Evolution of the concerns, perceptions and attitudes of the Spanish population during the COVID-19 pandemic

Both individual and population behavior are determining factors in controlling the spread of the COVID-19 pandemic. However, the restrictions have impacted the mental and physical well-being of citizens, the social cohesion, the economic stability, as well as the community resilience. In this complex scenario, understanding the feelings and attitudes of the population helps us to identify their needs and adopt response measures to control the pandemic in a more consensual and effective way. The COSMO-Spain study explores the concerns, perceptions, and attitudes of the population about the pandemic to find out the acceptance and adherence to behavioral prevention measures, as well as to analyze the citizens' risk perception, well-being and trust in information sources and institutions. The COSMO-Spain study has been carried out every two months since July 2020, through an online questionnaire to representative cross-sectional samples of the Spanish population, composed by 1000 people each. The results up to December 2021 show that the attitudes of the population are dynamic and evolve over time, influenced not only by individual factors, but also by contextual ones. Due to the changing nature of this pandemic, education and awareness campaigns need to be dynamic and continually updated based on real data.

Monitoring COVID-19 related changes in population mental health : Carmen Rodríguez-Blázquez

Background The COVID-19 pandemic, and its consequences in terms of control measures and restrictions to normal life, has affected the population mental health. One of the four case studies from the Population Health Information Research Infrastructure (PHIRI) for COVID-19 is focused on mental health with the objective to measure changes in incidence of mental health problems associated with the COVID-19 pandemic in several European countries. Methods Using electronic health records (EHR), data on new episodes of depression or anxiety, prescription of antidepressants and anxiolytics, and visits to primary care, specialized care or emergency units with an episode of depression/anxiety, were collected by participant data hubs at national/regional level for the period 2017-2021. A common data model to collect the data was defined for all participating data hubs and analysis of status prior and during the COVID-19 pandemic was performed using R. Results Data hubs from Austria, Finland, Spain (Aragon), and United Kingdom (Wales) were able to provide aggregated results from raw individual-level data. Preliminary analysis of trends suggests a decrease in new cases of depression and anxiety in the pandemic period (2020-2021) in comparison with previous years. Different trends were observed between data hubs regarding prescription of drugs and the number of primary/specialized care visits due to depression or anxiety. Issues in the access to data in some of the participating data hubs were observed, related to ethical and legal matters, and the lack of centralized registers and of private consultations statistics. Conclusions The results of this use case show that EHR for the secondary use can be retrieved in a common way across Europe to analyse and compare the impact of COVID-19 in population mental health in European countries. However, the process is more complicated and time consuming than expected.

Review of direct impact health indicators of COVID-19 in the scientific literature published between January 2020 and June 2021 : Cesar Garriga

Background The Joint Action Population Health Information Research Infrastructure (PHIRI) seeks to create infrastructures to generate quality data on the COVID-19 pandemic between European countries. The aim of this study is to present a synthesis of health indicators used to evaluate the direct impact of COVID-19 Methods Scoping review using a common search strategy in Pubmed, Embase and WHO Covid-19 databases. Health indicators of direct impact of COVID-19 were obtained from observational studies in the general population, hospitals and long-term care facilities from papers published worldwide in English between 01/01/2020 and 06/31/2021. Titles and s were screened first by 15 reviewers using the Rayyan tool. Any discrepancies were solved by agreement between reviewers. Then, articles containing indicators of direct impact were selected in a full-text reading phase. Of them, a random sample of 35 was drawn and their indicators were described. Results After eliminating 262 duplicates 3891 records were reviewed. Screening discarded 3171 s. Of 720 articles sought for retrieval, 445 met inclusion criteria for indicators extraction. In a sample of 35 papers (8.1%), 116 direct impact indicators of COVID-19 were identified. 28 morbidity indicators were found, classified as indicators of prevalence (n = 15), incidence (6), transmissibility (4) and underreported infection (4);32 of mortality (mortality rate, 9;case fatality rate, 17;time to death, 2);and 54 for severity (complications, 27;mechanical ventilation, 12;hospitalization, 8;requiring ICU admission, 1;time from hospitalization to ICU admission, 1). Two composite indicators of severity and mortality were also identified. Conclusions According to the scientific literature, a wide variety of health indicators has been used to measure the direct impact of COVID-19. The systematization of indicators used in the current COVID-19 pandemic could help for future health crises management.

Changes in perceived health status in older men and women during the COVID-19 pandemic : Carmen Rodríguez-Blázquez

Background The COVID-19 pandemic has severely impacted older people. The disease and the measures to combat it have had a differential impact according to gender, with higher mortality rates in men and worse psychological and social consequences in women. The objective of this work is to analyze the changes in perceived health of older people in Europe during the first months of the pandemic and to assess the combined role of age and gender. Methods Wave 8 data of SHARE-corona (Survey of Health, Aging and Retirement in Europe) (n = 51,695, aged≥50) collected between Jun-Aug 2020 were used. Perceived health status was explored with a question on whether there has been a change compared with the health status before the COVID-19 outbreak (response options: worse, the same and better). Two-way ANOVA with interaction and Student's t-test with Bonferroni correction were used to compare the effects of gender and age group (50-59 years, 60-69 years, 70-79 years, and ≥80) in changes in perceived health. Results Differences in perceived health were observed by age, as well as by gender in participants aged ≥70 years (F = 91.94;p < 0.001). These differences were significant both by gender (F = 19.39;p < 0.001) and age (F = 191.79;p < 0.001). No interaction was detected between both factors (p = 0.170), which allowed their effect to be studied individually. Among the people who reported a worsening in their perceived health, women aged 70 to 79 years predominated (11.1%), followed by men aged 80 and over (15.3%) and women of the same age group (16.4%). Conclusions The results suggest an association between the change in perceived health during the pandemic and age. Women have a slightly worse health status than men in all age groups. Therefore, gender can be considered as an influential factor in perceived health in old age, which in turn can have a potential impact in the quality of life of older people. Funding Projects Ref. H2019/HUM-5698 and Ref. 202010E158. Key messages Older people have been severely impacted by COVID-19 pandemic. The combined effect of age and gender on the change in perceived health status during the pandemic have been analyzed.

Older Women Images and Technologies to Increase Gender Peace in Crisis and COVID-19 Times

The violence - without the apparent “Gender Peace”, if data and households are examined - occurs against adult and older women, is beginning to become apparent, but there is only information from recent years. The objective is demonstrate that social isolation can be a key factor in gender peace in the case of adult and older women, even more so in the case of disability or dependency situation. This work focuses on what we call older women gender peace based on qualitative techniques. Moreover, women in this vital stage continue to be vulnerable, defenseless, have more fear and risk, despite their plausible gender peace – expression that we contribute - which connects with the current post-health crisis scenario, armed violence and wars. This chapter also contributes to the consideration of technologies addressed to adults and older women to increase gender peace. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey.

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

Research use cases measuring the impact of COVID-19 on population health

Background Wide variations in COVID-19 infection and outcomes exist across Europe and within countries. PHIRI will look at COVID-19 impacts in specific subgroups by conducting research through use cases of immediate relevance for public health policies focusing on indirect effects of the pandemic related to healthcare and other policies to contain the pandemic. Furthermore, the use cases represent pilot activities for the benefits and added value of a research infrastructure by bringing together data from different European countries. Methods Four research use cases will focus on selected aspects of vulnerable population groups and risk factors, delayed medical care in cancer, perinatal health outcomes, as well as mental health outcomes and are selected based on public health importance, geographic coverage, feasibility of producing actionable insights and relevance for the PHIRI infrastructure. The use cases will demonstrate how a broad variety of secondary data (e.g. administrative and survey data) can be pooled and/or reused in a distributed way across Europe. Results The outputs of the use cases will be processed by formalizing data models, data management processes and analytical pipelines in an interoperable way to feed in the federated research infrastructure. The use cases facilitate research by making scalable, reproducible methods available within PHIRI and by publishing the FAIRified use cases analysis results on the Health Information Portal. They will provide outcomes to guide policy makers in preparedness and response scenarios and will ensure the development of a format for the timely dissemination of use case results to the targeted groups. Conclusions PHIRI will provide insights in real life use cases to generate immediate results on key health impacts of COVID-19 on population health to underpin decision making and will drive the development of the federated research infrastructure that allows rapid cycle analysis.

Technology, Gender and COVID-19. Analysis of Perceived Health in Adults and Older People

This chapter aims to know the psychosocial impact and social behaviours and related to the perception of technological needs in adults and older persons with diseases, health problems and/or sensory or motor disabilities. This work delves into this reality from a gender, inclusive and, at the same time, technological, biotechnological and/or virtual device approach. This goal includes two secondary objectives: 1) To know the health conditions that affect the adult and older people, whether they suffer from chronic diseases and health problems. In this way, it will be possible to understand if there are specific conditions in which the adult and older persons have felt especially sensitive during the pandemic outbreak in Spain. 2) To understand the needs of older people with sensory or motor disabilities before the pandemic and how this connects with the looking forward to an activity after COVID-19. One conclusion is that new emerging technologies are essential in aspects such as safety, hygiene and other social factors that help to improve autonomy and independence - such as canes and support devices in functional disability type EGARA - of older persons during and after the pandemic times. In addition to the needs of adults and the older persons prior to the pandemic, especially in older women, there are others that require research from a more inclusive and gender perspective. © 2021, Springer Nature Switzerland AG.