COVID‐19 and Inequalities Blundell, Richard; Costa Dias, Monica; Joyce, Robert ...
Fiscal studies,
June 2020, 2020-06-00, 20200601, Volume:
41, Issue:
2
Journal Article
Peer reviewed
Open access
This paper brings together evidence from various data sources and the most recent studies to describe what we know so far about the impacts of the COVID‐19 crisis on inequalities across several key ...domains of life, including employment and ability to earn, family life and health. We show how these new fissures interact with existing inequalities along various key dimensions, including socio‐economic status, education, age, gender, ethnicity and geography. We find that the deep underlying inequalities and policy challenges that we already had are crucial in understanding the complex impacts of the pandemic itself and our response to it, and that the crisis does in itself have the potential to exacerbate some of these pre‐existing inequalities fairly directly. Moreover, it seems likely that the current crisis will leave legacies that will impact inequalities in the long term. These possibilities are not all disequalising, but many are.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Social connections are crucial for our health and well‐being. This is especially true during times of high uncertainty and distress, such as during the COVID‐19 lockdown. This period was ...characterized by unprecedented physical distancing (often communicated as social distancing) measures resulting in significant changes to people’s usual social lives. Given the potential effects of this disruption on people’s well‐being, it is crucial to identify factors which are associated with negative health outcomes, and conversely, those that promote resilience during times of adversity.
Aims
We examined the relationship between individuals’ levels of social connectedness during lockdown and self‐reported stress, worry, and fatigue. Method: Survey data were collected from 981 individuals in a representative sample of Austrian citizens. Data collection occurred during the last week of a six‐week nationwide lockdown due to the COVID‐19 pandemic. The final sample consisted of 902 participants. Participants were asked to complete validated questionnaires to assess levels of social connectedness as well as measures of perceived stress, worry—both general and COVID‐19 specific—and symptoms of fatigue during the previous two weeks.
Results
Our results demonstrate that greater social connectedness during the lockdown period was associated with lower levels of perceived stress, as well as general and COVID‐19‐specific worries. Furthermore, we found a negative relationship between fatigue and social connectedness, which was mediated by feelings of stress, general worries, and COVID‐19‐specific worries—respectively, indicating that individuals with smaller network sizes, who were highly distressed during the pandemic, were also likely to report feeling more fatigued.
Conclusion
Our findings highlight the important role that social connections play in promoting resilience by buffering against negative physical and mental health outcomes, particularly in times of adversity in times of adversity.
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DOBA, FSPLJ, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives
This scoping review aims to summarize the diagnostic value of saliva assessed from current studies that (1) compare its performance in reverse transcriptase‐polymerase chain reaction ...testing to nasopharyngeal swabs, (2) evaluate its performance in rapid and point‐of‐care COVID‐19 diagnostic tests, and (3) explore its use as a specimen for detecting anti‐SARS‐CoV‐2 antibodies.
Materials and Methods
A systematic search was performed on the following databases: Medline and Embase (Ovid), World Health Organization, Centers for Disease Control and Prevention, and Global Health (Ovid) from January 2019 to September 2021. Of the 657 publications identified from the searches, n = 146 articles were included in the final scoping review.
Results
Our findings showcase that salivary samples exceed nasopharyngeal swabs in detecting SARS‐CoV‐2 using reverse transcriptase‐polymerase chain reaction testing in several studies. A select number of rapid antigen and point‐of‐care tests from the literature were also identified capable of high detection rates using saliva. Moreover, anti‐SARS‐CoV‐2 antibodies have been shown to be detectable in saliva through biochemical assays.
Conclusion
We highlight the potential of saliva as an all‐rounded specimen in detecting SARS‐CoV‐2. However, future large‐scale clinical studies will be needed to support its widespread use as a non‐invasive clinical specimen for COVID‐19 testing.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The experiences and challenges of psychotherapists working remotely during the coronavirus pandemic were explored using a mixed‐methods approach. An online survey completed by 335 psychotherapists ...produced both quantitative and qualitative data with the latter being subject to a reflexive thematic analysis. Large numbers of therapists were using video‐link platforms and the telephone to conduct client sessions. A majority of therapists felt challenged by remote working, with reduced interpersonal cues, feelings of isolation and fatigue, and technical issues frequently cited concerns. At the same time, most therapists considered that remote working had been effective and that clients were comfortable with the process. Two‐thirds of therapists indicated that remote working would now become core business for them. The great majority of therapists thought that remote working skills should be part of formal therapy trainings.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Aims
This cohort study, based on Danish health registers, examined the post‐acute consequences of hospitalization for COVID‐19 in patients with diabetes.
Methods
The study population comprised all ...Danish citizens (≥18 years old) who had diabetes when the pandemic started. A patient was exposed if he/she had a hospitalization with COVID‐19 after 1 March 2020. A patient was unexposed when he/she was not hospitalized with COVID‐19 between 1 March 2020 and the end of follow‐up (4 January 2022), or the first registered event of interest. The outcomes included post‐COVID‐19 hospitalizations and death. We used a Cox proportional hazards model with time varying exposure estimating the hazards ratio (HR) to analyze if the hazard for an outcome of interest was impacted by being hospitalized with COVID‐19.
Results
In patients with type 1 diabetes, 101 were hospitalized with COVID‐19, and 25,459 were not. We did not have sufficient statistical power to identify differences in risk for those with type 1 diabetes. In type 2 diabetes, 1515 were hospitalized with COVID‐19, and 95,887 were not. The adjusted HRs of post‐acute hospitalization for respiratory diseases and infections were 1.71 (95% CI 1.45–2.03) and 1.87 (95% CI 1.61–2.18), respectively. The HR of death was 2.05 (95% CI 1.73–2.43). Patients with uncertain type had results similar to those with type 2 diabetes.
Conclusions/Interpretation
In type 2 diabetes and diabetes of uncertain type, hospitalization with COVID‐19 was associated with an increased risk of post‐acute hospitalization for respiratory diseases, infections and death.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
BACKGROUND/OBJECTIVES
Nursing homes have experienced a disproportionate share of COVID‐19 cases and deaths. Early analyses indicated that baseline quality was not predictive of nursing home cases, ...but a more nuanced study of the role of nurse staffing is needed to target resources and better respond to future outbreaks. We sought to understand whether baseline nurse staffing is associated with the presence of COVID‐19 in nursing homes and whether staffing impacts outbreak severity.
DESIGN
We analyzed Centers for Medicare & Medicaid Services (CMS) facility‐level data on COVID‐19 cases and deaths merged with nursing home and county characteristics. We used logistic regressions to examine the associations of staffing levels from Nursing Home Compare with the outcomes of any COVID‐19 cases and, conditional on at least one case, an outbreak. Among facilities with at least one case, we modeled count of deaths using hurdle negative binomial‐2 regressions.
SETTING
All nursing homes in the CMS COVID‐19 Nursing Home Dataset with reports that passed the CMS Quality Assurance Check as of June 25, 2020.
PARTICIPANTS
Residents of nursing homes that met COVID‐19 reporting requirements.
MEASUREMENTS
A nursing home is defined as having at least one case is if one or more confirmed or suspected COVID‐19 case among residents or staff is reported. Conditional on at least one case, we examine two outcomes: an outbreak, defined as confirmed cases/certified beds >10% or total confirmed and suspected cases/beds >20% or >10 deaths, and the total number of deaths attributed to COVID‐19 among residents and staff.
RESULTS
A total of 71% of the 13,167 nursing homes that reported COVID‐19 data as of June 14 had at least one case among residents and/or staff. Of those, 27% experienced an outbreak. Higher registered nurse‐hours are associated with a higher probability of experiencing any cases. However, among facilities with at least one case, higher nurse aide (NA) hours and total nursing hours are associated with a lower probability of experiencing an outbreak and with fewer deaths. The strongest predictor of cases and outbreaks in nursing homes is per capita cases in the county.
CONCLUSION
The prevalence of COVID‐19 in the community remains the strongest predictor of COVID‐19 cases and deaths in nursing homes, but higher NA hours and total nursing hours may help contain the number of cases and deaths.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The relationship between humans and digital technologies has been documented extensively in the past decades, but has yet to be reviewed through the lens of the current global pandemic crisis. This ...review synthesizes the rapidly growing literature on digital technology use during the current COVID‐19 pandemic. It addresses the following four topics: (1) the specific digital technologies that have been used, (2) the specific populations who have used these digital technologies, (3) the specific activities that individuals and groups have used these digital technologies, and (4) the specific effects of using these digital technologies on humans during the pandemic. The 281 empirical articles we have identified suggest that (1) 28 various forms of technologies have been used, ranging from computers to artificial intelligence, (2) 8 different populations of users are using these technologies, primarily medical professionals, (3) 32 generalized types of activities are involved, including providing health services remotely, analyzing data, and communicating, and (4) 35 various effects have been observed, such as improved patient outcomes, continued education, and decreased outbreak impact. Through this rapid review, we sketched an expansive, multilevel model of the current knowledge of how humans are using technology during the COVID‐19 pandemic. Major findings and future directions are discussed.
OBJECTIVES
In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID‐19) a pandemic. High morbidity and mortality rates of COVID‐19 have been observed among older adults ...and widely reported in both mainstream and social media. The objective of this study was to analyze tweets related to COVID‐19 and older adults, and to identify ageist content.
DESIGN
We obtained a representative sample of original tweets containing the keywords “elderly,” “older,” and/or “boomer” plus the hashtags “#COVID19” and/or “#coronavirus.”
SETTING
Tweets posted between March 12 and March 21, 2020.
MEASUREMENTS
We identified the type of user and number of followers for each account. Tweets were classified by three raters as (1) informative, (2) personal accounts, (3) personal opinions, (4) advice seeking, (5) jokes, and (6) miscellaneous. Potentially offensive content, as well as that downplaying the severity of COVID‐19 because it mostly affects older adults, was identified.
RESULTS
A total of 18,128 tweets were obtained, of which a random sample of 351 was analyzed. Most accounts (91.7%) belonged to individuals. The most common types of tweets were personal opinions (31.9%), followed by informative tweets (29.6%), jokes/ridicule (14.3%), and personal accounts (13.4%). Overall, 72 tweets (21.9%) likely intended to ridicule or offend someone and 21.1% had content implying that the life of older adults was less valuable or downplayed the relevance of COVID‐19.
CONCLUSION
Most tweets related to COVID‐19 and older adults contained personal opinions, personal accounts, and jokes. Almost one‐quarter of analyzed tweets had ageist or potentially offensive content toward older adults. J Am Geriatr Soc 68:1661‐1665, 2020.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK