Risk perception has a significant impact on decisions people make when facing a threat: a mismatch between actual hazard and perceived risk can lead to inappropriate behaviours and suboptimal compliance to recommended public health measures. The present study was conducted in the aftermath of a tuberculosis (TB) outbreak that occurred in 2019 in a primary school in Italy. The aim was to evaluate the impact of communication measures implemented by local health authorities (including face-to-face meetings between LHAs and the local population, weekly press announcements, implementation of a telephone hotline and of an information desk, and social media communication), on risk perception among parents of schoolchildren and school staff, and to identify factors related to a change in risk perception before and after the said activities. An anonymous questionnaire was administered to parents of schoolchildren (n = 846) and to school staff (n = 70). Participants were asked about the level of risk they had perceived at two distinct times: when they first became aware of the outbreak and following implementation of communication activities. A significant reduction of perceived risk was found in both groups (p < 0.001) following the communication activities. The largest reduction was found among participants who reported having appreciated the meetings with the LHA healthcare staff. Our findings suggest that keeping an open approach, explaining the actual threat to the population and adapting communication to different listening skills, are essential for health authorities to successfully manage a public health emergency.

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Across the world, people have avoided seeking medical attention during the coronavirus pandemic, resulting in a marked reduction in emergency department (ED) visits. This retrospective cohort study examines in detail how the present pandemic affects ED use by the elderly. The regional database on ED visits in Veneto (northeastern Italy) was consulted to extract anonymous data on all ED visits during 2019 and 2020, along with details concerning patients’ characteristics (access mode, triage code, chief complaint, and outcome). A year-on-year comparison was drawn between 2019 and 2020. There was a 25.3% decrease in ED visits in 2020 compared to the previous year. The decrease ranged from −52.4% in March to −18.4% in September when comparing the same months in the two years. This decrease started in late February 2020, with the lowest numbers of visits recorded in March and April 2020 (during the “first wave” of the COVID-19 pandemic in Italy), and in the autumn (during the “second wave”). The proportion of visits to the ED by ambulance has increased sharply since March 2020, and patients arrived more frequently with severe conditions (red or yellow triage tags) that often required a hospitalization. The greatest decrease was in fact observed for non-urgent complaints. This decreased concerned a wide range of conditions, including chest pain and abdominal pain. The sharp reduction observed in the present study is unlikely to be attributed entirely to the effect of lockdown measures. Individual psychological and media-induced fear of contagion most likely played a relevant role in leading people to avoid seeking medical attention.

Background COVID-19 pandemic has stretched healthcare system capacities worldwide and deterred people from seeking medical support at Emergency Departments (ED). Nevertheless, population-based studies examining the consequences on children are lacking. Methods All ED visits from 2019 to 2020 in Veneto, Italy (4.9 million residents) were collected. Anonymized records of pediatric (≤14 years) ED visits included patient characteristics, arrival mode, triage code, clinical presentation, and discharge mode. Year-on-year variation of the main ED visit characteristics, and descriptive trends throughout the study period have been examined. Results Overall, 425,875 ED presentations were collected, 279,481 in 2019, and 146,394 in 2020 (− 48%), with a peak (− 79%) in March–April (first pandemic wave), and a second peak (below − 60%) in November–December (second pandemic wave). Burn or trauma, and fever were the two most common clinical presentations. Visits for nonurgent conditions underwent the strongest reduction during both pandemic waves, while urgent conditions reduced less sharply. ED arrival by ambulance was more common in 2020 (4.5%) than 2019 (3.5%), with a higher proportion of red triage codes (0.5%, and 0.4% respectively), and hospitalizations following ED discharge (9.1%, and 5.9% respectively). Conclusion Since the beginning of the COVID-19 pandemic, pediatric ED presentations underwent a steeper reduction than that observed for adults. Lockdown and fear of contagion in hospital-based services likely deterred parents from seeking medical support for their children. Given COVID-19 could become endemic, it is imperative that public health experts guarantee unhindered access to medical support for urgent, and less urgent health conditions, while minimizing infectious disease risks, to prevent children from suffering direct and indirect consequences of the pandemic.

IntroductionAmong white people, the incidence of cutaneous malignant melanoma (CMM) has been increasing steadily for several decades. Meanwhile, there has also been a significant improvement in 5-year survival among patients with melanoma. This population-based cohort study investigates the five-year melanoma-specific survival (MSS) for all melanoma cases recorded in 2015 in the Veneto Tumor Registry (North-Est Italian Region), taking both demographic and clinical-pathological variables into consideration.MethodsThe cumulative melanoma-specific survival probabilities were calculated with the Kaplan-Meier method, applying different sociodemographic and clinical-pathological variables. Cox’s proportional hazards model was fitted to the data to assess the association between independent variables and MSS, and also overall survival (OS), calculating the hazard ratios (HR) relative to a reference condition, and adjusting for sex, age, site of tumor, histotype, melanoma ulceration, mitotic count, tumor-infiltrating lymphocytes (TIL), and stage at diagnosis.ResultsCompared with stage I melanoma, the risk of death was increased for stage II (HR 3.31, 95% CI: 0.94-11.76, p=0.064), almost ten times higher for stage III (HR 10.51, 95% CI: 3.16-35.02, p&lt;0.001), and more than a hundred times higher for stage IV (HR 117.17, 95% CI: 25.30-542.62, p&lt;0.001). Among the other variables included in the model, the presence of mitoses and histological subtype emerged as independent risk factors for death.ConclusionsThe multivariable analysis disclosed that older age, tumor site, histotype, mitotic count, and tumor stage were independently associated with a higher risk of death. Data on survival by clinical and morphological characteristics could be useful in modelling, planning, and managing the most appropriate treatment and follow-up for patients with CMM.