Determinants of worse care for non-COVID-19 health or disability needs in Australia in the first month of COVID-19 restrictions: A national survey.

We examined the effect of person-related factors on capacity to obtain needed healthcare for non-COVID-19 health conditions/disabilities under COVID-19 restrictions. This was an anonymous online survey of Australian residents ≥18 years (3rd April to 2nd May 2020). We determined the ability to obtain care needed for non-COVID-19 health conditions/disabilities, experience of COVID-19, COVID-19 restrictions and sociodemographic characteristics using study-specific questions; and clinically significant depressive and anxiety symptoms using Patient Health Questionnaire 9 and Generalised Anxiety Disorder Scale 7 respectively. We calculated the population attributable fraction (PAF) to determine the proportion of worse access to non-COVID-19 health/disability care attributable to independent risk factors. 13,829 (91.5%) participants had complete data. 6,712 (46.4%) identified a need for healthcare/disability services (<45 years 42.1%, ≥45 years 50.3%). 31.6% aged <45 years and 24.3% aged ≥45 years reported worse access to health/disability care than experienced prior to the pandemic. In those aged <45 years the PAF was highest for depressive symptoms (21.4%; 95% CI 12.6%-29.3%) and anxiety (PAF 19.9%, 12.3%-26.9%). with a PAF of 49.6% (40.1%-57.6%) if any one of the following was being experienced: doing unpaid work; being a student; depressive symptoms; symptoms of anxiety; experiencing high adverse impact of COVID-19 restrictions. In those ≥45 years, PAF was highest for having depressive symptoms (PAF 20.9%, 16.6-24.8) with a PAF of 44.1% (36.0%-51.2%) if any one of the following was being experienced: depressive symptoms; symptoms of anxiety; doing unpaid work; living alone; being in lowest socioeconomic quintile; main source of income from government benefits; any personal experience of COVID-19. The identified risk factors, which include many that characterise those with worse health outcomes generally, explained 44%-50% of worse access to necessary health/disability care. These data have the potential to inform targeted strategies aimed at reducing a post-pandemic escalation of poor health outcomes, especially in vulnerable populations.

Alcohol use and mental health status during the first months of COVID-19 pandemic in Australia.

BACKGROUND: We aimed to estimate the population prevalence of people with changes in their usual patterns of alcohol use during the early stages of the novel coronavirus pandemic of 2020 (COVID-19) pandemic in Australia; assess the association between mental health status and changes in alcohol use during the pandemic; and examine if the associations were modified by gender and age. METHODS: This study was an anonymously-completed online self-report survey. Changes in alcohol use were assessed using a single fixed-choice study-specific question. Mental health was assessed using the Patient Health Questionnaire 9 and the Generalized Anxiety Disorder Scale. RESULTS: A total of 13,829 people contributed complete data and were included in the analysis. Overall, about one in five adults reported that they had been drinking more alcohol since the COVID-19 pandemic began than they used to. People were more likely to be drinking alcohol more than they used to if they had more severe symptoms of depression or anxiety. The associations between depressive and anxiety symptoms and increased alcohol use since the COVID-19 pandemic began were consistent between females and males. LIMITATIONS: Online surveys are less accessible to some groups of people. The data are self-report and not diagnostic. Cross-sectional data can identify associations, not causal relationships. The study was limited to participants from Australia. CONCLUSIONS: These data indicate that there is a need for public policies focused on alcohol use during the COVID-19 pandemic and the strategies should include specific consideration of the needs of people with mental health problems.