Pandemic excess mortality in Spain, Sweden, and Switzerland during the COVID-19 pandemic in 2020 was at its highest since 1918

Estimating excess mortality allows quantification of overall pandemic impact. For recent decades, mortality data are easily accessible for most industrialized countries, but only a few countries have continuous data available for longer periods. Since Spain, Sweden, and Switzerland were militarily neutral and not involved in combat during both world wars, these countries have monthly all-cause mortality statistics available for over 100 years with no interruptions. We show that during the COVID-19 pandemic in 2020, Spain, Sweden and Switzerland recorded the highest aggregated monthly excess mortality (17%, 9% and 14%) since the 1918 influenza pandemic (53%, 33% and 49%), when compared to respective expected values. For Sweden and Switzerland, the highest monthly spikes in 2020 almost reached those of January 1890. These findings emphasize the historical dimensions of the ongoing pandemic and support the notion of a pandemic disaster memory gap. One-Sentence SummaryDuring the COVID-19 pandemic in 2020, Spain, Sweden, and Switzerland recorded their highest monthly excess and all-cause mortality levels since the 1918 influenza pandemic, emphasizing the historical dimension of the ongoing pandemic.

Losing ground at the wrong time: Trends in self-reported influenza vaccination uptake in Switzerland, Heath Survey 2007-2017

ObjectivesWe studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged [≥] 65 years. DesignThree cross-sectional surveys. ParticipantsIndividuals who participated in the Swiss Health Surveys 2007, 2012, and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses. ResultsThe proportion of reporting a history of influenza vaccination overall was 31.9% (95% confidence intervals [95% CI] 31.4-32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged [≥] 65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). Similarly, a decrease in vaccine uptake was seen in people with poor self-reported health status (39.4%, 33.1%, and 27.0%). In logistic regression, self-reported vaccination coverage decreased in the 65 to 75 years old (adjusted odds ratio (aOR) aOR 0.56, 95% Cl 0.48-0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77-1.03). Uptake was positively associated with the [≥] 65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession, and having any underlying chronic disease. Use of any alternative medicine therapy was negatively associated with influenza vaccination (aOR 0.72, 95% CI 0.67-0.80). ConclusionInfluenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the flu season 2020/21 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media. Strengths and limitations of this studyO_LIData analysis of the Swiss Health Survey 2007, 2012, and 2017 focussing on influenza vaccine uptake overall and in the age group [≥]65 years in Switzerland. C_LIO_LIThe Swiss Health Survey is a nationwide, representative survey that is repeated every five years using the same methodology. C_LIO_LIAnalyses were weighted and adjusted for a wide range of important cofactors. C_LIO_LIWe calculated percent of people reporting having been vaccinated and associations between vaccination status and socio-demographic and health-related factors. C_LIO_LIInfluenza vaccination status is self-reported in the Swiss Health Survey and the reliability of the data not ascertained. C_LI

Desenvolvimento de conceitos: o paradigma das transformações / Development of concepts: the transformations paradigm

Keil (1989) investigou se artefatos e espécies naturais permaneciam membros das mesmas categorias após transformações mudando seus aspectos característicos mais salientes. Este trabalho replica um de seus experimentos, objetivando comprovar a validade de seus resultados em nosso meio. Participaram 30 crianças, subdivididas em três grupos (6/7; 8/9 e 10/11 anos). Traduziu-se seis estórias, quatro referentes a espécies naturais, duas a artefatos. Estas relatavam situações em que médicos operavam espécies naturais e artefatos alterando suas propriedades comportamentais e perceptivas mais salientes e transformando-os em outras espécies, referentes à mesma categoria. A cada sujeito narrou-se as estórias e ao final de cada uma perguntava-se se ocorreu a transformação em outra espécie. Observou-se que os sujeitos avaliaram corretamente a identidade dos artefatos, mas somente com o aumento da idade os atributos definidores passaram a ser considerados para avaliação da identidade correta das espécies naturais. De maneira geral, nossos resultados confirmaram o estudo de Keil(AU)

Desenvolvimento de conceitos: o paradigma das transformações / Development of concepts: the transformations paradigm

Keil (1989) investigou se artefatos e espécies naturais permaneciam membros das mesmas categorias após transformações mudando seus aspectos característicos mais salientes. Este trabalho replica um de seus experimentos, objetivando comprovar a validade de seus resultados em nosso meio. Participaram 30 crianças, subdivididas em três grupos (6/7; 8/9 e 10/11 anos). Traduziu-se seis estórias, quatro referentes a espécies naturais, duas a artefatos. Estas relatavam situações em que médicos operavam espécies naturais e artefatos alterando suas propriedades comportamentais e perceptivas mais salientes e transformando-os em outras espécies, referentes à mesma categoria. A cada sujeito narrou-se as estórias e ao final de cada uma perguntava-se se ocorreu a transformação em outra espécie. Observou-se que os sujeitos avaliaram corretamente a identidade dos artefatos, mas somente com o aumento da idade os atributos definidores passaram a ser considerados para avaliação da identidade correta das espécies naturais. De maneira geral, nossos resultados confirmaram o estudo de Keil