The role of socioeconomic status and political attitudes in the spread of Covid-19 in Austria

Abstract   This study investigates the role of socioeconomic status (SES) and political attitudes marked by populism and libertarianism in the spread of Covid-19 infections across Austria. A spatial regression approach is adopted based on official registry data on Covid-19 cases at the municipality level, granted by the Austrian National Public Health Institute. This allows the consideration of spatial dependencies between observations in close geographic proximity. Moreover, to uncover potential temporal (in)stabilities in the effects, the associations are examined over two pandemic phases, namely the second (06/20 to 02/21) and third wave (02/21 to 07/21) of infections. The analysis shows that low educational attainment and income led to higher infection rates during both periods under investigation. In contrast, unemployment was negatively related to the Covid-19 incidence. While the findings for income and education were more pronounced during the third wave of infections, unemployment had a more significant impact during the second wave. Contrary to what was expected, the findings report that populist attitudes were associated with lower case numbers during the second wave. This association reversed and became positive in the third wave but was no longer significant. A positive yet non-significant relationship was detected between libertarian attitudes and Covid-19 cases for both periods studied. The findings suggest that low-income and less-educated groups carry a higher Covid-19 disease burden in Austria. This provides vital information for policymakers to develop targeted public health strategies to protect vulnerable groups and achieve a more equitable distribution of health in society. Only limited evidence was provided regarding the impact of populist and libertarian sentiments on the spread of Covid-19. As polarisation has increased throughout the pandemic, further research on attitudes characterized by skepticism towards state intervention and science is needed. Key messages This study shows that income, education, and unemployment had a significant impact on municipality-level Covid-19 infection rates in Austria during the second and third waves of the pandemic. While populist and libertarian attitudes were positively associated with the Covid-19 incidence during the third wave, the effects were not significant.


Background:
The COVID-19 pandemic has resulted in worldwide kidney transplantation (KT) moratoriums. The impacts of these moratoriums on the life expectancy of KT candidates remain unclear.

Methods:
We simulated the evolution of several French candidate populations for KT using a multistate semi-Markovian approach and according to moratorium durations ranging from 0 to 24 months. The transition rates were modeled from the 63,927 French patients who began dialysis or were registered on the waiting list for KT between 2011 and 2019. Results: Among the 8,350 patients active on the waiting list at the time of the French KT moratorium decided on March 16, 2020, for 2.5-months, we predicted 4.0 additional months [CI: 2.8, 5.0] on the waiting list and 42 additional deaths [CI: -70, 150] up to March 16, 2030. In this population, we reported a significant impact for a 9-month moratorium duration: 135 attributable deaths [CI: 31, 257] up to March 16, 2030. Patients who became active on the list after March 2020 were less impacted.

Interpretation:
The temporary moratorium of KT during a COVID-19 peak in order to free up hospitals' resources doesn't impact patients' 10-year survival if the moratorium does not exceed a prolonged period. Funding. French National Research Agency (ANR-20-COV8-0002-01).

Key messages:
The French 2020 KT moratorium didn't impair patients' 10years survival. 9-month or longer moratoriums may impair patients' 10years survival. This study investigates the role of socioeconomic status (SES) and political attitudes marked by populism and libertarianism in the spread of Covid-19 infections across Austria. A spatial regression approach is adopted based on official registry data on Covid-19 cases at the municipality level, granted by the Austrian National Public Health Institute. This allows the consideration of spatial dependencies between observations in close geographic proximity. Moreover, to uncover potential temporal (in)stabilities in the effects, the associations are examined over two pandemic phases, namely the second (06/ 20 to 02/21) and third wave (02/21 to 07/21) of infections. The analysis shows that low educational attainment and income led 15th European Public Health Conference 2022 to higher infection rates during both periods under investigation. In contrast, unemployment was negatively related to the Covid-19 incidence. While the findings for income and education were more pronounced during the third wave of infections, unemployment had a more significant impact during the second wave. Contrary to what was expected, the findings report that populist attitudes were associated with lower case numbers during the second wave. This association reversed and became positive in the third wave but was no longer significant. A positive yet non-significant relationship was detected between libertarian attitudes and Covid-19 cases for both periods studied. The findings suggest that low-income and less-educated groups carry a higher Covid-19 disease burden in Austria. This provides vital information for policymakers to develop targeted public health strategies to protect vulnerable groups and achieve a more equitable distribution of health in society. Only limited evidence was provided regarding the impact of populist and libertarian sentiments on the spread of Covid-19. As polarisation has increased throughout the pandemic, further research on attitudes characterized by skepticism towards state intervention and science is needed.

Background:
In Italy, the flu vaccine is recommended and free for target groups (adults60 years old, fragile people, healthcare workers, pregnant women). During the 2020/2021 flu season, an increased vaccination coverage (+6,9%) was observed compared to the previous season, also due to the Covid-19 pandemic. We aimed to investigate how strong the adherence to the flu vaccine was by the vulnerable groups and assess if the Covid-19 vaccination campaign may have influenced the rate of flu vaccines.

Methods:
At the beginning of autumn 2021 we conducted an online survey among the population of Tuscany. We collected data on demographics, health status (pregnancy, vulnerable), flu and COVID-19 vaccinations coverage and health information sources. In addition, we performed a descriptive and a risk factors analysis to assess correlation between our variables with R v 4.0.0. Significance level was set at p < 0.05.

Results:
Among 408 participants, 248 (61%) belong to a vulnerable group and are recommended to receive the flu vaccine, 229 (56%) usually get the flu vaccine, 386 (95%) got the Covid-19 vaccine, 267 (65%) choose and trust the general practitioner (GP) as their health information source. There is a statistically significant association between being part of a vulnerable group and getting the seasonal flu vaccine (OR 6.63 95% CI 4.26-10.3 p < 0.001). In addition, getting the Covid-19 vaccine increases the likelihood of receiving the flu vaccine (2.90 95% CI 1.16-7.28 p = 0.018). Moreover, participants who trust their GP as their health information source (OR 1.63 CI 1.08-2.46 p = 0.019) are more likely to receive the flu vaccine; other information sources (TV, newspaper, social media) are not associated with the flu vaccine.

Conclusions:
Our research shows that vulnerable groups get vaccinated against the flu. The increase in flu vaccine coverage may be due to the COVID-19 vaccines campaign. GPs play a crucial role in the health promotion, prevention and health literacy of patients.

Key messages:
GP plays a crucial role in the prevention and health literacy of patients. COVID-19 vaccines campaign may have positively influenced the flu vaccination campaign. However, we must continue to maintain the coverage we have managed to achieve in the future.

Background and Aims:
Elderly, especially those with chronic diseases, are a population at high risk of a severe course of the SARS-CoV-2 infection.
The study aimed to investigate the complex immune response after vaccination in nursing home residents older than 65 years depending on the previous COVID-19 status and vaccine brand.
Methods: 375 participants participated in the study in September-October 2021. IgG antibodies against spike protein and nucleocapsid protein, the titer of virus neutralization antibodies, and cellular immunity (interferon-gamma release assay) were tested in elderly nursing home residents vaccinated with Pfizer, Moderna 30-31 weeks after the completion of vaccination and in those vaccinated with AstraZeneca 23 weeks before sampling. The prevalence with 95% confidence intervals (CI) was evaluated in Stata version 17.