Dataset Information

How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown.

ABSTRACT:

Aims

The aim of this study was to examine how the Norwegian general adult population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown. We assessed quarantine, symptoms, social distancing, home office/school, work status, social contact and health-care contact through digital access and knowledge.

Methods

A cross-sectional survey was performed of 29,535 adults (aged 18-99) in Norway after six weeks of non-pharmaceutical interventions in March/April 2020.

Results

Most participants found the non-pharmaceutical interventions to be manageable, with 20% of all adults and 30% of those aged <30 regarding them as acceptable only to some or a limited degree. Sixteen per cent had been quarantined, 6% had experienced symptoms that could be linked to COVID-19 and 84% practiced social distancing. Eleven per cent reported changes in the use of health and social services. Three-quarters (75%) of those who had mental health or physiotherapy sessions at least monthly before the pandemic reported a reduction in their use of these services. A substantial reduction was also seen for home nursing, hospital services and dentists compared to usage before the non-pharmaceutical interventions. Immigrants were more likely to experience a reduction in follow-up from psychologists and physiotherapy. With regard to the use of general practitioners, the proportions reporting an increase and a reduction were relatively equal.

Conclusions

SUBMITTER: Mæland S

PROVIDER: S-EPMC8808225 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown.

Mæland Silje S Bjørknes Ragnhild R Lehmann Stine S Sandal Gro Mjeldheim GM Hazell William W Rabben Åsgeir Kjetland ÅK Vedaa Øystein Ø Skogen Jens Christoffer JC Fadnes Lars Thore LT

Scandinavian journal of public health 20210712 1

<h4>Aims</h4>The aim of this study was to examine how the Norwegian general adult population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown. We assessed quarantine, symptoms, social distancing, home office/school, work status, social contact and health-care contact through digital access and knowledge.<h4>Methods</h4>A cross-sectional survey was performed of 29,535 adults (aged 18-99) in Norway after six weeks of non-pharmaceutical interventi ...[more]

PMID: 34250865

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Project description:Background and aimIn order to cope with the requirements of COVID-19 pandemic and prevent overwhelming of the healthcare systems, during 2020 social distancing measures were proposed, and generalized lockdown. Aim of our study is to ascertain whether non-pharmaceutical intervention did have any impact on the epidemiology of Legionnaires' disease (LD), a respiratory infectious disease without interhuman spreading.MethodsOfficial national reports from 4 index countries in European Union (i.e. Germany, France, Italy, and Spain) were retrieved. The study included all cases notified during 2020 COVID-19 outbreak, versus the cases referred during the same period in 2019. Subgroup analyses for hospital-associated and travel-associated LD cases, as well as for lethality estimates were performed.ResultsA sustained drop for incidence rate was confirmed, at EU-level (3.5 per 100,000 vs. 5.3 per 100,000) as well as in the national estimates. The decrease was particularly evident in Italy (RR 0.880, 95%CI 0.839 to 0.905), despite a transient surge in notification rates during the month of June, 2020. Subgroup analyses demonstrated a fall in travel-associated cases (-66.8% at EU level), while hospital-associated cases decreased in absolute number when compared to 2019, but where substantially stable in terms when compared to EU estimates. While Case Fatality Ratio increased in comparison with 2019, no significant trend was similarly identified in comparison to EU estimates. Conclusions. Lockdown measures have impacted on the epidemiology of LD in Europe during 2020, but some heterogeneities were identified both across the assessed countries, and the various subgroup. Even though the absolute number of total cases did substantially decrease in 2020 compared to 2019, the effect of non-pharmaceutical interventions was mostly indirect, through a reduced interaction of individuals with environments at potentially high-risk for human infections (e.g. hospitals, accommodation sites, etc.).

Project description:BackgroundNon-pharmaceutical interventions (NPIs) are a crucial suite of measures to prevent and control infectious disease outbreaks. Despite being particularly important for crisis-affected populations and those living in informal settlements, who typically reside in overcrowded and resource limited settings with inadequate access to healthcare, guidance on NPI implementation rarely takes the specific needs of such populations into account. We therefore conducted a systematic scoping review of the published evidence to describe the landscape of research and identify evidence gaps concerning the acceptability, feasibility, and effectiveness of NPIs among crisis-affected populations and informal settlements.MethodsWe systematically reviewed peer-reviewed articles published between 1970 and 2020 to collate available evidence on the feasibility, acceptability, and effectiveness of NPIs in crisis-affected populations and informal settlements. We performed quality assessments of each study using a standardised questionnaire. We analysed the data to produce descriptive summaries according to a number of categories: date of publication; geographical region of intervention; typology of crisis, shelter, modes of transmission, NPI, research design; study design; and study quality.ResultsOur review included 158 studies published in 85 peer-reviewed articles. Most research used low quality study designs. The acceptability, feasibility, and effectiveness of NPIs was highly context dependent. In general, simple and cost-effective interventions such as community-level environmental cleaning and provision of water, sanitation and hygiene services, and distribution of items for personal protection such as insecticide-treated nets, were both highly feasible and acceptable. Logistical, financial, and human resource constraints affected both the implementation and sustainability of measures. Community engagement emerged as a strong factor contributing to the effectiveness of NPIs. Conversely, measures that involve potential restriction on personal liberty such as case isolation and patient care and burial restrictions were found to be less acceptable, despite apparent effectiveness.ConclusionsOverall, the evidence base was variable, with substantial knowledge gaps which varied between settings and pathogens. Based on the current landscape, robust evidence-based guidance is not possible, and a research agenda is urgently required that focusses on these specific vulnerable populations. Although implementation of NPIs presents unique practical challenges in these settings, it is critical that such an agenda is put in place, and that the lessons learned from historical and present experiences are documented to build a firm evidence base.

Project description:BackgroundThe 'third wave' of COVID-19 in Hong Kong, China was suppressed by non-pharmaceutical interventions (NPIs). Although social distancing regulations were quickly strengthened, the outbreak continued to grow, causing increasing delays in tracing and testing. Further regulations were introduced, plus 'targeted testing' services for at-risk groups. Estimating the impact of individual NPIs could provide lessons about how outbreaks can be controlled without radical lockdown. However, the changing delays in confirmation time challenge current modelling methods. We used a novel approach aimed at disentangling and quantifying the effects of individual interventions.MethodsWe incorporated the causes of delays in tracing and testing (i.e. load-efficiency relationship) and the consequences from such delays (i.e. the proportion of un-traced cases and the proportion of traced-cases with confirmation delay) into a deterministic transmission model, which was fitted to the daily number of cases with and without an epi‑link (an indication of being contact-traced). The effect of each NPI was then calculated.FindingsThe model estimated that after earlier relaxation of regulations, Re rose from 0.7 to 3.2. Restoration of social distancing to the previous state only reduced Re to 1.3, because of increased delay in confirmation caused by load on the contact-tracing system. However, Re decreased by 20.3% after the introduction of targeted testing and by 17.5% after extension of face-mask rules, reducing Re to 0.9 and suppressing the outbreak. The output of the model without incorporation of delay failed to capture important features of transmission and Re.InterpretationChanging delay in confirmation has a significant impact on disease transmission and estimation of transmissibility. This leads to a clear recommendation that delay should be monitored and mitigated during outbreaks, and that delay dynamics should be incorporated into models to assess the effects of NPIs.FundingCity University of Hong Kong and Health and Medical Research Fund.

Project description:ObjectiveIn this study, we investigated the impact of COVID-19 NPIs in South Africa to understand their effectiveness in the reduction of transmission of COVID-19 in the South African population. This study also investigated the COVID-19 testing, reporting, hospitalised cases, excess deaths and COVID-19 modelling in the first wave of the COVID-19 epidemic in South Africa.MethodsA semi-reactive stochastic COVID-19 model, the ARI COVID-19 SEIR model, was used to investigate the impact of NPIs in South Africa to understand their effectiveness in the reduction of COVID-19 transmission in the South African population. COVID-19 testing, reporting, hospitalised cases and excess deaths in the first COVID-19 epidemic wave in South Africa were investigated using regressional analysis and descriptive statistics.FindingsThe general trend in population movement in South African locations shows that the COVID-19 NPIs (National Lockdown Alert Levels 5,4,3,2) were approximately 30% more effective in reducing population movement concerning each increase by 1 Alert Level. The translated reduction in the effective SARS-CoV-2 daily contact number (β) was 6.12% to 36.1% concerning increasing Alert Levels. Due to the implemented NPIs, the effective SARS-CoV-2 daily contact number in the first COVID-19 epidemic wave in South Africa was reduced by 58.1-71.1% while the peak was delayed by 84 days. The estimated COVID-19 reproductive number was between 1.98 to 0.40. During South Africa's first COVID-19 epidemic wave, the mean COVID-19 admission status in South African hospitals was 58.5%, 95% CI [58.1-59.0] in the general ward, 13.4%, 95% CI [13.1-13.7] in the intensive care unit, 13.3%, 95% CI [12.6-14.0] on oxygen, 6.37%, 95% CI [6.23-6.51] in high care, 6.29%, 95% CI [6.02-6.55] on ventilator and 2.13%, 95% CI [1.87-2.43] in isolation ward respectively. The estimated mean South African COVID-19 patient discharge rate was 11.9 days per patient. While the estimated mean of the South African COVID-19 patient case fatality rate (CFR) in hospital and outside the hospital was 2.06%, 95% CI [1.86-2.25] (deaths per admitted patients) and 2.30%, 95% CI [1.12-3.83](deaths per severe and critical cases) respectively. The relatively high coefficient of variance in COVID-19 model outputs observed in this study shows the uncertainty in the accuracy of the reviewed COVID-19 models in predicting the severity of COVID-19. However, the reviewed COVID-19 models were accurate in predicting the progression of the first COVID-19 epidemic wave in South Africa.ConclusionThe results from this study show that the COVID-19 NPI policies implemented by the Government of South Africa played a significant role in the reduction of COVID-19 active, hospitalised cases and deaths in South Africa's first COVID-19 epidemic wave. The results also show the use of COVID-19 modelling to understand the COVID-19 pandemic and the impact of regressor variables in an epidemic.

Project description:Background: Attempts to quantify effect sizes of non-pharmaceutical interventions (NPI) to control COVID-19 in the US have not accounted for heterogeneity in social or environmental factors that may influence NPI effectiveness. This study quantifies national and sub-national effect sizes of NPIs during the early months of the pandemic in the US. Methods: Daily county-level COVID-19 cases and deaths during the first wave (January 2020 through phased removal of interventions) were obtained. County-level cases, doubling times, and death rates were compared to four increasingly restrictive NPI levels. Socio-demographic, climate and mobility factors were analyzed to explain and evaluate NPI heterogeneity, with mobility used to approximate NPI compliance. Analyses were conducted separately for the US and for each Census regions (Pacific, Mountain, east/West North Central, East/West South Central, South Atlantic, Middle Atlantic and New England). A stepped-wedge cluster-randomized trial analysis was used, leveraging the phased implementation of policies. Results: Aggressive (level 4) NPIs were associated with slower COVID-19 propagation, particularly in high compliance counties. Longer duration of level 4 NPIs was associated with lower case rates (log beta -0.028, 95% CI -0.04 to -0.02) and longer doubling times (log beta 0.02, 95% CI 0.01-0.03). Effects varied by Census region, for example, level 4 effects on doubling time in Pacific states were opposite to those in Middle Atlantic and New England states. NPI heterogeneity can be explained by differential timing of policy initiation and by variable socio-demographic county characteristics that predict compliance, particularly poverty and racial/ethnic population. Climate exhibits relatively consistent relationships across Census regions, for example, higher minimum temperature and specific humidity were associated with lower doubling times and higher death rates for this period of analysis in South Central, South Atlantic, Middle Atlantic, and New England states. Conclusion and Relevance: Heterogeneity exists in both the effectiveness of NPIs across US Census regions and policy compliance. This county-level variability indicates that control strategies are best designed at community-levels where policies can be tuned based on knowledge of local disparities and compliance with public health ordinances.

Dataset Information

How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown.

Aims

Methods

Results

Conclusions

Publications

How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown.

Similar Datasets

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