The indirect impact of COVID-19 large-scale containment measures on the incidence of community-acquired pneumonia in older people: a region-wide population-based study in Tuscany, Italy

Abstract

Objective : to evaluate the indirect effect of COVID-19 large-scale containment measures on the incidence of community-acquired pneumonia (CAP) in the elderly during the first epidemic wave of COVID-19 in Tuscany, Italy. Methods : a population based study was carried out on data from the Tuscany healthcare system. The outcome measures were: hospitalization rate for CAP, severity of CAP hospitalizations, and outpatient consumptions of antibacterials for CAP in people aged 65 years and older. Outcome comparisons between corresponding periods of the 2020 and previous years were made. Results : Compared with the average of the corresponding periods of the previous three years, significant reductions in the weekly hospitalization rates for CAP were observed starting from the week in which the national containment measures were imposed until the end of the first wave of COVID-19 in July. All the antibacterial classes for CAP showed a significant decrease in their outpatient consumptions during the COVID-19 epidemic period. Conclusions : The implementation of large-scale COVID-19 containment measures likely reduced the incidence of CAP in the elderly during the first wave of COVID-19 pandemic. Taking into account this indirect impact of pandemic containment measures on respiratory tract infections may improve the planning of health services during a pandemic.

The Role of Health Literacy in COVID-19 Preventive Behaviors and Infection Risk Perception: Evidence from a Population-Based Sample of Essential Frontline Workers during the Lockdown in the Province of Prato (Tuscany, Italy)

“…To contain the circulation of SARS-CoV-2 during the first wave of the epidemic, the Italian government adopted a national lockdown from 11 March to 3 May 2020, which suspended all non-essential services and activities, including schools, and imposed a stay-at-home order prohibiting all non-essential travel and contact with others. Besides these measures, physical distancing rules and the obligation to wear a face mask when leaving home were introduced [ 4 , 5 ].…”

The indirect impact of COVID-19 pandemic on the utilization of the emergency medical services during the first pandemic wave: A system-wide study of Tuscany Region, Italy

“…The health care system in Italy is a regionally based national health service; the TPHCS provides universal health coverage for all the residents of Tuscany. TPHCS counts 34 general hospitals and 4 university teaching hospitals; in total TPHCS have 38 EDs [15,21].…”

“…Although the management at home of less severe acute cases in the primary care setting or by remote care may have prevented some hospital or ED admissions, this shift in the provision of care can only partly account for the observed drop of cases as this setting cannot replace the treatment received during a hospital admission. Instead, the decrease in the ED or hospital utilization likely reflects the tendency for patients to defer care due to fear of contagion, even when they are acutely ill [3,7,15]. Indeed, several studies described a decline in ED admission driven by a fall in both emergent and non-emergent ED visits, suggesting that the decrease may also be due to patient reluctance to visit hospitals during the pandemic [16][17][18].…”

“…The Italian government has dealt with the pandemic by planning a three-phased strategy to contain the circulation of SARS-CoV-2 [15]. The first phase, from March 11 to May 3 2020, coincided with the national lockdown.…”

COVID-19 and schools: what is the risk of contagion? Results of a rapid-antigen-test-based screening campaign in Florence, Italy

“…The main measures taken were the promotion of physical distancing, the closure of borders between different regions, the cancellation of public events and the closure of schools, universities, and other educational institutions. Italy was one of the first Western countries severely affected by the coronavirus pandemic and the Region of Tuscany has been mildly affected during the first wave [2]. In the Province of Prato, in May 2020, the seroprevalence of SARS-CoV-2 antibodies in a representative sample of health care workers, participants involved in essential support services and those who worked from home were 4.1%, 1.4% and 1.0%, respectively [3].…”