RESUMO
Public health emergencies such as the coronavirus (SARS-CoV-2) pandemic have significant impact on mental health, and have been shown to impact on already prevalent affective disorders during and after pregnancy. The aim of this study was to utilize modern tools to assess depressive and anxiety symptoms, as well as wellbeing and life changes in pregnant women during the pandemic in Sweden, where no lockdown has been in place. Data from the Mom2B, a national ongoing mobile application-based study of pregnant and newly-delivered women were utilized. Participants (n= 1345) filled out self-report screeners of depression, anxiety and wellbeing. Questions about COVID symptoms and effects on life and health care were added from March 2020. Movement data was collected using the phones GPS sensor. Mood scores were compared with throughout the months of 2020 and to the levels of a previous collected material. Highest levels of depression and anxiety were evident in April and October 2020. Symptoms were higher among those feeling socially isolated, but not for those infected or with symptomatic family members. Wellbeing and mobility were strongly positively correlated and were lowest in April. Women reported on cancelled healthcare appointments and worry about their partners being absent from the delivery. The Mom2B application enabled gathering information at a national level in real-time as the pandemic has been evolving. Levels of perinatal affective symptoms and low wellbeing were elevated compared with previous years as well as with months with fewer cases of SARS-Cov-2. Similar applications can help healthcare providers and governmental bodies to in real time monitor high-risk groups during crises, as well as to adjust measures and the support offered. FundingThis project was funded by the Uppsala Region to AS, the Swedish Association of Local Authorities and Regions (SKR) to the department of Obstetrics and Gynecology, Akademiska University Hospital, the Swedish Research Council (Grant number 2020-01965) to AS, as well as the Fredrik and Inger Thurings Foundation to EF.
RESUMO
BackgroundSufficient community testing for suspected COVID-19 regardless of residential area is essential for a successful test-trace-isolate strategy. AimThis study aimed to elucidate area level characteristics linked to testing rates. MethodsFree-of-charge diagnostic tests (PCR) of SARS-CoV-2 was made available to the general public in late June 2020 in Uppsala County, Sweden, at four main test stations, and to a lesser extent at other health care units. We analysed 35,794 tests performed on individuals from 346 postal codes, from 24 June to 12 October 2020. ResultsWe observed varying testing rates across postal code areas within Uppsala City as well as in Uppsala County. Testing rates were lower in areas characterized by longer distance to the nearest test station, lower neighbourhood deprivation index indicating higher deprivation (NDI) and higher proportion of inhabitants with foreign background. Multivariable regression models could not separate influences of foreign background and NDI on COVID-19 testing rates as these were collinear. Further, we did not detect any association between COVID-19 hospitalization rates and testing rates, indicating that underlying community infection rates did not substantially affect test frequency during this period. ConclusionWe observed that testing rates were associated with distance to test station and socioeconomic and demographic circumstances. As lower testing rates can contribute to inequity in pandemic health effects, there is an urgent need to ensure adequate test accessibility in all parts of society.