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During the COVID-19 pandemic, many companies implemented working from home to mitigate the spread of the disease among their employees. Using data from Corona Immunitas Nestlé, a seroepidemiological study conducted among employees from two Nestlé sites in Switzerland, we aimed to investigate whether there was a difference in SARS-CoV-2 infection rates between employees working most of the time from home and employees mobilized in a workplace equipped with a specialized occupational safety unit and strict sanitary measures. We also investigated whether this association was modified by household size, living with children, vulnerability, worries about an infection, and worries about adverse health consequences if infected. Data were collected between 8 December 2020, and 11 February 2021. Previous SARS-CoV-2 infections were ascertained by the presence of anti-SARS-CoV-2 IgG antibodies in the blood. Of the 425 employees included (53% women;mean age 42 years ranging between 21 and 64 years), 37% worked most of the time from home in 2020 and 16% had been infected with SARS-CoV-2. Participants who worked most of the time from home in 2020 had slightly higher odds of being infected with SARS-CoV-2 compared to participants who never or only sometimes worked from home (adjusted OR 1.29, 95% CI 0.73–2.27). The association was stronger in participants living alone or with one other person (adjusted OR 2.62, 95% CI 1.13–6.25). Among participants living with two or more other persons (adjusted OR 0.66, 95% CI 0.30–1.39) and among vulnerable participants (adjusted OR 0.53, 95% CI 0.13–1.93), working from home tended to be associated with lower odds of infection. In conclusion, in a context of strict sanitary measures implemented in the workplace, employees working from home did not seem to be at lower risk of infection compared to those working on site, especially if living alone or with one other person.
ABSTRACT
BACKGROUND: To curb the spread of the first wave of the COVID-19 pandemic, the Swiss government declared a state of health emergency and ordered a legal restriction concerning the opening of healthcare institutions. In this study, we aimed to assess the proportion of traditional Chinese medicine (TCM) physicians and therapists who consulted patients regarding COVID-19 during the first wave of the pandemic in 2020 in Switzerland, as well as the extent to which COVID-19 affected their practices during the same period. METHODS: A retrospective study was performed by using a questionnaire from January to April 2021 among a random sample of TCM physicians and therapists based in Switzerland. The survey included questions on demographic characteristics, opening status of practices, channels of communication used for the medical encounter, and experience in managing the prevention, acute, and recovery stages of COVID-19 infection. RESULTS: Among the 320 participants, 76% consulted a patient regarding COVID-19 at least once. Overall, physicians and therapists consulted more patients during recovery (76.3%) and prevention (67.8%) than during the acute stage (19.8%) of the disease. Acupuncture was the most frequently used technique among TCM therapists and physicians consulting for prevention (80.4%) and recovery (92.5%), whereas Chinese pharmacopeia was the most used technique among those consulting for the acute stage (59.3%). Of those who closed their practices from March to April 2020 but kept consulting, telephone (30.4%) and home visits (29.9%) were the two principal methods of consultation. CONCLUSIONS: The restriction concerning the opening of practices induced a loss of the health workforce, especially among TCM therapists. Nonetheless, TCM therapists and physicians consulted patients regarding COVID-19, especially during the recovery stage. As there is a demand for the use of TCM in the context of COVID-19, it raises the need for a better consideration of TCM in the Swiss health care system.
Subject(s)
COVID-19 , Medicine, Chinese Traditional , Humans , Pandemics , Retrospective Studies , SwitzerlandABSTRACT
Continuity of care is important for the health of aging individuals with comorbidities. When initial coronavirus mitigation campaigns involved messaging such as "Stay at home-stay safe," and banned provision of non-urgent care, at-risk patients depending upon regular consultations with general practitioners (GPs) faced confusion about the possibility of seeking non-COVID-19 related healthcare. We employed a sequential explanatory mixed-methods design, consisting of a quantitative component followed by a qualitative component, to understand at-risk patients' health services use during the COVID-19 pandemic in Switzerland. Quantitatively, we used electronic medical records data from 272 GPs and 266,796 patients. Based on pre-pandemic data, we predicted weekly consultation counts as well as weekly measurement counts (blood pressure, glycated hemoglobin, and low-density lipoprotein cholesterol) per 100 patients that would be expected in 2020 in absence of a pandemic and compared those to actual observed values. Qualitatively, we conducted 23 semi-structured interviews with 24 GPs (â¼45 min) and 37 interviews with at-risk patients (â¼35 min). Quantitative results demonstrate a significant decrease in consultation and measurement counts during the first shutdown period, with consultation counts quickly returning to normal and moving within expected values for the rest of 2020. Qualitative data contextualize these findings with GPs describing constantly implementing material, administrative, and communication changes. GPs reported communication gaps with the authorities and noted a lack of clear guidelines delineating how to define "at-risk patients" and what cases were "urgent" to treat during shutdowns. Patient interviews show that patient-level factors, such as fear of contracting coronavirus, perceptions that GPs were overburdened, and a sense of solidarity, influenced patients' decisions to consult less at the beginning of the pandemic. Findings demonstrate communication gaps during pandemic periods and provide valuable lessons for future pandemic preparedness, particularly the need for contingency plans for the overall healthcare system instead of plans focusing only on the infectious agent itself.
Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Continuity of Patient Care , Humans , Primary Health Care , Switzerland/epidemiologyABSTRACT
Objectif Comparer l’efficacité de la TCCi de groupe pratiquée en distanciel ou en présentiel, et sur 2 ans autour du pic de la pandémie COVID-19. Méthodes Il s’agit d’une étude clinique rétrospective chez des patients atteints d’insomnie chronique et pris en charge au centre du sommeil et de la vigilance de l’Hôtel-Dieu. Les analyses portent sur trois groupes de patients traités respectivement : en présentiel avant (« pré-COVID ») et après (« post-COVID ») le confinement, et en distanciel pendant ce dernier (« COVID »). La TCCi, pratiquée par deux thérapeutes, comportait 6 séances hebdomadaires de 2h chacune, et une séance de suivi 2 mois plus tard. Les évaluations étaient recueillies à partir de questionnaires renseignés par les patients : au moment du diagnostic, juste avant la première séance de TCC, après la 6e séance et deux mois plus tard. La comparaison inter-groupes porte sur les scores de l’ISI, de la BDI(II) et de la BAI, ainsi que ceux de la qualité de vie (SF-12) et les données des agendas du sommeil (temps total de sommeil, latence d’endormissement, temps d’éveil intra-sommeil). Résultats Les résultats indiquent que les scores d’ISI, BDI(II) et BAI à l’inclusion sont identiques dans les 3 groupes. De plus, on observe la même diminution de ces scores à 6 semaines (notamment une baisse de 7 points de l’ISI), qui se maintient à deux mois. Conclusion La pandémie n’a pas modifié le profil des patients pris en charge par TTC à l’Hôtel-Dieu. De plus, la TCCi est aussi efficace en distanciel qu’en présentiel, ce qui permet d’envisager des perspectives futures d’élargissement de sa pratique.
ABSTRACT
To illustrate the novelties in integrative and complementary medicine in 2021, the authors present a selection of six articles. One of them is specifically related to COVID-19. The other articles deal with themes that are always relevant and where complementary approaches represent a real added value. Two articles focus on low back pain, a common problem in primary care medicine. The others examine acupuncture in the oncological context, the use of therapeutic suggestions in an operative context, and Tai Chi. The authors thus provide an overview of the range of possible complementary therapeutic approaches that are increasingly supported by evidence, inviting them to be better integrated into clinical practice.
Pour illustrer les nouveautés en médecine intégrative et complémentaire en 2021, les auteur·e·s présentent une sélection de six articles. L'un s'intéresse plus spécifiquement au Covid-19. Les autres touchent des thématiques qui restent toujours d'actualité et où des approches complémentaires peuvent représenter une réelle plus-value. Deux articles ont pour thème les lombalgies, problématique courante en médecine de premier recours. Les autres examinent l'acupuncture dans le contexte oncologique, l'utilisation de suggestions thérapeutiques dans un contexte opératoire, et le Tai Chi. Les auteur·e·s donnent ainsi un aperçu de l'éventail d'approches thérapeutiques complémentaires possibles et de plus en plus soutenues par la science, invitant à les intégrer de mieux en mieux dans la pratique clinique.
Subject(s)
Acupuncture Therapy , COVID-19 , Complementary Therapies , Integrative Medicine , HumansABSTRACT
Objectives: We aimed to explore the impact of the Swiss shutdown in spring 2020 on the intensity of health services use in general practice. Methods: Based on an electronic medical records database, we built one patient cohort each for January-June 2019 (control, 173,523 patients) and 2020 (179,086 patients). We used linear regression to model weekly consultation counts and blood pressure (BP) and glycated hemoglobin (HbA1c) measurement counts per 100 patients and predicted non-shutdown values. Analyses were repeated for selected at-risk groups and different age groups. Results: During the shutdown, weekly consultation counts were lower than predicted by -17.2% (total population), -16.5% (patients with hypertension), -17.5% (diabetes), -17.6% (cardiovascular disease), -15.7% (patients aged <60 years), -20.4% (60-80 years), and -14.5% (>80 years). Weekly BP counts were reduced by -35.3% (total population) and -35.0% (hypertension), and HbA1c counts by -33.2% (total population) and -29.8% (diabetes). p-values <0.001 for all reported estimates. Conclusion: Our results document consequential decreases in consultation counts and chronic disease monitoring during the shutdown. It is crucial that health systems remain able to meet non-COVID-19-related health care needs.