that in 2020, hospitalizations declined by 50% in April, with greatest declines occurring in same‐day surgery (−73%). The youngest patients (0−17) experienced largest declines in ER, observation, and same‐day surgery admissions; inpatient admissions declined the most among the oldest patients (65+). Infectious disease admissions increased by 52%. The monthly measures of inpatient case mix index, length of stay, and non‐COVID death rate were higher in all months in 2020 compared with respective months in 2019.

One of six nursing home residents and staff with positive SARS-CoV-2 tests ≥90 days after initial infection had specimen cycle thresholds (Ct) <30. Individuals with specimen Ct<30 were more likely to report symptoms but were not different from individuals with high Ct value specimens by other clinical and testing data.

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Background: The US–Mexico border represents a unique region of the country where antibiotics are more accessible and nonprescription treatment with antibiotics is deeply enculturated. Currently, both the United States and Mexico are experiencing widespread community transmission of SARS-CoV-2, which may have implications for antibiotic seeking and use. The objective of this study was to examine antibiotic seeking behavior as it relates to COVID-19 in the border region relative to the greater US and Mexico populations. Methods: An interdisciplinary team at The University of Arizona developed a survey to assess knowledge, attitudes, and beliefs about antibiotics along the US–Mexico border region (defined as 100 km from the border) and to compare findings from the border region to the broader US and Mexico populations. The team recruited survey participants through Amazon’s MTurk survey platform and through the distribution of recruitment flyers to community partners in Arizona and Mexico border regions from October 2020 to January 2021. Targeted recruitment was 750 through March 2021. We report here on findings from the first round of recruitment (n = 116). These participants were asked whether they had sought out antibiotics specifically as a treatment for COVID-19, as well as their general beliefs and behaviors on self-seeking antibiotics for illness. Results: As of January 24, 2021, we surveyed 116 participants: 82 (70.7%) from the United States and 34 (29.3%) from Mexico. Most participants (71.2%) were aged 25–44 years; 56.9% were male; and 50% reported Hispanic ethnicity. Of these, 13.8% lived within 100 km of the US–Mexico border. Overall, 21.6% of participants reported taking antibiotics to fight COVID-19–like illness. Of these participants, 28% obtained the antibiotics directly from a pharmacy, without a physician prescription, and 16% obtained them from an online vendor. Additionally, 33% of US respondents reported that they would be willing to travel to Mexico to obtain antibiotics if they were too difficult to obtain in the United States. Of these respondents, 55% said they would be willing to travel for >1 hour to obtain antibiotics. Conclusions: Preliminary data suggest that the COVID-19 pandemic will have widespread ramifications on antibiotic seeking behavior and could propagate antibiotic resistance. Targeted intervention strategies in the border region are necessary to mitigate the unique factors that contribute to antibiotic use in this area.Funding: NoDisclosures: None