Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 150
Filter
1.
BMC Health Serv Res ; 22(1): 725, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1951222

ABSTRACT

AIMS: The COVID-19 pandemic has challenged health systems and their capacity to deliver essential health services while responding to COVID-19. This study examines the pandemic's impact on health service usage among patients with type 2 diabetes in the North Karelia region, in Finland. METHODS: This retrospective cohort study used electronic health records of 11,458 type 2 diabetes patients, comprising all primary and specialised care contacts in 2019 and 2020. We analysed diabetes and dental healthcare contacts to primary care nurses, doctors and dentists and all emergency visits in specialised care. We compared healthcare usage in three different periods in 2020 (pre-lockdown [1 January-15 March], lockdown [16 March-31 May], post-lockdown [1 June-31 December]) with the equivalent period in 2019. RESULTS: During the lockdown period, the number of diabetes-related contacts decreased significantly but quickly increased again to nearly the same level as in 2019. Overall, healthcare usage was lower in the pandemic year, with proportionally 9% fewer contacts per person (mean 2.08 vs 2.29) and a proportionally 9% lower proportion of patients making any contact (59.9% vs 65.8%). The proportion of remote consultations was similar in both years in the pre-lockdown period (56.3-59.5%) but then increased to 88.0% during the 2020 lockdown. Patterns were similar when analysed by age group and gender. Emergency visits went down significantly at the beginning of the lockdown period, but a "rebound effect" was observed, so after the lockdown, the number of emergency visits in 2020 exceeded the numbers of the previous year. CONCLUSION: Despite the COVID-19 pandemic, diabetes care was continuous, and even elderly patients aged ≥70 years accessed the health services. The delivery of many essential services was facilitated by processes that strongly relied on telemedicine already before the pandemic.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Drug-Related Side Effects and Adverse Reactions , Aged , COVID-19/epidemiology , Communicable Disease Control , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Finland/epidemiology , Health Services , Humans , Pandemics , Retrospective Studies
2.
Am J Epidemiol ; 191(7): 1180-1189, 2022 Jun 27.
Article in English | MEDLINE | ID: covidwho-1931792

ABSTRACT

In high-income countries, childhood infections are on the rise, a phenomenon attributed in part to persistent hesitancy toward vaccines. To combat vaccine hesitancy, several countries recently made vaccinating children mandatory, but the effect of such vaccination laws on vaccination coverage remains debated, and the long-term consequences are unknown. Here we quantified the consequences of vaccination laws on vaccination coverage, monitoring for a period of 63 years (1837-1899) rural Finland's first vaccination campaign against the highly lethal childhood infection smallpox. We found that annual vaccination campaigns were focused on children up to 1 year old and that their vaccination coverage was low and declined over time until the implementation of the vaccination law, which stopped the declining trend and was associated with an abrupt coverage increase, of 20%, to cover >80% of all children. Our results indicate that vaccination laws can have a long-term beneficial effect of increasing the vaccination coverage and will help public health practitioners to make informed decisions on how to act against vaccine hesitancy and optimize the impact of vaccination programs.


Subject(s)
Immunization Programs , Vaccines , Child , Finland , Humans , Vaccination , Vaccination Coverage
3.
BMC Public Health ; 22(1): 1016, 2022 05 20.
Article in English | MEDLINE | ID: covidwho-1910290

ABSTRACT

BACKGROUND: Electronic gambling machines (EGMs) are amongst the most harmful forms of gambling. The high availability of EGMs is also linked to increased consumption. To reduce the burden of EGMs on public health, policies to reduce their numbers have recently been introduced in Italy and Finland. This study compares the aims and justifications of these legislative changes, as well as their overall impacts on total consumption. METHODS: The objectives and justifications of policies to reduce the number of EGMs were based on qualitative media analysis. The impacts on total consumption were measured using financial figures provided by gambling providers in Italy and Finland. RESULTS: Results show that the reductions in EGM numbers were justified in terms of public health concerns in both countries, but the amplitude of policies varied. In Italy, the reductions were more ambitious than in Finland, and included reductions in the number of gambling locations. The financial data nevertheless indicated that the reductions may not have been significant enough. CONCLUSIONS: Public health concerns were initially highlighted in the media discussions, but eventually in both countries reduction policies were less ambitious due to industry lobbying and state revenue interests. The reductions therefore do not appear to have been effective in reducing total consumption and the burden on public health.


Subject(s)
Behavior, Addictive , Gambling , Electronics , Finland , Gambling/prevention & control , Humans , Policy , Public Health
4.
Int J Environ Res Public Health ; 19(10)2022 05 20.
Article in English | MEDLINE | ID: covidwho-1903362

ABSTRACT

Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees' work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher education employees in a one-year follow-up during the enforced WFH. Secondly, we investigated demographic, organizational, and ergonomic factors associated with the developmental profiles. Methods: A longitudinal web-survey was conducted with four measurement points (April 2020-February 2021). Employees of a Finnish university who answered the questionnaire at baseline and at least at two follow-up surveys (n = 678) were included (71% women, 45% teachers/research staff, 44% supporting staff, 11% hired students). Perceived work ability was measured on a scale of 1-5 in all timepoints. Latent class growth curve analysis was used to identify profiles of work ability. Multinomial logistic regression was used to determine the associations of demographic factors, perceived stress, musculoskeletal pain, functionality of home for work, and organizational support with the work ability profiles. Results: Six distinct work ability profiles were identified. For most (75%), work ability remained stable during the follow-up. A total of 17% had a favourable trend (very good-stable or increasing) of work ability, and 8% had non-favourable (poor-stable or decreasing). Poor ergonomics at home, low organizational support, high stress, and musculoskeletal pain were associated with non-favourable development of work ability. Conclusions: Heterogeneity in development of work ability during forced WFH was found. Several factors were identified through which work ability can be supported.


Subject(s)
COVID-19 , Musculoskeletal Pain , COVID-19/epidemiology , Female , Finland/epidemiology , Humans , Male , Musculoskeletal Pain/epidemiology , Pandemics , Work Capacity Evaluation
5.
Medicine (Baltimore) ; 101(23): e29496, 2022 Jun 10.
Article in English | MEDLINE | ID: covidwho-1891121

ABSTRACT

ABSTRACT: We aim to report the incidences of ED visits due to back pain, hospitalizations, and urgent spine surgeries during the first and second waves of COVID-19 in Finland. The number of emergency department visits and hospitalizations due to back pain as well as urgent spine surgeries in the adult population was collected from hospital discharge registers for the years 2017 through 2019 (reference years) and 2020.This study was conducted at three large Finnish hospitals. The monthly incidence with 95% confidence intervals (CI) of emergency department visits and hospitalizations due to back pain and spine surgeries in the three participating hospitals were calculated and compared by incidence rate ratios (IRR).Visits to ED due to back pain decreased during the pandemic. The incidence of ED visits due to back pain was similar in February (IRR 0.95, CI: 0.82-1.10), but a decrease was seen after lockdown began (March IRR 0.67, CI: 0.57-0.78; April IRR 0.65, CI: 0.56-0.76) compared to the reference years. A second decrease in visits was seen after regional restrictions were implemented in October (IRR 0.88, CI: 0.76-1.02). The most common diagnoses were non-specific back pain, lumbar disk herniation, and back contusion. Incidence of non-specific back pain decreased during the lockdown (March IRR 0.65, CI: 0.55-0.78) and regional restrictions (October IRR 0.83, CI: 0.70-0.98), whereas the rates of other diagnoses remained unchanged, and incidences of hospitalizations and urgent spine surgeries remained stable.A clear decrease in ED visits due to back pain was seen during the first and second waves of the pandemic. This decrease was mainly the result of patients with non-specific back pain avoiding visits to the ED. The incidence of specific back pain, hospitalizations, and urgent spine surgeries remained unchanged during the pandemic.


Subject(s)
COVID-19 , Adult , Back Pain/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Emergency Service, Hospital , Finland/epidemiology , Humans , Pandemics , Retrospective Studies
6.
JAMA Netw Open ; 5(6): e2217375, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1888481

ABSTRACT

Importance: Vaccinations are paramount to halt the COVID-19 pandemic, and safety data are essential to determine the risk-benefit ratio of each COVID-19 vaccine. Objective: To evaluate the association between the AZD1222, BNT162b2, and mRNA-1273 vaccines and subsequent thromboembolic and thrombocytopenic events. Design, Setting, and Participants: This self-controlled case series used individual-level data from national registries in Norway, Finland, and Denmark. Participants included individuals with hospital contacts because of coronary artery disease, coagulation disorders, or cerebrovascular disease between January 1, 2020, and May 16, 2021. Exposures: AZD1222, BNT162b2, or mRNA-1273 vaccine. Main Outcomes and Measure: Relative rate (RR) of hospital contacts for coronary artery disease, coagulation disorders, or cerebrovascular disease in a 28-day period following vaccination compared with the control period prior to vaccination. Results: We found 265 339 hospital contacts, of whom 112 984 [43%] were for female patients, 246 092 [93%] were for patients born in 1971 or earlier, 116 931 [44%] were for coronary artery disease, 55 445 [21%] were for coagulation disorders, and 92 963 [35%] were for cerebrovascular disease. In the 28-day period following vaccination, there was an increased rate of coronary artery disease following mRNA-1273 vaccination (RR, 1.13 [95% CI, 1.02-1.25]), but not following AZD1222 vaccination (RR, 0.92 [95% CI, 0.82-1.03]) or BNT162b2 vaccination (RR, 0.96 [95% CI, 0.92-0.99]). There was an observed increased rate of coagulation disorders following all 3 vaccines (AZD1222: RR, 2.01 [95% CI, 1.75-2.31]; BNT162b2: RR, 1.12 [95% CI, 1.07-1.19]; and mRNA-1273: RR, 1.26 [95% CI, 1.07-1.47]). There was also an observed increased rate of cerebrovascular disease following all 3 vaccines (AZD1222: RR, 1.32 [95% CI, 1.16-1.52]; BNT162b2: RR, 1.09 [95% CI, 1.05-1.13]; and mRNA-1273: RR, 1.21 [95% CI, 1.09-1.35]). For individual diseases within the main outcomes, 2 notably high rates were observed: 12.04 (95% CI, 5.37-26.99) for cerebral venous thrombosis and 4.29 (95% CI, 2.96-6.20) for thrombocytopenia, corresponding to 1.6 (95% CI, 0.6-2.6) and 4.9 (95% CI, 2.9-6.9) excess events per 100 000 doses, respectively, following AZD1222 vaccination. Conclusions and Relevance: In this self-controlled case series, there was an increased rate of hospital contacts because of coagulation disorders and cerebrovascular disease, especially for thrombocytopenia and cerebral venous thrombosis, following vaccination with AZD1222. Although increased rates of several thromboembolic and thrombocytopenic outcomes following BNT162b2 and mRNA-1273 vaccination were observed, these increases were less than the rates observed after AZD1222, and sensitivity analyses were not consistent. Confirmatory analysis on the 2 mRNA vaccines by other methods are warranted.


Subject(s)
COVID-19 Vaccines , COVID-19 , Cerebrovascular Disorders , Coronary Artery Disease , Thrombocytopenia , Venous Thrombosis , 2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Cerebrovascular Disorders/chemically induced , Cerebrovascular Disorders/epidemiology , ChAdOx1 nCoV-19 , Coronary Artery Disease/chemically induced , Coronary Artery Disease/epidemiology , Denmark , Female , Finland , Humans , Male , Middle Aged , Norway , Pandemics , Registries , Thrombocytopenia/chemically induced , Thrombocytopenia/epidemiology , Venous Thrombosis/chemically induced , Venous Thrombosis/epidemiology
7.
Int J Environ Res Public Health ; 19(12)2022 06 07.
Article in English | MEDLINE | ID: covidwho-1884164

ABSTRACT

We investigated whether people with disabilities-cognition, vision, hearing, mobility, or at least one of these disabilities-report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes-sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson-Holm-Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.


Subject(s)
COVID-19 , Disabled Persons , Psychological Distress , Sleep Wake Disorders , COVID-19/epidemiology , Disabled Persons/psychology , Finland/epidemiology , Humans , Life Style , Mental Health , Pandemics , Sleep Wake Disorders/epidemiology , Stress, Psychological/psychology
9.
J Med Virol ; 94(9): 4528-4532, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1844143

ABSTRACT

Social restrictions interrupted the normal respiratory virus circulation in Spring 2020. This report describes virus circulation in the pediatric population before and after the restrictions ended in Finland in September 2021. We used data from the Finnish Infectious Disease Register. Nationwide influenza A and B, rhinovirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), and respiratory syncytial virus (RSV) findings from January 2018 to December 2021. Age stratified (0-4, 5-9, and 10-14 years) weekly incidences per 100 000 children were calculated. School and day-care closures interrupted completely the circulation of all other respiratory viruses than rhinovirus in spring 2020. After restrictions were relaxed in September 2021, SARS-Cov-2 detections increased majorly. We observed high RSV season atypically early. SARS-Cov-2 was detected in older children whereas RSV season peaked especially among children aged under 5. Influenza seemed to return to normal circulation. In conclusion, we report that the ending of social restrictions in September 2021 led to an increase in SARS-Cov-2 detections and high epidemic peaks of RSV and parainfluenza in atypical timing in children. Our results highlight the importance of continuous pathogen surveillance during the pandemic, as atypical surges of non-COVID-19 respiratory viruses were observed.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Viruses , COVID-19/epidemiology , COVID-19/prevention & control , Child , Finland/epidemiology , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Rhinovirus , SARS-CoV-2 , Seasons
10.
J Appl Gerontol ; 41(8): 1812-1820, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1840806

ABSTRACT

This cross-sectional study assessed the experiences of family caregivers of older adults during the COVID-19 pandemic. Participants were recruited (n = 101) between April and December 2019. We applied a mixed-method approach. Quantitative data were analyzed using an independent samples t-test and logistic regression analysis, and qualitative experiences with modified thematic content analysis. The mean age of the family caregivers was 76 years (SD = 7), and 72% were females. Experiences of loneliness and worry during the pandemic were evaluated by self-assessment. Approximately one-third of the participants reported loneliness and worry. These experiences were further associated with female sex, increased psychological distress and depressive symptoms, and decreased physical condition and social relationships. Family caregivers were also worried about the pandemic's impact on health and well-being. Thus, the COVID-19 pandemic has added an extra psychosocial load to family caregivers. The post-pandemic era requires increased attention to re-evaluating policies and services.


Subject(s)
COVID-19 , Pandemics , Aged , COVID-19/epidemiology , Caregivers/psychology , Cross-Sectional Studies , Female , Finland , Humans , Male
12.
Euro Surveill ; 27(16)2022 04.
Article in English | MEDLINE | ID: covidwho-1809283

ABSTRACT

Recombinant sequences of the SARS-CoV-2 Omicron variant were detected in surveillance samples collected in north-western Finland in January 2022. We detected 191 samples with an identical genome arrangement in weeks 3 to 11, indicating sustained community transmission. The recombinant lineage has a 5'-end of BA.1, a recombination breakpoint between orf1a and orf1b (nucleotide position 13,296-15,240) and a 3'-end of BA.2 including the S gene. We describe the available genomic and epidemiological data about this currently circulating recombinant XJ lineage.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Finland/epidemiology , Genomics , Humans , SARS-CoV-2/genetics
13.
Influenza Other Respir Viruses ; 16(5): 842-845, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1807135

ABSTRACT

COVID-19 vaccination effectiveness has been monitored in observational studies (test-negativity design or traditional cohort design), but these studies have not addressed the potential behavioral bias between vaccinated and unvaccinated individuals. We aimed to address this by comparing COVID-19 testing rates between vaccination status and whether vaccination changes the testing rates. We found that three times vaccinated had least tests performed during the pandemic and unvaccinated had the highest testing rate. Each vaccination dose increased the testing rate. In conclusion the observational studies addressing vaccine effectiveness should also present testing rates between vaccinated and unvaccinated to address the potential behavioral bias.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Finland/epidemiology , Humans , Observational Studies as Topic , Vaccination , Vaccine Efficacy
14.
Vaccine ; 40(24): 3345-3355, 2022 05 26.
Article in English | MEDLINE | ID: covidwho-1799677

ABSTRACT

INTRODUCTION: The aim of this study was to investigate how age and underlying medical conditions affect the risk of severe outcomes following SARS-CoV-2 infection and how they should be weighed while prioritising vaccinations against COVID-19. METHODS: This population-based register study includes all SARS-CoV-2 PCR-test-positive cases until 24 Feb 2021, based on the Finnish National Infectious Diseases Register. The cases were linked to other registers to identify presence of predisposing factors and severe outcomes (hospitalisation, intensive care treatment, death). The odds of severe outcomes were compared in those with and without the pre-specified predisposing factors using logistic regression. Furthermore, population-based rates were compared between those with a given predisposing factor and those without any of the specified predisposing factors using negative binomial regression. RESULTS: Age and various comorbidities were found to be predictors of severe COVID-19. Compared to 60-69-year-olds, the odds ratio (OR) of death was 7.1 for 70-79-year-olds, 26.7 for 80-89-year-olds, and 55.8 for ≥ 90-year-olds. Among the 20-69-year-olds, chronic renal disease (OR 9.4), malignant neoplasms (5.8), hematologic malignancy (5.6), chronic pulmonary disease (5.4), and cerebral palsy or other paralytic syndromes (4.6) were strongly associated with COVID-19 mortality; severe disorders of the immune system (8.0), organ or stem cell transplant (7.2), chronic renal disease (6.7), and diseases of myoneural junction and muscle (5.5) were strongly associated with COVID-19 hospitalisation. Type 2 diabetes and asthma, two very common comorbidities, were associated with all three outcomes, with ORs from 2.1 to 4.3. The population-based rate of SARS-CoV-2 infection decreased with age. Taking the 60-69-year-olds as reference, the rate ratio was highest (3.0) for 20-29-year-olds and < 1 for 70-79-year-olds and 80-89-year-olds. CONCLUSION: Comorbidities predispose for severe COVID-19 among younger ages. In vaccine prioritisation both the risk of infection and the risk of severe outcomes, if infected, should be considered.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Renal Insufficiency, Chronic , COVID-19/epidemiology , Finland/epidemiology , Hospitalization , Humans , SARS-CoV-2 , Vaccination
15.
PLoS One ; 17(2): e0263435, 2022.
Article in English | MEDLINE | ID: covidwho-1793529

ABSTRACT

INTRODUCTIONS: The rate of acute hand trauma visits to emergency departments (ED) and surgeries decreased during the COVID-19 lockdown. Our aim was to analyze the influence of national lockdown during the first wave and the regional restrictions during the second wave on the rate of visits to the ED and urgent hand surgeries in Finland. METHODS: Material for this retrospective study was gathered from three Finnish hospitals All ED visits and urgent or emergency surgeries from January 2017 to December 2020 were included. Incidences per 100 000 persons with 95% confidence intervals (CI) were calculated and compared by incidence rate ratios (IRR). RESULTS: The incidence of hand injury was lower after the beginning of the lockdown in March 2020 (IRR 0.70 CI 0.63-0.78). After lockdown ended in May, the monthly incidences of ED visits returned to the reference level. During the lockdown, the incidence of fractures and dislocations was 42% lower in March (IRR 0.58 CI 0.50-0.68) and 33% lower in April 2020 (IRR 0.67 CI 0.57-0.80). The incidence of fracture repair surgeries was 43% lower in March 2020 (IRR 0.57 CI 0.35-0.93) and 41% lower in July 2020 (IRR 0.59 CI 0.36-0.98). Incidence of replantation was 49% higher in March 2020 (IRR 1.49 CI 0.53-4.20) and 200% higher in July 2020 (IRR 3.00 CI 0.68-13.2) but these increases had high uncertainty. CONCLUSIONS: The rate of ED visits due to hand injuries decreased while the rate of emergency hand operations remained unchanged during the national COVID-19 lockdown in spring. After the lockdown, the incidences returned to reference level and were unaffected by regional restrictions during the second wave of pandemic.


Subject(s)
Emergency Medical Services/trends , Hand Injuries/epidemiology , Adult , COVID-19 , Emergency Medical Services/statistics & numerical data , Emergency Service, Hospital , Female , Finland/epidemiology , Hand/surgery , Hand Injuries/surgery , Hospitalization , Hospitals , Humans , Incidence , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
16.
Int J Environ Res Public Health ; 19(8)2022 04 17.
Article in English | MEDLINE | ID: covidwho-1792695

ABSTRACT

Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within Greater Helsinki dedicated to caring for all ambulatory patients with possible COVID-19 symptoms. The study objectives were to make PHC crisis response contributions known and to provide an in-action review (IAR) of crisis response efforts. Nurse managers from the four COVID-19 hubs in Greater Helsinki were interviewed using thematic pair interviews. The data were analyzed inductively using thematic analysis, by which four main themes emerged: (1) capacity development led to a state of flux, (2) infection prevention control (IPC) was critical, (3) management of staff was essential in facilitating crisis response, and (4) respondents' personal experiences. The state of flux stressed the provision of PHC services, but quick developments in telemedicine eased that burden. Conversation surrounding IPC was extensive, though discrepancies suggest that global efforts to standardize IPC practices must begin locally. Leadership was adjusted to accommodate for the crisis, especially regarding the motivation of staff. A vision to aspire toward in crisis recovery is needed.


Subject(s)
COVID-19 , Nurse Administrators , Telemedicine , Finland , Humans , Infection Control , Qualitative Research
17.
Int J Cancer ; 151(3): 381-395, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1787663

ABSTRACT

The severity of the COVID-19 pandemic and subsequent mitigation strategies have varied across the Nordic countries. In a joint Nordic population-based effort, we compared patterns of new cancer cases and notifications between the Nordic countries during 2020. We used pathology notifications to cancer registries in Denmark, the Faroe Islands, Finland, Iceland, Norway and Sweden to determine monthly numbers of pathology notifications of malignant and in situ tumours from January to December 2020 compared to 2019 (2017-2019 for Iceland and the Faroe Islands). We compared new cancer cases per month based on unique individuals with pathology notifications. In April and May 2020, the numbers of new malignant cases declined in all Nordic countries, except the Faroe Islands, compared to previous year(s). The largest reduction was observed in Sweden (May: -31.2%, 95% CI -33.9, -28.3), followed by significant declines in Finland, Denmark and Norway, and a nonsignificant decline in Iceland. In Denmark, Norway, Sweden and Finland the reporting rates during the second half of 2020 rose to almost the same level as in 2019. However, in Sweden and Finland, the increase did not compensate for the spring decline (annual reduction -6.2% and -3.6%, respectively). Overall, similar patterns were observed for in situ tumours. The COVID-19 pandemic led to a decline in rates of new cancer cases in Sweden, Finland, Denmark and Norway, with the most pronounced reduction in Sweden. Possible explanations include the severity of the pandemic, temporary halting of screening activities and changes in healthcare seeking behaviour.


Subject(s)
COVID-19 , Neoplasms , COVID-19/epidemiology , Denmark/epidemiology , Finland/epidemiology , Humans , Iceland/epidemiology , Neoplasms/diagnosis , Neoplasms/epidemiology , Norway , Pandemics , Scandinavian and Nordic Countries/epidemiology , Sweden/epidemiology
18.
Pharmacol Res Perspect ; 10(2): e00931, 2022 04.
Article in English | MEDLINE | ID: covidwho-1782680

ABSTRACT

The aim of this study was to estimate healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions in Finland from 2008 to 2019. Serious adverse reaction types were identified from the Finnish Pharmaceutical Insurance Pool's pharmaceutical injury claims and the Finnish Medicines Agency's Adverse Reaction Register. A decision tree model was built to predict costs and mortality associated with serious adverse drug reactions (ADR). Severe clostridioides difficile infections, severe cutaneous adverse reactions, tendon ruptures, aortic ruptures, and liver injuries were included as serious adverse drug reactions in the model. Direct healthcare costs of a serious ADR were based on the number of reimbursed fluoroquinolone prescriptions from the Social Insurance Institution of Finland's database. Sensitivity analyses were conducted to address parameter uncertainty. A total of 1 831 537 fluoroquinolone prescriptions were filled between 2008 and 2019 in Finland, with prescription numbers declining 40% in recent years. Serious ADRs associated with fluoroquinolones lead to estimated direct healthcare costs of 501 938 402 €, including 11 405 ADRs and 3,884 deaths between 2008 and 2019. The average mortality risk associated with the use of fluoroquinolones was 0.21%. Severe clostridioides difficile infections were the most frequent, fatal, and costly serious ADRs associated with the use of fluoroquinolones. Although fluoroquinolones continue to be generally well-tolerated antimicrobials, serious adverse reactions cause long-term impairment to patients and high healthcare costs. Therefore, the risks and benefits should be weighed carefully in antibiotic prescription policies, as well as with individual patients.


Subject(s)
Anti-Bacterial Agents/adverse effects , Fluoroquinolones/adverse effects , Health Care Costs/statistics & numerical data , Adverse Drug Reaction Reporting Systems/statistics & numerical data , Anti-Bacterial Agents/economics , Databases, Factual/statistics & numerical data , Decision Trees , Drug-Related Side Effects and Adverse Reactions/economics , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/mortality , Finland , Fluoroquinolones/economics , Humans , Retrospective Studies
19.
Emerg Infect Dis ; 28(6): 1229-1232, 2022 06.
Article in English | MEDLINE | ID: covidwho-1775623

ABSTRACT

Multiple introductions of SARS-COV-2 Omicron variant BA.1 and BA.1.1. lineages to Finland were detected in early December 2021. Within 3 weeks, Omicron overtook Delta as the most common variant in the capital region. Sequence analysis demonstrated the emergence and spread through community transmission of a large cluster of BA.1.1 virus.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Finland/epidemiology , Humans , SARS-CoV-2/genetics
20.
Euro Surveill ; 27(11)2022 03.
Article in English | MEDLINE | ID: covidwho-1753316

ABSTRACT

BackgroundThe shortage of FFP2 and FFP3 respirators posed a serious threat to the operation of the healthcare system at the onset of the COVID-19 pandemic.AimOur aim was to develop and validate a large-scale facility that uses hydrogen peroxide vapour for the decontamination of used respirators.MethodsA multidisciplinary and multisectoral ad hoc group of experts representing various organisations was assembled to implement the collection and transport of used FFP2 and FFP3 respirators from hospitals covering 86% of the Finnish population. A large-scale decontamination facility using hydrogen peroxide vapour was designed and constructed. Microbiological tests were used to confirm efficacy of hydrogen peroxide vapour decontamination together with a test to assess the effect of decontamination on the filtering efficacy and fit of respirators. Bacterial and fungal growth in stored respirators was determined by standard methods.ResultsLarge-scale hydrogen peroxide vapour decontamination of a range of FFP2 and FFP3 respirator models effectively reduced the recovery of biological indicators: Geobacillus stearothermophilus and Bacillus atrophaeus spores, as well as model virus bacteriophage MS2. The filtering efficacy and facial fit after hydrogen peroxide vapour decontamination were not affected by the process. Microbial growth in the hydrogen peroxide vapour-treated respirators indicated appropriate microbial cleanliness.ConclusionsLarge-scale hydrogen peroxide vapour decontamination was validated. After effective decontamination, no significant changes in the key properties of the respirators were detected. European Union regulations should incorporate a facilitated pathway to allow reuse of appropriately decontaminated respirators in a severe pandemic when unused respirators are not available.


Subject(s)
COVID-19 , Hydrogen Peroxide , Decontamination/methods , Finland , Humans , Hydrogen Peroxide/pharmacology , Pandemics , Ventilators, Mechanical
SELECTION OF CITATIONS
SEARCH DETAIL