Spatial scales, patterns, and positivity trends of SARS-CoV-2 pandemics in mass rapid antigen testing in Slovakia

Policies on children and schools during the SARS-CoV-2 pandemic in Western Europe

During the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mitigation policies for children have been a topic of considerable uncertainty and debate. Although some children have co-morbidities which increase their risk for severe coronavirus disease (COVID-19), and complications such as multisystem inflammatory syndrome and long COVID, most children only get mild COVID-19. On the other hand, consistent evidence shows that mass mitigation measures had enormous adverse impacts on children. A central question can thus be posed: What amount of mitigation should children bear, in response to a disease that is disproportionally affecting older people? In this review, we analyze the distinct child versus adult epidemiology, policies, mitigation trade-offs and outcomes in children in Western Europe. The highly heterogenous European policies applied to children compared to adults did not lead to significant measurable differences in outcomes. Remarkably, the relative epidemiological importance of transmission from school-age children to other age groups remains uncertain, with current evidence suggesting that schools often follow, rather than lead, community transmission. Important learning points for future pandemics are summarized.

Mass Screening of SARS-CoV-2 With Rapid Antigen Tests in a Receding Omicron Wave: Population-Based Survey for Epidemiologic Evaluation

BACKGROUND

The COVID-19 Omicron BA.2 epidemic wave in Hong Kong peaked in the first quarter of 2022. Following the implementation of stringent public health measures, the daily number of reported cases fell from over 50,000 to below 2000. Although outbreaks steadily receded, the government rolled out a 3-day "voluntary universal rapid testing" campaign to invite all citizens to self-perform a rapid antigen test (RAT) daily to identify undetected prevalent infections.

OBJECTIVE

This study aimed to evaluate the uptake and results of RAT mass screening to estimate the population's residual epidemic burden and assess the risk of further transmission.

METHODS

A cross-sectional study comprising an open web-based population-based survey was conducted a week after the RAT campaign. Participants were asked to report their COVID-19 vaccination and infection history and the RAT performance and test result during the period. They were also invited to report their coliving individuals' test performance and results. Reasons for nonuptake were enquired. Testing and positive rates were age-adjusted. Determinants of undergoing RAT were identified using univariable and multivariable logistic regression models.

RESULTS

In total, particulars from 21,769 individuals were reported by 8338 participants. The overall age-adjusted testing rate was 74.94% (95% CI 73.71%-76.18%), with over 80% of participants in the age groups between 45-84 years having self-performed RAT during the campaign period. After age-adjustment, 1.03% (95% CI 0.86%-1.21%) of participants tested positive. The positive rates in the age groups between 20-29 years and >84 years exceeded 2%. Taking into account the positive rate and 5819 reported cases during the period, the cases identified in the campaign might account for 7.65% (95% CI 6.47%-9.14%) of all infections. Testers were more likely to be female, older, not previously diagnosed with COVID-19, and have received COVID-19 vaccination. Adjusting for the number of household members, those living with a child aged <12 years and whose household members were also tested were more likely to have self-performed an RAT. Main reasons for not performing an RAT included the absence of symptoms (598/1108, 53.97%), disbelief of the appropriateness of the campaign as an antiepidemic measure (355/1108, 32.04%), and a recent COVID-19 diagnosis (332/1108, 29.96%).

CONCLUSIONS

The residual population burden remained substantial in spite of the clear evidence of a receding epidemic wave. Despite caution in generalization to the Hong Kong population, the high participation rate in mass screening indicated that the voluntary RAT was well accepted, making it a feasible option for implementation as a complementary means of public health surveillance.

Perception of testing for COVID-19 during the first wave of the pandemic in Slovakia with emphasis on population age groups

OBJECTIVE

The aim of this study was to evaluate the perception of the respondents in selected areas of testing for COVID-19 during the first waves of this disease with an emphasis on the age categories.

METHODS

The research sample consisted of 806 Slovak respondents and the collection of data took place in February 2021. The study examined six areas, of which five focused on the perception of testing and one area focused on examining the risk of population behaviour. All areas were examined in the first as well as in the last testing for COVID-19. In terms of age, we focused on 4 age categories: up to 24 years, 25-44 years, 45-59 years, and over 60 years. Data were obtained by online survey, using descriptive analysis and nonparametric analysis of differences.

RESULTS

The results of the analysis show that age is a socioeconomic characteristic that is of great importance for the creation and implementation of epidemiological processes and programmes and therefore epidemiologists should pay increased attention to it when creating prevention programmes. Younger people perceived testing more positively than older ones, even though the course of the disease caused by COVID-19 is much more severe in older people. The difference in the perception of testing between age categories was confirmed in the first as well as in the last test study. Respondents perceived the last test more negatively and thus they showed slightly riskier behaviour compared to the first test.

CONCLUSIONS

We perceive testing as an efficient way in the fight against pandemics generally, but we point out that testing should be well accomplished in a managerial way, otherwise testing can have a negative impact on society's confidence.