COVID-19 Confinement Measures Research Articles

Changes in Body Weight and Risk Factors for Overweight and Obesity in 5-6-Year-Old Children Attending School in Geneva.

Background: The prevalence of obesity and overweight in children is increasing in industrialized countries. Monitoring the evolution of these phenomena is essential for understanding prevention and health promotion programs. This study aims to present the analysis of anthropometric data collected by school nurses from the School Health Service of Geneva (Service de santé de l'enfance et de la jeunesse) for children aged 5 to 6 years during the 2021-2022 school year, as well as describe the trends in overweight and obesity from 2003-2004 to 2021-2022. Risk factors were also assessed in the 2021-2022 sample. Methods: This study included a random sample of 958 (479 girls and 479 boys) primary school pupils aged 5 to 6 years in Geneva. Data on weight, height and socioeconomic status were collected. BMI was analyzed using the Cole standard. A multivariate analysis was conducted to assess the influence of socioeconomic factors on overweight and obesity. We compared these results with BMI trends in students of the same age since 2003. Results: In 2021-2022, overall prevalence of overweight was 12.73%, and obesity was 5.64%. Girls had higher rates of overweight (14.20%) and obesity (6.68%) compared to boys (11.27% and 4.59%, respectively) (p < 0.0001). Overweight in boys significantly increased since the 2013-2014 and 2019-2020 measurements (p = 0.003). The trend for girls was similar but not statistically significant. Obesity rates have not significantly increased since 2019-2020 in both genders, but there is a significantly increasing trend for girls since 2013-2014 p = 0.045). Socioeconomic factors, particularly the socioeconomic class of parents, played a predictive role in overweight and obesity. Conclusions: The School Health Service of Geneva and the Directorate General of Health have a crucial role in monitoring and preventing childhood obesity. The prevalence of overweight and obesity has remained high since 2010, justifying continuous efforts for prevention. A significant increase in prevalence has been observed since 2020, particularly among overweight boys, and could be related to COVID-19 confinement measures.

The Devil in the Details: Changes Under Stable Trends of Femicide in Italy During COVID-19 Lockdowns

In recent decades, the issue of violence against women has increasingly drawn the attention of international and national legislators and policymakers. The term “femicide” became widespread in the early 2000s and was incorporated into the criminal codes of several countries. The onset of the COVID-19 pandemic and the subsequent social distancing measures raised significant concerns about their impact on women’s safety. This study examines the effect of COVID-19 confinement measures on femicide trends in Italy, a country which adopted stringent COVID-19 confinement measures and, since 2019, implemented new legislation to counteract violence against women. Using two data sets—one from the Italian Ministry of Interior containing 1,382 cases of female homicides (2013–2022) and another from Italian NGOs detailing 1,253 femicides according to media coverage (2012–2022)—the study employs autoregressive integrated moving average (ARIMA) analysis to assess monthly trends alongside the stringency index for COVID-19 containment efforts. The findings reveal that, although overall femicide rates remained stable during lockdowns, there was a significant shift in victim–perpetrator relationships. Specifically, from March to May 2020, there was a decline in femicides by former partners, offset by an increase in those by cohabiting partners. These results underscore the complexity of femicide and the need for further research on various facets of violence against women. This includes the potential escalation of physical and psychological violence during lockdowns, influenced by forced proximity and substance abuse in domestic environments.

How the pandemic shaped teenagers’ views on violence: exploring the complexities of post-confinement attitudes

IntroductionViolent extremism is a complex and urgent issue that affects all sectors of society and necessitates research aimed at preventing and transforming violent behavior.MethodsThis study presents the findings of a questionnaire comprising 34 items administered to 1,169 teenagers from two secondary schools in Almería and Madrid, Spain, immediately following the conclusion of COVID-19 confinement measures. The primary objective of the study is to analyze teenagers’ perspectives on violent extremism and pro-violent attitudes, along with their association with various factors such as digital consumption, interpersonal relationships, and the socio-demographic circumstances of their families. Data collection involved direct interventions with the students at the participating educational institutions.ResultsThe findings demonstrate that variables such as gender, number of siblings, and religious practice influence violent extremism, whereas nationality does not emerge as a significant factor. Additionally, the study identifies several contributing factors to the prevalence of extremist and pro-violent attitudes, and employs a moderation analysis utilizing the mother’s level of education as a moderator variable.DiscussionBased on these results, the study recommends further research to enhance our understanding of the development of violent attitudes and behaviors. Additionally, it suggests implementing family and personal support programs aimed at fostering healthy adolescent development.

Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing.

Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.

Depression, Anxiety, Stress, and Suicidality Levels in Young Adults Increased Two Years into the COVID-19 Pandemic.

The severity of both the COVID-19 clinical picture and confinement measures in Slovenia was higher during the initial phase of the pandemic in 2020 than during the Omicron wave in 2022. This could lead us to expect a higher level of distress during the initial phase. On the other hand, prolonged stress can have a detrimental effect on mental health. This study aimed to explore how the prolonged stress of the COVID-19 pandemic and the accompanying changes affected the mental health of young adults in Slovenia. We analyzed and compared the levels of depression, anxiety, stress, and suicidal ideation in young adults during the initial phase of the pandemic and the Omicron wave, as well as between the COVID-19-infected and non-infected individuals. An online survey was used to survey 587 young adults in the first wave (July-December 2020) and 511 in the Omicron wave (January-February 2022). Levels of depression, anxiety, stress, and suicidal ideation were compared using Mann-Whitney U test. Results show that the Omicron wave significantly worsened depression, anxiety, stress, and suicidal ideation. Young adults who had tested positive for COVID-19 reported no worse or only slightly worse mental health than those who never tested positive. The current study provides new evidence about the mental health of young adults during the Omicron wave. Our results show that two years into the pandemic, they expressed more negative emotions and suicidal thoughts than at the beginning.

COVID-19 containment measures impact utilization and provision of healthcare in Europe

Abstract Background The COVID-19 containment measures, implemented to curb the pandemic, impacted health of children and adolescents by numerous pathways. We present the impact on health care utilization and provision. Methods A systematic review on secondary health impact is ongoing (PubMed, PsychInfo, Embase). Literature is screened (title, abstract, full-text) by 2 researchers, and data of interest extracted systematically.. Inclusion criteria are age (0 - 25 yrs.), exposure: containment measures, outcome: secondary health outcome, and European data origin. Results Jan. 2020 - Aug. 2021 10112 studies were identified, 337 were included. n = 60 were on health care utilization and provision. Utilization studies relied on objective hospital or registry data, care provision studies more often on survey data (professionals, parents). Data yields a large but varying decrease in emergency department visits during the lockdown: Italy ∼75%, Spain ∼65%, France ∼60%, and Germany ∼64%, and a substantial change in case mix and severity compared to comparable pre-COVID. Specialized and primary pediatric practices report that elective interventions were postponed, state of the art diagnostics withheld, and rehabilitation services disrupted. Vaccinations in infants, children, and adolescents dropped during the lockdown inversely proportional to children's age. Studies repeatedly suggest patients’ health services avoidance out of fear of infection and stay-at-home rules.Results on catch-up utilization and provision to follow (ongoing study). Conclusions COVID-19 measures exerted a measurable impact on health utilization and provision in children and adolescents. The utilization was comparatively lower and service provision disrupted across Europe. So far little can be said about a potential recovery in terms of catch-up of visits, diagnostics, or treatments. Analyses of the long-term health impact of the observed effects is recommended and can serve to improve future pandemic preparedness. Key messages • COVID-19 confinement measures had measurable secondary health impact on children and adolescents. • Data on catch-up healthcare is important to establish long term impact and learnings.

The effect of COVID-19 confinement and economic support measures on the mental health of older population in Europe and Israel

This study focuses on the impact of confinement and economic support measures on the mental health of the older population (aged 50 and above) across twenty-five European countries and Israel. While studies evaluating the effect of confinement measures on mental health exist, they largely ignore the potentially offsetting effects of economic support measures. Moreover, previous findings on the effect of confinement measures are inconsistent, and many studies are based solely on cross-sectional designs. Using data from the Corona Survey wave (2020) of the Survey on Health, Ageing and Retirement in Europe (SHARE), we leverage the date of interview information to vary individual exposure to different policy contexts within countries. Overall, we do not find support for the negative effect of confinement measures on older adults’ mental health. If anything, both confinement and support measures worked in tandem to soothe mental distress, resulting from the pandemic. The confinement effects, however, are contingent on age, potentially indicating that younger people are more likely to be negatively affected by lockdowns.

The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: An interrupted time series analysis.

The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five's admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.

The Moderating Role of Resilience in the Personality-Mental Health Relationship During the COVID-19 Pandemic.

Background: Associations between personality traits and mental health outcomes (depression, anxiety, loneliness, and stress) have rarely been assessed in a population-representative sample of a high-income country during the COVID-19 pandemic. Additionally, as far as we know, the role of health and social behaviors as well as resilience in the personality-mental health relationship has yet to be explored.Methods: A representative sample of 1,828 residents of Luxembourg filled in validated scales to assess personality traits and resilience, depressive symptoms, generalized anxiety, loneliness, and stress, indicating mental health, in mid-April 2020.Results: Approximately 21% of the participants scored above the cut-off for moderate depression and moderate loneliness. Moderate anxiety and moderate stress were present in 6.2 and 0.3% of the participants, respectively. Higher-educated respondents and those living in higher-value housing reported better mental health. Agreeableness and conscientiousness were most consistently associated with better mental health; neuroticism was most consistently associated with worse mental health. Spending more time on social media was also associated with elevated levels of all four mental health outcomes. Social and health behaviors did not change the personality-mental health relationships. Resilience moderated some of the personality-mental health associations, most consistently in neuroticism.Conclusions: Findings suggest educational and socioeconomic inequalities in mental health in a nationally representative sample during the COVID-19 confinement measures. Personality traits, particularly agreeableness, conscientiousness, and low neuroticism were associated with mental health. The moderating role of resilience in the personality-mental health relationship suggests intervention potential to improve mental health during periods of confinement.

The Impact of COVID-19 Confinement Measures on the Air Quality in an Urban-Industrial Area of Portugal

This study evaluated the temporal variability of the concentrations of pollutants (namely, NO2, O3, PM2.5, PM10 and SO2) in an urban-industrial area of mainland Portugal during two decades (from 2001 to 2020), to assess the impact of the COVID-19 pandemic on the levels of these atmospheric pollutants. Mean levels of pollutants in 2020 were compared with those measured in the six previous years (2014–2019). A significant improvement in air quality, namely regarding PM10 and NO2, was found and it can be attributable to the restrictions of anthropogenic activities (such as traffic) promoted during the March–May 2020 national lockdown that occurred due to the pandemic. Significant and expressive reductions of 44.0% and 40.3% were found in April 2020 for NO2 and PM10, respectively, showing the impact of local traffic in the study area. A similar trend of reduction for these pollutants was also found in the following months. However, ozone levels did not show the same trend, with significant increases in several months after the lockdown period, highlighting other contributions to this pollutant. This unique period can be considered as a living lab, where the implementation of strict measures due to COVID-19 confinement promoted the reduction of anthropogenic activities and allowed us to understand more comprehensively their impact on local air quality.

Analyzing spatial mobility patterns with time-varying graphical lasso: Application to COVID-19 spread.

This work applies the time‐varying graphical lasso (TVGL) method, an extension of the traditional graphical lasso approach, to address learning time‐varying graphs from spatiotemporal measurements. Given georeferenced data, the TVGL method can estimate a time‐varying network where an edge represents a partial correlation between two nodes. To achieve this, we use a COVID‐19 data set from the Argentine province of Chaco. As an application, we use the estimated network to study the impact of COVID‐19 confinement measures and evaluate whether the measures produced the expected result.

The Relationship Between COVID-19 Confinement, Psychological Adjustment, and Sexual Functioning, in a Sample of Portuguese Men and Women

Past research has revealed the detrimental effects of social isolation and physical distancing measures in health related outcomes. However, only recently COVID-19 confinement measures provided a context to test whether such detrimental effects exist in the human sexuality domain. This study was aimed at testing the relationship between COVID-19 confinement levels and sexual functioning domains in men and women, while accounting for the mediating role of psychological adjustment during lockdown. Two hundred and forty five men and 417 women completed a web survey on the effects of COVID-19 in sexual health. The reference period includes the first confinement in Portugal (March 19-June 1, 2020). Data were handled under Hays' procedures for simple mediation analysis. Measurement outcomes included self-reported levels of confinement, IIEF and FSFI scores, and psychological adjustment during lockdown. Psychological adjustment during lockdown mediated the relationship between confinement levels and most sexual functioning domains in men but not in women. Also, while confinement levels were not directly related with most sexual functioning domains, psychological adjustment during lockdown did predict lower sexual functioning in both genders. Findings support that human sexual functioning should be framed within a contextual perspective, emphasizing how psychological adjustment and situational life stressors, such as lockdown situations, shape individuals' sexuality. Such perspective should be considered in treatment protocols implemented during current pandemic. Data add to the literature on the effects of lockdown in the sexuality domain. However, the study precludes inference of causality and targets only a little proportion of all the dynamics involved in sexuality during the current historical moment. Psychological adjustment during COVID-19 seems to have a role on human sexual functioning, over the single effects of confinement. Carvalho J, Campos P, Carrito M, etal. The Relationship Between COVID-19 Confinement, Psychological Adjustment, and Sexual Functioning, in a Sample of Portuguese Men and Women. J Sex Med 2021;18:1191-1197.

Short-term impact of the COVID-19 confinement measures on health behaviours and weight gain among adults in Belgium

BackgroundIn Belgium, confinement measures were introduced on the 13th of March 2020 to curb the spread of the coronavirus disease (COVID-19). These measures may affect health behaviours of the population such as eating habits, physical activity and alcohol consumption, which in turn can lead to weight gain resulting in overweight and obesity, increasing the risk of several chronic diseases, but also of severe COVID-19. The purpose of this study is to assess the impact of confinement measures on health behaviours and their associations with weight gain.MethodsData were derived from the second national COVID-19 health survey. Data were collected between the 16th and the 23rd of April 2020. The recruitment of participants was based on snowball sampling via Sciensano’s website, invitations via e-mail and social media. The study sample includes participants aged 18 years and over with no missing data on the variables of interest (n = 28,029). The association between self-reported weight gain and health behaviour changes, adjusted for gender, age group and household composition was assessed through OR’s (95% CI) calculated with logistic regression models, using post-stratification weights.ResultsOverall, 28.6% reported weight gain after 6 weeks of confinement. Higher odds of weight gain were observed among participants who increased or decreased their consumption of sugar-sweetened beverages (OR = 1.39 (1.15–1.68) and 1.29 (1.04–1.60), respectively), among those who increased their consumption of sweet or salty snacks (OR = 3.65 (3.27–4.07)), among those who became less physically active (OR = 1.91 (1.71–2.13)), and among those who increased their alcohol consumption (OR = 1.86 (1.66–2.08)).ConclusionsThe most important correlates of weight gain during confinement were an increased consumption of sweet or salty snacks and being less physically active. These findings confirm the impact of diet and exercise on short term weight gain and plead to take more action, in supporting people to achieve healthier behaviours in order to tackle overweight and obesity, especially during the COVID-19 pandemic.

Decreased volume of hip fractures observed during COVID-19 lockdown.

The aim was to study the incidence and characteristics of fragility hip fractures admitted during COVID-19 lockdown. We analysed socio-demographic and baseline characteristics of patients suffering fragility hip fractures between March 1st and May 1st 2020, period most affected by COVID-19 confinement measures. Cases (n = 64) were compared with controls (n = 172) from corresponding periods in 2018 and 2019. Poisson Generalised Linear Model regression analysis was performed to compare daily case counts, and LOESS curves compared time series. No differences were found regarding age or gender distributions, pre-fracture living, ambulatory, functional or cognitive status. More patients in 2020 had a high-risk ASA score. Fewer cases [Reduction = 26% (95% CI 1-44%)] were admitted in 2020. The reduction seemed to correspond with confinement. Approximately, one quarter less fragility hip fractures were admitted to our hospital during lockdown. Patients' baseline status and socio-demographic characteristics were similar.

Food insecurity and its association with changes in nutritional habits among adults during the COVID-19 confinement measures in Belgium.

To assess food insecurity and its association with changes in nutritional habits among Belgian adults during confinement due to COVID-19. Three cross-sectional online health surveys were conducted during March-May 2020. Multinomial logistic regression models were used to determine associations between self-reported changes in fruit, vegetable, soft drink and sweet and salted snack consumption or weight as dependent variables and food insecurity indicators as independent variables, adjusted for gender, household composition, educational attainment and household income. Belgium. In total, 8640 adults recruited by convenience sampling. About 10·4 % of Belgians often or sometimes feared food shortages, 5·0 % were often or sometimes short of food without money to buy more and 10·3 % often or sometimes could not afford to eat a healthy diet during confinement. These percentages were highest among single-parent families (26·7, 14·4 and 23·4 %, respectively). Adults who often or sometimes feared that food would run out during confinement had significantly higher odds of decreased v. unchanged fruits (3·53; 95 % CI = 2·06, 6·05) and vegetables (5·42; 95 % CI = 2·90, 10·11) consumption and significantly higher odds of increased v. unchanged soft drink consumption (3·79; 95 % CI = 2·20, 6·54). Similar results were found for adults who often or sometimes ran out of food and for adults who often or sometimes were not able to afford a healthy diet. Food insecurity during the COVID-19 confinement measures in Belgium was associated with adverse changes in most dietary behaviours. A strong government response is needed to tackle malnutrition and food insecurity to protect public health from ongoing and future pandemics.

Measuring the impact of COVID-19 confinement measures on human mobility using mobile positioning data. A European regional analysis

This work presents a mobility indicator derived from fully anonymised and aggregated mobile positioning data. Even though the indicator does not provide information about the behaviour of individuals, it captures valuable insights into the mobility patterns of the population in the EU and it is expected to inform responses against the COVID-19 pandemic. Spatio-temporal harmonisation is carried out so that the indicator can provide mobility estimates comparable across European countries. The indicators are provided at a high spatial granularity (up to NUTS3). As an application, the indicator is used to study the impact of COVID-19 confinement measure on mobility in Europe. It is found that a large proportion of the change in mobility patterns can be explained by these measures. The paper also presents a comparative analysis between mobility and the infection reproduction number Rt over time. These findings will support policymakers in formulating the best data-driven approaches for coming out of confinement, mapping the socio-economic effects of the lockdown measures and building future scenarios in case of new outbreaks.

A Tale of 40 Cities: A Preliminary Analysis of Equity Impacts of COVID-19 Service Adjustments across North America

To cope with COVID-19 confinement measures and precipitous declines in ridership, public transport agencies across North America have made significant adjustments to their services, slashing trip frequency in many areas while increasing it in others. These adjustments, especially service cuts, appear to have disproportionately affected areas where lower income and more-vulnerable groups reside in North American Cities. This paper compares changes in service frequency across 30 U.S. and 10 Canadian cities, linking these changes to average income levels and a vulnerability index. The study highlights the wide range of service outcomes while underscoring the potential for best practices that explicitly account for vertical equity, or social justice, in their impacts when adjusting service levels.

COVID-19: Perspectives, Based on An Ethnographic Study, from Mauritius, a Southern African Country.

Background: In the context of the COVID-19 pandemic, the Government of Mauritius announced the first three COVID-19 cases in the island on 18 March 2020. Following the outbreak, measures for national lockdown which were implemented as from 20 March 2020 were subsequently upgraded to national curfew as from 23 March. The need thus arose to observe the natural behaviour of Mauritians in the social environment resulting from the COVID-19 confinement measures. Methods: A qualitative study with ethnographic approach was undertaken in Mauritius, during the period 18 March to 1 May 2020, by Mauritian investigators who were immersed in the social context. As ethnographers in the digital era, we travelled through the internet in order to be on the field site. Following participant observation, data analysis and interpretation, we followed the Standards for Reporting Qualitative Research (SRQR). We also undertook the ethnography-related reflexivity process for quality assurance of this qualitative study. Findings: This study revealed four main themes with respect to the behaviour of Mauritians in the social context of the COVID-19 outbreak as follows: Adapting to confinement measures, panic buying, sustaining media communication and facing the dangers of COVID-19. Interpretation: The interpretation of our findings led us to draw the lessons learnt during the course of this study which provides insights potentially applicable to middle-income countries for their respective public health response to COVID-19.