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Original research
Transmission of SARS-CoV-2 into and within immigrant households: nationwide registry study from Norway
  1. Fredrik Methi1,
  2. Rannveig Kaldager Hart1,
  3. Anna Aasen Godøy1,
  4. Silje Bakken Jørgensen1,2,
  5. Oliver Kacelnik1,
  6. Kjetil Elias Telle1
  1. 1 Norwegian Institute of Public Health, Oslo, Norway
  2. 2 Akershus University Hospital, Lorenskog, Norway
  1. Correspondence to Fredrik Methi, Norwegian Institute of Public Health, Oslo, Norway; fredrik.methi{at}fhi.no

Abstract

Background 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.

  • COVID-19
  • epidemiology
  • statistics
  • social sciences

Data availability statement

No data are available. The individual-level data used in this study are not publicly available due to privacy laws. However, the individual-level data in the registries compiled in BeredtC19 are accessible to authorised researchers after ethical approval and application to helsedata.no administered by the Norwegian Directorate of eHealth. Stata do-files are available upon request.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jech-2021-217856

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    Data availability statement

    No data are available. The individual-level data used in this study are not publicly available due to privacy laws. However, the individual-level data in the registries compiled in BeredtC19 are accessible to authorised researchers after ethical approval and application to helsedata.no administered by the Norwegian Directorate of eHealth. Stata do-files are available upon request.

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    Footnotes

    • Correction notice This article has been corrected since it first published. A typographical error has been corrected in the Results section of the Abstract.

    • Contributors FM had access to all of the data in the study, takes full responsibility for the integrity of the data and the accuracy of the data analysis, and serves as a guarantor for the overall content. RKH and AAG coded the initial dataset. FM and KET performed the statistical analyses and drafted the manuscript with SBJ and OK. All authors contributed with acquisition of data, conceptual design, analyses and interpretation of results. All authors contributed to writing the article or critically revising it for important intellectual content. All authors gave final approval for the version to be submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.