Serial roze siah part 197
Each of these is divided into 2–3 NUTS2 territories (total 8) and these are further divided into 20 NUTS3 territories, comprising the capital and 19 counties. There are three territories at Nomenclature of National Units for Statistics (NUTS) 1 level, Central Hungary, which includes the capital, Budapest, Transdanubia, in the West, and the Great Plain and North, in the East.
Morbidity was defined as the incidence of COVID-19 cases confirmed during the second wave.Ī brief explanation of the subnational divisions of Hungary is necessary. Official COVID-19 data by age, gender and municipality were obtained from NPHC. The epidemic curve was constructed using daily confirmed COVID-19 cases reported to NPHC from various data sources. These days were 22 June 2020 and 24 January 2021. The first and last days of the second pandemic wave in Hungary were defined as the days before and after the peak of the second wave when the lowest daily number of cases was recorded. A person with laboratory confirmation (detection of SARS-CoV-2 by PCR and, since 7 November 2020, SARS-CoV-2 antigen detection by a lateral flow test) of COVID-19 infection, irrespective of clinical signs and symptoms, was considered a confirmed case. Under the Hungarian protocol, suspected cases of COVID-19 (who met the clinical and epidemiological criteria or at the discretion of the physician) were reported to NPHC by the healthcare provider. The national surveillance protocol for COVID-19, which includes case definitions, was updated several times in line with changing European Centre for Disease Prevention and Control and WHO guidance. We address this gap with a study from Hungary, investigating the association between socioeconomic status of the population and COVID-19 morbidity, mortality, case fatality and excess mortality.ĭata on COVID-19 cases were obtained from the Hungarian Notifiable Disease Surveillance System, operated by the National Public Health Center (NPHC). There has not, to our knowledge, been any study of inequalities in COVID-19 outcomes in an entire country during the second wave of the pandemic when it might be expected that many lessons had already been learnt. 17–19 The apparently paradoxical findings in the Brazilian study may reflect differences in access to testing.Īs this brief review shows, the existing body of research is limited, especially so in the European Union, even though it has been severely affected during the pandemic. 16 Poorer people are also more likely to have the known risk factors for severe disease and death, including comorbidities such as cardiovascular disease, hypertension and diabetes. 15 Other studies have looked at different elements of the causal pathway, showing, for example, that those living precarious lives are more likely to have public facing jobs and to be less able to afford time to get tested or isolate if infected. 8 9 11 A study in the UK concluded that deprivation explained most, but not all, of the large ethnic gaps in COVID-19 outcomes. Research in Brazil pointed to inequalities in access to health facilities. There is unlikely to be a single explanation for these findings. 14 A rare exception is a single study from Rio de Janeiro that found that ‘age-standardised incidence rates were higher in wealthy neighbourhoods, mortality rates were higher in deprived municipalities during the first 2 months’ (in April and May 2020) of the pandemic. This has been found whether the disadvantage is measured at individual or community level and in many different settings, including the USA, 4–7 Brazil, 8–11 Columbia, 12Chile 13 and the UK. When they are infected, they are more likely to become seriously ill or die. Those already disadvantaged, whether on grounds of socioeconomic position, ethnicity or some other characteristic, have been most likely to become infected. 2 3ĬOVID-19 has shone a light on longstanding inequalities in societies everywhere.
This points to the need for a more detailed analysis to understand what was happening, for example, by looking at the different counties with their varying socioeconomic characteristics. There are good reasons to believe that it has not affected everyone to the same extent. 1 Nevertheless, the second wave was more severe in terms of both morbidity and mortality. Community transmission of COVID-19 was first detected in Hungary in March 2020 but the first epidemic wave was suppressed rapidly with an intensive government response.