Comparing the COVID-19 pandemic in space and over time in Europe, using numbers of deaths, crude rates and adjusted mortality trend ratios

Gallo, Valentina; Chiodini, Paolo; Bruzzese, Dario; Kondilis, Elias; Howdon, Dan; Mierau, Jochen O.; Bhopal, Raj

doi:10.1038/s41598-021-95658-4

Cited by 20 publications

(20 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Eastern Europe ranks first in the continent among subregions ranked by population, having currently 292,309,880 inhabitants, based on the latest United Nations estimates [ 14 ]. At the same time as Eastern European countries battle vaccine hesitancy, the region was proved to have the highest adjusted mortality trend ratios [ 15 ]. Moreover, the negative implications cross the Eastern Europe borders.…”

Section: Introductionmentioning

confidence: 99%

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

et al. 2022

View full text Add to dashboard Cite

Herd immunity is necessary to control the coronavirus disease 2019 (COVID-19) pandemic. However, a low proportion of vaccinated people and low levels of vaccine acceptance have been noted in Eastern Europe. Our paper aimed to review the central attitudes associated with the hesitancy toward COVID-19 vaccination specific to Eastern European countries. The main Eastern European determinants of COVID-19 vaccine acceptance identified from the included studies are: public confidence in the vaccines’ safety and efficacy, vaccine literacy, and public trust in the government and the medical system. Each of these determinants is discussed along with possible improvement measures. Variables specific to Eastern Europe that predict the willingness to vaccinate have also been highlighted. The specific attitudes and their context as identified by our review should be incorporated into local public health programs, with the ultimate goal of reducing viral spreading, mutation emergence, and COVID-19 morbidity and mortality both within the borders of Eastern Europe and beyond.

show abstract

Section: Introductionmentioning

confidence: 99%

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Countries with more capacity for contact tracing and systematic testing (eg, in Seychelles) will be significantly less biased towards identifying only the most severe cases, and earlier treatment can lead to better outcomes. That said, high-income countries from other parts of the world, such as the United States, were not successful in reducing mortalities during the first wave of COVID-19, indicating that developed health systems alone were not sufficient to control COVID-19 related deaths 30. Thus, other aspects responsible for the better performance of relatively wealthy African countries should be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…That said, high-income countries from other parts of the world, such as the United States, were not successful in reducing mortalities during the first wave of COVID-19, indicating that developed health systems alone were not sufficient to control COVID-19 related deaths. 30 Thus, other aspects responsible for the better performance of relatively wealthy African countries should be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

et al. 2022

View full text Add to dashboard Cite

During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p<0.001) and cumulative (p<0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p<0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p<0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. We thus urge decision-makers to prioritise the reduction of resource-based health disparities, and surveillance and response capacities in particular, to ensure global resilience against future threats to public health and economic stability.

show abstract

“…Countries with more capacity for contact tracing and systematic testing (eg, in Seychelles) will be significantly less biased towards identifying only the most severe cases, and earlier treatment can lead to better outcomes. That said, high-income countries from other parts of the world, such as the United States, were not successful in reducing mortalities during the first wave of COVID-19, indicating that developed health systems alone were not sufficient to control COVID-19 related deaths [31]. Thus, other aspects responsible for the better performance of relatively wealthy African countries should be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

James

Dalal

Kousi

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective: To quantify the initial spread of COVID-19 in the WHO African region, and to investigate the possible drivers responsible for variation in the epidemic among member states. Design: A cross-sectional study. Setting: COVID-19 daily case and death data from the initial case through 29 November 2020. Participants: 46 countries comprising the WHO African region. Main outcome measures: We used five pandemic response indicators for each country: speed at which the pandemic reached the country, speed at which the first 50 cases accumulated, maximum monthly attack rate, cumulative attack rate, and crude case fatality ratio (CFR). We studied the effect of 13 predictor variables on the country-level variation in them using a principal component analysis, followed by regression. Results: Countries with higher tourism activities, GDP per capita, and proportion of older people had higher monthly (p < 0.001) and cumulative attack rates (p < 0.001) and lower CFRs (p = 0.052). Countries having more stringent early COVID-19 response policies experienced greater delay in arrival of the first case (p < 0.001). The speed at which the first 50 cases occurred was slower in countries whose neighbors had higher cumulative attack rates (p = 0.06). Conclusions: While global connectivity and tourism could facilitate the spread of airborne infectious agents, the observed differences in attack rates between African countries might also be due to differences in testing capacities or age distribution. Wealthy countries managed to minimize adverse outcomes. Further, careful and early implementation of strict government policies, such as restricting tourism, could be pivotal to controlling the COVID-19 pandemic. Evidently, good quality data and sufficient testing capacities are essential to unravel the epidemiology of an outbreak. We thus urge decision-makers to reduce these barriers to ensure rapid responses to future threats to public health and economic stability.

show abstract

Comparing the COVID-19 pandemic in space and over time in Europe, using numbers of deaths, crude rates and adjusted mortality trend ratios

Cited by 20 publications

References 48 publications

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review

An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

Contact Info

Product

Resources

About