Delays, Masks, the Elderly, and Schools: First Covid-19 Wave in the Czech Republic.

Running across the globe for nearly 2 years, the Covid-19 pandemic keeps demonstrating its strength. Despite a lot of understanding, uncertainty regarding the efficiency of interventions still persists. We developed an age-structured epidemic model parameterized with epidemiological and sociological data for the first Covid-19 wave in the Czech Republic and found that (1) starting the spring 2020 lockdown 4 days earlier might prevent half of the confirmed cases by the end of lockdown period, (2) personal protective measures such as face masks appear more effective than just a realized reduction in social contacts, (3) the strategy of sheltering just the elderly is not at all effective, and (4) leaving schools open is a risky strategy. Despite vaccination programs, evidence-based choice and timing of non-pharmaceutical interventions remains an effective weapon against the Covid-19 pandemic.

Influence of Demographic Factors on Standardised Rate Ratio of Age-adjusted Mortality Rates of Men in Comparison with Women Caused by Neoplasms and Circulatory System Diseases in Slovak Regions during 1996-2013.

AIM: The aim of our study was to find statistical associations including trends of standardised rate ratio of age-adjusted mortality rates for the male population as compared to the female population, in relation to available demographic factors (Chapter II - Neoplasms vs. Chapter IX - Diseases of the circulatory system, Slovak region and calendar year of death). METHODS: Dataset of individual cases of death in Slovakia with some demographic factors during 1996-2013 were provided by Slovak National Health Information Center. We used regression and correlation analyses, as well as analyses of variance and covariance along with descriptive statistics. RESULTS: The standardised rate ratio of age adjusted mortality rates of men versus age-adjusted mortality rates of women differs between Chapter II and Chapter IX (mean 2.08 vs. 1.35, p<0.001). There are also significant differences of standardised rate ratio among regions (p<0.05). Trends show that the standardised rate ratio has significant regional decline for Chapter II: Kosice (p<0.01), Trencín (p<0.001) and Zilina (p<0.05) whereas in Chapter IX Zilina region (p<0.01) is implicated. In other Slovak regions standardised rate ratio stagnates. CONCLUSIONS: Standardised rate ratios of age-adjusted mortality rates for the male population compared to the female population are significantly dependent on chapter, sex and region. Standardised rate ratios either decline or stagnate.

Income Inequality in Non-communicable Diseases Mortality among the Regions of the Slovak Republic.

AIM: A great amount of non-communicable disease deaths poses a threat for all people and therefore represents the challenge for health policy makers, health providers and other health or social policy actors. The aim of this study is to analyse regional differences in non-communicable disease mortality in the Slovak Republic, and to quantify the relationship between mortality and economic indicators of the Slovak regions. METHODS: Standardised mortality rates adjusted for age, sex, region, and period were calculated applying direct standardisation methods with the European standard population covering the time span from 2005 to 2013. The impact of income indicators on standardised mortality rates was calculated using the panel regression models. RESULTS: The Bratislava region reaches the lowest values of standardised mortality rate for non-communicable diseases for both sexes. On the other side, the Nitra region has the highest standardised mortality rate for non-communicable diseases. Income quintile ratio has the highest effect on mortality, however, the expected positive impact is not confirmed. Gini coefficient at the 0.001 significance level and social benefits at the 0.01 significance level look like the most influencing variables on the standardised mortality rate. By addition of one percentage point of Gini coefficient, mortality rate increases by 148.19 units. When a share of population receiving social benefits increases by one percentage point, the standardised mortality rate will increase by 22.36 units. CONCLUSIONS: Non-communicable disease mortality together with income inequalities among the regions of the Slovak Republic highlight the importance of economic impact on population health.

Time Trend, Age and Sex Distribution of Deceased from Diabetes Mellitus at the Regional Level in the Slovak Republic.

AIM: To describe the time trends, age and sex distribution of death from diabetes mellitus (E10-E14) as a significant part of endocrine, nutritional and metabolic diseases (E00-E90), during 1996-2014 in the Slovak regions, and to estimate the influence of social characteristics on mortality. METHODS: Secondary data on deaths during 1996-2014 were gathered from the National Health Information Center in the Slovak Republic. The total crude death rate per 100,000 of the standard Slovak population and age-standardized death rate per 100,000 of the standard European population were calculated by direct standardization. Multilevel logistic regression analysis was performed. RESULTS: Deaths from diabetes mellitus account for 91.6% of deaths registered in the endocrine, nutritional and metabolic diseases Chapter. The age-standardized death rate per 100,000 of inhabitants decreased from 19.2 in 1996 to 15.3 in 2014 in the Slovak Republic, although a massive increase of up to 32.5 was reported in 1999. The highest age-standardized death rates per 100,000 inhabitants were typical for the Kosice, Nitra and Trencín regions. On the other hand, the lowest counts were recorded in the Bratislava region. Mortality from diabetes mellitus starts to be evident in the 45-49 year age-group in both sexes. The median age of death for women is lower in the 75-79 year age-group in comparison to men although the total crude death rate for men in lower age groups is higher. After age 80 the situation is reversed. The odds of dying due to endocrine, nutritional and metabolic diseases decreases by 0.4% each year. The odds of dying are lower by 17% and 12.3%, respectively, in the Zilina and Presov regions compared to Bratislava region. Women have a higher probability of dying by 38% in contrast to men, and married couples by 16.7% than singles. Age is proved to be an insignificant factor. CONCLUSIONS: In spite of the declining trend of mortality from diabetes mellitus, it is necessary to reduce the risk of its incidence by healthier food consumption and physical activity.

Delays, masks, the elderly, and schools: first COVID-19 wave in the Czech Republic.

Running across the globe for more than a year, the COVID-19 pandemic keeps demonstrating its strength. Despite a lot of understanding, uncertainty regarding the efficiency of interventions still persists. We developed an age-structured epidemic model parameterized with sociological data for the Czech Republic and found that (1) delaying the spring 2020 lockdown by four days produced twice as many confirmed cases by the end of the lockdown period, (2) personal protective measures such as face masks appear more effective than just a reduction of social contacts, (3) only sheltering the elderly is by no means effective, and (4) leaving schools open is a risky strategy. Despite the onset of vaccination, an evidence-based choice and timing of non-pharmaceutical interventions still remains the most important weapon against the COVID-19 pandemic.