Austria's Lockdown: What Does It Mean For The Country And Beyond?

Austria has implemented several lockdowns since the start of the COVID-19 pandemic. The first lockdown was announced on March 16, 2020, and included a complete closure of non-essential stores, schools, and a full curfew. The country has since experienced multiple waves of COVID-19 infections, leading to additional lockdowns and restrictions. In November 2021, Austria became the first European country to instate a vaccine mandate and initiate a nationwide lockdown during the surge. This lockdown applied to everyone initially and then transitioned to only include those who were unvaccinated.

The impact on healthcare

The Austrian lockdown had a significant impact on the healthcare system, with a decline in outpatient medical consultations and an increase in psychiatric consultations. During the lockdown weeks, the number of curative consultations dropped by 33.6%, and preventive consultations (cancer screening, health checks) decreased by 61.3% compared to the same period in 2019. This reduction in consultations likely led to deficits in acute medical care, particularly for those with serious illnesses who avoided going to the hospital due to fears of infection.

The lockdown also had specific effects on different areas of healthcare:

Hospital Care

The main reason for the lockdown was to prevent a capacity overload in hospitals, especially in intensive care units. While there were some local shortages of hospital beds, there was never a system-wide overload. COVID-19 utilization of hospital beds peaked at 2.0% in March 2020 and 9.4% in November 2020, while intensive care unit utilization reached a maximum of 10.1% in March 2020 and 26.9% in November 2020.

Primary and Outpatient Care

The lockdown led to a significant decline in outpatient medical consultations. During the lockdown weeks, curative consultations dropped by 33.6%, and preventive consultations decreased by 61.3% compared to the same period in 2019. This reduction in consultations likely led to deficits in acute medical care, and there was an observed decline in hospital admissions for acute coronary syndromes and strokes.

Mental Health

The lockdown had a significant impact on mental health, particularly among young people and adolescents. There was an increase in psychiatric consultations, with a 15.9% rise in outpatient consultations in general psychiatry and a 10.3% increase in pediatric psychiatry. A survey conducted during the lockdown period revealed a 3 to 5-fold increase in anxiety disorders, depression, and sleep disorders compared to pre-lockdown levels. These psychosocial effects persisted even after the lockdown was lifted.

Additionally, migrants living in Austria, who already face lower income levels and poorer living conditions, experienced further challenges during the lockdown. The restrictions on social life and the closure of schools may have disproportionately affected their well-being.

Medication

The COVID-19 pandemic has been associated with an increase in psychopharmacological medication prescriptions, particularly among female adolescents. There was a steep upward trend in antidepressant prescriptions among females aged 10-19, with rates significantly above model predictions. This trend is consistent with reports of increasing rates of depressive symptoms worldwide during the pandemic.

The economic impact

The COVID-19 lockdowns in Austria had a significant economic impact, with the total damage estimated to exceed €70 billion for 2020-2022. This includes approximately €35 billion in governmental aid to citizens and businesses affected by the lockdown measures. The lockdowns caused a sharp rise in unemployment, peaking at 12.7% in April 2020, compared to an average of 7.4% in 2019. Many employees also had to reduce their working hours, with over 1.2 million on reduced hours in May 2020. The unemployment rate remained high during the second lockdown in the winter of 2020/2021, peaking at 11.4%. Even in the summer of 2022, almost 200,000 employees were still on reduced hours.

The lockdown measures also disrupted education, with schools completely or partially closed for about nine months between March 2020 and June 2021. This resulted in a significant loss of learning opportunities and a likely increase in educational inequality. The impact of these disruptions could have long-term socioeconomic consequences, affecting income, health, and life expectancy.

The lockdown also had a substantial impact on healthcare. There was a decline in outpatient medical consultations, with curative consultations dropping by 33.6% and preventive consultations, such as cancer screening and health checks, decreasing by 61.3%. This likely led to deficits in acute medical care and may have contributed to an increase in the severity of cases for certain conditions. For example, there was a decrease in inpatient cancer treatment during the lockdowns, which may have led to tumour progression and a worsening of prognosis for some patients.

The psychological effects of the lockdown were also notable, with a significant increase in anxiety, depression, and sleep disorders. Surveys conducted during and after the lockdown periods revealed a three to five-fold increase in these mental health issues among the Austrian population.

Overall, the economic and social costs of the lockdowns in Austria were substantial, and it is difficult to determine the cost-effectiveness of these measures in terms of preventing hospitalizations or long COVID. International studies suggest that the collateral damage of lockdowns may be considerably larger than the benefits.

The psychological effects

Lockdown measures in Austria have had a significant impact on the mental health of the population, with a notable increase in anxiety, depression, and sleep disorders. The effects of lockdown on mental health have been particularly pronounced in certain groups, including women, young people, those with lower incomes, and those who are single or separated.

Impact on Mental Health Services

The lockdown led to a significant decline in outpatient medical consultations, with a 33.6% drop in curative consultations and a 61.3% drop in preventive consultations compared to the same period in 2019. However, there was an increase in consultations for general and pediatric psychiatry, with a 15.9% and 10.3% rise, respectively.

Impact on Different Age Groups

The lockdown had a disproportionate impact on the mental health of younger adults aged 18-24, with 50% of this age group exhibiting clinically relevant symptoms of depression and over 30% showing moderate anxiety. In contrast, older adults over 65 were less affected, with lower rates of depression, anxiety, and insomnia.

Impact on Gender

Women experienced poorer mental health than men across all measures, with higher levels of depression, anxiety, insomnia, and perceived stress. The relative change in mental health measures from pre-pandemic levels was also higher for women than men, indicating a greater impact of the pandemic on women's mental health.

Impact on Marital Status

Single and separated individuals were more affected by the lockdown, with higher rates of depression, anxiety, and insomnia compared to married people. Married individuals reported better mental health than other marital status groups.

Impact on Income

Mental health improved with higher income levels, with those earning below €1000 per month experiencing poorer mental health. Financial concerns and unemployment have been identified as important factors contributing to the decline in mental health during the pandemic.

Impact on Physical Activity

Engaging in regular physical activity of at least 30 minutes per day was found to have a positive effect on mental health. Those who participated in physical activity at least once a week reported better mental health outcomes.

Long-term Effects

The impact on schools

The impact of lockdown on schools in Austria has been far-reaching, with schools being completely or partially closed for around nine months between March 2020 and June 2021. This has had a significant effect on the education and health of students.

Loss of Learning Opportunities

Due to school closures, students in Austria lost a significant amount of learning time. A German study, which can be applied to Austria due to similarities in the education system, found that learning time was reduced by 3.8 hours per day on average. This loss of learning time was often replaced with activities such as watching TV or playing video games. As a result, students experienced a loss of learning opportunities and an increase in educational inequality.

Health and Fitness

The closure of schools and sports facilities during lockdowns resulted in major changes to students' daily routines. Studies have shown that the COVID-19 restrictions led to a decrease in cardiorespiratory endurance and action speed among primary school students. There was also a significant increase in waist circumference and body mass index (BMI), with more students falling into the overweight or obese categories. These negative effects on health and fitness are likely to have long-term consequences for the growing and developing individuals.

Psychological Effects

Lockdowns and school closures have also had psychological impacts on students. A survey of over 5000 children in Austria during the second lockdown in 2021 found that 49% of children between the ages of 6 and 18 experienced anxiety due to the situation. Many children were afraid that their parents or siblings might die from COVID-19. The survey also revealed that more than 70% of the children felt worse overall compared to before the pandemic, with high percentages of children feeling angry, lonely, and depressed.

The public's perception of the lockdown

The COVID-19 lockdowns in Austria had a significant impact on the public's mental health and well-being. A survey conducted in January and February 2021 revealed that 67.2% of respondents feared that a close relative could be infected with COVID-19, while only 15.2% feared dying from the disease themselves. The most stressful factors during the pandemic were isolation from family and friends (78%), homeschooling for parents (68.4%), and economic consequences (67.7%). The lockdown also led to a decline in outpatient medical consultations, with curative consultations dropping by 33.6% and preventive consultations by 61.3% compared to the same period in 2019.

The Austrian public's perception of the lockdown was influenced by their media consumption. Those who primarily consumed public media felt more constrained by the COVID-19 restrictions and were more likely to overestimate their personal risk of infection and hospitalization. On the other hand, those who regularly consumed private media were more critical of the government's measures and were less likely to trust the objectivity of media reports.

The lockdown also had economic impacts, with unemployment rising from 7.4% in 2019 to a peak of 12.7% in April 2020. The total economic damage caused by the COVID-19 crisis in Austria is estimated to exceed 70 billion euros for the years 2020-2022.

Additionally, the lockdown affected education, with schools completely or partially closed for 39 weeks between March 2020 and June 2021. Learning time was significantly reduced, particularly for low-achieving students, and distance learning may have negatively impacted their educational outcomes.

Overall, the COVID-19 lockdowns in Austria had far-reaching consequences for the public's mental health, social connections, economic situation, and education. The public's perception of the lockdown was shaped by their personal fears, media consumption, and trust in the government's handling of the crisis.

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