ABSTRACT
Rationale: Telemedicine is a simple way to virtually see a doctor and determine what care a patient may need. The telemedicine platform was introduced to Greater Austin Allergy, Asthma & Immunology (GAAAI) in March 2020 to offer medical services to patients at home, especially for those with concerns due to the COVID-19 pandemic. Common allergy/asthma symptoms include runny nose, nasal congestion, and cough, which tend to overlap with COVID-19 symptoms. We hypothesized an increase in use of ICD-10 codes representing respiratory illness for telemedicine compared with in-clinic visits in an Allergy/Immunology subspecialty network during the COVID-19 epic. This study explores the use of telemedicine during the COVID-19 pandemic from 03/01/2020 through 12/31/2021 in patients seen in an Allergy/Immunology subspecialty network. Methods: GAAAI collected 35,299 patient encounters across 6 clinics from January 1, 2019 through December 31, 2021 and separated patients into the following groups: (1) All visits from 01/01/2019 through 02/28/2020, (2) In-clinic visits from 03/01/2020 through 12/31/2021, and (3) Telemedicine visits from 03/01/2020 through 12/31/2021. The data was imported into RStudio and ICD-10 code frequencies were generated for each group. Results: There was a 49% decrease in ICD-10 code use for respiratory illness for telehealth versus a 38% decrease for in-clinic visits compared with all patients seen prior to March 1, 2020. Acute infections had an 18% increase in telehealth visits and a 53% decrease for in-clinic visits. Immune deficiencies had a 220% increase for telehealth versus a 4% increase for in-clinic visits. Environmental allergy symptoms showed a 38% increase for telehealth and a 19% increase for in-clinic visits. Lastly, food allergies exhibited a 67% increase for both telehealth and in-clinic visits. Conclusions: Our original exploration was centered around patients experiencing respiratory symptoms and utilizing telemedicine to prevent spreading COVID- 19. The results display the opposite, and convey that patients were less likely to utilize a telemedicine visit when experiencing respiratory symptoms. Patients may be prioritizing their primary care physician when concerned about a potential COVID-19 diagnosis over their Allergy/Asthma specialist. It is apparent that there is still an influx of patients for nasal and food allergies for telemedicine and in-clinic visits after 02/2020. Finally, immunocompromised patients preferred to use the telemedicine platform over an in-office visit which may underline their fear of contracting COVID-19.
ABSTRACT
Introduction Dans le but de réduire le nombre de personnes infectées par la COVID-19, plusieurs pays ont mis en œuvre des applications mobiles pour retracer les contacts étroits de la personne infectée par le SARS-CoV-2. Cependant, cette approche nécessite une large adhésion de la population pour être efficace. Cependant, depuis mars, de telles applications n’ont été installées que par 9,3 % des personnes dans le monde. Nos objectifs étaient d’estimer, en France, l’acceptabilité d’une application utilisant les téléphones mobiles pour retracer les contacts étroits entre les personnes lors d’épidémies, et les barrières potentielles à son utilisation. Méthodes Nos données ont été collectées parallèlement à l’enquête « Health Literacy Survey 2019 » réalisée en ligne auprès de 1003 français deux semaines après la fin du premier confinement en France (du 27 mai au 5 juin 2020). Les données utilisées étaient les caractéristiques sociodémographiques, la littératie en santé, la confiance dans les institutions et les connaissances sur la COVID-19 et les comportements préventifs. L’acceptabilité d’une application mobile de traçage a été mesurée par le biais d’une question ad hoc, dont les réponses ont été regroupées en trois modalités : App-partisan, App-favorable et App-réticent. Résultats Seulement 19,2 % étaient des partisans de l’application tandis que la moitié des participants (50,3 %) étaient réticents. Les facteurs associés à la non-réticence (App-adepte, App-favorable) étaient : l‘absence de difficultés financières et l’utilité perçue d’applications mobiles pour envoyer des questionnaires de santé aux médecins. L’âge de plus de 60 ans, la confiance dans les représentants politiques, les préoccupations envers la situation pandémique et des connaissances adéquates sur la transmission du SARS-CoV-2 augmentaient la probabilité d’adhérer complétement à l’application de traçage. Conclusion Les personnes les plus démunies, connues pour être plus à risque d’être atteintes par la COVID-19, sont également les plus réticentes à utiliser une application de traçage des contacts. Par conséquent, une adhésion optimale nécessite de mieux comprendre ces réticences et de larges campagnes de sensibilisation, proposant un discours rationalisé sur les avantages de santé publique d’adopter une telle application.
ABSTRACT
OBJECTIVES: Both the political appetite for a science-based coronavirus disease 2019 (COVID-19) policy and its acceptability to the public are little understood, at a time of sharp distrust not only of governments but also of scientists and their journals' review practices. We studied the case of France, where the independent Scientific Council on COVID-19 was appointed by President Macron on March 12, 2020. STUDY DESIGN: We conducted a survey on a representative sample of the French adult population. METHODS: Our data were collected by the French Institute of Public Opinion using a self-administered online questionnaire. This was completed by a sample of 1016 people stratified to match French official census statistics for gender, age, occupation, and so on. We conducted statistical analysis using Python (Pandas-SciPy-Statsmodels) with Chi-squared and Wilcoxon rank-sum tests to control for statistical significance. RESULTS: Intense media coverage has given the council a very high public profile, with three respondents out of four (73%) having heard about it. Perceptions are positive but complex. French citizens expect science to be important in political decision-making. Four of five (81.5%) want political decisions, in general, to be based on scientific knowledge. But one in two (55%) says that the government has not relied enough on science and only 36% are satisfied with the government's crisis management to date. Although most feel that the council has a legitimate advisory role even in situations of uncertainty (only 15% disagree), it is not perceived as fully independent. Only 44% think that it directly represents the scientific community, and only one of three people considers it completely independent from the government (39%) and the pharmaceutical industry (36%). CONCLUSIONS: Our study confirms that while the transparency of scientific advice is important, it alone cannot ensure public confidence in political decision-making. We suggest that efforts made today to instill a 'science-savvy' public culture-one that allows the complex articulation between scientific knowledge, uncertainty, and political decision-making to be understood and accounted for would greatly benefit evidence-based policy in future crises.