Multigenerational households put some nations at greater risk

The age-related structure of households and their size appear to have a significant influence on the impact of COVID-19 in different nations, a modelling study has found

Welcome to The Medical Republic‘s live COVID-19 blog.

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The latest

• Afternoon update: Multigenerational households may increase risk of secondary COVID-19 deaths, and Australians were pretty good at following hygiene and distancing recommendations.
• Morning update: COVID-19 claims life of Victorian man, and review suggests increase risk of disease and poor outcomes in BAME individuals.
• Another family cluster takes Victorian COVID-19 count up by 17 new cases, while NSW goes backwards by two.

4.25pm, 24 June

• The age-related structure of households and their size appear to have a significant influence on the impact of COVID-19 in different nations, a modelling study has found.
  Writing in PNAS, researchers used census data from 81 countries to look at age and co-residence patterns for private households – for example, whether households tended to be smaller and single generations, or larger and with multiple generations living under the same roof – as well as age-specific mortality rates from COVID-19 to predict how those factors might influence COVID-19 mortality rates in those countries.
  Comparing the rate of direct deaths – the primary infection in a household – with secondary or indirect deaths in household and family members, the study suggested that in nations with older populations, the number of direct deaths is higher compared to nations with younger populations.
  When it comes to co-residence patterns, areas where elderly people tend to live with their families – such as Africa and parts of Asia – are associated with an increase in indirect deaths caused by within-household transmission of COVID-19.
  Nations that have both a large elderly population and multigenerational living patterns, such as some southern European countries, are the most vulnerable to COVID-19 outbreaks.
  “For instance, countries with similar direct death rates, such as France and Spain, show remarkably different indirect rates, due to higher levels of intergenerational coresidence in Spain,” the authors wrote. “Countries with similar indirect death rates, such as Italy and China, have quite distinct direct death rates, due to differences in their age structure.”
• Nearly 85% of Australians adopted at least one of the hygiene recommendations and more than 90% adopted at least one of the avoidance-related behaviours advised during the COVID-19 pandemic.
  In a paper published in PLoS ONE, researchers reported the results of a survey of an online survey of 1420 Australian adults when the pandemic was at its peak, which examined respondents’ perceptions of risk, of the effectiveness of measures aimed at reducing that risk, and their ability to adopt some of the social distancing measures that were recommended.
  More than 70% of participants felt their risk of catching COVID-19 was very high, around half felt that COVID-19 would ‘somewhat’ impact their health, and 12% felt it would impact their health extremely.
  Nearly half felt wearing a mask wearing would be effective at limiting the spread of COVID-19, but only 37% felt that closing bars and restaurants would have a high or very high effect.
  Three-quarters of respondents were washing their hands with soap and water, and two-thirds were avoiding crowded places. People who described themselves as worried or very worried about COVID-19 were more likely to adopt hygiene-related and avoidance behaviours.

12.25pm, 24 June

• A Victorian man has died from COVID-19, taking the state toll to 20 and the national toll from the pandemic to 103.
• Black, Asian and Minority Ethnic (BAME) individuals appear to be at greater risk of contracting COVID-19 and of worse outcomes from infection, according to a systematic review published in EClinicalMedicine.
  But what is perhaps more surprising about the 690 articles from major journals is that only 12 of these articles reported ethnicity of participants. Preprints did a little better; of 209 preprints, 34 reported ethnicity.
  Overall, the studies that did include data on ethnicity pointed to Black, Asian and Hispanic individuals having a higher risk of acquiring the infection compared to White individuals, with Black individual having the highest risk. There was also some evidence – mainly from preprint and ‘grey’ literature that people of Black and Asian ethnicity have a higher risk of hospitalisation, admission to intensive care, and death from COVID-19.
  “Elucidating the role of ethnicity in the current pandemic is of urgent public health importance,” the authors wrote.

9.50am, 24 June

• While NSW actually went backwards in its COVID-19 infection count – thanks to the exclusion of two previous positive tests – Victoria continues to show a rise in cases with 17 new infections reported to 9pm yesterday.
  There are a number of major family and household clusters, with a new cluster of five cases in one family reported yesterday. The state’s Chief Health Officer Professor Brett Sutton urged anyone with symptoms to get tested and self-isolate until they had a result.
  Across Australia to 9pm yesterday, here are the latest confirmed COVID-19 infection figures:
  National – 7492, with 102 deaths and 6915 recovered
  ACT – 108
  NSW – 3150
  NT – 29
  QLD – 1066
  SA – 440
  TAS – 228
  VIC – 1864
  WA – 607