Blood donation in times of crisis: Early insight into the impact of COVID-19 on blood donors and their motivation to donate across European countries
Torsten Chandler, Hamburg Center for Health Economics
The COVID-19 pandemic has caused unprecedented impact on blood transfusion and collection with both large-scale disruption to the supply and demand for blood. In this survey, we aimed to provide early insight into the impact of COVID-19 on blood donors and their motivation to donate during the COVID-19 crisis.
We asked representative samples in 7 European countries (Denmark, France, Germany, Italy, Portugal, the Netherlands and the UK) about their blood donation activity and motivation to donate using an online survey. We analysed donor turnout during the COVID-19 period descriptively and using logistic regression.
Results: Of the 7,122 people that responded to the survey, 1,205 (16.9%) blood donors were identified across the 7 European countries, with 33.8% donating during the first 4-5 months of the COVID-19 period. We observed that around half of donors donated less than normal. The vast majority of donors that did donate made a special effort to do so in response to COVID-19. Also, the majority of donors were not aware of their blood being tested for COVID-19. Although, the perceived risk of infection whilst donating blood was relatively low, those who anticipated a high risk of infection were much less likely to donate (OR=0.546; p-value=0.007). Furthermore, those that were adherent to COVID guidelines were also less likely to donate (OR=0.761; p-value= 0.001). Having a vulnerable household member at home did not appear to deter people from donating.
In summary, we observed that despite half of donors donating less than they normally would during the pandemic, most that did donate made a special effort to do so. Furthermore, survey respondents who anticipated a high risk of infection were much less likely to donate. This change in donation behaviour and the associated motivations of donors are relevant to policy makers who are concerned with maintaining adequate blood supply during this crisis. We suggest that blood collection services consider specialist campaigns that focus on the altruistic motivation of donors during the crisis and they continue to reassure donors of the safety measures in place in their centres. Lastly, the majority of donors appear to have not been incentivised by COVID-19 antibody tests, which could be considered alongside free health checks as incentive to elicit blood donations.
Torsten Chandler, Hamburg Center for Health Economics
Tom Stargardt, Hamburg Center for Health Economics
The toll of voting in a pandemic: Municipal elections and the spread of COVID-19 in Bavaria
Felix Krüger, Martin-Luther-Universität Halle-Wittenberg
Abstract: Elections may take place in precarious environments that even pose health risks. We consider the case of Bavaria, where close to ten million people were eligible to vote in the municipal elections on March 15 of 2020, to quantify the toll of elections in a pandemic. Despite declaring a state of emergency on the very next day, two weeks later, Bavaria had left behind any other German state in terms of COVID-19 infections and deaths per capita. Constructing synthetic controls for each of Bavaria's 96 districts, we find that about 87 per 100,000 or over a third of the increase in positive test results between March 15 and April 4 are not explained by district-level demographic, economic, health and child care characteristics, or the distance to Ischgl. We find mixed evidence that the spread of COVID-19 across Bavarian districts is associated with voter participation in the municipal elections. While OLS regression results suggest that a 1% increase in voter participation is associated with an additional 15.4 positive tests and 1.9 deaths per 100,000 inhabitants over the following three weeks, this is not corroborated by a proxy for the share of present voters and tentative IV regression results.
Jochen Güntner, Johannes Kepler University Linz
Felix Krüger, Martin-Luther-University Halle-Wittenberg
Tobias Schäffer, Martin-Luther-University Halle-Wittenberg
Gerrit Stahn, Martin-Luther-University Halle-Wittenberg
Amelie Wuppermann, Martin-Luther-University Halle-Wittenberg
Effect of the COVID-19 Lockdown on Disease Recognition and Utilization of Healthcare Services in the Older Population in German: A Cross-sectional Study
Bernhard Michalowsky, Deutsches Zentrum für Neurodegeneratie Erkrankungen (DZNE) e.V., Standort Rostock/ Greifswald
There is little evidence about the utilization of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdowns.
Based on a cross-sectional observational study that includes 1,095 general practitioners' (GPs) and 960 specialist practices in Germany and their 2.45 million older patients aged 65 or older the number of documented physician consultations, specialist referrals, hospital admissions, and incident diagnoses during the imposed lockdown in 2020 was descriptively analyzed and compared to 2019.
Physician consultations decrease slightly in February (-2%), increase before the imposed lockdown in March (+9%), and decline in April (-18%) and May (-14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (-39% vs. -6% respectively). Overall, 15%, 16%, and 18% fewer incident diagnoses were documented by GPs, neurologists, and diabetologists respectively in 2020. Diabetes, dementia, depression, cancer, and stroke were diagnosed less frequently during the lockdown (-17% to -26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations.
The data suggest that organizational changes were adopted quickly by practice management, but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.
Wolfgang Hoffmann, Deutsches Zentrum für Neurodegeneratie Erkrankungen (DZNE) e.V., Standort Rostock/ Greifswald
Karel Kostev, IQVIA
“Rather online than no midwife at all” - a comparative study on changed requirements for midwifery services during the Covid-19 pandemic (working title)
Jessica Rheindorf, WHU Otto-Beisheim School of Management
A pandemic is probably not the ideal time to give birth or to be born. As a consequence of the extensive restrictions on public life aiming to contain Covid 19, family networks break away and hospitals implement strict visit regulations, even limiting the birth attendance of fathers. At the same time, people start questioning whether hospitals and medical practices are safe enough. The lack of skilled professionals tapers off, as personal contacts need to be limited. However, midwives may offer (and charge for) additional digital services due to Covid-19. We aim to provide insights on how the pandemic changed clients’ preferences, needs and concerns regarding midwifery care.
In a mixed-methods approach, we evaluate results of a survey that was conducted among (expecting) parents partly in October and November 2019 (n=1.034) before the pandemic and partly in April 2020 (n=2,0539) during the first national lockdown. The survey was promoted via Facebook and mainly completed by females (99%) with the youngest child born in 2019 or 2020 (72%). Besides comparing quantitative results, we elicit the relative importance of different phases of midwifery care by examining three best-worst-tasks related to care during pregnancy, delivery and postnatal. Furthermore, a total of 1,228 answers to optional open-ended questions are analyzed and compared.
35% of respondents indicate that midwifery care has become more important to them during the crisis. Participants generally prefer care during pregnancy to be provided hand-in-hand by their midwife and gynecologist, but there is a slight shift towards sole midwifery-care during the lockdown by 3%. The majority prefers giving birth in a hospital with midwife-led care and medical equipment at hand, but here again, we observe a significant shift towards sole midwifery care by 5%. Even more than before the crisis, parents first of all expect their midwives to provide practical guidance with everyday challenges postnatal (increase by 14%). The acceptance for online consulting increases from 60 to 67% during pregnancy and from 67 to 78% postnatal, even though less women actually prefer online over personal support.
The urge to find a midwife has become even more pressing for women in times of pandemic. There is an even higher need for support with everyday challenges and at the same time contacts need to be limited. Hence, the willingness for compromises, e.g. in form of online support has increased. Women rather accept an online midwife than having no midwifery support at all. Furthermore, we observe a shift in preferences from medical-led care towards midwifery-led care due to avoidance of hospitals in times of contact restrictions, leading to an increased demand for home-births.