The impact of COVID-19 on deaths from dementia and Alzheimer's disease in Chile: an analysis of panel data for 16 regions, 2017-2022.

Background: Although several studies have documented the detrimental impacts of global COVID-19 containment measures on individuals with Alzheimer's disease and dementia, a comprehensive analysis of mortality rates for these conditions within the Chilean population is notably lacking. This study aimed to analyze the impact of COVID-19 on mortality rates among individuals with dementia and Alzheimer's disease in Chile. Methods: A retrospective longitudinal cross-sectional study was conducted, considering mortality data for specific mental health conditions during the pre-pandemic and pandemic contexts of COVID-19 in Chile. Quantile regression techniques were employed to analyze the existence of differences between the two periods, while non-observable heterogeneity models for panel data methods were used to evaluate the effect of COVID-19 mortality on crude mortality rates. Findings: Statistically significant differences were observed in the number of deaths from dementia and Alzheimer's disease between the pre-pandemic and COVID-19 pandemic periods. Specifically, crude mortality rates decreased by 10% (-0.10 [95% CI: -0.16, -0.05]) during the pandemic period. Furthermore, the number of deaths from COVID-19 during the pandemic period has a very weak incidence of deaths from mental health conditions such as dementia and Alzheimer's. Specifically, a unit percentage increase in confirmed cases from COVID-19 would result in a 7% (-0.07 [95% CI: -0.13, -0.001]) decrease in the number of deaths from dementia and Alzheimer's. These findings are supported by the application of panel regression with one-way random effects models. Interpretation: The study findings indicate a reduction in mortality rates attributed to dementia and Alzheimer's disease during the COVID-19 pandemic in Chile. This decline could be attributed to the potential underreporting of mental illness as the cause of death during the pandemic period. Several studies have highlighted that approximately 30% of death certificates fail to document the presence of a dementia syndrome. Moreover, the cause of death recorded for individuals with mental health conditions may be influenced by the physician's familiarity with the patient or reflect the prevailing approach to managing end-stage dementia patients. Funding: This work received no funding.

Indirect estimation of the need for palliative care during the COVID-19 pandemic: A descriptive cross-sectional study using mortality data in the Biobío Region, Chile.

BACKGROUND: People with chronic diseases in their advanced phase require palliative care. This is essential to ensure their quality of life as it ends. However, a very low percentage of patients receive the necessary palliative care. The COVID-19 pandemic has adversely affected the planning and provision of palliative care. Despite this, in Chile, palliative care coverage was extended by law to cover nononcological chronic diseases. Implementation of this law is expected to be a significant challenge in terms of material resources, as well as the need for the formation of specialized palliative care teams. Therefore, it is essential to estimate the need for palliative care for all chronic diseases to generate useful input for planning and decision-making in public health. OBJECTIVES: To indirectly estimate the need for palliative care among people with Chronic Oncological Diseases (COD) and Chronic Non-Oncological Diseases (CNOD) during the prepandemic and pandemic context due to COVID-19 in the Biobío Region in Chile. METHODS: Cross-sectional study based on mortality data from chronic oncological and nononcological diseases during the prepandemic (2010-2018) and pandemic (2020-2021) contexts due to COVID-19 in a Region of Chile through indirect estimation using minimal estimate, standardized mortality rates and geographically weighted regression. RESULTS: It was estimated that 76.25% of deaths from chronic diseases in the Biobío Region would have required palliative care, which represents 77,618 people who should have been included in these health benefits. The pandemic had a significant effect on the average number of deaths from CNOD. People belonging to this group were more likely to die from COVID-19 than from their baseline disease, unlike the deaths of people from COD, where no significant changes were observed. CONCLUSION: These estimates highlight the potential size of the population requiring palliative care and emphasize the importance of recognizing the rights of individuals with COD and CNOD conditions. It is evident that there is a significant demand for palliative care services, as well as a pressing need for adequate resources, effective management, and strategic planning to cater to the needs of this population. This is particularly crucial in the heavily impacted areas and communes of the Biobío Region, Chile.

Burnout y factores predictores en profesionales de Enfermería chilenos a un año de pandemia por COVID-19 / Burnout and predicting factors in Chilean nursing professional after one year of COVID-19 pandemic

Objetivo: analizar la asociación de variables sociodemográficas y laborales, estado de salud, inteligencia emocional, apoyo social percibido y espiritualidad en el desarrollo del burnout en profesionales de Enfermería a un año del comienzo de la pandemia COVID-19 en Chile.Método: se llevó a cabo un estudio descriptivo transversal (julio-octubre 2021). La población de estudio fueron enfermeras, que hubieran trabajado durante la pandemia en cualquier centro de atención sanitaria en Chile, atendiendo a pacientes al menos durante tres meses. Se aplicó un cuestionario online que incluía perfil enfermera, Maslach Burnout Inventory, Cuestionario Nórdico Estandarizado, Trait-Meta Mood Scale-24, Escala Multidimensional de Apoyo Social Percibido e Índice Breve de Religiosidad y Espiritualidad. Se llevó a cabo análisis descriptivo, correlaciones y regresión lineal.Resultados: participaron 192 profesionales, 181 (94,3%) eran mujeres. La edad media (DE) fue de 30,8 (6,81) años. La antigüedad laboral media (DE) fue de 5,6 (5,98) años. El 64,1% de las enfermeras presentó burnout. Se evidenció relación inversa y moderada entre las dimensiones de burnout e inteligencia emocional (directas, para el caso de realización personal). Se observó relación directa y moderada entre la realización personal y el apoyo social de amigos. También hubo relación indirecta y cercana a moderada entre cansancio emocional y espiritualidad. En los modelos predictivos, el dolor físico y la inteligencia emocional se asociaron con burnout.Conclusiones: más de la mitad de los profesionales de Enfermería de la muestra presentó burnout, siendo sus principales predictores el dolor físico y la inteligencia emocional.(AU)

Objective: to analyse the impact of sociodemographic and occupational variables, health status, emotional intelligence, perceived social support and spirituality, upon the development of burnout in Nursing professionals at one year after the start of the COVID-19 pandemic in Chile.Methods: a descriptive cross-sectional study was conducted (July to October 2021). The study population were nurses who had worked during the pandemic at any healthcare centre in Chile, seeing patients during at least three months. An online questionnaire was applied, including the nurse profile, the Maslach Burnout Inventory, the Standardized Nordic questionnaire, the Trait-Meta Mood Scale-24, the Multidimensional Scale of Perceived Social Support, and the Brief Spirituality/Religiousness Index. Descriptive analysis, correlations and linear regression were conducted.Results: the study included 192 professionals, 181 (94,3%) were female. Their mean age (SD) was 30.8 (6.81) years. Their mean seniority (SD) was 5.6 (5.98) years. Of these nurses, 64.1% presented burnout. A reverse and moderate relationship was observed between the burnout and emotional intelligence dimensions (direct in the case of personal fulfilment). A direct and moderate relationship was observed between personal fulfilment and social support by friends. There was also an indirect and close to moderate relationship between emotional exhaustion and spirituality. In the predictive models, physical pain and emotional intelligence were associated with burnout.Conclusions: more than half of Nursing professionals presented burnout, and its main predictors were physical pain and emotional intelligence.(AU)

Assessing the effectiveness of quarantine measures during the COVID-19 pandemic in Chile using Bayesian structural time series models.

Background: With the emergence of the COVID-19 pandemic, all existing health protocols were tested under the worst health crisis humanity has experienced since the Black Death in the 14th century. Countries in Latin America have been the epicenter of the COVID-19 pandemic, with more than 1.5 million people killed. Worldwide health measures have included quarantines, border closures, social distancing, and mask use, among others. In particular, Chile implemented total or partial quarantine measures depending on the number of infections in each region of the country. Therefore, it is necessary to study the effectiveness of these quarantines in relation to the public health measures implemented by government entities at the national level. Objective: The main objective of this study is to analyze the effectiveness of national- and region-level quarantines in Chile during the pandemic based on information published by the Chilean Ministry of Health, and answers to the following question are sought: Were quarantine measures in Chile effective during the COVID-19 pandemic? Methods: The causal effect between the rates of COVID-19 infections and the population rates in Phase 1 and Phase 2 quarantines in the period from March 2020 to March 2021 in different regions of Chile were evaluated using intervention analyses obtained through Bayesian structural time series models. In addition, the Kendall correlation coefficient obtained through the copula approach was used to evaluate the comovement between these rates. Results: In 75% of the Chilean regions under study (12 regions out of a total of 16), an effective Phase 1 quarantine, which was implemented to control and reduce the number of cases of COVID-19 infection, was observed. The main regions that experienced a decrease in cases were those located in the north and center of Chile. Regarding Phase 2, the COVID-19 pandemic was effectively managed in 31% (5 out of 16) of the regions. In the south-central and extreme southern regions of Chile, the effectiveness of these phases was null. Conclusion: The findings indicate that in the northern and central regions of Chile, the Phase 1 quarantine application period was an effective strategy to prevent an increase in COVID-19 infections. The same observation was made with respect to Phase 2, which was effective in five regions of northern Chile; in the rest of the regions, the effectiveness of these phases was weak or null.

Impact of COVID-19 on deaths from respiratory diseases: Panel data evidence from Chile.

The COVID-19 pandemic has relegated pathologies that were previously commonplace to a secondary context. Therefore, it is necessary to study the evolution of these diseases in the presence or absence of COVID-19. OBJECTIVE: The present study had the following objectives: 1. to evaluate the relationship between the COVID-19 epidemic and the possible decrease in death from respiratory disease (DRd) in Chile; and 2. to study the relationships between meteorological variables and severity of COVID-19 with respect to DRd from January 2018 to February 2021. METHODS: The variable number of DRds in Chile was analyzed considering the monthly records of meteorological variables (temperature, precipitation and humidity) in each region of Chile and the severity of COVID-19 to evaluate the mortality trend before and after the pandemic. For this, different nonobservable heterogeneity models for panel data were used. RESULTS: The variables that affect DRd include the number of deaths from COVID-19, which led to a decrease in DRd (negative effect) when increased, the number of patients with COVID-19 in the intensive care unit (ICU), which led to an increase in DRd (positive effect) when increased, and the minimum temperature, which had a negative effect on DRd. These results are supported by the application of panel regression with one-way random-effects models. CONCLUSION: This study revealed a reduction in the number of DRds other than COVID-19 during the pandemic in Chile. This could be explained by the sanitary measures applied by the Ministry of Health of Chile in relation to mobility restrictions and social distancing, among others. Therefore, DRd decreased in accordance with the appearance of the COVID-19 pandemic.

Prediction of confirmed cases of and deaths caused by COVID-19 in Chile through time series techniques: A comparative study.

BACKGROUND: Chile has become one of the countries most affected by COVID-19, a pandemic that has generated a large number of cases worldwide. If not detected and treated in time, COVID-19 can cause multi-organ failure and even death. Therefore, it is necessary to understand the behavior of the spread of COVID-19 as well as the projection of infections and deaths. This information is very relevant so that public health organizations can distribute financial resources efficiently and take appropriate containment measures. In this research, we compare different time series methodologies to predict the number of confirmed cases of and deaths from COVID-19 in Chile. METHODS: The methodology used in this research consisted of modeling cases of both confirmed diagnoses and deaths from COVID-19 in Chile using Autoregressive Integrated Moving Average (ARIMA henceforth) models, Exponential Smoothing techniques, and Poisson models for time-dependent count data. Additionally, we evaluated the accuracy of the predictions using a training set and a test set. RESULTS: The dataset used in this research indicated that the most appropriate model is the ARIMA time series model for predicting the number of confirmed COVID-19 cases, whereas for predicting the number of deaths from COVID-19 in Chile, the most suitable approach is the damped trend method. CONCLUSION: The ARIMA models are an alternative to modeling the behavior of the spread of COVID-19; however, depending on the characteristics of the dataset, other methodologies can better predict the behavior of these records, for example, the Holt-Winter method implemented with time-dependent count data.