Video triage of children with respiratory symptoms at a medical helpline is safe and feasible-a prospective quality improvement study.

BACKGROUND: Young children are among the most frequent patients at medical call centers, even though they are rarely severely ill. Respiratory tract symptoms are among the most prevalent reasons for contact in pediatric calls. Triage of children without visual cues and through second-hand information is perceived as difficult, with risks of over- and under-triage. OBJECTIVE: To study the safety and feasibility of introducing video triage of young children with respiratory symptoms at the medical helpline 1813 (MH1813) in Copenhagen, Denmark, as well as impact on patient outcome. METHODS: Prospective quality improvement study including 617 patients enrolled to video or standard telephone triage (1:1) from February 2019-March 2020. Data originated from MH1813 patient records, survey responses, and hospital charts. Primary outcome was difference in patients staying at home eight hours after the call. Secondary outcomes weas hospital outcome, feasibility and acceptability. Adverse events (intensive care unit admittance, lasting injuries, death) were registered. Logistic regression was used to test the effect on outcomes. The COVID-19 pandemic shut the study down prematurely. RESULTS: In total, 54% of the included patients were video-triaged., and 63% of video triaged patients and 58% of telephone triaged patients were triaged to stay at home, (p = 0.19). Within eight and 24 hours, there was a tendency of fewer video-triaged patients being assessed at hospitals: 39% versus 46% (p = 0.07) and 41% versus 49% (p = 0.07), respectively. At 24 hours after the call, 2.8% of the patients were hospitalized for at least 12 hours. Video triage was highly feasible and acceptable (>90%) and no adverse events were registered. CONCLUSION: Video triage of young children with respiratory symptoms at a medical call center was safe and feasible. Only about 3% of all children needed hospitalization for at least 12 hours. Video triage may optimize hospital referrals and increase health care accessibility.

Changes in mental well-being during the COVID-19 pandemic: A longitudinal study among Danes from 2019 to 2021.

Numerous studies have shown that the COVID-19 pandemic had large influence on mental health during the first lockdown, but fewer studies have focused on the long-term influence on mental health. In a national longitudinal study, we examined mental well-being measured just before (fall 2019) and twice during (falls of 2020 and 2021) the COVID-19 pandemic. We utilized the Danish Health and Wellbeing Survey with questionnaires collected in 2019, 2020 and 2021 among the same study population consisting of 8179 persons. The outcome was mental well-being measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear regression models were conducted to evaluate change in SWEMWBS from 2019 to 2021. The SWEMWBS distribution was similar in 2019, 2020 and 2021, although the distribution moved to lower scores in 2020 compared to 2019 and moved slightly to higher scores in 2021 compared to 2020. Mean SWEMWBS decreased from 24.8 (95%CI 24.7-25.0) in 2019 to 24.1 (24.0-24.2) in 2020 and increased to 24.4 (24.3-24.6) in 2021 (p < 0.001). The mean decrease from 2019 to 2020 and increase from 2020 to 2021 was strongest among women, persons below age 75 years, persons without depression and among persons with higher education and with employment. In conclusion, we find that mental well-being decreased from 2019 to 2020 and slightly increased from 2020 to 2021 without reaching the pre-pandemic level. These changes are statistically significant but small and support that COVID-19 may only have had a small long-term influence on mental health in the general population.

Short- and Long-Term Self-Reported Symptoms in Adolescents Aged 12-19 Years after Vaccination against SARS-CoV-2 Compared to Adolescents Not Vaccinated-A Danish Retrospective Cohort Study.

This study investigated self-reported short- and long-term symptoms among adolescents receiving the BNT162b2 (Pfizer/BioNTech) vaccine against SARS-CoV-2 and those who did not. A retrospective cohort study based on Danish national survey (collected between 20 July and 15 September 2021) and register data was conducted. Differences in short-term (<14 days) and long-term (>two months) symptoms were explored using logistic regression adjusted for confounders. A total of 747 vaccinated (first dose n = 326; second dose n = 421) and 6300 unvaccinated adolescents were included in analyses of short-term symptoms and 32 vaccinated and 704 unvaccinated adolescents in long-term symptom analyses. In the first 14 days after the first and second vaccine dose the most reported symptoms included headache and muscle or joint symptoms. In both vaccinated and unvaccinated adolescents, the 15-19-year-olds reported significantly higher proportions of all symptoms compared to the 12-14-year-olds. After the second vaccine dose vaccinated 12-14-year-olds reported significantly more headache in adjusted analyses (OR 2.20 (95% CI 1.24; 3.90)). Among the 15-19-year-olds, significantly more vaccinated adolescents reported gastrointestinal symptoms (1.38 (1.06; 1.81)), headache (1.66 (1.24; 2.22)), and tiredness (1.44 (1.08; 1.93)). No differences were found in long-term symptoms. Vaccinated adolescents reported significantly more short-term symptoms including headache, tiredness, and gastrointestinal symptoms after the second vaccine dose than unvaccinated adolescents. Long-term symptom results should be interpreted with caution due to limited sample size.

Mental wellbeing among Danish employees during the COVID-19 pandemic: results from a longitudinal study on the role of industry and working environment.

BACKGROUND: The COVID-19 pandemic has had a profound impact on working life. Previous studies have primarily focused on the mental health and wellbeing of healthcare workers and are mostly based on cross-sectional data from non-representative samples. The aim of this study was to investigate mental wellbeing trajectories among employees from different industries, and to longitudinally identify factors that affect mental wellbeing during the COVID-19 pandemic, including job insecurity, fear of COVID-19, working from home or being discharged with wage compensation and management quality. METHODS: Baseline data were obtained from the Danish Health and Wellbeing Survey in 2019 (September-December), with follow-up in September-November 2020. We included 1995 respondents, who completed the questionnaire in both waves and were employed in 2020 and measured mental wellbeing using the Short Warwick-Edinburgh Mental Well-Being Scale. RESULTS: Mental wellbeing declined among employees in all industries. Employees working from home and employees unsatisfied with management experienced a greater decline in mental wellbeing. We found no differences in mental wellbeing trajectories in relation to fear of infecting others or contracting COVID-19, job insecurity and being discharged with wage compensation. CONCLUSIONS: Mental wellbeing declined among employees in all industries with no difference between industries. Employees working from home may have been particularly vulnerable, and the analyses show that managers play a key role in mitigating the negative consequences of the pandemic by ensuring adequate information and involvement of employees.

Decreasing mental well-being during the COVID-19 pandemic: A longitudinal study among Danes before and during the pandemic.

The COVID-19 pandemic has had a huge impact on people's lives and may influence mental health in the general population. In a unique representative Danish longitudinal study, we examined mental well-being measured just before and during the COVID-19 pandemic. The Danish Health and Wellbeing Survey is the Danish contribution to the European Health Interview Survey. In this study, we included the wave from autumn 2019, which we re-invited in the autumn 2020. The study population consisted of 4,234 persons. The main outcome was mental well-being measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear and logistic regression models were conducted to evaluate change in SWEMWBS between 2019 and 2020. The SWEMWBS distribution was similar in 2019 and 2020, although the distribution moved to lower scores in 2020 compared to 2019. Mean SWEMWBS decreased significantly from 25.5 in 2019 to 24.6 in 2020 corresponding to a mean change of -1.0 (95%CI, -1.1. to -0.8). The proportion with low SWEMWBS increased from 16.5% in 2019 to 20.1% in 2020 (p < 0.001). The mean change was similar for men and women and for different age groups. The most negative development was observed among persons without depression or long-standing illnesses at baseline and among persons with higher educational level. Among persons with depression SWEMWBS increased. As expected, mental well-being significantly decreased in the adult Danish population during the COVID-19 pandemic. However, somewhat more unexpectedly, the decrease was most pronounced among persons without depression or long-standing illnesses and among higher educated groups.

The Danish Health and Wellbeing Survey: Study design, response proportion and respondent characteristics.

AIMS: This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. METHODS: The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N=12,000) and 2019 (N=14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N=13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. RESULTS: The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. CONCLUSIONS: The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study.