Medical appointments and provision of medical care during the COVID-19 pandemic in Mainz, Germany.

Previous evidence suggested that non-COVID-19-related medical care was reduced during the first wave of the COVID-19 pandemic, but it remained unclear whether or to which extent this effect lasted beyond the first wave, or existed in a longer time frame. Here, we consider questionnaire data of the Gutenberg-COVID-19 study together with pre-pandemic baseline data of the Gutenberg Health Study concerning the region around Mainz, Germany, to study the effects of the pandemic on the provision of medical care until April 2021. We observed that the proportion of cancelled medical appointments was low and that the fraction of participants with a medical appointment as an indicator for the number of appointments being made was in line with pre-pandemic levels. Appointments were more likely cancelled by the patient (rather than the provider), and more likely cancelled by medical specialists such as dentists or ophthalmologists (rather than GPs). In conclusion, we found some evidence that, at least with regard to realized appointments, the medical system and the provision of medical care were not harmed by the COVID-19 pandemic on a longer time scale.

The burdens of poverty during the COVID-19 pandemic

Background Individuals living at-risk-of-poverty have an increased risk of poor mental health. The pandemic and its societal impacts might have negative effects especially on this group widening the gap between rich and poor and also exacerbate gender gaps, which in turn might impact social cohesion. Aim The objective of this longitudinal study was to determine if people living at-risk-of-poverty were more vulnerable to economic and psychosocial impacts of the pandemic and showed poorer mental health. Moreover, gender differences were analyzed. Method We drew data from a sample of N = 10,250 respondents of two time points (T1 starting from October 2020, T2 starting from March 2021) of the Gutenberg COVID-19 Study. We tested for differences between people living at-risk-of-poverty and more affluent respondents regarding economic impacts, psychosocial stressors, as well as depressiveness, anxiety and loneliness, by comparing mean and distributional differences. To test for significant discrepancy, we opted for chi-square- and t-tests. Results The analysis sample compromised N = 8,100 individuals of which 4,2% could be classified as living at-risk-of-poverty. 23% of respondents living at-risk-of-poverty had a decrease in income since the beginning of the pandemic–twice as many as those not living at-risk-of-poverty, who reported more often an increase in income. Less affluent individuals reported a decrease in working hours, while more affluent people reported an increase. Between our survey time points, we found a significant decrease in these economic impacts. Gender differences for economic changes were only found for more affluent women who worked more hours with no change in income. Less affluent respondents were more impacted by psychosocial stressors, depressiveness, anxiety, and loneliness. Gender differences were found particularly with regard to care responsibilities. Discussion Our results indicate a widening in the gap between the rich and the poor at the beginning of the pandemic. Gender differences concerning economic changes affect more affluent women, but women in both income groups are more burdened by care responsibilities, which might indicate a heightened resurgence of gender role in times of crisis. This increase in inequality might have impacted social cohesion.

Protective behavior and SARS-CoV-2 infection risk in the population – Results from the Gutenberg COVID-19 study

Background During the SARS-CoV-2 pandemic, preventive measures like physical distancing, wearing face masks, and hand hygiene have been widely applied to mitigate viral transmission. Beyond increasing vaccination coverage, preventive measures remain urgently needed. The aim of the present project was to assess the effect of protective behavior on SARS-CoV-2 infection risk in the population. Methods Data of the Gutenberg COVID-19 Study (GCS), a prospective cohort study with a representative population-based sample, were analyzed. SARS-CoV-2 infections were identified by sequential sampling of biomaterial, which was analyzed by RT-qPCR and two antibody immunoassays. Self-reported COVID-19 test results were additionally considered. Information on protective behavior including physical distancing, wearing face masks, and hand hygiene was collected via serial questionnaire-based assessments. To estimate adjusted prevalence ratios and hazard ratios, robust Poisson regression and Cox regression were applied. Results In total, 10,250 participants were enrolled (median age 56.9 [43.3/68.6] years, 50.8% females). Adherence to preventive measures was moderate for physical distancing (48.3%), while the use of face masks (91.5%) and the frequency of handwashing (75.0%) were high. Physical distancing appeared to be a protective factor with respect to SARS-CoV-2 infection risk independent of sociodemographic characteristics and individual pandemic-related behavior (prevalence ratio [PR] = 0.77, 95% confidence interval [CI] 0.62–0.96). A protective association between wearing face masks and SARS-CoV-2 transmission was identified (PR = 0.73, 95% CI 0.55–0.96). However, the protective effect declined after controlling for potential confounding factors (PR = 0.96, 95% CI 0.68–1.36). For handwashing, this investigation did not find a beneficial impact. The adherence to protective behavior was not affected by previous SARS-CoV-2 infection or immunization against COVID-19. Conclusion The present study suggests primarily a preventive impact of physical distancing of 1.5 m, but also of wearing face masks on SARS-CoV-2 infections, supporting their widespread implementation. The proper fit and use of face masks are crucial for effectively mitigating the spread of SARS-CoV-2 in the population. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-14310-6.