Transmission of SARS-CoV-2 into and within immigrant households: nationwide registry study from Norway
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Abstract
Minority groups and immigrants have been hit disproportionally hard by COVID-19 in many developed countries, including Norway.
Methods
Using individual-level registry data of all Norwegian residents, we compared infections across all multiperson households. A household with at least one member born abroad was defined as an immigrant household. In households where at least one person tested positive for SARS-CoV-2 from 1 August 2020 to 1 May 2021, we calculated secondary attack rates (SARs) as the per cent of other household members testing positive within 14 days. Logistic regression was used to adjust for sex, age, household composition and geography.
Results
Among all multiperson households in Norway (n=1 422 411), at least one member had been infected in 3.7% of the 343 017 immigrant households and 1.4% in the 1 079 394 households with only Norwegian-born members. SARs were higher in immigrant (32%) than Norwegian-born households (20%). SARs differed considerably by region, and were particularly high in households from West Asia, Eastern Europe, Africa and East Asia, also after adjustment for sex and age of the secondary case, household composition and geography.
Conclusion
SARS-CoV-2 is more frequently introduced into multiperson immigrant households than into households with only Norwegian-born members, and transmission within the household occurs more frequently in immigrant households. The results are likely related to living conditions, family composition or differences in social interaction, emphasising the need to prevent introduction of SARS-CoV-2 into these vulnerable households.
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SciScore for 10.1101/2021.07.09.21260253: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Institutional board review was conducted, and the project was approved by the Ethics Committee of South-East Norway (March 9th, 2021, #198964). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Potential limitations: We did not have data to confirm that the secondary cases were in fact transmissions from the index …
SciScore for 10.1101/2021.07.09.21260253: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Institutional board review was conducted, and the project was approved by the Ethics Committee of South-East Norway (March 9th, 2021, #198964). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Potential limitations: We did not have data to confirm that the secondary cases were in fact transmissions from the index case. It is possible that both the index case and the secondary cases had a common external source, or that they were infected by different external sources. Better knowledge of actual directions of transmission within families would improve our ability to evaluate this, for example by judgements by health care personnel following each family or by genomic characterization of the viruses. However, several transmissions into the same household have been unlikely in Norway as the incidence rate of SARS-CoV-2 has been low throughout the pandemic. Still, immigrants more often live in urban areas with higher infection rates, possibly making several introduction events into immigrant households marginally more likely than for households with only Norwegian-born members. A clear advantage of our registry-based study to most other studies, is that we do not have attrition: We observe every household, and we can observe all household members in the follow-up period, regardless of motivation to participate in a study or not. Indeed, our data stem from a real-world situation, where detection of secondary cases relates to a combination of the actual transmission of the virus and the behavioral responses to disease and the actual testing regime. Conclusions: By looking at register data of all Norwegian residents living in multi-person households, we see that households...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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