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1.
Vaccine ; 40(46): 6640-6648, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2106120

ABSTRACT

BACKGROUND: Studies on sociodemographic disparities in Covid-19 vaccination uptake in the general population are still limited and mostly focused on older adults. This study examined sociodemographic differences in Covid-19 vaccination uptake in the total Swedish population aged 18-64 years. METHODS: National Swedish register data within the SCIFI-PEARL project were used to cross-sectionally investigate sociodemographic differences in Covid-19 vaccination among Swedish adults aged 18-64 years (n = 5,987,189) by 12 October 2021. Using logistic regression models, analyses were adjusted for sociodemographic factors, region of residence, history of Covid-19, and comorbidities. An intersectional analysis approach including several cross-classified subgroups was used to further address the complexity of sociodemographic disparities in vaccination uptake. FINDINGS: By 12 October 2021, 76·0% of the Swedish population 18-64 years old had received at least two doses of Covid-19 vaccine, an additional 5·5% had received only one dose, and 18·5% were non-vaccinated. Non-vaccinated individuals were, compared to vaccinated, more often younger, male, had a lower income, were not gainfully employed, and/or were born outside Sweden. The social patterning for vaccine dose two was similar, but weaker, than for dose one. After multivariable adjustments, findings remained but were attenuated indicating the need to consider different sociodemographic factors simultaneously. The intersectional analysis showed a large variation in vaccine uptake ranging from 32% to 96% in cross-classified subgroups, reflecting considerable sociodemographic heterogeneity in vaccination coverage. INTERPRETATION: Our study, addressing the entire Swedish population aged 18-64 years, showed broad sociodemographic disparities in Covid-19 vaccine uptake but also wide heterogeneities in coverage. The intersectional analysis approach indicates that focusing on specific sociodemographic factors in isolation and group average risks without considering the heterogeneity within such groups will risk missing the full variability of vaccine coverage. FUNDING: SciLifeLab / Knut & Alice Wallenberg Foundation, Swedish Research Council, Swedish government ALF agreement, FORMAS.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Male , Aged , Adolescent , Young Adult , Adult , Middle Aged , Sweden/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination , Vaccination Coverage
2.
Scand J Trauma Resusc Emerg Med ; 30(1): 12, 2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-2098408

ABSTRACT

BACKGROUND: Given that Swedish authorities have been widely viewed as having practiced an unusual approach to the COVID-19 pandemic and given that Sweden is notable for a low incidence of trauma, we wanted to learn how the pandemic may have affected the number of trauma admissions in Sweden. METHODS: We conducted a retrospective cohort study based on the Swedish trauma registry (Svenska Traumaregistret). The study period was March 1, 2020 to June 30, 2020. As a basis for comparison, the record for the same time during the previous year, 2019 was used. RESULTS: During the four months of the first wave of COVID-19, 2020 there was a decline of 24.2% in the total number of trauma patients in Sweden. There was no significant change in 30-day mortality rates, 4.7% 2019 and 5.1% 2020, (p = 0.30). The number of injuries per patient was higher during the pandemic 3.8 injuries 2019 and 4.1 injuries 2020 (p = 0.02). The NISS 6, 2019 and 8, 2020 was higher during the pandemic. CONCLUSIONS: As a consequence of what were seen by many as all too lenient actions taken to deal with COVID-19 in Sweden during spring 2020, there was still a reduction in trauma admissions most likely due to an adherence to the voluntary recommendations, the reduction was not as prominent as what was seen in many countries with harsher restrictions and lockdowns.


Subject(s)
COVID-19 , Pandemics , Cohort Studies , Communicable Disease Control , Humans , Retrospective Studies , SARS-CoV-2 , Sweden/epidemiology
3.
Med (N Y) ; 3(9): 636-643.e4, 2022 09 09.
Article in English | MEDLINE | ID: covidwho-2095786

ABSTRACT

BACKGROUND: Throughout the SARS-CoV-2 pandemic, multiple waves of variants of concern have swept across populations, leading to a chain of new and yet more contagious variants dominating COVID-19 cases. Here, we tracked the remarkably rapid shift from Omicron BA.1 to BA.2 sublineage dominance in the Swedish population in early 2022 at a day-by-day basis. METHODS: Using a custom SARS-CoV-2 Omicron BA.1 lineage-typing RT-PCR assay, we analyzed 174,933 clinical upper airway samples collected during January to March 2022. FINDINGS: Our study demonstrates the feasibility and reliability of parallel lineage assignment of select variants at population scale, tracking the dominant sublineage transition from BA.1 to BA.2 at day-to-day resolution and uncovering nearly 2-fold higher levels of viral RNA in cases infected with Omicron BA.2 relative to BA.1. CONCLUSIONS: Our data provide unique insights into the Omicron BA.1 to BA.2 transition that occurred in Sweden during early 2022, and later, across the world. This may help to understand the increased transmissibility of the BA.2 variant.


Subject(s)
COVID-19 , RNA, Viral , COVID-19/epidemiology , Humans , RNA, Viral/genetics , Reproducibility of Results , SARS-CoV-2/genetics , Sweden/epidemiology
4.
Virol J ; 19(1): 164, 2022 10 18.
Article in English | MEDLINE | ID: covidwho-2079512

ABSTRACT

BACKGROUND: Since the beginning of the COVID-19 pandemic, new variants of significance to public health have emerged. Consequently, early detection of new mutations and variants through whole-genome sequencing remains crucial to assist health officials in employing appropriate public health measures. METHODS: We utilized the ARTIC Network SARS-CoV-2 tiled amplicon approach and Nanopore sequencing to sequence 4,674 COVID-19 positive patient samples from Uppsala County, Sweden, between week 15 and 52 in 2021. Using this data, we mapped the circulating variants of concern (VOC) in the county over time and analysed the Spike (S) protein mutational dynamics in the Delta variant throughout 2021. RESULTS: The distribution of the SARS-CoV-2 VOC matched the national VOC distribution in Sweden, in 2021. In the S protein of the Delta variant, we detected mutations attributable to variants under monitoring and variants of interest (e.g., E484Q, Q613H, Q677H, A222V and Y145H) and future VOC (e.g., T95I and Y144 deletion, which are signature mutations in the Omicron variant). We also frequently detected some less well-described S protein mutations in our Delta sequences, that might play a role in shaping future emerging variants. These include A262S, Q675K, I850L, Q1201H, V1228L and M1237I. Lastly, we observed that some of the Delta variant's signature mutations were underrepresented in our study due to artifacts of the used bioinformatics tools, approach and sequencing method. We therefore discuss some pitfalls and considerations when sequencing SARS-CoV-2 genomes. CONCLUSION: Our results suggest that genomic surveillance in a small, representative cohort can be used to make predictions about the circulating variants nationally. Moreover, we show that detection of transient mutations in currently circulating variants can give valuable clues to signature mutations of future VOC. Here we suggest six such mutations, that we detected frequently in the Delta variant during 2021. Lastly, we report multiple systematic errors that occurred when following the ARTIC Network SARS-CoV-2 tiled amplicon approach using the V3 primers and Nanopore sequencing, which led to the masking of some of the important signature mutations in the Delta sequences.


Subject(s)
COVID-19 , Nanopore Sequencing , Humans , SARS-CoV-2/genetics , Sweden/epidemiology , Spike Glycoprotein, Coronavirus/genetics , Genome, Viral , Pandemics , COVID-19/epidemiology , Mutation
5.
Int J Environ Res Public Health ; 19(20)2022 Oct 16.
Article in English | MEDLINE | ID: covidwho-2071465

ABSTRACT

BACKGROUND: The COVID-19 pandemic hit the world with severe health consequences, affecting some populations more than others. One understudied population is the academic community. This study, part of a larger project looking at COVID-19 in Sweden and internationally, aims to understand the individual and collective dimensions of resilience among academics in Sweden during the early wave of the pandemic. METHOD: A quantitative research design was applied for this cross-sectional study. We used simple random sampling, administered through an online survey, on academics at Swedish universities (n = 278, 64% women). We employed the CD-RISC 2 (the Connor-Davidson Resilience Scale) to measure personal/individual resilience, additional items for social/collective resilience, and a meaning-making coping instrument (meaning, control, comfort/spirituality, intimacy/spirituality, life transformation). RESULTS: The results revealed a strong level of personal/individual resilience among men (M = 6.05) and a level just below strong among women (M = 5.90). By age group, those 35-49-year-olds showed strong resilience (M = 6.31). Family was the dominant social/collective resilience factor, followed by friends, nature, work/school, and, lastly, religion/spirituality. There was a positive and significant correlation between self-rated health and personal/individual resilience (r = 0.252, p = 0.001) and positive but weak correlations and negative significant correlations between personal/individual resilience and religious coping methods. CONCLUSIONS: During the pandemic, the family took priority in meaning-making, which is an interesting change in a strong individual-oriented society such as Sweden.


Subject(s)
COVID-19 , Resilience, Psychological , Male , Female , Humans , Pandemics , Sweden/epidemiology , Psychometrics/methods , Cross-Sectional Studies , COVID-19/epidemiology
6.
Soc Sci Med ; 314: 115447, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2069699

ABSTRACT

Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.


Subject(s)
COVID-19 , Loneliness , Humans , Aged , Loneliness/psychology , Pandemics , COVID-19/epidemiology , Sweden/epidemiology , Socioeconomic Factors
7.
BMC Pregnancy Childbirth ; 22(1): 260, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-2038675

ABSTRACT

BACKGROUND: The COVID-19 pandemic has contributed to unprecedented worries and challenges for pregnant women due to social restrictions and changes in maternity care provision. We aimed to investigate the mental health impact of COVID-19 pandemic on pregnant women in Sweden and explore factors associated with poor perinatal mental health in this specific context. METHOD: This was a nation-wide cross-sectional survey of pregnant women living in Sweden. Validated questionnaires were distributed through non-profit organizations´ websites and social media channels from May 2020 to February 2021. Perinatal depression, anxiety, and acute stress reaction were assessed using the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7 (GAD-7) and Impact Event Scale (Revised) (IES-R), respectively. Sociodemographic characteristics and self-perceived mental well-being were also obtained. Factors associated with mental health outcomes were analyzed using multivariate logistic regression model. RESULTS: Among a total of 470 participants, 43.2% (n = 203) reported depression (EPDS ≥13), 25.7% (n = 121) moderate to severe anxiety (GAD-7 score ≥ 10), and 23.7% (n = 110) moderate to severe acute stress reaction (IES-R ≥ 33). 27.4% participants (n = 129) expressed concerns regarding their mental well-being during the pandemic. Pregnant mothers who had sick family members reported poorer mental health outcomes than those who did not (median [Interquartile range (IQR)] EPDS scores: 14.0 [8.75-18.0] vs 11.0 [6.25-15.0], p < .001; median (IQR) GAD7 scores: 7.0 [4.0-12.25] vs 6.0 [3.0-9.0], p = .003); median (IQR) IES-R scores: 20.0 [9.0-38.0] vs 15.0 [7.0-30.0], p = .048). Logistic regression analyses revealed that risk factors for poor mental health outcomes were having a sick family member with any illness, unemployment, and experiencing a substantially stressful life event. Having a higher educational level and a younger age during the pandemic were protective. CONCLUSION: Depression and anxiety were highly prevalent among pregnant women in Sweden during the COVID-19 pandemic, indicating a need for professional mental health support for this vulnerable group of population. Unemployment was an associated risk factor whereas younger age and higher educational level were protective suggesting an important role of socio-economic factors in modulating the impact of COVID-19 pandemic on perinatal mental health.


Subject(s)
COVID-19 , Maternal Health Services , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Health Status , Humans , Pandemics , Pregnancy , Pregnant Women/psychology , Self Report , Sweden/epidemiology
8.
Eur J Epidemiol ; 37(10): 1025-1034, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2035120

ABSTRACT

The Covid-19 pandemic has not affected the population evenly. This must be acknowledged when it comes to understanding the Covid-19 death toll and answering the question of how many life years have been lost. We use level of geriatric care to account for variation in remaining life expectancy among individuals that died during 2020. Based on a linkage of administrative registers, we estimate remaining life expectancy stratified by age, sex, and care status using an incidence-based multistate model and analyze the number of years of life lost (YLL) during 2020 in Sweden. Our results show that remaining life expectancy between individuals with and without care differs substantially. More than half of all Covid-19 deaths had a remaining life expectancy lower than 4 years. Yet, in a 1-year perspective, Covid-19 did not seem to replace other causes of death. Not considering the differences in remaining life expectancy in the affected populations overestimated YLL by 40% for women and 30% for men, or around 2 years per death. While the unadjusted YLL from Covid-19 amounted to an average of 7.5 years for women and 8.6 years for men, the corresponding YLL adjusted for care status were 5.4 and 6.6, respectively. The total number of YLL to Covid-19 in 2020 is comparable to YLL from ischemic heart disease in 2019 and 2020. Our results urge the use of subgroup specific mortality when counting the burden of Covid-19. YLL are considerably reduced when the varying susceptibility for death is considered, but even if most lifespans were cut in the last years of life, the YLL are still substantial.


Subject(s)
COVID-19 , Male , Female , Humans , Aged , Pandemics , Sweden/epidemiology , Life Expectancy , Longevity
9.
JAMA Ophthalmol ; 140(10): 957-964, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-2013255

ABSTRACT

Importance: Observational studies have indicated that glasses might protect against contracting COVID-19 through reduced airborne and contact transmission. Objective: To investigate the association between wearing one's own glasses with contracting COVID-19 when adjusting for relevant confounders. Design, Setting, and Participants: This cohort study was conducted during the first wave of the COVID-19 pandemic (June to August 2020) in Denmark and Sweden, where personal protective equipment was not recommended for the general population at the time. Employees at Falck, an international rescue corps with different job functions (ambulance, health care, office, and field staff, firefighters, and roadside assistance) participated in the study. Exposures: The main exposure was wearing glasses (also including contact lenses and reading glasses), which was assessed in a questionnaire. Persons wearing glasses were compared with those who did not wear glasses (ie, nonusers). To adjust for potential confounders, information on age, sex, job function, and number of workday contacts were included. Main Outcomes and Measures: The outcome was COVID-19 infection before (positive polymerase chain reaction test) or during the study period (biweekly voluntary tests with a rapid test). The investigated hypothesis was formulated after collecting the data. Results: A total of 1279 employees in Denmark and 841 in Sweden were included (839 [39.6%] female and 1281 [60.4%] male; 20.5% were aged <40 years; 57.0%, 40-60 years, and 22.5%, >60 years). Of these, 829 individuals (64.8%) in Denmark and 619 (73.6%) in Sweden wore glasses. Wearing glasses was inversely associated with COVID-19 infection in the Swedish cohort (odds ratio [OR], 0.61 [95% CI, 0.37-0.99]; P = .047; seroprevalence, 9.3%) but not in the Danish cohort (OR, 1.14 [95% CI, 0.53-2.45]; P = .73; seroprevalence, 2.4%). Adjusting for age, sex, job function, and number of workday contacts in Sweden, wearing glasses no longer was associated with COVID-19 infection (OR, 0.64 [95% CI, 0.37-1.11]; P = .11). When stratifying by job function, a large difference was observed among office staff (OR, 0.20 [95% CI, 0.06-0.70]; P = .01) but not ambulance staff (OR, 0.83 [95% CI, 0.41-1.67]; P = .60) nor health care staff (OR, 0.89 [95% CI, 0.35-2.30]; P = .81). Conclusions and Relevance: While wearing one's glasses was inversely associated with COVID-19 in Sweden in an unadjusted analysis, an association no longer was identified when adjusting for confounders. These results provide inconclusive findings regarding whether wearing one's own glasses is associated with a decreased risk of COVID-19 infections.


Subject(s)
COVID-19 , Humans , Male , Female , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Sweden/epidemiology , Prevalence , Seroepidemiologic Studies , Cohort Studies , Denmark/epidemiology
10.
Sci Rep ; 12(1): 15176, 2022 09 07.
Article in English | MEDLINE | ID: covidwho-2008323

ABSTRACT

Previous spatio-temporal COVID-19 prediction models have focused on the prediction of subsequent number of cases, and have shown varying accuracy and lack of high geographical resolution. We aimed to predict trends in COVID-19 test positivity, an important marker for planning local testing capacity and accessibility. We included a full year of information (June 29, 2020-July 4, 2021) with both direct and indirect indicators of transmission, e.g. mobility data, number of calls to the national healthcare advice line and vaccination coverage from Uppsala County, Sweden, as potential predictors. We developed four models for a 1-week-window, based on gradient boosting (GB), random forest (RF), autoregressive integrated moving average (ARIMA) and integrated nested laplace approximations (INLA). Three of the models (GB, RF and INLA) outperformed the naïve baseline model after data from a full pandemic wave became available and demonstrated moderate accuracy. An ensemble model of these three models slightly improved the average root mean square error to 0.039 compared to 0.040 for GB, RF and INLA, 0.055 for ARIMA and 0.046 for the naïve model. Our findings indicate that the collection of a wide variety of data can contribute to spatio-temporal predictions of COVID-19 test positivity.


Subject(s)
COVID-19 , COVID-19/diagnosis , COVID-19/epidemiology , Humans , Sweden/epidemiology
11.
Cytokine ; 159: 156020, 2022 11.
Article in English | MEDLINE | ID: covidwho-2004005

ABSTRACT

BACKGROUND: COVID-19 disease severity and need for intensive care has been associated with profound immune disturbances in which interleukin 6 (IL-6) is central. IL-6 signals through two pathways: classical IL-6 signalling with C-reactive protein (CRP) as a product is pivotal in the acute immune response against pathogens while IL-6 trans-signalling is involved in prolonged inflammation. We measured biomarkers of the IL-6 classical and trans-signalling pathways in patients with moderate or severe COVID-19 in the first wave of the COVID-19 pandemic. METHOD: In a longitudinal cohort study including patients admitted to Danderyd hospital, Stockholm, Sweden, with COVID-19 (n = 112), plasma IL-6 mirroring activity in both pathways, CRP as marker of classical signalling and the soluble IL-6 receptor (sIL-6R) and soluble glycoprotein 130 (sgp130) as markers of trans-signalling were analysed at baseline. Potential differences in biomarker levels between groups of moderate and severe COVID-19 defined by care level, level of respiratory support and one-month mortality was analysed, as was correlations between biomarkers. In addition, levels 4 months after hospital admission were compared to those at baseline. RESULTS: Levels of IL-6 and CRP were increased in severe COVID-19 whereas IL-6 trans-signalling markers (sIL-6R, sgp130) did not differ between the groups. CRP correlated positively with IL-6 in all patients while correlation with IL-6 could not be demonstrated for sIL-6R and sgp130 in either group. Levels of IL-6, CRP and sIL-6R were significantly decreased after 4 months whereas sgp130 levels increased. CONCLUSION: Classical signalling is the dominating IL-6 pathway in moderate-severe COVID-19.


Subject(s)
COVID-19 , Interleukin-6 , Biomarkers , C-Reactive Protein , Cytokine Receptor gp130/metabolism , Humans , Hyperplasia , Longitudinal Studies , Pandemics , Receptors, Interleukin-6/metabolism , SARS-CoV-2 , Sweden/epidemiology
12.
Emerg Infect Dis ; 28(10): 2119-2121, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2002464

ABSTRACT

Given the recent surge in SARS-CoV-2 Omicron infections, we performed a quantitative PCR screening survey during June 28-29, 2022, in Stockholm, Sweden, to investigate SARS-CoV-2 point prevalence in a group with high exposure risk. Results showed SARS-CoV-2 infection in 2.3% of healthcare workers who were asymptomatic at time of sampling.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19 Testing , Health Personnel , Humans , Sweden/epidemiology
13.
Support Care Cancer ; 30(11): 9101-9108, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1999946

ABSTRACT

PURPOSE: We aimed to determine whether there was a difference in access to cancer-related healthcare between people living in Sweden and the United Kingdom (UK) during the COVID-19 pandemic. We also describe how the pandemic affected social contact of patients undergoing treatment. METHODS: This cross-sectional study used survey data collected through the War on Cancer mobile phone application between September 5, 2020, and January 6, 2021. We included individuals with cancer diagnoses living in Sweden or the UK. The association between difficulty accessing cancer-related healthcare and country was examined using logistic regression. Frequencies were used to describe the effect of the pandemic on social contact. RESULTS: Of 491 individuals included in the study, 183 were living in the UK and 308 in Sweden. Living in the UK was associated with greater difficulty accessing cancer-related healthcare (n = 99/183, 54.1%) than living in Sweden (n = 100/308, 32.5%) (odds ratio 2.12, 95% CI 1.39-3.23, p < 0.001). The pandemic affected social contact for almost all patients (n = 218/238, 91.6%) undergoing treatment. CONCLUSION: This study highlights the differential impact that the pandemic may have had on patients' access to cancer-related care in the UK and Sweden. In both countries, the pandemic overwhelmingly affected social contact of individuals undergoing cancer treatment. New ways must be found to improve access to cancer-related care and reduce social isolation for patients with cancer during a pandemic.


Subject(s)
COVID-19 , Neoplasms , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Sweden/epidemiology , United Kingdom/epidemiology , Neoplasms/epidemiology , Neoplasms/therapy
14.
Viruses ; 14(8)2022 08 22.
Article in English | MEDLINE | ID: covidwho-1997803

ABSTRACT

It has been very difficult to predict the development of the COVID-19 pandemic based on mathematical models for the spread of infectious diseases, and due to major non-pharmacological interventions (NPIs), it is still unclear to what extent the models would have fit reality in a "do nothing" scenario. To shed light on this question, the case of Sweden during the time frame from autumn 2020 to spring 2021 is particularly interesting, since the NPIs were relatively minor and only marginally updated. We found that state of the art models are significantly overestimating the spread, unless we assume that social interactions significantly decrease continuously throughout the time frame, in a way that does not correlate well with Google-mobility data nor updates to the NPIs or public holidays. This leads to the question of whether modern SEIR-type mathematical models are unsuitable for modeling the spread of SARS-CoV-2 in the human population, or whether some particular feature of SARS-CoV-2 dampened the spread. We show that, by assuming a certain level of pre-immunity to SARS-CoV-2, we obtain an almost perfect data-fit, and discuss what factors could cause pre-immunity in the mathematical models. In this scenario, a form of herd-immunity under the given restrictions was reached twice (first against the Wuhan-strain and then against the alpha-strain), and the ultimate decline in cases was due to depletion of susceptibles rather than the vaccination campaign.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Immunity, Herd , Pandemics/prevention & control , SARS-CoV-2 , Sweden/epidemiology
15.
PLoS One ; 17(1): e0252994, 2022.
Article in English | MEDLINE | ID: covidwho-1997319

ABSTRACT

The global impact of coronavirus disease 2019 (COVID-19) is unprecedented, and many control and prevention measures have been implemented to test for and trace COVID-19. However, invisible-spreaders, who are associated with nucleic acid detection and asymptomatic infections, have received insufficient attention in the current COVID-19 control efforts. In this paper, we analyze the time series infection data for Italy, Germany, Brazil, India and Sweden since the first wave outbreak to address the following issues through a series of experiments. We conclude that: 1) As of June 1, 2020, the proportion of invisible-spreaders is close to 0.4% in Sweden, 0.8% in early Italy and Germany, and 0.4% in the middle and late stages. However, in Brazil and India, the proportion still shows a gradual upward trend; 2) During the spread of this pandemic, even a slight increase in the proportion of invisible-spreaders could have large implications for the health of the community; and 3) On resuming work, the pandemic intervention measures will be relaxed, and invisible-spreaders will cause a new round of outbreaks.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/transmission , Brazil/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Germany/epidemiology , Humans , India/epidemiology , Italy/epidemiology , Models, Theoretical , Pandemics , SARS-CoV-2/isolation & purification , Sweden/epidemiology
16.
Public Health ; 211: 14-20, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1996504

ABSTRACT

OBJECTIVES: The impact of COVID-19 on gambling behavior and the gambling industry itself has been widely speculated. Prior studies have shown how boredom, social isolation, poor mental health, and financial hardships, all of which have been associated with COVID-19, can aggravate problem gambling behaviors in patients with gambling disorders while also luring newcomers. Few studies have used methods other than self-report to assess longitudinal behavioral changes in gambling behavior before versus during the pandemic. STUDY DESIGN: The present study addresses this gap by using an interrupted time series approach on data obtained from the Swedish Gambling Authority measuring taxation on gambling vendors' revenue between January 2019 and November 2021. METHODS: March, June, and October 2020 were chosen as interruption points as they correspond to the pandemic's commencement, the return of elite sports, and the second wave of cases in Sweden, respectively. We hypothesized that the pandemic would be associated with both temporary changes for select gambling types and long-term increases in online gambling. RESULTS: Results revealed the pandemic's onset was associated with transient effects at each point of interruption, as well as long-term upward trends in total gambling and commercial online gambling, excluding horse betting and the state-owned operator for online casinos and betting. CONCLUSIONS: The present study's findings, although consistent with the theory that gambling activity could increase during the pandemic, contradict previous studies that found no changes or a decrease from pre-COVID-19 levels. Findings indicate that the pandemic and Sweden's reaction to it were associated with increased use of some gambling products.


Subject(s)
COVID-19 , Gambling , Animals , COVID-19/epidemiology , Gambling/epidemiology , Gambling/psychology , Horses , Humans , Interrupted Time Series Analysis , Pandemics , Sweden/epidemiology , Taxes
17.
BMJ Open ; 12(8): e063640, 2022 08 11.
Article in English | MEDLINE | ID: covidwho-1993030

ABSTRACT

OBJECTIVE: To investigate whether Swedish men living with children had elevated risk for severe COVID-19 or infection with SARS-CoV-2 during the first three waves of the pandemic. DESIGN: Prospective registry-based cohort study. PARTICIPANTS: 1 557 061 Swedish men undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. MAIN OUTCOME MEASURES: Infection with SARS-CoV-2 and hospitalisation due to COVID-19 from March 2020 to September 2021. RESULTS: There was a protective association between preschool children at home and hospitalisation due to COVID-19 during the first and third waves compared with only older or no children at all, with ORs (95% CIs) 0.63 (0.46 to 0.88) and 0.75 (0.68 to 0.94) respectively. No association was observed for living with children 6-12 years old, but for 13-17 years old, the risk increased. Age in 2020 did not explain these associations. Further adjustment for socioeconomic and health factors did not attenuate the results. Exposure to preschool children also had a protective association with testing positive with SARS-CoV-2, with or without hospitalisation, OR=0.91 (95% CI 0.89 to 0.93), while living with children of other ages was associated with increased odds of infection. CONCLUSIONS: Cohabiting with preschool children was associated with reduced risk for severe COVID-19. Living with school-age children between 6 and 12 years had no association with severe COVID-19, but sharing the household with teenagers and young adults was associated with elevated risk. Our results are of special interest since preschools and compulsory schools (age 6-15 years) in Sweden did not close in 2020.


Subject(s)
COVID-19 , Pandemics , Adolescent , COVID-19/epidemiology , Child , Child, Preschool , Cohort Studies , Humans , Male , Registries , SARS-CoV-2 , Sweden/epidemiology , Young Adult
18.
Eur J Public Health ; 32(5): 799-806, 2022 10 03.
Article in English | MEDLINE | ID: covidwho-1992174

ABSTRACT

BACKGROUND: This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household. METHODS: We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy. RESULTS: Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification. CONCLUSIONS: It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.


Subject(s)
COVID-19 , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , Humans , Middle Aged , Pandemics/prevention & control , Physical Distancing , SARS-CoV-2 , Sweden/epidemiology
19.
Int J Food Microbiol ; 378: 109823, 2022 Oct 02.
Article in English | MEDLINE | ID: covidwho-1991066

ABSTRACT

Thermophilic Campylobacter species are the most common cause of bacterial gastroenteritis worldwide, and handling and consumption of broiler meat is considered a major foodborne transmission route. Both the incidence of campylobacteriosis and the prevalence of Campylobacter in broilers show seasonality but the impact of this association and broiler prevalence on human incidence is not clear. To explore this relationship we applied two approaches for analyzing time series data using different time resolutions (weekly, bi-weekly or monthly data) of human campylobacteriosis cases and prevalence of Campylobacter spp. in broiler slaughter batches in Sweden between 2009 and 2019. The decomposition of time series into seasonal (S), long-term trend (T) and residual components (STL model) showed a close overlap in seasonal patterns in terms of timing and the proportional change of peaks from normalized yearly levels. Starting 2016, when a large outbreak was reported, there was significant overlap in the trend components as well. The trend component of human cases prior to the outbreak corresponded to a linear increase of 6.5 % cases annually. In comparison, the estimated annual increase in broiler consumption was 2.7 %. An additive approach for time-series counts incorporating seasonal and epidemic (cases are a function of previous cases) components found a positive association between human cases and broiler prevalence with an optimal lag of 2 weeks, 1 bi-week, or 0 months. Considering the estimated time between slaughter and consumption, incubation time, and the time between on-set of disease and testing, a 2-week lag may be consistent with transmission via handling and consumption of fresh broiler meat. The best model included broiler prevalence as a factor in the epidemic model component, not in the seasonal component. The outcomes in terms of best model, optimal lags and significance of parameters, using weekly, bi-weekly or monthly data were, in general, in agreement but varied with data resolution when only a subset of the time series, not including any known broiler associated outbreaks, was analyzed. The optimal resolution based on the available data and conditions of the present analysis appeared to be weekly or bi-weekly data. Results suggest that broiler prevalence with a 2 week lag period can explain part of the human cases but has a smaller explanatory impact during the part of the study period not including the large known outbreaks. There is no simple relationship between broiler prevalence and human cases. Additional factors than broiler prevalence need to be evaluated in order to understand the transmission routes and epidemiology of campylobacteriosis.


Subject(s)
Campylobacter Infections , Campylobacter , Gastroenteritis , Poultry Diseases , Animals , Campylobacter Infections/epidemiology , Campylobacter Infections/microbiology , Campylobacter Infections/veterinary , Chickens/microbiology , Humans , Poultry Diseases/microbiology , Prevalence , Sweden/epidemiology
20.
BMC Med Educ ; 22(1): 602, 2022 Aug 05.
Article in English | MEDLINE | ID: covidwho-1974140

ABSTRACT

BACKGROUND: To outline how the training program and work situation of residents in Obstetrics and Gynecology (OB-GYN) was affected by the pandemic and to illuminate how residents experienced these changes. METHODS: As part of the COVID-19 in Pregnancy and Early Childhood Staff (COPE Staff) cohort study, between January and May 2021, all participating residents were invited to answer a 28-question online Resident Survey focusing on their specialist education, work situation and experiences during the COVID-19 pandemic. Descriptive statistics were given in percentages for categorical variables and means and standard deviations (SD) for continuous variables. Univariate comparative analyses were performed with the use of the Pearson's Chi-2-test for dichotomous data. The association between residents' worry about the quality and length of their specialist training, with extra clinical hours and transfer to other healthcare institutions were assessed by multivariate logistic regression. Free text responses were analyzed by content analysis. RESULTS: Of the 162 participating OB-GYN residents, 69% expressed concern that the pandemic would have a negative impact on their training. Ninety-five (95%) reported cancellation/postponement of educational activities, 70% performed fewer surgeries and 27% had been transferred to other healthcare institutions where about half reported having gained more general knowledge as a physician. Working extra clinical hours was reported by 69% (7.4 ± 5.3 hours per week) and 14% had considered changing their profession due to the pandemic. Senior residents, compared to junior residents, more often experienced cancelled/postponed clinical rotations (30% vs 15%, P=0.02) and reported performing fewer surgeries (P=0.02). The qualitative analysis highlighted the lack of surgical procedural training as a major concern for residents. CONCLUSION: The COVID-19 pandemic has strongly impacted the training program and work situation of OB-GYN residents in Sweden. Residents were concerned over the negative impact of the pandemic on their training program and senior residents reported more missed educational opportunities as compared to junior residents. Program directors, head of institutions and clinical supervisors can use the problem areas pinpointed by this study to support residents and compensate for missed educational opportunities. While hands-on-training and operating time cannot be compensated for, the authors hope that the findings of the study can help develop new strategies to minimize the negative impact of the current and future pandemics on resident education and work situation.


Subject(s)
COVID-19 , Gynecology , Internship and Residency , Obstetrics , COVID-19/epidemiology , Child, Preschool , Cohort Studies , Female , Gynecology/education , Humans , Obstetrics/education , Pandemics , Pregnancy , Surveys and Questionnaires , Sweden/epidemiology
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