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Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

It is hard to overstate the importance of a timely prediction of the COVID-19 pandemic progression. Yet, this is not possible without a comprehensive understanding of environmental factors that may affect the infection transmissibility. Studies addressing parameters that may influence COVID-19 progression relied on either the total numbers of detected cases and similar proxies (which are highly sensitive to the testing capacity, levels of introduced social distancing measures, etc.), and/or a small number of analyzed factors, including analysis of regions that display a narrow range of these parameters. We here apply a novel approach, exploiting widespread growth regimes in COVID-19 detected case counts. By applying nonlinear dynamics methods to the exponential regime, we extract basic reproductive number R0 (i.e., the measure of COVID-19 inherent biological transmissibility), applying to the completely naïve population in the absence of social distancing, for 118 different countries. We then use bioinformatics methods to systematically collect data on a large number of potentially interesting demographics and weather parameters for these countries (where data was available), and seek their correlations with the rate of COVID-19 spread. While some of the already reported or assumed tendencies (e.g., negative correlation of transmissibility with temperature and humidity, significant correlation with UV, generally positive correlation with pollution levels) are also confirmed by our analysis, we report a number of both novel results and those that help settle existing disputes: the absence of dependence on wind speed and air pressure, negative correlation with precipitation; significant positive correlation with society development level (human development index) irrespective of testing policies, and percent of the urban population, but absence of correlation with population density per se. We find a strong positive correlation of transmissibility on alcohol consumption, and the absence of correlation on refugee numbers, contrary to some widespread beliefs. Significant tendencies with health-related factors are reported, including a detailed analysis of the blood type group showing consistent tendencies on Rh factor, and a strong positive correlation of transmissibility with cholesterol levels. Detailed comparisons of obtained results with previous findings, and limitations of our approach, are also provided.

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