Which are factors determining a low COVID-19 mortality in society? High health expenditure and lower exposure of population to air pollution as critical factors for an effective strategy to cope with future pandemics similar to COVID-19

Abstract

One of the problems hardly clarified in the scientific field of Coronavirus Disease 2019 (COVID-19) is inter-related factors associated with a lower mortality of COVID-19 to design effective strategies to cope with unforeseen pandemic crises. The main goal of this study is to explain these factors determining a lower fatality rate of the Coronavirus disease 2019 (COVID-19) in society with a global analysis based on more than 160 countries worldwide. This study reveals a novel finding: countries with a low average COVID-19 mortality have high investments in health sectors as % of GDP (>7.5%), high health expenditures per capita (>$2,300) associated with a lower exposure of population to days exceeding safe levels of particulate matter (PM2.5), reinforcing these factors with a policy response of lockdown. In addition, these countries have lower fatality rates of COVID-19, regardless a higher percentage of population aged more than 65 years in these countries. Overall, then, this study must conclude that an effective strategy to reduce the negative impact of future epidemics similar to COVID-19 has to be based on a reinforcement of healthcare sector to have an efficient organization prearranged to cope with pandemics of new viral agents and to be able to minimize fatality rates in a context of sustainable environment having low air pollution.

Spatial effects of air pollution on the economic burden of disease: implications of health and environment crisis in a post-COVID-19 world

“…Relevant research on the outbreak of COVID-19 has paid attention to this matter. It has been found that a large number of bacteria and viruses are suspended in PM 2.5 , PM 10 , and other atmospheric particles in air pollution; that is, viruses such as the SARS-CoV-2 can be transmitted to the human body through biological aerosols [61]. First, this discovery should help policymakers realise that it is extremely important to reduce pollution sources as much as possible, because a clean natural environment can also reduce the burden of infectious [62] and other [11,12] diseases caused by air pollution.…”

“…For a long time, compared with other aspects, politicians have regarded health as a secondary aspect of the government's action plan, thus redistributing the budget and paying more attention to those aspects that drive economic development [61]. An important way to improve health services is to improve health investment [66].…”

“…A recent study found that the higher the government health expenditure, the lower the mortality brought on by the COVID-19 pandemic [61]. Health investment strengthens the health care sector's capacity to respond to epidemics and other diseases [61], including those caused by air pollution, which can benefit residents facing the economic burden of any disease. However, we must emphasise that proactive health investment should be encouraged.…”