COVID-19 Containment Measures Research Articles

A cross-country comparison of Covid-19 containment measures and their effects on the epidemic curves

BackgroundEuropean countries are still searching to eliminate or contain the Covid-19 pandemic. A variety of approaches have achieved different levels of success in limiting the spread of the disease early and preventing avoidable deaths. Governmental policy responses may explain these differences and this study aims to describe evidence about the effectiveness of containment measures throughout the course of the pandemic in five European countries (France, Germany, Italy, Spain and the UK).MethodsThe research approach adopted consisted of three steps: 1) Build a Containment Index (C.I.) that considers nine parameters to make an assessment on the strength of measures; 2) Develop dynamic epidemiological models for forecasting purposes; 3) Predict case numbers by assuming containment measures remain constant for a period of 30 days.ResultsOur analysis revealed that in the five European countries we compared, the use of different approaches definitively affected the effectiveness of containment measures for the Covid-19 pandemic.ConclusionThe evidence found in our research can be useful to inform policy makers’ decisions when deciding to introduce or relax containment measures and their timing, both during the current pandemic or in addressing possible future health crises.

Resistance strategy to ageism-based frailty in Italian older women in the COVID-19 pandemic.

The objective of the present study was to examine the relationship between resistance to ageism-based frailty (A-BF) and physical activity (PA) and sport in a cohort of women, aged 65 and older, living in Central Italy. The study was conducted in the spring of 2021 when rigorous COVID-19 containment measures were in force across Italy. A quanti-qualitative investigation was carried out in the cohort. A questionnaire to evaluate older women's engagement in (PA) and sport was administered and subsequently semi-structured phone interviews with those subjects who were found to be physically active were conducted to evaluate their forms of resistance to the crisis. A total number of 88 subjects responded and participated in the survey. Two tools were used to determine the study outcomes in the quantitative investigation. An altered version of Godin and Shephard's Leisure-Time Exercise Questionnaire (GSLTPAQ) was used to evaluate the engagement of women in PA and sport. Moreover, subjects' motivation to exercise was evaluated when they completed the survey using the Behavioral Regulation in Exercise Questionnaire (BREQ-2), a tool that assesses exercise regulation according to the Self-Determination Theory (SDT) framework. The active women resulting from the quantitative investigation were then interviewed in the qualitative investigation, using an interview grid. In the quantitative investigation it was found that PA is correlated with autonomy. Identified and intrinsic regulations prevail in women who are engaged in medium or high PA, vice-versa external regulation, introjected regulation and amotivation prevail in women who are engaged in insufficient PA or who are sedentary. In the qualitative investigation it was found that the participants experienced ambivalence, conflicts and crises at multiple levels (individual, interpersonal and institutional), generating contrasting feelings, which they faced by developing an active, peaceful and silent form of resistance by caring for their bodies and minds engaging in PA and sport.

How the COVID-19 pandemic divides society: Towards a better understanding of differences between supporters and opponents of the COVID-19 pandemic lockdown in Germany

Implemented COVID-19 containment measures have been fiercely discussed in Germany and corona-related protests have emerged. We assessed mental health in response to the lockdown in Germany and aimed at detecting factors differentiating opponents and supporters of the COVID-19 containment measures. Using a cross-sectional online survey (n = 1219) with a mixed-methods approach, we found increased levels of anxiety and depressive symptoms (PHQ-4 and GAD-7), overall lower well-being (WHO-5), worsened sleep, increased prevalence of interpersonal violence (5.2%) as well as more pronounced irritability including anger and aggression compared to pre-COVID-19 times for all participants. Moreover, opponents demonstrated a more pronounced mental burden with more depression and anxiety, more anger and coping difficulties compared to supporters. In line with previous research, we found opponents to be well-educated, financially stable and strongly estranged by their political institutions. Additionally, applying regression analysis, we found anxiety and negative self-concept to differentiate between opponents and supporters of the COVID-19 pandemic lockdown. Qualitative data confirms an increase in mental burden. Taken together, we identify a more vulnerable group opposing COVID-19 containment measures. Our results inform the public about opponents' motives, concerns and needs and open another perspective on the effects of the COVID-19 pandemic and its related containment measures.

Impact of COVID-19 containment measures on antibiotic prescribing for respiratory and ear diseases in pediatric primary care.

In Italy, the antibiotic prescription rate for children is very high. The aim of this study is to evaluate the change in the monthly rate of antibiotic prescriptions for respiratory and ear infections among children during the COVID-19 pandemic. This retrospective study included all children aged <14 years who referred to a pediatric primary care clinic in Milan (Italy) between January 1, 2019, and April 30, 2022. We examined the trends in the antibiotic prescription rate, comparing the pre-lockdown (2019), total lockdown (March-April 2020), partial lockdown (November-December 2020) and post-lockdown (November-December 2021 and March-April 2022) periods. A total of 12 569 visits (mean age of patients: 6.3±3.8 years), with 3228 antibiotic prescriptions, were included in the study. The overall antibiotic prescription rate was 25.7%, with a nadir (5.8%) in May 2020. Compared to 2019, the highest reduction in antibiotic prescription rate was found in February 2021 (-30.3% [95% CI, -36.2%, -24.4%]). A significant increase in the antibiotic prescription rate was observed in November-December 2021 and in March-April 2022 compared to the corresponding periods of the previous year (P<0.001). This study showed a drastic decrease in the antibiotic prescription rate for respiratory and ear infections during the COVID-19 pandemic, with a nadir immediately after the total lockdown. Day care center and school attendance did not reverse this positive trend during the partial lockdown, unlike what happened with the relaxation of restrictive measures and the resumption of social activities after the lockdown.

Continuing chronic care services during a pandemic: results of a mixed-method study

BackgroundPatients with chronic diseases have seen unprecedented changes to healthcare practices since the emergence of COVID-19. Traditional ‘on-site’ clinics have had to innovate to continue services. Whether these changes are acceptable to patients and are effective for care continuation are largely unreported.MethodsWe evaluated the effectiveness of care provision at a re-structured chronic care clinic and elicited the patient experiences of care and self-management. We conducted a convergent, parallel, mixed-methods study. Adult patients attending a chronic care clinic were included. We extracted data from 4,849 clinic visits before and during the COVID-19 pandemic, including operational metrics and attendee profile. We also conducted fifteen interviews with patients from the same clinic using a semi-structured interview guide.ResultsRe-structuring the chronic clinic, including the introduction of teleconsultations, home-delivery of prescriptions and use of community-based phlebotomy services, served to maintain continuity of care while adhering to COVID-19 containment measures. Qualitatively, five themes emerged. Patients were able to adjust to healthcare practice changes and adapt their own lifestyles, although poor self-management practices were adopted. While most were apprehensive about attending the clinic, they valued ongoing care access and were reassured by the on-site containment measures.ConclusionsContinuation of routine services is desired by patients and can be achieved through the adoption of containment measures, by greater collaboration with community partners, and the use of technology. Patients adapted to service changes, but poor self-management was evident. To prevent chronic disease relapse, services must strive to innovate rather than suspend services during pandemics.

Explorer l’expérience subjective du confinement lié à l’épidémie de la Covid-19 par les familles : une analyse interprétative et phénoménologique (IPA) du discours de parents

IntroductionThe COVID-19 containment measures had many effects on parents and children (stress, concerns), and the functioning of the whole family has been disrupted (lifestyle, habits, relationships). ObjectiveThe objective of this work is to highlight the idiosyncratic nature of the experience of confinement, its psychological consequences, and the changes it has induced within families. MethodInterested in the experiences of parents who had been confined within their families, we conducted interviews with parents and analyzed their discourse using the IPA method. We interviewed five parents (38–44 years old) with at least two children each (3–13 years old). Three of the interviewees were women. ResultsWe have identified seven major axes that illustrate the confinement experience of these families: accompanied by extracts from participants’ interviews (verbatims). The subjects lived this experience in confinement as a unique opportunity to spend time with their family and recalibrate what matters to them fundamentally in life. ConclusionThe experience of confinement has brought changes in the daily lives of these parents as well as in their way of understanding their existence. A form of positive revaluation emanates from their discourse.

Gendered impact of COVID-19 containment measures on unpaid care work and mental health in Europe: a scoping review protocol

IntroductionWomen are more likely than men to provide unpaid care work. Previous research has shown that lack of support for various forms of unpaid care work and work-family conflicts have...

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

Aim/HypothesisTo compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019.MethodsForty-seven pediatric diabetes centers caring for >90% of young people with diabetes in Italy recruited 4,237 newly diagnosed children with type 1 diabetes between 2017 and 2020 in a longitudinal study. Four subperiods in 2020 were defined based on government-imposed containment measures for COVID-19, and the frequencies of DKA and severe DKA compared with the same periods in 2017-2019.ResultsOverall, the frequency of DKA increased from 35.7% (95%CI, 33.5-36.9) in 2017-2019 to 39.6% (95%CI, 36.7-42.4) in 2020 (p=0.008), while the frequency of severe DKA increased from 10.4% in 2017-2019 (95%CI, 9.4-11.5) to 14.2% in 2020 (95%CI, 12.3-16.4, p<0.001). DKA and severe DKA increased during the early pandemic period by 10.4% (p=0.004) and 8% (p=0.002), respectively, and the increase continued throughout 2020. Immigrant background increased and high household income decreased the probability of presenting with DKA (OR: 1.55; 95%CI, 1.24-1.94; p<0.001 and OR: 0.60; 95 CI, 0.41-0.88; p=0.010, respectively).Conclusions/InterpretationThere was an increase in the frequency of DKA and severe DKA in children newly diagnosed with type 1 diabetes during the COVID-19 pandemic in 2020, with no apparent association with the severity of COVID-19 infection severity or containment measures. There has been a silent outbreak of DKA in children during the pandemic, and preventive action is required to prevent this phenomenon in the event of further generalized lockdowns or future outbreaks.

The role of party preferences in explaining acceptance of freedom restrictions in a pandemic context: the Italian case

As a consequence of the Covid-19 pandemic, several governments adopted disease containment measures limiting individual freedom, especially freedom of movement. Our contribution aims at studying the role played by party preferences in explaining attitudes towards those freedom limitations during the pandemic, taking into account the moderating role played by confidence in institutions and collectivist-individualistic orientations. Focussing on Italy, as the first western democracy to be hit by Covid-19 and to adopt harsh restrictive measures, we analyse data coming from the ResPOnsE COVID-19 project. Our study initially investigates whether attitudes towards freedom restrictions are associated with the dynamics of the pandemic and the institutional responses to it. Then, through multilevel regression models, we test several hypotheses about the relationship between party preferences, confidence in institutions, collectivistic orientations and public acceptance of Covid-19 containment measures limiting individual freedom. Findings show that party preferences are associated with different attitudes towards freedom restrictions to contain the pandemic, but this occurs only if people have individualistic orientations. Collectivistic orientations and confidence in institutions are positively associated with acceptance of freedom restrictions, regardless of party preferences. As regards the latter, neither a classical ideological explanation (conservative people more inclined to accept limitations to personal freedoms) nor a government-opposition explanation (supporters of government parties more inclined to accept freedom restrictions) seems to be adequate to fully account for the mechanisms behind acceptance of Covid-19 harsh containment measures. Thus, we offer an alternative ideological explanation by pointing out the ambiguous nature of contemporary right-wing populisms.

Dietary and Lifestyle Habits During the First Lockdown Declared in a Western Country: Results of the Survey Conducted on Vo’ Residents, Italy

ObjectivesThe first case of COVID-19 in Europe was detected on 21 February 2020 in a resident of Vo’, a small town in the province of Padova, Italy, of less than 4000 inhabitants. Consequently, for the first time in a Western country, a lockdown was declared for the village of Vo’ residents to contain the virus spread. The present work aimed at understanding if containment measures affect the dietary and lifestyle habits of Vo’ residents. MethodsA survey was done. Questionnaires were mailed to all Vo’ residents asking about socio-demographic characteristics, dietary and lifestyle habits before and during the lockdown. Descriptive statistics were reported as I quartile/median/III quartile for continuous variables and percentages (absolute numbers) for categorical variables. ResultsThe survey respondents were 588. The female gender was the most prevalent (53%), and the most represented age group was the 66–75 (22%), followed by the 56–65 (19%) and the 46–55 (17%). Among survey respondents, 90% spent the lockdown at home with the family. Interestingly, no changes were detected in lifestyle habits and the consumption of all food groups in 90% of subjects compared to before the lockdown. ConclusionsEven though several studies have already presented data about dietary and lifestyle habits of the population during the lockdown, that of Vo’ residents represent the first experience of COVID-19 containment measures in a Western country. Interestingly, no changes in dietary habits were detected. One possible explanation is that about one-third of respondents were above 45 years of age. It is known from literature that young people are most affected by the potential side effect of lockdown in terms of dietary and lifestyle habits changes. Funding SourcesNone.

Stock market reactions to COVID-19 shocks: do financial market interventions walk the talk?

PurposeFollowing the COVID-19 outbreak, various economies imposed different financial interventions as part of initiatives to cushion their stock markets from deteriorating performance. Our article examines the effectiveness of these interventions in protecting stock markets during the pandemic.Design/methodology/approachThe authors employ Panel Vector Autoregression to model the magnitude and timing of shocks from COVID-19 to stock markets. The fixed effects regression is then utilized to assess the role of financial interventions in protecting stock markets during COVID-19. The study uses daily stock index returns as well COVID-19 containment measures stringency index data from 39 countries ranging from 2nd January 2020 to 30th September 2021.FindingsOur findings firstly reveal a significant positive stock market reaction to country-level containment measures stringency but only during the first wave of COVID-19. We secondly show that stock market functioning interventions that include short selling bans and circuit breakers amplify the positive effects of COVID-19 containment measures stringency on stock market performance.Research limitations/implicationsThe authors stress the need for policymakers and regulators to timely intervene in protecting economies and stock markets during crises such as COVID-19 in order to reduce panic among investors. Moreover, investors should adjust their portfolios by investing in stocks from countries that have proper financial market interventions in place.Originality/valueDespite growing body of literature on COVID-19 and stock market performance, there is limited evidence on the role of financial sector interventions to cushion stock markets during tumultuous conditions caused by the pandemic.

Increased genetic contribution to wellbeing during the COVID-19 pandemic.

Physical and mental health are determined by an interplay between nature, for example genetics, and nurture, which encompasses experiences and exposures that can be short or long-lasting. The COVID-19 pandemic represents a unique situation in which whole communities were suddenly and simultaneously exposed to both the virus and the societal changes required to combat the virus. We studied 27,537 population-based biobank participants for whom we have genetic data and extensive longitudinal data collected via 19 questionnaires over 10 months, starting in March 2020. This allowed us to explore the interaction between genetics and the impact of the COVID-19 pandemic on individuals' wellbeing over time. We observe that genetics affected many aspects of wellbeing, but also that its impact on several phenotypes changed over time. Over the course of the pandemic, we observed that the genetic predisposition to life satisfaction had an increasing influence on perceived quality of life. We also estimated heritability and the proportion of variance explained by shared environment using variance components methods based on pedigree information and household composition. The results suggest that people's genetic constitution manifested more prominently over time, potentially due to social isolation driven by strict COVID-19 containment measures. Overall, our findings demonstrate that the relative contribution of genetic variation to complex phenotypes is dynamic rather than static.

Trends in educational disparities in preventive behaviours, risk perception, perceived effectiveness and trust in the first year of the COVID-19 pandemic in Germany.

BackgroundEducational disparities in health and health behaviours have always been relevant in public health research and are particularly challenging in the context of the COVID-19 pandemic. First studies suggest that factors important for the containment of the COVID-19 pandemic, such as prevention behaviour, risk perception, perceived effectiveness of containment measures, and trust in authorities handling the pandemic, vary by educational status. This study builds on recent debate by examining trends in absolute and relative educational disparities in these factors in the first year of the COVID-19 pandemic in Germany.MethodsData stem from four waves of the GESIS Panel surveyed between March and October 2020 in Germany (15,902 observations from 4,690 individuals). Trends in absolute and relative disparities were examined for preventive behaviour, risk perception, perceived effectiveness of COVID-19 containment measures, and trust in individuals and institutions handling the COVID-19 pandemic by educational status using sex, age, residence, nationality, children under 16 living in household, family status, household size, the Big Five Inventory, and income class as control factors. Descriptive statistics as well as unadjusted and adjusted linear regression models and random effects models were performed.ResultsWe observed an initially rising and then falling trend in preventive behaviour with consistent and significant absolute and relative disparities with a lower preventive behaviour among low educated individuals. Indication of a U-shaped trend with consistent significantly lower values among lower educated individuals was found for risk perception, whereas perceived effectiveness and trust decreased significantly over time but did not significantly vary by educational status.ConclusionsResults indicate persistent educational disparities in preventive behaviour and risk perception and a general decline in perceived effectiveness and trust in the first year of the COVID-19 pandemic in Germany. To address this overall downward trend and existing disparities, comprehensive and strategic management is needed to communicate the risks of the pandemic and the benefits of COVID-19 containment measures. Both must be adapted to the different needs of educational groups in particular in order to overcome gaps in preventive behaviour and risk perception by educational status.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-022-13341-3.

Covid-19 and Sargassum blooms: impacts and social issues in a mass tourism destination (Mexican Caribbean).

When the COVID-19 pandemic reached the Mexican Caribbean in late March 2020, this world-renown tourist destination had already been struggling with Sargassum influxes for 5 years. The nature and magnitude of these two impacts are not directly comparable, but both have contributed to profoundly transforming the region. As extreme COVID-19 containment measures were implemented nationwide, the tourism industry contracted by 98% as over 23 million visitors failed to arrive in 2020 and 400 daily flights stopped landing at Cancun Airport. Sargassum accumulations on Caribbean beaches, and their collection, containment and removal had been a challenging socioeconomic issue in the Caribbean region years before the COVID-19 pandemic shut down the tourist industry. We explore Beck’s concept of a risk society as an approach to these socioenvironmental impacts. We analyze five premises about risk society, combining them with a mainly ethnography methodology involving 61 informants. We present the results in terms of impacts. Using the concept of trajectory based on pandemic event chronology, we review the main stages of the pandemic during the research period (May to July 2020) and how the studied population worked to prevent virus infection and spread. We employ narratives to analyze risk perception both of the Sargassum influx and the pandemic. The discussion highlights the importance of moving beyond nature/society dichotomies and dualisms. In summary, the profound transformations caused by these impacts provide a unique opportunity for the Mexican Caribbean to reconstitute itself in a way that encompasses the world risk society concept, perhaps in a more socially and environmentally resilient incarnation.

The impact of the COVID-19 pandemic on people living with HIV in Zimbabwe

The COVID-19 pandemic was reported from March 2020 in Zimbabwe. COVID-19 containment measures which included repeated lockdowns have disrupted community interactions, reduced working hours, restricted travel and restricted HIV services for people living with HIV (PLHIV), among others. The study adopted a cross-sectional design. Both qualitative and quantitative data were collected in all the 10 provinces and analysed. A sample size of 480 was calculated for the cross-sectional survey. Secondary data on HIV early warning indicators from 2018 to 2021 were extracted from 20 randomly selected health facilities and used for modelling. Mathematical modelling was conducted to assess the impact of COVID-19 on PLHIV. AIDS-related deaths increased from 20 100 in 2019 to 22 200 in 2020. In addition, there were significant years of life lost (yLLs) from premature mortality and years of life lost due to disability (yLDs) from COVID-19. Prevalence of COVID-19 among PLHIV was 4%. COVID-19 vaccination coverage was 64%, which is higher than the national average of 42%. Stress and breach of confidentiality as ARV medicines were given out in open spaces and fear of contracting COVID-19 were the perceived psychological issues. COVID-19 disrupted HIV service provision, increased AIDS-related deaths and caused psychological challenges.

Gender inequality in domestic chores over ten months of the UK COVID-19 pandemic: Heterogeneous adjustments to partners’ changes in working hours

COVID-19 containment measures led to a generalised decrease in working hours. The limited chances of spending time outside the home and the increased needs related to children and housekeeping triggered gender-specific reactions to unpaid labour. Little is

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students.

BackgroundThe sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand.MethodsThailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis.ResultsAbout two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6; p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep.ConclusionAlthough online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

From the Lab to Real Life: Monitoring Cardiorespiratory Fitness during the COVID-19 Pandemic through Wearable Devices. An Exploratory Longitudinal Study on Healthy Participants

COVID-19 containment measures hampered population cardiorespiratory fitness (which can be quantified as peak oxygen consumption (O2peak)) and the possibility to assess it using laboratory-based techniques. Although it is useful to ascertain the O2peak recovery after lockdowns, the community and most scientific institutions were unable to evaluate it. Wearable devices may provide the opportunity to estimate cardiorespiratory fitness outside of the laboratory, without breaking self-isolation; herein, we explore the feasibility of this approach. Fifteen healthy participants were tested every 2 weeks for 10 weeks during a reduction of containment measures after a strict lockdown. Physical activity levels were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). O2peak was estimated through a previously validated test based on the speed of a 60 m sprint run, the baseline-to-peak heart rate (HR) variation, and the velocity of HR decay after the sprint, and measured through a wearable HR monitor. Participants increased physical activity from the end of lockdown (1833 [917–2594] MET-min/week; median [1st quartile–3rd quartile]) until the end of follow-up (2730 [1325–3380] MET-min/week). The estimated O2peak increased by 0.24 ± 0.19 mL/(min*kg*week) (regression coefficient ± standard error). Based on previous knowledge on the impact of inactivity on O2peak, our study indicates that a 10-week period of reducing the stringency of containment measures may not be sufficient to counteract the detrimental effects of the preceding lockdown.

Impact of Covid-19 containment measures on trade

Combining Spanish firm-level monthly trade data with country-level Covid-19 containment measures over February–July 2020, we show that the value of exports decreased more in destinations that introduced strict containment measures, whereas the value of imports remained unaffected. Strict containment measures in a partner country increased the probability of a firm ceasing to trade with it. Negative effects were concentrated between March and May 2020. The detrimental effect of containment on exports was larger in destinations where the share of jobs that could be done remotely was low, for goods consumed outside the household, for wholesalers and retailers, and for manufacturers not participating in global value chains.

Individual Differences in Compliance with Covid-19 Containment Measures in V4 Countries

Individual Differences in Compliance with Covid-19 Containment Measures in V4 Countries