Second, third, fourth COVID‐19 waves and the ‘pancession’: We need studies that account for the complexities of how the pandemic is affecting alcohol consumption in Australia
Second, third, fourth COVID‐19 waves and the ‘pancession’: We need studies that account for the complexities of how the pandemic is affecting alcohol consumption in Australia
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第二次、第三次、第四次 COVID-19 浪潮和“暂停”：我们需要研究来解释这一流行病如何影响澳大利亚的酒精消费的复杂性
DOI：
10.1111/dar.13188
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发表时间：
2020
影响因子：
3.8
通讯作者：
S. Callinan
中科院分区：
文献类型：
--
作者：
C. Wright;M. Livingston;R. Dwyer;S. Callinan
新冠肺炎大流行和相关限制措施以各种方式影响了酒类消费。对许多澳大利亚人来说，对社交聚会的限制和有执照的场所的关闭影响了他们通常饮酒的环境和性质，这限制了社交饮酒的机会，并将饮酒几乎完全转移到家里，这一环境迄今在研究或政策中几乎没有受到关注[1]。这篇社论探讨了理解大流行的影响所必需的更长期的研究。我们把重点放在了澳大利亚的背景下，这为新冠肺炎和酒精消费之间的关系的复杂性提供了一个有用的例证，但我们的建议具有广泛的相关性。关于大流行的初期如何影响澳大利亚的酒精消费的证据正在浮现。大多数研究发现，饮酒增加和减少的比例相似(例如，在澳大利亚统计局的一项研究中，分别为14%和10%)[2，3]。银行业关于消费者信用卡支出的数据显示，自3月下旬以来，包装酒类的支出有所增加，4月份出现了一些波动[4]。虽然这被酒类服务(酒吧、酒店)支出的显著下降所抵消，但与2019年7月相比，2020年7月的酒类总支出高出约20%[5](尽管应该注意到，这些数字因疫情期间从现金转移而变得复杂)。主要连锁超市的销售数据还表明，在疫情爆发的头几个月里，场外酒类销售大幅增加[6-8]，而其他酒类行业消息来源报告称，自4月[8，9]以来，整体销售大幅下降。公共卫生学者担心，放宽许可法，允许从餐馆和咖啡馆外卖，会使酒类更广泛地获得，并可能在限制取消后继续存在[1，10]。也有人担心，目前没有得到很好监管的在线和送货销售的繁荣，可能会增加醉酒的人和未成年人获得酒精的机会[10]。澳大利亚的疫情主要集中在大都市地区，特别是悉尼(第一波)和墨尔本(第二波)，截至2020年8月初，该国其他地区的病例数量较低，社区传播很少[11]。从2020年3月中旬开始，全国范围内对集会和场地的限制开始实施，3月下旬进一步限制了行动。各州和领地以不同的速度重新开放。酒精政策研究中心发布了迄今为止在每个州和地区实施的限制措施的摘要[12]6月中旬，维多利亚州开始看到社区传播的增加，这导致重新实施对社交集会的限制，并在几周内封锁了“热点”地区，随后在整个维多利亚州重新实施了严格的封锁。维多利亚时代的疫情突显了第二波(以及可能的第三波/第四波/第五波)的长尾可能，包括放松限制，然后重新实施限制。这已经在国际上上演了。例如，香港、日本和以色列都重新引入了社会距离和边境管制等限制措施，因为它们正在进入第二波或第三波[13]。尽管候选疫苗显示出早期有希望的结果，但疫苗的有效推出至少在12个月内不太可能发生[14]。这意味着，我们可能会面临反复的浪潮，直到疫苗能够得到足够广泛的实施，以减轻对限制和边境管制的需求[15]。澳大利亚的后续浪潮可能会通过疲劳、抑郁和压力的增加，再加上日益困难的经济环境，对酒精消费产生明显不同的影响。政治家和卫生专家必须逐步平衡限制措施，以充分限制这种高度传染性疾病的传播，同时尽可能少地对工作、教育和心理健康施加限制。尽管努力限制经济损失，但澳大利亚已经进入了由大流行引发的经济衰退，一些经济学家称之为“衰退”[16，17]。以往经济危机的证据表明，我们可以预期这会影响一个人的酒精消费。一项现实主义的系统回顾[18]确定
The COVID-19 pandemic and related restrictions have influenced alcohol consumption in a variety of ways. For many Australians, restrictions on social gatherings and closures of licensed venues affected the settings and nature of their usual drinking, that is limiting opportunities for social drinking and moving drinking almost exclusively to homes, a setting that has received little attention in research or policy to date [1]. This editorial explores the longer-term research necessary to understand the pandemic’s impact. We focus on the Australian context, which provides a useful illustration of the complexity of the relationship between COVID-19 and alcohol consumption, but our recommendations are broadly relevant. Evidence is emerging on how the initial phase of the pandemic has affected alcohol consumption in Australia. Most studies have found similar proportions reporting increases and decreases in drinking (e.g. 14% and 10%, respectively, in an Australian Bureau of Statistics study) [2,3]. Banking data on consumer credit card spending show an increase in spending on packaged alcohol since late March, with some volatility in April [4]. While this is offset by pronounced declines in spending on alcohol services (pubs, hotels), overall spending on alcohol was around 20% higher in July 2020 compared to July 2019 [5] (although it should be noted these figures are complicated by the shift away from cash during the pandemic). Sales data from major supermarket chains also indicate a substantial increase in off-premise alcohol sales in the early months of the pandemic [6–8], while other alcohol industry sources report major overall declines in sales from April [8,9]. Public health academics have raised concerns that the relaxation of licensing laws to permit take-away purchases from restaurants and cafes makes alcohol more widely available and may potentially continue after restrictions are lifted [1,10]. Concerns have also been raised that the boom in online and delivery sales of alcohol, which is not currently well-regulated, may increase the accessibility of alcohol to intoxicated people and minors [10]. Australia’s epidemic has largely been concentrated in metropolitan areas, in particular in the cities of Sydney (first wave) and Melbourne (second wave), with the rest of the country showing low case numbers and little community transmission as of early August 2020 [11]. Nation-wide restrictions on gatherings and venues began in mid-March 2020, with further limits on movement imposed late-March. States and territories moved to re-open at varying paces. A summary of the restrictions implemented throughout the pandemic in each state and territory to date has been published by the Centre for Alcohol Policy Research [12] In mid-June, Victoria began to see an increase in community transmission which led to the reimposition of restrictions on social gatherings and, within weeks, lockdowns of ‘hotspot’ areas, followed by the reintroduction of strict lockdowns across Victoria. The Victorian outbreak has highlighted the potential for a long tail of second (and possible third/fourth/fifth) waves, involving the easing and then reimposition of restrictions. This is already playing out internationally. For instance, Hong Kong, Japan and Israel have all reintroduced restrictions such as social distancing and border controls as they shift into second or third waves [13]. Although vaccine candidates show early promising results, the effective rollout of a vaccine is not likely to occur for at least another 12 months [14]. This means we will likely face repeated waves until a vaccine is able to be implemented widely enough to mitigate the need for restrictions and border controls [15]. Subsequent waves in Australia have the potential for markedly different impacts on alcohol consumption, via increases in fatigue, depression and stress, combined with increasingly difficult economic circumstances. Politicians and health experts must progressively balance restrictions which adequately limit the spread of this highly contagious illness while imposing on work, education and mental health as little as possible. Despite efforts to limit economic damage, Australia has moved into a pandemic-induced recession, which some economists are calling the ‘pancession’ [16,17]. Evidence from previous economic crises shows that we can expect this to affect a population’s alcohol consumption. A realist systematic review [18] identified