Gendered impact of COVID-19 containment measures on unpaid care work and mental health in Europe: a scoping review protocol.

INTRODUCTION: Women are more likely than men to provide unpaid care work. Previous research has shown that lack of support for various forms of unpaid care work and work-family conflicts have negative impacts on caregivers' mental health, especially among female caregivers. COVID-19 containment measures may exacerbate existing gender inequalities both in terms of unpaid care work and adverse mental health outcomes. This scoping review protocol describes the systematic approach to review published literature from March 2020 onwards to identify empirical studies and grey literature on the mental health impact of COVID-19 containment measures on subgroups of unpaid caregivers at the intersection of gender and other categories of social difference (eg, ethnicity, age, class) in Europe. METHODS AND ANALYSIS: This scoping review is informed and guided by Arksey and O'Malley's methodological framework. We will search the databases Medline, PsycINFO, Scopus, CINAHL, Social Sciences Abstracts, Sociological Abstracts as well as Applied Social Sciences Index & Abstracts (ASSIA) and hand-search reference lists of selected articles to identify relevant peer-reviewed studies. We will conduct a grey literature search using Google Scholar and targeted hand-search on known international and European websites and include reports, working papers, policy briefs and book chapters that meet the inclusion criteria. Studies that report gender-segregated findings for mental health outcomes associated with unpaid care work in the context of COVID-19 containment measures in Europe will be included. Two reviewers will independently screen all abstracts and full texts for inclusion, and extract general information, study characteristics and relevant findings. Results will be synthesized narratively. ETHICS AND DISSEMINATION: This study is a review of published literature; ethics approval is not warranted. The findings of this study will inform public health research and policy. The results will be disseminated through a peer-reviewed publication and conference presentations.

SARS-CoV-2 Transmissibility Within Day Care Centers-Study Protocol of a Prospective Analysis of Outbreaks in Germany.

Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA ("Corona outbreak-related examinations in day care centers") is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.

Differences in risk perception, knowledge and protective behaviour regarding COVID-19 by education level among women and men in Germany. Results from the COVID-19 Snapshot Monitoring (COSMO) study.

The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1-28: 27,957 participants aged 18-74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.