Covid-19 - Wissenschaft und Gesellschaft. Beiträge in Zeiten der Pandemie

Das Virus verstehen, Todesfälle verhindern, Chaos vermeiden, Fakten aufzeigen und den Boden bereiten für gesellschaftliches Mittragen von Massnahmen - Wissenschaft, Politik und Gesellschaft kamen sich in der Pandemie näher, gleichzeitig kam es auch zu Konfrontationen. Der vorliegende Sammelband vereinigt Analysen und Diskussionsbeiträge, die im Umfeld der Akademien der Wissenschaften Schweiz entstanden sind. Es ist einerseits ein Zeitdokument über die Jahre 2020 bis zum Spätsommer 2021 und bildet eine Periode ab, in der WissenschafterInnen mit grossem Engagement geforscht haben und ihre Erkenntnisse unmittelbar der Gesellschaft zugänglich gemacht haben. Andererseits sind auch Texte entstanden, die vorwärts denken. Was können wir aus der Pandemie lernen? Wie sollte wissenschaftliche Politikberatung funktionieren? Wie können Wissenschaft, Gesellschaft und Politik im Dialog bleiben? Was können wir gegen Fake News tun? Die Publikation gibt Anregungen, diese Fragen weiterzuverfolgen, damit durch Diskussion ein Fundament für die Zukunft entsteht

Mastering Demographic Change in Europe: Eight European Academies’ Statement

The population of Europe is changing significantly: it is growing older than it has ever before and it is ahead of other continents in that regard, in most European countries the total period fertility rate has fallen well below two children. The population in some countries has started to decline while in others migration is compensating low fertility. Thus, besides a lengthening life span and reduced child bearing, demographic change in the EU is characterized by increasing migration within Europe, and also by more immigrants from outside of Europe entering European Union member states. Such changes in the composition of the EU population, in particular when considered jointly with other global changes such as climate change or potential shortage in natural resources, pose challenges for the wellbeing of individuals, communities and societies. Against this background, environmental, economic and social sustainability have gained increasing importance for the welfare of Europe. The resources of this planet are finite, and at the same time societal institutions are in need of transformation such that they provide for longer healthy and productive lives. Policies informed by a clear understanding of the sources and likely directions of demographic change as well as the changes in the ageing process across historical time are required to achieve these goals. As National Academies of Science, we consider it one of our tasks to contribute to well-informed policymaking. We are convinced that European citizens need the support of their EU institutions besides their national governments to plan and manage their longer lives, to maintain productivity and quality of life beyond economic employment, and to consume in a sustainable manner. Eight European Academies of Science have assembled for this Statement pooling their knowledge on demographic change and its causes and consequences, building on scientific work as well as prior national statements of individual Academies. We seek to highlight areas and steps of priority for mastering demographic change, and we should like to contribute to creating a Europe that makes the most of its resources to the benefit of all. The following considerations and recommendations have taken into account that the European Union had identified demographic change as a priority requiring social policy change in 2006 and since then many initiatives in the areas of lifelong learning, health and labour force participation have been under way

Systematic review of cost and cost-effectiveness of different TB-screening strategies

<p>Abstract</p> <p>Background</p> <p>Interferon-γ release assays (IGRAs) for TB have the potential to replace the tuberculin skin test (TST) in screening for latent tuberculosis infection (LTBI). The higher per-test cost of IGRAs may be compensated for by lower post-screening costs (medical attention, chest x-rays and chemoprevention), given the higher specificity of the new tests as compared to that of the conventional TST. We conducted a systematic review of all publications that have addressed the cost or cost-effectiveness of IGRAs. The objective of this report was to undertake a structured review and critical appraisal of the methods used for the model-based cost-effectiveness analysis of TB screening programmes.</p> <p>Methods</p> <p>Using Medline and Embase, 75 publications that contained the terms "IGRA", "tuberculosis" and "cost" were identified. Of these, 13 were original studies on the costs or cost-effectiveness of IGRAs.</p> <p>Results</p> <p>The 13 relevant studies come from five low-to-medium TB-incidence countries. Five studies took only the costs of screening into consideration, while eight studies analysed the cost-effectiveness of different screening strategies. Screening was performed in high-risk groups: close contacts, immigrants from high-incidence countries and healthcare workers. Two studies used the T-SPOT.TB as an IGRA and the other studies used the QuantiFERON-TB Gold and/or Gold In-Tube test. All 13 studies observed a decrease in costs when the IGRAs were used. Six studies compared the use of an IGRA as a test to confirm a positive TST (TST/IGRA strategy) to the use of an IGRA-only strategy. In four of these studies, the two-step strategy and in two the IGRA-only strategy was more cost-effective. Assumptions about TST specificity and progression risk after a positive test had the greatest influence on determining which IGRA strategy was more cost-effective.</p> <p>Conclusion</p> <p>The available studies on cost-effectiveness provide strong evidence in support of the use of IGRAs in screening risk groups such as HCWs, immigrants from high-incidence countries and close contacts. So far, only two studies provide evidence that the IGRA-only screening strategy is more cost-effective.</p