ABSTRACT
We examine changes in the well-being of family caregivers during the early phase of the COVID-19 pandemic in Germany, using data from the German Socio-Economic Panel (SOEP) and the SOEP-CoV study. The COVID-19 pandemic posed an extraordinary challenge for family caregivers, as care recipients are a high-risk group requiring special protection, and professional care services were severely cut back. The specific situation of the COVID-19 pandemic allows us to re-examine the caregiver stress process model. Using first difference regression models, we analyse changes in general life satisfaction and depressive symptoms (PHQ-4 score) among family caregivers between 2019 and spring 2020, differentiating by care intensity and duration of the care episode. Caregivers show similar changes in well-being as non-caregivers: a simultaneous increase in depressive symptoms and life satisfaction between 2019 and 2020. However, our results reveal heterogeneity within the group of family caregivers as we find differences according to caregiving dynamics and intensity. Among the group of continuing caregivers, high-intensity caregivers experience a larger increase in life satisfaction, and low-intensity caregivers a smaller increase in life satisfaction, compared to non-caregivers. Our results therefore provide some support for the role enhancement hypothesis for continuing caregivers with high time commitment.
ABSTRACT
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Adult , Female , Male , Seroepidemiologic Studies , COVID-19 Testing , Travel , COVID-19/diagnosis , COVID-19/epidemiology , Travel-Related Illness , Antibodies, Viral , Immunoglobulin GABSTRACT
SARS-CoV-2, the coronavirus, spread across Germany within just a short period of time. Seroepidemiological studies are able to estimate the proportion of the population with antibodies against SARS-CoV-2 infection (seroprevalence) as well as the level of undetected infections, which are not captured in official figures. In the seroepidemiological study Corona Monitoring Nationwide (RKI-SOEP-2), biospecimens and interview data were collected in a nationwide population-based subsample of the Socio-Economic Panel (SOEP). By using laboratory-analyzed blood samples to detect antibodies to the SARS-CoV-2 virus, we were able to identify a history of vaccination or infection in study participants. By combining these results with survey data, we were able to identify groups within the population that are at increased risk of infection. By linking the RKI-SOEP-2 survey data with data from other waves of the SOEP survey, we will be able to examine the medium- to long-term impacts of the COVID-19 pandemic, including effects of long COVID, in diverse areas of life. Furthermore, the data provide insight into the population's willingness to be vaccinated as well as related attitudes and conditions. In sum, the RKI-SOEP-2 survey data offer a better understanding of the scope of the epidemic in Germany and can help in identifying target groups for infection control in the present and future pandemics.
ABSTRACT
The SARS-CoV-2 coronavirus has spread rapidly across Germany. Infections are likely to be under-recorded in the notification data from local health authorities on laboratory-confirmed cases since SARS-CoV-2 infections can proceed with few symptoms and then often remain undetected. Seroepidemiological studies allow the estimation of the proportion in the population that has been infected with SARS-CoV-2 (seroprevalence) as well as the extent of undetected infections. The 'CORONA-MONITORING bundesweit' study (RKI-SOEP study) collects biospecimens and interview data in a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). Participants are sent materials to self-collect a dry blood sample of capillary blood from their finger and a swab sample from their mouth and nose, as well as a questionnaire. The samples returned are tested for SARS-CoV-2 IgG antibodies and SARS-CoV-2 RNA to identify past or present infections. The methods applied enable the identification of SARS-CoV-2 infections, including those that previously went undetected. In addition, by linking the data collected with available SOEP data, the study has the potential to investigate social and health-related differences in infection status. Thus, the study contributes to an improved understanding of the extent of the epidemic in Germany, as well as identification of target groups for infection protection.
ABSTRACT
Die Weltgesundheitsorganisation (WHO) hat im Frühjahr 2020 Richtlinien für Bevölkerungsstichproben veröffentlicht, die Basisdaten für gesundheitspolitische Entscheidungen im Pandemiefall liefern können. Diese Richtlinien umzusetzen ist keineswegs trivial. In diesem Beitrag schildern wir die Herausforderungen einer entsprechenden statistischen Erfassung der Corona Pandemie. Hierbei gehen wir im ersten Teil auf die Erfassung der Dunkelziffer bei der Meldung von Corona Infektionen, die Messung von Krankheitsverläufen im außerklinischen Bereich, die Messung von Risikomerkmalen sowie die Erfassung von zeitlichen und regionalen Veränderungen der Pandemie-Intensität ein. Wir diskutieren verschiedene Möglichkeiten, aber auch praktische Grenzen der Survey-Statistik, den vielfältigen Herausforderungen durch eine geeignete Anlage der Stichprobe und des Survey-Designs zu begegnen. Ein zentraler Punkt ist die schwierige Koppelung medizinischer Tests mit bevölkerungsrepräsentativen Umfragen, wobei bei einer personalisierten Rückmeldung der Testergebnisse das Statistik-Geheimnis eine besondere Herausforderung darstellt. Im zweiten Teil berichten wir wie eine der großen Wiederholungsbefragungen in Deutschland, das Sozio-oekonomische Panel (SOEP), für eine WHO-konforme Covid-19-Erhebung genutzt wird, die im Rahmen einer Kooperation des Robert-Koch-Instituts (RKI) mit dem SOEP als „RKI-SOEP Stichprobe“ im September 2020 gestartet wurde. Erste Ergebnisse zum Rücklauf dieser Studie, die ab Oktober 2021 mit einer zweiten Erhebungswelle bei denselben Personen fortgesetzt werden wird, werden vorgestellt. Es zeigt sich, dass knapp fünf Prozent der bereits in der Vergangenheit erfolgreich Befragten aufgrund der Anfrage zwei Tests zu machen die weitere Teilnahme an der SOEP-Studie verweigern. Berücksichtigt man alle in der Studie erhobenen Informationen (IgG-Antikörper-Tests, PCR-Tests und Fragebögen) ergibt eine erste Schätzung, dass sich bis November 2020 nur etwa zwei Prozent der in Privathaushalten lebenden Erwachsenen in Deutschland mit SARS-CoV‑2 infiziert hatten. Damit war die Zahl der Infektionen etwa doppelt so hoch wie die offiziell gemeldeten Infektionszahlen.
ABSTRACT
BACKGROUND: Evidence on the relationship between socioeconomic position (SEP) and infections with SARS-CoV-2 is still limited as most of the available studies are ecological in nature. This is the first German nationwide study to examine differences in the risk of SARS-CoV-2 infections according to SEP at the individual level. METHODS: The 'CORONA-MONITORING bundesweit' (RKI-SOEP) study is a seroepidemiological survey among a dynamic cohort of the German adult population (n=15 122; October 2020-February 2021). Dried blood samples were tested for SARS-CoV-2 antibodies and oral-nasal swabs for viral RNA. SEP was measured by education and income. Robust logistic regression was used to examine adjusted associations of SARS-CoV-2 infections with SEP. RESULTS: 288 participants were seropositive, PCR positive or self-reported a previous laboratory-confirmed SARS-CoV-2 infection. The adjusted odds of SARS-CoV-2 infection were 1.87-fold (95% CI 1.06 to 3.29) higher among low-educated than highly educated adults. Evidence was weaker for income differences in infections (OR=1.65; 95% CI 0.89 to 3.05). Highly educated adults had lower odds of undetected infection. CONCLUSION: The results indicate an increased risk of SARS-CoV-2 infection in low-educated groups. To promote health equity in the pandemic and beyond, social determinants should be addressed more in infection protection and pandemic planning.
Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Health Promotion , Humans , Pandemics , SARS-CoV-2 , Socioeconomic FactorsABSTRACT
Substantial educational inequalities have been documented in Germany for decades. In this article, we examine whether educational inequalities among children have increased or remained the same since the school closures of spring 2020 due to the COVID-19 pandemic. Our perspective is longitudinal: We compare the amount of time children in secondary schools spent on school-related activities at home before the pandemic, during school closures, and immediately after returning to in-person learning. We operationalize family socio-economic status using the highest parental educational attainment. Based on the theoretical assumption that the pandemic affected everyone equally, we formulate a hypothesis of equalization during the first period of school closures. For the period thereafter, however, we assume that parents with a low level of education had more difficulties bearing the additional burden of supervising and supporting their children's learning activities. Thus, for that period, we postulate an increase in educational inequality. To study our hypotheses, we use data from the 2019 wave of the SOEP and the SOEP-CoV study, both of which are probability samples. The SOEP-CoV study provides a unique database, as it was conducted during the lockdown of spring 2020 and in the following month. For statistical analysis, we use probit regressions at three measurement points (in 2019, in 2020 during the school closures, and in the month after closures). The comparison of these three time points makes our analysis and findings unique in the research on education during the COVID-19 pandemic, in particular with regard to Germany-wide comparisons. Our results confirm the hypothesis of equalization during the first school closures and the hypothesis of an increase in educational in the subsequent period. Our findings have direct policy implications regarding the need to further expand support systems for children.