ABSTRACT
Aim: Since the early phases of the COVID-19 pandemic, health systems tried to adapt to ensure the continuity of care of oncological patients. This study aimed to describe the impact of SARS-CoV- 2 on rectal cancer screening and staging. Method(s): A two-year (March 2019 to March 2021) retrospective study concerning rectal cancer patients from a referral center was conducted. Patients clinical data from pre-COVID (March 2019 -February 2020) and COVID time (March 2020 -March 2021) was compared. Descriptive and inferential analysis was performed (Chi-Square test). Result(s): One hundred and sixty-five patients were discussed at the multidisciplinary meetings during the 2-year study period (mean age 69 years [+/- 11.1];M: 64%;F:36%). Upon comparative analysis both pre-COVID and COVID patients were found to have similar demographic characteristics, however during the pandemic a higher proportion of patients presented with low rectal cancers (36% vs. 42%;P = 0.1). Moreover, during the COVID period, fewer patients (minus 26%;npre-covid= 95 vs. ncovid = 70) were referred to the hospital, and a larger number of patients presented in Stage IV of the disease (17,9% (n = 17) in pre COVID period vs. 28,6% (n = 20) in COVID period (P = 0.07)). Lastly, the authors run a comparative sub-analysis between the above results and data from the 3 years prior to the pandemic (2017-2019) and still came across with lesser rectal cancer referrals during the pandemic year. Conclusion(s): Our data clearly shows that, during the COVID period, fewer patients received in-hospital care and a higher number were referred in Stage IV. This represents a red flag for the community and should alert the government to implement public health policies to reestablish colorectal cancer standard of care.
ABSTRACT
Background The rollout of the COVID-19 vaccination program in Portugal was one of the most successful in the world. However, there was still a challenge for Public Health services to determine the health literacy needs of the population in the context of a new vaccine and the uncertainty of the pandemic. The goal of this study was to evaluate the usefulness of Google Trends data to gauge the health literacy needs of the general population during the pandemic. Methods A Google Trends search was performed for Portugal including 5 topics related to health literacy needs of the population (“vaccination”, “scheduling”, “isolation”, “booster dose” and “vaccination certificate” ) between the 28th of december 2019 and the 10th of march 2022. The variation shows the relative popularity of each term referring to the total number of Google searches during that period in a normalized scale of 0-100. The variation was compared to the number of doses administered daily in Portugal and key moments of the vaccination campaign as defined by the Directorate-General for Health in Portugal. Results The terms “vaccination” and “isolation” had a steady rise in popularity from December 2019 to January 2021. The term “vaccination” was the most popular search term with peak popularity in July 2021 and a downward trend followed by an ascent to a lower peak in popularity in January 2022. The terms “scheduling” and “vaccination certificate” both followed a similar pattern, though at lower popularity levels. The term “isolation” was low on popularity since February 2021, with a significant rise and peak in January 2022. This variation relates to key dates during the Portuguese vaccination campaign. Conclusions Google Trends data seems to correlate with key events during the Portuguese COVID-19 vaccination campaign. That data might be incorporated in the planning framework of health literacy activities for national and local Public Health services. Key messages • Google Trends might be an important source of information for public health teams. • There is a need for further research into how Google Trends data can be incorporated with other sources of information to inform health literacy activities.
ABSTRACT
Background In the context of infectious disease control (IDC), public health services (PHS) have been under great pressure during the COVID-19 pandemic, especially with the burden of contact tracing. Most European Union countries have developed contact tracing apps for smartphones (CTA) with the goal of aiding PHS in IDC. CTAs generally use proximity data from mobile devices to determine a user's risk of exposure to SARS-CoV-2, thus providing testing and isolation recommendations. This review aimed to study the acceptance and adoption of CTAs in Europe. Methods 5 European countries were selected: Germany, Spain, France, Ireland, Italy. A literature review was carried out and official sources of information from each country were consulted in order to compare the adoption of each national CTA. Criterias included number of downloads, rating in the app stores, costo of development, proportion of positive tests registered. Potential factors influencing population adherence to CTAs were also investigated. Results In proportion to their population, the number of downloads varied significantly in each country (18 % in Spain, 67% in France, 75% in Ireland). Except for Spain, all countries integrated additional functions into the CTA to increase its uptake, such as access to the vaccination certificate. App stores ratings ranged from 3.0 (Spain) to 3.9 (France and Ireland). The proportion of tests added in the apps varied significantly (1% in Italy and Spain, 4% in Ireland, 10% in France and 17% in Germany). Concerns that lead to the non-use of CTAs were related to data protection, smartphone battery drainage and app bugs. Conclusions CTAs as a way to identify contacts from a positive case had a low impact in the analyzed countries, with low population adherence being an important factor. Adding more features within the apps, minimizing bugs, and increasing public confidence in data privacy seem essential to increase uptake in the future. Key messages Although conceptually attractive, CTAs have not proven to be effective in the context of the COVID-19 pandemic. There is a need for research and evaluation of the use of CTA, including cost effectiveness metrics, to inform future implementation similar technologies.
ABSTRACT
Background Mental disorders are a major contributor to the global burden of disease. During the first year of the pandemic by COVID-19, increases of 25% in the prevalence of anxiety and depression were reported globally. In Portugal, studies conducted during lockdown showed an increase in the prevalence of these disorders. However, previous studies have shown that negative life events, such as exposure to disasters or grief, later lead to resilience or recovery. It is therefore necessary to study the evolution of these disorders in order to adapt mental health measures. Methods The number of patients registered with “P76 - Depressive Disorder” and “P74 - Anxiety Disorder/anxiety state”, according to ICPC-2 criteria, and the total number of patients registered in the Portuguese Health Centers for the months of January 2019 to 2022 were obtained from the Portuguese NHS Information and Monitoring System (SIM@SNS). We calculated the percentage of patients with each of the disorders, individually and combined. Data by health regions were also obtained in order to compare the evolution within each region (North, Center, Lisbon and Tagus Valley, Alentejo and Algarve). Results Between January 2019 and 2022, the proportion of patients with anxiety disorder increased linearly from 8% to 9%. Similarly, the proportion of patients with depressive disorder increased from 11% to 12%. When considered together, anxiety and depression disorders affected 21% of users in mainland Portugal at the beginning of 2022. The Alentejo and Center regions have the highest prevalence of anxiety and depression (24.9% and 24%, respectively) and the Algarve region has the lowest (16.74%). The increases were consistent across health regions, with the largest increase in the North region (2.6%) and the smallest in the Central region (1.7%). Conclusions Anxiety and depression disorders increased in mainland Portugal during the years of the COVID-19 pandemic. Key messages • Mental health has been an important factor in public health since before the pandemic. • Monitoring depression and anxiety levels in the general public can guide priorities after the pandemic.