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, , 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.
ABSTRACT
Background Young adults are not considered a risk group for contracting COVID-19, but they are disproportionately affected by pandemic containment measures compared to other age groups. University students were confronted with abrupt changes both in their personal and academic lives. The “Health in Students during the Corona pandemic” study (HES-C) investigated the health and health behavior, concerns and views in students of the Zurich University of Applied Sciences. In the current analyses, we focused on COVID-19 related preventive behaviors, alcohol and marijuana consumption during the pandemic. Methods All students of the Zurich University of Applied Sciences (N = 12,429) were invited to a voluntary repeated cross-sectional open cohort survey which took place from the April 3 2020 (T0) to January 25 (T5), covering two university semesters with overall 6 surveys. Participation rates varied from T0 20% to T5 13%. Results While overall adherence to containment measures was high, men yielded lower adjusted odds (OR;95%-CI) of adherence regarding the following measures: social distancing (0.68;0.53-0.87), non-utilization of public transport (0.74;0.56-0.97), 5-person limit for social gatherings (0.47;0.35-0.64) and the stay at home rule (0.64;0.51-0.82). In addition to gender, factors associated with adherence were information source and perceived susceptibility to the virus. Out of 80% who reported having drunk alcohol during the last 30 days at T0, 31% engaged at least once in binge drinking (>5 beverages) and 18% consumed more than usual. Marijuana was consumed by 11%, of which 27% reported higher use during the lock-down than before. Longitudinal data on risk behavior and factors associated with risk behavior and changes in behavior are currently being analyzed and will be presented. Conclusions Public health communication targeting university students should not only address pandemic related preventive behavior but also risk behavior during the pandemic. Key messages The pandemic has led to increased risky health behavior among certain students. Public health communication targeting university students should not only address pandemic related preventive behavior but also risk behavior during the pandemic.