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A Year of COVID-19 Pandemic Roller-Coaster: The Malta Experience, Lessons Learnt, and the Future

Published online by Cambridge University Press:  02 May 2022

Sarah Cuschieri*
Affiliation:
Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Malta
Stephan Grech
Affiliation:
Mater Dei Hospital, Malta
Victor Grech
Affiliation:
Mater Dei Hospital, Malta
*
Corresponding author: Sarah Cuschieri, Email: sarah.cuschieri@um.edu.mt.

Abstract

Objective:

The coronavirus disease 2019 (COVID-19) pandemic had a global impact. The study explores the various COVID-19 experiences in Malta over the past year and provides a snapshot of acute and post-acute COVID-19 symptoms, as well as national vaccination roll-out and hesitancy.

Methods:

Data on medical access, lifestyle habits, acute and post-acute COVID-19 symptoms, and vaccination hesitancy was gathered through a social media survey targeting adults of Malta. COVID-19 data were gathered from the Malta Ministry of Health COVID-19 dashboard.

Results:

Malta controlled COVID-19 spread exceptionally well initially. Since August 2020, the positivity rate, mortality, and hospital admission rates saw a fluctuating incline. From COVID-19 onset, a decrease in physical activity and an increase in body weight was reported. Most participants acquiring COVID-19 were asymptomatic but nontrivial proportion experienced post-acute symptoms. The majority opted to take the COVID-19 vaccine with only a minority expressing safety concerns.

Conclusions:

Malta has experienced roller coaster events over a year. The population faced elevated levels of morbidity, mortality, and economic hardship along with negative and positive risk-associated behaviors. Vaccination in combination with population adherence to social distancing, mask wearing, and personal hygiene are expected to be the beacons of hope in the coming months.

Type
Original Research
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020. Published March 11, 2020. Accessed April 15, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 Google Scholar
Worldometer. Coronavirus cases. Published 2021. Accessed May 11, 2022. https://www.worldometers.info/coronavirus/coronavirus-cases/#daily-cases Google Scholar
COVID-19 Public Health Response Team - Ministry for Health. COVID-19 Data Management System. 2021. Accessed May 11, 2022. https://www.facebook.com/sahhagovmt/photos Google Scholar
Cuschieri, S, Falzon, C, Janulova, L, et al. Malta’s only acute public hospital service during COVID-19: a diary of events from the first wave to transition phase. Int J Qual Heal Care. 2021;33(1): mzaa138. doi: 10.1093/intqhc/mzaa138 CrossRefGoogle ScholarPubMed
Cuschieri, S. COVID-19 panic, solidarity and equity—the Malta exemplary experience. J Public Health. 2020;30:1-6. doi: 10.1007/s10389-020-01308-w Google ScholarPubMed
Cuschieri, S. COVID-19: the transition towards a new normal-experiences from the European country of Malta. Z Gesundh Wiss. 2021:1-8. doi: 10.1007/s10389-021-01486-1 Google ScholarPubMed
Cuschieri, S, Balzan, M, Gauci, C, et al. Mass events trigger Malta’s second peak after initial successful pandemic suppression. J Community Health. 2021;46(3):618-625. doi: 10.1007/s10900-020-00925-6 CrossRefGoogle ScholarPubMed
Times of Malta. Health Minister suggests three reasons for high number of COVID cases. Published 2021. Accessed April 5, 2021. https://timesofmalta.com/articles/view/health-minister-suggests-three-reasons-for-high-number-of-covid-cases.853876.Google Scholar
The Malta Independent. Malta registers three cases of UK-variant of Covid-19. Published 2020. Accessed April 9, 2021. https://www.independent.com.mt/articles/2020-12-30/local-news/Malta-registers-first-cases-of-UK-variant-of-Covid-19-6736229784 Google Scholar
Delia, J. First case of South Africa COVID-19 variant found in Malta. Times of Malta. Published 2021. Accessed April 9, 2021. https://timesofmalta.com/articles/view/malta-records-first-case-of-south-africa-covid-19-variant.851942 Google Scholar
Times of Malta. Malta enters month-long shutdown as schools, services close, amid virus spike. Published 2021. Accessed March 18, 2021. https://timesofmalta.com/articles/view/watch-prime-minister-announcing-new-covid-19-measures.857200 Google Scholar
Times of Malta. Public gatherings limited to two persons from Wednesday. Published 2021. Accessed April 8, 2021. https://timesofmalta.com/articles/view/public-gatherings-limited-to-two-persons-from-wednesday.860941 Google Scholar
Farrugia, C, Borg, B. Schools to reopen next week, shops from April 26. Times of Malta. Published 2021. Accessed April 8, 2021. https://timesofmalta.com/articles/view/abela-fearne-gauci-announce-covid-easing-measures-schools.863055 Google Scholar
Malta Independent. First Covid-19 vaccine in Malta administered. Published 2020. Accessed April 3, 2021. https://www.independent.com.mt/articles/2020-12-27/local-news/WATCH-First-Covid-19-vaccine-in-Malta-administered-6736229731 Google Scholar
Ministry of Health Malta. Vaccines. Published 2021. Accessed May 11, 2022. https://deputyprimeminister.gov.mt/en/health-promotion/covid-19/Pages/vaccines.aspx Google Scholar
The Malta Independent. Moderna vaccine arrives in Malta. Published 2021. Accessed April 6, 2021. https://www.independent.com.mt/articles/2021-01-11/local-news/Moderna-vaccine-arrives-in-Malta-6736230039 Google Scholar
Times of Malta. AstraZeneca vaccine consignment cleared for use in Malta. Published 2021. Accessed April 6, 2021. https://timesofmalta.com/articles/view/astrazeneca-consignment-cleared-for-use-in-malta.850697 Google Scholar
Vella, M. COVID-19 vaccine roll-out for over-60s to start in days. Malta today. Published 2021. Accessed April 3, 2021. https://www.maltatoday.com.mt/news/national/108157/covid19_vaccine_rollout_for_over60s_to_start_in_days#.YGhV6S8Rocg Google Scholar
Statista. Europe: COVID-19 vaccination rate by country 2021. Statista. Published 2021. Accessed April 6, 2021. https://www.statista.com/statistics/1196071/covid-19-vaccination-rate-in-europe-by-country/ Google Scholar
Farrugia, C. Hospitals open fifth ITU as doctors struggle to cope with influx of patients. Times of Malta. Published 2021. Accessed March 18, 2021. https://timesofmalta.com/articles/view/hospitals-forced-to-open-fifth-itu-to-deal-with-patients-influx.857116 Google Scholar
Palmer, K, Monaco, A, Kivipelto, M, et al. The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing. Aging Clin Exp Res. 2020;32(7):1189-1194. doi: 10.1007/s40520-020-01601-4 Google ScholarPubMed
Kluge, HHP, Wickramasinghe, K, Rippin, HL, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020;395(10238):1678-1680. doi: 10.1016/S0140-6736(20)31067-9 CrossRefGoogle ScholarPubMed
Bambra, C, Riordan, R, Ford, J, et al. The COVID-19 pandemic and health inequalities. J Epidemiol Community Health. 2020;74(11):964-968. doi: 10.1136/jech-2020-214401 Google ScholarPubMed
Cuschieri, S, Mamo, J. Taking care of the ordinary in extraordinary times—delayed routine care means more morbidity and pre-mature mortality. Eur J Public Health. 2021;31(Suppl_4):iv27-iv30. doi: 10.1093/eurpub/ckab156 CrossRefGoogle ScholarPubMed
Country Meters. Current world population by country. Population data for every country as of 2021. Published 2021. Accessed November 5, 2021. https://countrymeters.info/en Google Scholar
Smith, WG. Does gender influence online survey participation? A record-linkage analysis of university faculty online survey response behavior. Eric Ed501717. 2008. Accessed December 31, 2021. https://files.eric.ed.gov/fulltext/ED501717.pdf Google Scholar
Bubar, KM, Reinholt, K, Kissler, SM, et al. Model-informed COVID-19 vaccine prioritization strategies by age and serostatus. Science. 2021;371(6532):916-921. doi: 10.1126/science.abe6959 CrossRefGoogle ScholarPubMed
Buitrago-Garcia, D, Egli-Gany, D, Counotte, MJ, et al. Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: a living systematic review and meta-analysis. PLoS Med. 2020;17(9):e1003346. doi: 10.1371/journal.pmed.1003346 CrossRefGoogle ScholarPubMed
Crook, H, Raza, S, Nowell, J, et al. Long covid-mechanisms, risk factors, and management. BMJ. 2021;374:n1648. doi: 10.1136/bmj.n1648 Google ScholarPubMed
Lopez-Leon, S, Wegman-Ostrosky, T, Perelman, C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. doi: 10.1038/s41598-021-95565-8 CrossRefGoogle ScholarPubMed
Al-Jahdhami, I, Al-Naamani, K, Al-Mawali, A. The Post-acute COVID-19 Syndrome (Long COVID). Oman Med J. 2021;36(1):e220. doi: 10.5001/omj.2021.91 CrossRefGoogle ScholarPubMed
Radwan, H, Al Kitbi, M, Hasan, H, et al. Indirect health effects of COVID-19: unhealthy lifestyle behaviors during the lockdown in the United Arab Emirates. Int J Environ Res Public Health. 2021;18(4):1964. doi: 10.3390/ijerph18041964 CrossRefGoogle ScholarPubMed
Grech, S, Borg, JN, Cuschieri, S. Back pain: an aftermath of Covid-19 pandemic? A Malta perspective. Musculoskeletal Care. 2022;20(1):145-150. doi: 10.1002/msc.1574 CrossRefGoogle ScholarPubMed
Callaghan, P. Exercise: a neglected intervention in mental health care? J Psychiatr Ment Health Nurs. 2004;11(4):476-483. doi: 10.1111/j.1365-2850.2004.00751.x Google ScholarPubMed
Owen, N, Sparling, PB, Healy, GN, et al. Sedentary behavior: emerging evidence for a new health risk. Mayo Clin Proc. 2010;85(12):1138-1141. doi: 10.4065/mcp.2010.0444 CrossRefGoogle ScholarPubMed
Scully, M, Dixon, H, Wakefield, M. Association between commercial television exposure and fast-food consumption among adults. Public Health Nutr. 2009;12(1):105-110. doi: 10.1017/S1368980008002012 CrossRefGoogle ScholarPubMed
Vujčić, I, Safiye, T, Milikić, B, et al. Coronavirus disease 2019 (COVID-19) epidemic and mental health status in the general adult population of Serbia: a cross-sectional study. Int J Environ Res Public Health. 2021;18(4):1957. doi: 10.3390/ijerph18041957 CrossRefGoogle ScholarPubMed
World Health Organization. Growing up unequal: gender and socioeconomic difference in young people’s health and well-being. 2016. Accessed May 11, 2022. https://apps.who.int/iris/handle/10665/326320 Google Scholar
Cuschieri, S. The characteristics of an obesogenic small European country: results from a Malta cross-sectional study. Perspect Public Health. 2020;140(6):327-337. doi: 10.1177/1757913920926533 CrossRefGoogle ScholarPubMed
Cuschieri, S, Grech, S. Insight into the occurrence of common non-communicable diseases at a population level and the potential impact during the coronavirus pandemic — a need for a syndemic healthcare approach? SN Compr Clin Med. September 2021;3(12):2393-2400. doi: 10.1007/s42399-021-01064-2 CrossRefGoogle Scholar
Simonnet, A, Chetboun, M, Poissy, J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring). 2020;28(7):1195-1199. doi: 10.1002/oby.22831 CrossRefGoogle ScholarPubMed
Peng, YD, Meng, K, Guan, HQ, et al. Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48(6):450-455. doi: 10.3760/cma.j.cn112148-20200220-00105 Google ScholarPubMed
Cuschieri, S, Grech, S. Obesity population at risk of COVID-19 complications. Glob Health Epidemiol Genom. 2020;5:e6. doi: 10.1017/gheg.2020.6 Google ScholarPubMed
Cuschieri, S, Vassallo, J, Calleja, N, et al. Relationship of past, present, and passive smoking with sociodemographic, anthropometric, biochemical, and dysglycemic profiles. J Diabetes. 2019;11(1):87-89. doi: 10.1111/1753-0407.12844 CrossRefGoogle ScholarPubMed
Yingst, JM, Krebs, NM, Bordner, CR, et al. Tobacco use changes and perceived health risks among current tobacco users during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(4)1795. doi: 10.3390/ijerph18041795 Google ScholarPubMed
Phillips, N. The coronavirus is here to stay — here’s what that means. Nature. 2021;590(7846):382-384. doi: 10.1038/d41586-021-00396-2 CrossRefGoogle ScholarPubMed
Reuters. Malta has achieved herd immunity with COVID shots, says minister. Reuters. Published 2021. Accessed May 29, 2021. https://www.reuters.com/business/healthcare-pharmaceuticals/malta-has-achieved-herd-immunity-with-covid-shots-says-minister-2021-05-24/ Google Scholar
Cordina, M, Lauri, MA, Lauri, J. Attitudes towards COVID-19 vaccination, vaccine hesitancy and intention to take the vaccine. Pharm Pract (Granada). 2021;19(1):2317. doi: 10.18549/PharmPract.2021.1.2317 CrossRefGoogle ScholarPubMed
Sallam, M. COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates. Vaccines. 2021;9(2):160. doi: 10.3390/vaccines9020160 CrossRefGoogle ScholarPubMed
National Statistics Office (NSO). Regional statistics Malta 2020 edition. 2020. Accessed July 28, 2021. https://nso.gov.mt/en/publicatons/Publications_by_Unit/Documents/02_Regional_Statistics_(Gozo_Office)/2020/Regional_Statistics_Malta-2020 Edition.pdfGoogle Scholar
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