The Integrated Health Monitor COVID-19: A Protocol for a Comprehensive Assessment of the Short- and Long-Term Health Impact of the Pandemic in the Netherlands

BACKGROUND

The global COVID-19 pandemic has profoundly affected public health. Directly, the pandemic resulted in over 6.6 million deaths, numerous hospitalizations, and widespread illness. The pandemic has also affected health indirectly through government-imposed protective measures, causing decline in mental well-being and increasing social isolation. Unlike previous disasters or crises, the pandemic's worldwide and enduring impact necessitates a unique research approach. The Network for Health Research in Disasters in the Netherlands responded by initiating a longitudinal, extensive research project called the Integrated Health Monitor COVID-19. The Integrated Health Monitor COVID-19 explores both the direct and indirect health effects of the pandemic at the population level.

METHODS

The Integrated Health Monitor COVID-19 employs a dual-pronged monitoring strategy alongside an annual literature review. This strategy comprises short-cycle monitoring (conducted quarterly) and long-cycle monitoring (conducted once every one or two years). This comprehensive approach enables the evaluation of health trends during the pandemic, facilitating comparisons with pre-pandemic levels and identification of risk and protective factors. Both monitoring methods incorporate data from surveys and general practice registries. The integration of annual literature reviews with these measurements enables iterative research, while dialogues on policy and practice improvements enhance the knowledge-to-action process.

DISCUSSION

Much of the existing knowledge about the potential impact of the COVID-19 pandemic is derived from research on sudden-onset disasters limited to specific geographical areas. This study is anticipated to provide valuable fresh insights into the evolving dynamics of population health and specific vulnerabilities within the ongoing pandemic context.

A wave of COVID-19 related PTSD? Disentangling the impact of exposure to COVID-19 related events on probable posttraumatic stress disorder in the general Dutch population

INTRODUCTION

The COVID-19 pandemic highlighted a critical gap in our knowledge on the impact on mental health, especially trauma-related disorders like PTSD. With future pandemics anticipated due to global health risks, it is essential to rigorously study the prevalence of PTSD resulting from COVID-19. Such research will help us understand the psychological effects of pandemics and develop better strategies for mental health support in future crises.

METHODS

This study uses data from the Dutch Public Health Monitor Adults and Elderly 2022, consisting of 365,000 Dutch adults recruited using random sampling. Pandemic-related and non-COVID related potentially traumatic events were assessed and anchored to a validated screening instrument for PTSD, the Dutch version of the PCL-5.

RESULTS

Two-thirds of participants reported experiencing traumatic events during the pandemic. Exposure to pandemic-related traumatic events was reported more frequently than non-COVID related traumatic events. Overall probable PTSD prevalence due to these events was 2.4%, evenly split between pandemic-related and non-COVID related traumatic events. Among exposed individuals, probable PTSD prevalence was 3.7%. The risk was higher for exposure to non-COVID related events such as sexual violence, physical violence and life-threatening accidents than exposure to pandemic-related traumatic events like hospitalization or death of someone significant. Risk factors for developing probable PTSD after exposure to a traumatic event during the pandemic were younger age, financial difficulties, loneliness, low resilience, and experiencing multiple events.

DISCUSSION

Exposure to traumatic events during the pandemic influenced the prevalence of probable PTSD. Despite the lower relative impact of pandemic-related traumatic events compared to non-COVID related traumatic events, exposure to pandemic-related traumatic events accounted for 1.1% of probable PTSD in the population and is thereby comparable in impact to five commonly occurring traumatic events. This emphasizes the need to address mental health consequences and risk factors during pandemics and, potentially, other crises with population-wide exposure to events.