The 2010 HIV Outbreak Among People Who Inject Drugs in Athens, Greece Could Have Been Prevented If the 2009 Undetected HCV Outbreak Had Been Detected. What Would Have Been the Savings If There Was an Outbreak Detection System?

Objectives: Wars, pandemics, and disasters that cause societal instability are referred to as "Big Events" and have been associated with outbreaks of infectious diseases. At the initiation of the 2008 severe economic recession in Greece (the last Big-Event before the pandemic), a hepatitis C virus (HCV) outbreak emerged among people who inject drugs (PWID) in 2009, which was the root of the 2010 Human Immunodeficiency Virus (HIV) outbreak. The HCV-outbreak was not detected, while that of HIV was identified in mid-2011. Given that HCV and HIV share common transmission routes, the HIV-interventions directly reduced the HIV-incidence by 78% and indirectly HCV-incidence by 64.8%. This study aims to assess what would have been the course of the two outbreaks, and their economic consequences if the 2009 HCV-outbreak had been timely detected. Method(s): A published, stochastic, dynamic model was used to simulate HCV and HIV transmission among PWID (Gountas et al. IJDP 2020, Gountas et al. PLOS 2021). The model was calibrated to reproduce the observed epidemiological parameters among PWID of Athens, Greece. The time-horizon of the analysis was 2002-2019 to capture second-order transmission effects. Result(s): Under the status-quo scenario, the cumulative HCV and HIV cases were 6480 (95% CrI: 6000, 6900) and 1360 (95% CrI: 400, 2600), respectively. If the HCV outbreak had been detected and integrated interventions had been initiated in 2009 or 2010, 440 and 970 new HCV cases and 740 and 1110 new HIV cases could have been averted by 2019, respectively. Concerning the costs of treating the new cases for both diseases, the existence of an efficient notification system would have saved 40.9-65.8 million by 2019. Conclusion(s): An accurate automated outbreak detection system among PWID is a cost-saving investment. During the COVID-19 pandemic, which is the current Big Event, HIV/HCV surveillance should be more intense to timely detect new outbreaks. Copyright © 2022

The knowledge, perceptions and mental health impact of the COVID-19 pandemic in the Greek general population

OBJECTIVE To explore the knowledge and perceptions of COVID-19 in the general population in Greece, to gauge the prevalence of stress, anxiety and depression, and to examine the association between perceptions and socio-demographic variables and mental health status. METHOD Telephone interviews were conducted with a random, representative sample of 1,041 participants across Greece in the period 10th–14th April 2020. Knowledge and perceptions were assessed with a specially constructed questionnaire, mental health status was measured using the Depression, Anxiety Stress Scale-21 (DASS-21), and sociodemographic and physical characteristics were recorded. RESULTS According to the responses, COVID-19 has evoked diverse opinions in the general public, especially with respect to its similarity to common influenza, its mode of transmission (airborne), the belief that it is manufactured, and whether it is out of control. The responses to DASS-21 showed the prevalence of moderate/severe/extreme cases to be 22.3% for depression, 15.9% for anxiety, and 13.1% for stress. Those who acknowledged the dangerous nature of COVID-19 for certain groups exhibited higher stress and depression scores. Respondents who believed that the coronavirus is manufactured and those neutral towards its transmission by air, had higher anxiety, stress and depression scores, while those who agreed that the virus is out of control had lower stress scores. Women, young people, residents of urban areas, those residing in households with a member vulnerable to the virus, individuals with high educational attainment and respondents of lower socio-economic status, all manifested higher risk of mental health problems, as did people who endorsed the view that the virus was manufactured and served specific purposes. CONCLUSIONS Health education intervention, tele-psychiatry and mental health promotion strategies are urgently needed for mitigating the psychological burden of the COVID-19 pandemic. © Athens Medical Society.

“Young people are not invincible”: What drives young people’s health behaviours during the COVID-19 pandemic in greece?

IntroductionThe illusion of invulnerability has been linked to lower perceived risk and increased engagement in risky behaviors among youth. Therefore, it has been purported to influence young people’s poor adherence to public health measures aiming to contain the COVID-19 pandemic. Concomitantly, beliefs about the virus and mental health may also shape public health behaviours.ObjectivesTo investigate the role of beliefs, perceived invincibility and mental health status in explaining frequency of hand-washing and hours outside the house among youth in GreeceMethodsA total of 1.899 students, aged between 18-29 years old, were recruited from the main universities of the country. An online questionnaire entailing: (i) popular beliefs about COVID-19, (ii) the DASS-21, (iii) the Adolescent Invincibility Tool and (iv) queries about health behaviours, was distributed during the lockdown period.ResultsMost participants reported washing their hands rarely/never within a day (78.6%) and spending 2-6 hours outside the house (68.1%). Handwashing was largely influenced by mental health [OR = 0.94, 95%CI= 0.91 – 0.98 for stress;OR = 0.96, 95%CI = 0.93-0.99 for anxiety and OR = 1.05, 95%CI= 1.02-1.08 for depression];while hours outside the house by perceptions that the virus is out of control [OR=0.76, 95%CI = 0.61-0.95], manufactured [OR=1.21, 95%CI = 1.53, 95%CI =1.21 – 1.93] and airborne [OR= 0.78, 95%CI = 0.64-0.95].ConclusionsAddressing stress and anxiety as well as health education interventions should be prioritized to foster young people’s adherence to public health measures amid the pandemic.DisclosureNo significant relationships.

Costs associated with COVID-19 in healthcare personnel in Greece: a cost-of-illness analysis.

BACKGROUND: Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the aetiological agent of coronavirus disease 2019 (COVID-19). AIM: To estimate the costs related to SARS-CoV-2 exposure and infection among HCP in Greece. METHODS: Data were retrieved from the national database of SARS-CoV-2 infections and from the database of HCP exposed to patients with COVID-19. A cost-of-illness analysis was performed to estimate total, direct and indirect costs. RESULTS: In total, 254 HCP with COVID-19 and 3332 HCP exposed to patients with COVID-19 during the first epidemic wave were studied. Of the 254 HCP with COVID-19, 49 (19.3%) were hospitalized (mean length of hospitalization 11.6 days) and four were admitted to intensive care units (mean duration 10.8 days). Overall, 1332 (40%) exposed HCP had a mean duration of absenteeism of 7.5 days, and 252 (99.2%) HCP with COVID-19 had a mean duration of absenteeism of 25.8 days. The total costs for the management of the two groups were estimated at €1,735,830 (€772,890 Euros for HCP with COVID-19 and €962,940 for exposed HCP). Absenteeism accounted for a large proportion of the total costs (80.4% of all expenditures), followed by costs for reverse transcriptase polymerase chain reaction and hospitalization (10.2% and 6.5% of all expenditures, respectively). CONCLUSION: COVID-19 is associated with increased rates and duration of absenteeism among HCP. Indirect costs, particularly absenteeism, are the major driver of total costs among exposed HCP and HCP with COVID-19. The estimated total costs are conservative. Studies are needed to explore the impact of COVID-19 vaccination of HCP on absenteeism and COVID-19-associated costs.