A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19.


Journal

European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966

Informations de publication

Date de publication:
03 10 2022
Historique:
pubmed: 14 8 2022
medline: 5 10 2022
entrez: 13 8 2022
Statut: ppublish

Résumé

This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household. We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy. Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification. It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.

Sections du résumé

BACKGROUND
This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household.
METHODS
We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy.
RESULTS
Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification.
CONCLUSIONS
It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.

Identifiants

pubmed: 35962987
pii: 6665904
doi: 10.1093/eurpub/ckac101
pmc: PMC9384721
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

799-806

Investigateurs

Andrew T Chan (AT)
Sébastien Ourselin (S)
Tim D Spector (TD)
Jonathan Wolf (J)
Beatrice Kennedy (B)
Hugo Fitipaldi (H)
Ulf Hammar (U)
Marlena Maziarz (M)
Neli Tsereteli (N)
Nikolay Oskolkov (N)
Georgios Varotsis (G)
Lampros Spiliopoulos (L)

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.

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Auteurs

Carl Bonander (C)

Health Economics & Policy, School of Public Health & Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Debora Stranges (D)

Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.

Johanna Gustavsson (J)

Centre for Societal Risk Research, Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden.

Matilda Almgren (M)

Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.

Malin Inghammar (M)

Department of Clinical Sciences Lund, Section for Infection Medicine, Skåne University Hospital, Lund University, Lund, Sweden.

Mahnaz Moghaddassi (M)

Department of Clinical Sciences Malmö, Social Medicine and Global Health, Lund University, Malmö, Sweden.

Anton Nilsson (A)

Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.

Joan Capdevila Pujol (J)

ZOE Limited, London, UK.

Claire Steves (C)

Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Paul W Franks (PW)

Department of Clinical Sciences, Lund University Diabetes Center, Skåne University Hospital, Malmö, Sweden.
Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA.

Maria F Gomez (MF)

Department of Clinical Sciences in Malmö, Diabetic Complications Unit, Lund University Diabetes Centre, Lund, Sweden.

Tove Fall (T)

Department of Medical Sciences, Molecular Epidemiology, and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.

Jonas Björk (J)

Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.

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