Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974 |
Resumo: | Introduction: The use of face masks in public was one of several COVID-19 non-pharmaceutical interventions adopted to mitigate the pandemic in Portugal. The aim of this study was to evaluate the impact of lifting the mask mandate on the April 22, 2022 on COVID-19 incidence and mortality in mainland Portugal and in the Azores. As a secondary objective, we aimed to evaluate the evolution of COVID-19 cases in a setting without a mask mandate (Azores islands) and in a setting with a mask mandate (Madeira islands).Methods: Surveillance data on laboratory-confirmed COVID-19 cases and COVID-19 deaths were used to conduct an interrupted time series analysis to estimate changes in daily incidence and deaths during a mask mandate period (28th March – 21st April 2022) and during a post-mask mandate period (22nd April – 15th May 2022), in mainland Portugal and the Azores. In a second phase, for each group of islands, we fitted a negative binomial regression model, with daily COVID-19 incident cases as the primary outcome of interest, and relative frequency of Omicron BA.5 lineage as explanatory variable.Results: Significant changes in trends were observed for the overall incidence rate and COVID-19 deaths; increasing trends were observed for COVID-19 incidence and deaths in the post mandate period [5.3% per day; incidence rate ratio (IRR): 1.053; 95% confidence interval (CI): 1.029 - 1.078] and [3.2% per day; mortality rate ratio (MRR): 1.032; 95% CI: 1.003 - 1.062], respectively. For every unit increase in the percentage of Omicron BA.5 lineage there was a 1.5% increase per day (IRR: 1.015; 95% CI: 1.006 - 1.024) in COVID-19 incidence rate in the Azores islands, while for Madeira islands an increase of 0.05% COVID-19 cases per day was observed (IRR: 1.005; 95% CI: 1.000 - 1.010).Conclusion: Lifting the mask mandate in Portugal was associated with an increase in COVID-19 incidence and deaths, thus highlighting the positive effect of face mask policies in preventing respiratory virus transmission and saving lives. |
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Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological StudyImpacto do Fim da Obrigatoriedade do Uso de Máscara em Portugal na Incidência e Mortalidade de COVID-19: Um Estudo EcológicoCOVID-19MasksPandemicsPortugalSARS-CoV-2COVID-19MáscarasPandemiaPortugalSARS-CoV-2Introduction: The use of face masks in public was one of several COVID-19 non-pharmaceutical interventions adopted to mitigate the pandemic in Portugal. The aim of this study was to evaluate the impact of lifting the mask mandate on the April 22, 2022 on COVID-19 incidence and mortality in mainland Portugal and in the Azores. As a secondary objective, we aimed to evaluate the evolution of COVID-19 cases in a setting without a mask mandate (Azores islands) and in a setting with a mask mandate (Madeira islands).Methods: Surveillance data on laboratory-confirmed COVID-19 cases and COVID-19 deaths were used to conduct an interrupted time series analysis to estimate changes in daily incidence and deaths during a mask mandate period (28th March – 21st April 2022) and during a post-mask mandate period (22nd April – 15th May 2022), in mainland Portugal and the Azores. In a second phase, for each group of islands, we fitted a negative binomial regression model, with daily COVID-19 incident cases as the primary outcome of interest, and relative frequency of Omicron BA.5 lineage as explanatory variable.Results: Significant changes in trends were observed for the overall incidence rate and COVID-19 deaths; increasing trends were observed for COVID-19 incidence and deaths in the post mandate period [5.3% per day; incidence rate ratio (IRR): 1.053; 95% confidence interval (CI): 1.029 - 1.078] and [3.2% per day; mortality rate ratio (MRR): 1.032; 95% CI: 1.003 - 1.062], respectively. For every unit increase in the percentage of Omicron BA.5 lineage there was a 1.5% increase per day (IRR: 1.015; 95% CI: 1.006 - 1.024) in COVID-19 incidence rate in the Azores islands, while for Madeira islands an increase of 0.05% COVID-19 cases per day was observed (IRR: 1.005; 95% CI: 1.000 - 1.010).Conclusion: Lifting the mask mandate in Portugal was associated with an increase in COVID-19 incidence and deaths, thus highlighting the positive effect of face mask policies in preventing respiratory virus transmission and saving lives.Introdução: O uso de máscara em público foi uma das várias intervenções não farmacêuticas adotadas para mitigar a pandemia de COVID-19 em Portugal. Pretendeu-se com este estudo avaliar o impacto do levantamento da obrigatoriedade do uso de máscara, a 22 de abril de 2022, na incidência e mortalidade por COVID-19, em Portugal Continental e nos Açores. Como objetivo secundário, pretendeu-se avaliar a evolução de casos de COVID-19 numa região sem obrigatoriedade de uso de máscara (Região Autónoma dos Açores) e numa região com obrigatoriedade de uso de máscara (Região Autónoma da Madeira).Métodos: O número de casos de COVID-19 confirmados laboratorialmente e de mortes específicas por COVID-19 foram utilizados para realizar uma análise de séries temporais interrompidas, de modo a estimar mudanças na incidência diária e óbitos, durante um período com obrigatoriedade de uso de máscara (28 de março a 21 de abril de 2022) e durante um período após o fim da obrigatoriedade de uso de máscara (22 de abril a 15 de maio de 2022), em Portugal Continental e nos Açores. Numa segunda fase, para cada região autónoma, ajustou-se um modelo de regressão binomial negativa, tendo como variável de interesse os casos diários de COVID-19 e como variável explicativa a frequência relativa da linhagem Omicron BA.5.Resultados: Foi observada uma alteração significativa nas tendências relativas à taxa de incidência e mortes por COVID-19; foi observada uma tendência crescente quer para a incidência, quer para as mortes por COVID-19 no período pós-obrigatoriedade de uso de máscara [5,3% por dia; razão da taxa de incidência (IRR): 1,053; intervalo de confiança (IC) a 95%: 1,029 - 1,078] e [3,2% por dia; razão da taxa de mortalidade (MRR): 1,032; IC 95%: 1,003 - 1,062], respetivamente. Para cada aumento de 1% na linhagem BA.5 da variante Omicron estimou-se um aumento de 1,5% por dia (IRR: 1,015; IC 95%: 1,006 - 1,024) na taxa de incidência de COVID-19 na região autónoma dos Açores, enquanto que para a região autónoma da Madeira se observou um aumento de 0,05% nos casos de COVID-19 diários (IRR: 1,005; IC 95%: 1,000 - 1,010).Conclusão: O fim da obrigatoriedade do uso de máscara em Portugal esteve associado a um aumento na incidência e mortes por COVID-19, destacando-se assim o efeito positivo desta medida de saúde pública na prevenção da transmissão de vírus respiratórios e na redução da mortalidade.Ordem dos Médicos2023-05-22info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 661-669Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 661-6691646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974/15138https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974/15137Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessTorres, Ana RitaSilva, SusanaKislaya, IrinaNunes, BaltazarBarreto, MartaMachado, AusendaTorres, Ana Paula2023-10-08T03:00:14Zoai:ojs.www.actamedicaportuguesa.com:article/18974Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:56:30.228208Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study Impacto do Fim da Obrigatoriedade do Uso de Máscara em Portugal na Incidência e Mortalidade de COVID-19: Um Estudo Ecológico |
title |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
spellingShingle |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study Torres, Ana Rita COVID-19 Masks Pandemics Portugal SARS-CoV-2 COVID-19 Máscaras Pandemia Portugal SARS-CoV-2 |
title_short |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
title_full |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
title_fullStr |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
title_full_unstemmed |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
title_sort |
Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study |
author |
Torres, Ana Rita |
author_facet |
Torres, Ana Rita Silva, Susana Kislaya, Irina Nunes, Baltazar Barreto, Marta Machado, Ausenda Torres, Ana Paula |
author_role |
author |
author2 |
Silva, Susana Kislaya, Irina Nunes, Baltazar Barreto, Marta Machado, Ausenda Torres, Ana Paula |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Torres, Ana Rita Silva, Susana Kislaya, Irina Nunes, Baltazar Barreto, Marta Machado, Ausenda Torres, Ana Paula |
dc.subject.por.fl_str_mv |
COVID-19 Masks Pandemics Portugal SARS-CoV-2 COVID-19 Máscaras Pandemia Portugal SARS-CoV-2 |
topic |
COVID-19 Masks Pandemics Portugal SARS-CoV-2 COVID-19 Máscaras Pandemia Portugal SARS-CoV-2 |
description |
Introduction: The use of face masks in public was one of several COVID-19 non-pharmaceutical interventions adopted to mitigate the pandemic in Portugal. The aim of this study was to evaluate the impact of lifting the mask mandate on the April 22, 2022 on COVID-19 incidence and mortality in mainland Portugal and in the Azores. As a secondary objective, we aimed to evaluate the evolution of COVID-19 cases in a setting without a mask mandate (Azores islands) and in a setting with a mask mandate (Madeira islands).Methods: Surveillance data on laboratory-confirmed COVID-19 cases and COVID-19 deaths were used to conduct an interrupted time series analysis to estimate changes in daily incidence and deaths during a mask mandate period (28th March – 21st April 2022) and during a post-mask mandate period (22nd April – 15th May 2022), in mainland Portugal and the Azores. In a second phase, for each group of islands, we fitted a negative binomial regression model, with daily COVID-19 incident cases as the primary outcome of interest, and relative frequency of Omicron BA.5 lineage as explanatory variable.Results: Significant changes in trends were observed for the overall incidence rate and COVID-19 deaths; increasing trends were observed for COVID-19 incidence and deaths in the post mandate period [5.3% per day; incidence rate ratio (IRR): 1.053; 95% confidence interval (CI): 1.029 - 1.078] and [3.2% per day; mortality rate ratio (MRR): 1.032; 95% CI: 1.003 - 1.062], respectively. For every unit increase in the percentage of Omicron BA.5 lineage there was a 1.5% increase per day (IRR: 1.015; 95% CI: 1.006 - 1.024) in COVID-19 incidence rate in the Azores islands, while for Madeira islands an increase of 0.05% COVID-19 cases per day was observed (IRR: 1.005; 95% CI: 1.000 - 1.010).Conclusion: Lifting the mask mandate in Portugal was associated with an increase in COVID-19 incidence and deaths, thus highlighting the positive effect of face mask policies in preventing respiratory virus transmission and saving lives. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-05-22 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974/15138 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18974/15137 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2023 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2023 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
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application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 661-669 Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 661-669 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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