4.6 Article

Fueling the Covid-19 pandemic: summer school holidays and incidence rates in German districts

Journal

JOURNAL OF PUBLIC HEALTH
Volume 43, Issue 3, Pages E415-E422

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/pubmed/fdab080

Keywords

infectious disease; public health; communicable disease

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The study found that during the holiday period, there was around a 45% impact on the average incidence rates in Germany, especially during the final week of holidays and the 2 weeks after holidays end. Western states were more affected than Eastern states. Additionally, there were statistically significant interaction effects between school holidays, per capita taxable income, and the share of foreign residents in a district's population.
Background The Robert-Koch-Institute reports that during the summer holiday period a foreign country is stated as the most likely place of infection for an average of 27 and a maximum of 49% of new SARS-CoV-2 infections in Germany. Methods Cross-sectional study on observational data. In Germany, summer school holidays are coordinated between states and spread out over 13 weeks. Employing a dynamic model with district fixed effects, we analyze the association between these holidays and weekly incidence rates across 401 German districts. Results We find effects of the holiday period of around 45% of the average district incidence rates in Germany during their respective final week of holidays and the 2 weeks after holidays end. Western states tend to experience stronger effects than Eastern states. We also find statistically significant interaction effects of school holidays with per capita taxable income and the share of foreign residents in a district's population. Conclusions Our results suggest that changed behavior during the holiday season accelerated the pandemic and made it considerably more difficult for public health authorities to contain the spread of the virus by means of contact tracing. Germany's public health authorities did not prepare adequately for this acceleration.

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