More Time, Carrot-and-Stick, or Piling Coffins? Estimating the Role of Factors Overcoming COVID-19 Vaccine Hesitancy in Poland and Lithuania in the Years 2021-2022.

In this study, motivation for late (from 2021-W22, i.e., 24 July 2021) uptake of the first dose of the COVID-19 vaccine among adults in Poland and Lithuania is indirectly measured in order to avoid social-desirability bias or rationalisation in retrospect of prior decisions. Weekly vaccine uptake is modeled as if vaccine hesitant people were late adopters of a new product, with a fitted non-linear trend representing steadily decreasing interest. Before the analysed period, the vaccine uptake among Polish and Lithuanian adults was almost identical. Vaccination simply explainable by the trend was responsible for the vaccination of an additional 19.96% and 19.06% adults, respectively. The fear incurred by spikes in consecutive waves of infection motivated 3.20% and 3.89% more people, respectively, while the COVID-19 passport, introduced only in Lithuania, convinced an additional 13.98% of the overall population. The effect of the COVID passport was the biggest in the 18-24 age group, and the least visible among people aged 80 or more. In the latter group, other factors also had a limited impact, with merely 1.32% tempted by the one-time €100 payment offered to everybody aged 75 or more.

Am I Paid Well Enough to Be Diagnosed with COVID-19? Determinants of Gender Differences in Infection Detection Rate among Polish Working Age Population.

In comparison to Western European countries, Poland had a relatively lower percentage of its population diagnosed with COVID-19. Moreover, even the detected cases were not showing any pattern consistent with the expected chance of infection and were at best only remotely related to the severity of the illness that is known to increase with age. Instead, the crucial factor in detecting illness was whether the individual was likely to receive adequate compensation for being confined to their home, with employed women being the most likely to be diagnosed. In every Polish sub-region (powiat), in the 25-54 age group, the share of men diagnosed with COVID-19 was lower than that of women, with the missing share ranging from 8% to 36%. Based on the regression model (adjusted R² = 43.9%), there were relevant non-economic factors such as education, vaccination rate and increasing median age that were reducing this gap. However, the key factors, such as the share of population entitled to sick leave derived from employment rate, or the share of the self-employed population who were unlikely to receive adequate compensation, were related to economic incentives. It would seem that gender differences, in reaction to economic stimuli, widened the discrepancies, as the same factors were affecting women as well. While the testing rates in Poland, the lowest of all the EU countries, clearly played a role in creating the environment in which testing was perceived by the general population as somewhat optional, Polish citizens themselves through their actions aggravated the problem further, creating the impression of people receiving inadequate or no compensation for their time of self-isolation. In spite of well-intentioned government efforts to extend compensation to at least some groups, a significant share of the population clearly behaved as if they feared self-isolation more than the actual virus. Therefore, for both compliance and fairness purposes, both the severity of restrictions and the availability of compensation should be reconsidered.

Better Late Than Never: Predictors of Delayed COVID-19 Vaccine Uptake in Poland.

In this study, regression models were created to explain the increase of COVID-19 vaccination rates in 378 Polish sub-regions. In order to trace the factors that could explain the willingness to delay vaccination, vaccination rates were compared for age groups of 20 years and more for 30 June 2020 and 31 January 2021. Initially high vaccination rates, rather than leading to the gradual exhaustion of the pool of those wishing to get vaccinated, were a very good predictor of the share of the remainder willing to do so, which increased the divergence between sub-regions in nominal vaccination rates. Support for Eurosceptic and anti-establishment parties was a strong predictor of persistent vaccine hesitancy. Ideological divergence from the mainstream appeared to reinforce vaccine hesitancy, and this relationship remained highly relevant even when controlling for possible time or spatial lag. Markers of social inclusion and social capital-voter turnout and employment rate-remained statistically significant even when controlling for time lag, thus implying clear relevance of trust in the public message. The share of the population with higher education remained a highly relevant factor as well, though in the 20-39 age bracket it predicted a higher vaccination rate, while in all older brackets it was a negative predictor-this implies that those people had already made up their minds. Delaying vaccination seems predominantly explainable by political views, as well as social exclusion and the historical specificity of sub-regions. On a regional level, there was actually a paradoxical Spearmans Rho correlation (0.641) between the share of population refusing mandatory vaccination for kids and the percentage of people receiving a COVID-19 vaccine, which further undermines the idea that overall observed vaccine hesitancy was in any meaningful way affected by anti-vaccine movements.

Teleconsultations Quality During the COVID-19 Pandemic in Poland in the Opinions of Generation Z Adults.

Introduction: The aim of the study was to collect and evaluate the opinions of representatives of Generation Z on their satisfaction with medical teleconsultation services during the COVID-19 pandemic in Poland. Methods: An online survey was conducted from April to June 2021. We received replies from 424 students. The research tools used comprised a validated Doctor-Patient Communication (DPC) questionnaire, the Telehealth Satisfaction Scale (TeSS), and a self-authored questionnaire. Results: About 60% of the respondents rated communication with a doctor during the remote visit as medium, with a DPC score value in the intermediate range (36-50). Only 7.5% of students rated DPC as high (DPC score over 50). Also, satisfaction with telemedicine measured by the modified Telehealth Satisfaction Scale was assessed as intermediate by 61.3% of respondents. DPC and satisfaction with telemedicine services are better assessed by students living in large cities and those who used paid telemedicine services. Conclusions: The need to improve the quality of DPC has been observed. Also, the functioning of telemedicine platforms, with the possibility of using images in teleconsultations would be welcome, with the concomitant leveling out of the disproportions in the quality of telemedicine services and DPC between urban and rural areas, as well as between commercial and noncommercial services. This could improve the service delivery process and, consequently, be beneficial for the competitiveness of telemedicine, which will be based on medical rather than organizational aspects.

Underestimation in Reporting Excess COVID-19 Death Data in Poland during the First Three Pandemic Waves.

The issue whether official Polish COVID-19 death statistics correctly reflect the actual number of deaths is a contentious issue in public discourse and an important policy-wise question in Poland although it has not been the subject of thorough research so far. There had been clearly elevated excess mortality-5100 (death rate of 2.3 per 10,000) during the first wave, 77,500 (21.0 per 10,000) during the second one, and 48,900 (13.5 per 10,000) in the third. This study finds that during the second and the third pandemic wave, our data on excess mortality will match very well the somewhat belatedly officially reported COVID-19 deaths if we assume that only 60% of cases were officially detected. Based on principal component analysis of death timing, except for the age bracket below 40, where COVID-19 deaths calculated on the basis of our model explain 55% of excess mortality, for the remaining age groups, combined COVID-19 deaths explain 95% of excess mortality. Based on the share of excess mortality attributable to COVID-19 during the second wave, this infection in Poland caused the death of 73,300 people and not of 37,600 as officially reported. The third wave caused 46,200 deaths instead of the reported 34,700. The first wave was, indeed, as officially reported, very mild, and the number of excess deaths was too low to be used to calculate COVID-19 deaths directly. However, assuming that the detection rate remained comparable to the average in subsequent waves, we can set the number of deaths at 3500 instead of the reported 2100.

Phenylketonuria Patients' and Their Caregivers' Perception of the Pandemic Lockdown: The Results of a National Online Survey.

The first pandemic lockdown dramatically impacted many aspects of everyday life, including healthcare systems. The purpose of this study was to identify problems of patients with phenylketonuria (PKU) and their parents/caregivers during that time. We aimed to analyse potential differences in the self-reported compliance and characteristics of contacts with a doctor/dietitian before and during the pandemic lockdown and the perception of access to special food and opinions on remote contacts between a particular group of respondents. All participants (n = 614) were asked to complete an online questionnaire that consisted of 31 questions on pandemic-related events and circumstances which may have directly or indirectly impacted health and treatment. The people who completed the survey were divided into three groups: parents of PKU children (n = 403), parents of PKU adults (n = 58) and PKU patients older than 16 years (n = 153). The differences among the three analysed groups were found in the number of contacts, the way of contacting a doctor/dietitian during the pandemic and satisfaction with remote contact. Caregivers of children with PKU reported better therapy compliance, more frequent contacts with specialists and more satisfaction with remote visits than adult patients. We also observed a relationship between satisfaction from remote contact and self-reported frequency of contacts with a doctor/dietitian, as well as a relationship between satisfaction from remote contact and recommended blood Phe levels reported by both patients and caregivers. Travel time exceeding three hours from the respondents' location to their doctor was associated with higher odds of their recognition of remote contact as a method of PKU treatment only in the group of caregivers. In the caregiver groups, the reported worse access to low-Phe products during the lockdown was linked to the perceived difficulty of maintaining the diet. However, such a relationship was not found among patients. In conclusion, significant differences in the perception of the pandemic lockdown and its impact on health and treatment-related issues were found.

COVID-19 Passport as a Factor Determining the Success of National Vaccination Campaigns: Does It Work? The Case of Lithuania vs. Poland.

As the ongoing COVID-19 pandemic poses a global threat, it is of utmost importance that governments should find effective means of combating vaccine hesitancy and encouraging their citizens to vaccinate. In our article, we compare the vaccination outcomes in the past months in two neighbouring post-communist EU states, Lithuania and Poland. Both introduced COVID-19 certificates, but only the former followed with gradual limitations for those who failed to get vaccinated, beginning with restricted access to restaurants, sports facilities and indoor events, and finally banning residents without a certificate from entering supermarkets or larger shops and using most services. By contrast, in Poland, the certificate remained a tool for international travel only. We show using statistical data that Lithuania's strict policy, regardless of its social implications, led to markedly higher vaccination outcomes in all age groups than those in Poland at the time.

Predictors of COVID-19 Vaccination Campaign Success: Lessons Learnt from the Pandemic So Far. A Case Study from Poland.

The high effectiveness of a vaccination-promotion campaign, which may be measured by the number of those successfully convinced to get vaccinated, is a key factor in combating the COVID-19 pandemic. This, however, appears to be linked to the precise identification of the underlying causes for vaccine hesitancy behaviours. Based on a regression model (adjusted R2 of 0.78) analysing 378 sub-regions of Poland, we showed that such behaviours, even when going against the party agenda, can be indirectly yet precisely gauged predominantly through voting patterns. Additionally, education and population density were found to be positively related to low vaccine hesitancy, while markers of social exclusion, both external (employment rate) and psychological (voter turnout) ones, affected it negatively. In the second, follow-up part of our study, which analyses the changes that took place in two months (adjusted R2 of 0.53), we found a further increase in vaccination rate to be positively related to the number of those already vaccinated and to the political views of the population, and negatively related to its level of education. In both cases, there was a surprisingly weak relationship between the potential markers of accessibility and vaccination rate. In spite of the known overall differences in vaccination rates for different age and sex groups, these variables did not have any additional informative value in explaining the observed regional differences.

The Impact of the First 2020 COVID-19 Lockdown on the Metabolic Control of Patients with Phenylketonuria.

The present study assessed patients' metabolic control of phenylketonuria (PKU) during the first 2020 COVID-19 lockdown in Poland. Blood (phenylalanine) Phe results of the tests of 535 patients, performed in 2019 and in the first months of 2020, were analysed. The six-week lockdown period was compared to the preceding six-week period as well as to the two corresponding periods of 2019 (three non-lockdown periods). More patients failed to perform Phe tests in the lockdown period (32.7%) than in non-lockdown periods (15.6%, 15.1%, 17.2%; p < 0.001 for all). The median Phe levels for those patients who performed testing in all the four periods did not differ between periods. However, these patients tended to perform only one test during the lockdown (ORs: 1.43 to 1.60; 95% CI: from 1.01-2.04 to 1.11-2.30, p-value 0.02 to 0.005). Patients who did not take blood during the lockdown (46.7%) performed significantly fewer blood tests in the remaining periods (median : 1 <0-1> vs. 2 <1-4>; p < 0.001). In conclusion, direct assessment of patients' compliance based upon Phe levels during the pandemic lockdown was not possible. Pre-pandemic non-compliant patients frequently failed to perform the test during the lockdown, whereas the previously compliant ones were more likely to perform only one test. This strongly suggests that metabolic control might have worsened.

The Impact of the COVID-19 Pandemic on the Perception of Health and Treatment-Related Issues among Patients with Phenylketonuria in Poland-The Results of a National Online Survey.

There is agreement that the pandemic has affected the healthcare system and behaviour of patients. This study aims to identify problems encountered by patients with phenylketonuria (PKU) and their parents/caregivers during the six-week pandemic lockdown in Poland (15 March to 30 April 2020). To determine the factors that influenced health and treatment-related issues, as well as the respondents' perception of the impact of the pandemic, study participants were asked to complete a non-validated online questionnaire comprising 31 questions (including 27 single-choice, two multiple-choice and two open-ended ones). A total of 571 patients or their parents completed the questionnaire, with 9.5% of respondents not performing any blood phenylalanine (Phe) test in the analysed period, 21.3% declaring a blood Phe increase, and 15.3% a decrease. Increased problems in contacting the doctor or dietitian were reported by 26.1% of subjects, whereas 39.3% of them felt restricted access to dietary products. Most (63.4%) participants were satisfied with remote contact with their PKU clinic. Better compliance was associated with higher odds of acceptance of remote contact and of reporting fewer problems with contacting the doctor, and with lower odds of missing Phe testing. Self-reported high stress was associated with higher odds of reporting the limited availability of low-Phe products and Phe-free formulas, as well as with increased Phe concentrations and non-PKU-related health problems. These patients also had poor dietary compliance and experienced more problems in contacting specialists. Health and treatment-related problems experienced during the pandemic lockdown were related to a higher intensity of stress in patient's family and worse therapy compliance before the pandemic. Previous experience of remote visits resulted in a better perception of this method of contact. It seems that this form of communication should be popularized and improved to increase therapy effectiveness in case of different limitations in the future. Special attention should be paid to vulnerable patients who may be at extra risk when the provision of standard care is affected.

Does Religion Influence the Motivations of Future Healthcare Professionals to Volunteer During the COVID-19 Pandemic in Poland? An Exploratory Study.

This study was designed to determine the relation between religion and the motivations of future healthcare professionals to volunteer during the COVID-19 outbreak in Poland. Data were collected from 417 healthcare students via an online questionnaire. The results indicated that although students' religiosity was not a significant predictor of volunteering during the pandemic, it played a key role in determining their motivations to join the fight against COVID-19. There was a significant positive relationship between students' religiosity and their eagerness to commit for the sake of the community rather than for personal or egoistic motives.

Mental Well-Being (Depression, Loneliness, Insomnia, Daily Life Fatigue) during COVID-19 Related Home-Confinement-A Study from Poland.

The COVID-19 pandemic is a great threat to both physical and mental health as it may lead to psychological stress connected with an economic crisis, threat of unemployment, or fear of losing family members. Emerging data shows that the general public may be vulnerable to the pandemic-related stress and experience frequently prevalent anxiety. A study involving 471 subjects (85.6% female) was conducted online during the COVID-19 pandemic. We used the following scales: Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), Revised University of California, Los Angeles (R-UCLA) Loneliness Scale, and Daily Life Fatigue scale (DLF). Women had higher mean scores of depression, loneliness, and daily life fatigue and more often than males started exercising. Among people professionally active before the pandemic, there were more cases of increased alcohol consumption than among students. No differences in alcohol consumption patterns were found between genders. People living alone had higher scores of loneliness and daily life fatigue compared to those living with someone. Respondents who started taking any new drugs during COVID-19 home confinement had higher outcomes in all questionnaires. During home confinement, high scores of depression, insomnia, loneliness, and everyday fatigue were observed.