Leslie Kirstin, Findlay Beth, Ryan Theresa, Green Leonardo I, Harvey Ciaran, Whettlock Alice E, Bishop Jen, Ponce Hardy Vicki, Went April, Wallace Lesley, McLeod Allan, Weir Amanda, Marsh Kimberly
Clinical and Protecting Health, Public Health Scotland Glasgow Office, Glasgow, UK
Clinical and Protecting Health, Public Health Scotland Glasgow Office, Glasgow, UK.
J Epidemiol Community Health. 2022 Nov 8;77(1):1-8. doi: 10.1136/jech-2022-219367.
The early COVID-19 pandemic in Scotland-defined as the era before widespread access to vaccination and monoclonal antibody treatment-can be characterised into three distinct waves: March-July 2020, July 2020-April 2021 and May-August 2021. Each wave was met with various societal restrictions in an effort to reduce disease transmission and associated morbidity and mortality. Understanding the epidemiology of infections during these waves can provide valuable insights into future pandemic planning.
Scottish RT-PCR testing data reported up until 8 August 2021, the day prior to most restrictions being lifted in Scotland, were included. Demographic characteristics including age, sex and social deprivation associated with transmission, morbidity and mortality were compared across waves. A case-control analysis for each wave was then modelled to further compare risk factors associated with death over time.
Of the 349 904 reported cases, there were 18 099, 197 251 and 134 554 in waves 1, 2 and 3, respectively. Hospitalisations, intensive care unit admissions and deaths appeared highest in wave 2, though risk factors associated with COVID-19 death remained similar across the waves. Higher deprivation and certain comorbidities were associated with higher deaths in all waves.
Despite the higher number of cases reported in waves 2 and 3, case fatality rates were lower: likely a combination of improved detection of infections in younger age groups, introduction of social measures and vaccination. Higher social deprivation and comorbidities resulted in higher deaths for all waves.
苏格兰早期的新冠疫情（定义为广泛接种疫苗和单克隆抗体治疗之前的时期）可分为三个不同阶段：2020年3月至7月、2020年7月至2021年4月以及2021年5月至8月。为了减少疾病传播以及相关的发病率和死亡率，每一波疫情都伴随着各种社会限制措施。了解这些阶段的感染流行病学情况可为未来的疫情防控规划提供宝贵见解。
纳入截至2021年8月8日（苏格兰大部分限制措施解除的前一天）报告的苏格兰逆转录聚合酶链反应（RT-PCR）检测数据。对各阶段与传播、发病率和死亡率相关的年龄、性别和社会剥夺等人口统计学特征进行比较。然后针对每一阶段进行病例对照分析，以进一步比较不同时间与死亡相关的风险因素。
在报告的349904例病例中，第一波、第二波和第三波分别有18099例、197251例和134554例。住院、重症监护病房收治和死亡人数在第二波似乎最高，不过各波中与新冠死亡相关的风险因素保持相似。在所有阶段，较高的社会剥夺程度和某些合并症与较高的死亡人数相关。
尽管第二波和第三波报告的病例数较多，但病死率较低：这可能是年轻年龄组感染检测改善、社会措施的实施和疫苗接种共同作用的结果。较高的社会剥夺程度和合并症导致所有阶段的死亡人数都更高。
