ABSTRACT
INTRODUCTION: Socio-demographic factors are known to influence epidemic dynamics. The town of Nice, France, displays major socio-economic inequalities, according to the National Institute of Statistics and Economic Studies (INSEE), 10% of the population is considered to live below the poverty threshold, i.e. 60% of the median standard of living. OBJECTIVE: To identify socio-economic factors related to the incidence of SARS-CoV-2 in Nice, France. METHODS: The study included residents of Nice with a first positive SARS-CoV-2 test (January 4-February 14, 2021). Laboratory data were provided by the National information system for Coronavirus Disease (COVID-19) screening (SIDEP) and socio-economic data were obtained from INSEE. Each case's address was allocated to a census block to which we assigned a social deprivation index (French Deprivation index, FDep) divided into 5 categories. For each category, we computed the incidence rate per age and per week and its mean weekly variation. A standardized incidence ratio (SIR) was calculated to investigate a potential excess of cases in the most deprived population category (FDep5), compared to the other categories. Pearson's correlation coefficient was computed and a Generalized Linear Model (GLM) applied to analyse the number of cases and socio-economic variables per census blocks. RESULTS: We included 10,078 cases. The highest incidence rate was observed in the most socially deprived category (4001/100,000 inhabitants vs 2782/100,000 inhabitants for the other categories of FDep). The number of observed cases in the most social deprivated category (FDep5: N = 2019) was significantly higher than in the others (N = 1384); SIR = 1.46 [95% CI:1.40-1.52; p < 0.001]. Socio-economic variables related to poor housing, harsh working conditions and low income were correlated with the new cases of SARS-CoV-2. CONCLUSION: Social deprivation was correlated with a higher incidence of SARS-CoV-2 during the 2021 epidemic in Nice. Local surveillance of epidemics provides complementary data to national and regional surveillance. Mapping socio-economic vulnerability indicators at the census block level and correlating these with incidence could prove highly useful to guide political decisions in public health.
Subject(s)
COVID-19 , Epidemics , Humans , SARS-CoV-2 , COVID-19/epidemiology , Housing , PovertyABSTRACT
INTRODUCTION: In the SARS-CoV-2 epidemic, the monitoring of epidemiological surveillance indicators is a central issue. OBJECTIVE: We were able to describe the monitoring of the epidemic of hospitalized patients in the department of Alpes-Maritimes from three data sources: 1) Santé Publique France (SPF) via the SI-VIC software, 2) the Regional Health Agency (ARS Paca) with conventional hospitalization or department critical care data taken from SI-VIC, adjusting them to those of the Health Establishments (ES), 3) The ES of Alpes-Maritimes associated with the ARS of Alpes-Maritimes and the Department of Public Health (DSP) of the CHU, with the collection of patients hospitalized in the conventional sector or in critical/intensive care in the dedicated COVID-19 beds. The aim of this study was to verify the consistency of these three information systems. RESULTS: We observed disparities between the number of cases of hospitalization of SPF and the data from ES/ARS/DSP. We did not observe any differences in patients hospitized in intensive care/critical care units. The Scientific Council uses SPF data on the number of hospitalizations or intensive/critical beds to justify its recommendations.However, SPF data from SI-VIC have associated patients hospitalized for COVID and patients who tested positive for PCR, but whose reason for hospitalization is not related to SARS-CoV2 infection (formerly infected or asymptomatic patients). CONCLUSIONS: We believe that hospital surveillance indicators should only take into account the number of patients in conventional hospitalization or resuscitation for a COVID-19 infection.
