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Martínez-Portillo A, Garcia-Garcia D, Leon I, Ramis-Prieto R, Gómez-Barroso D. Latitude and longitude as drivers of COVID-19 waves' behavior in Europe: A time-space perspective of the pandemic. PLoS One 2023; 18:e0291618. [PMID: 37713435 PMCID: PMC10503727 DOI: 10.1371/journal.pone.0291618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Social restrictions and vaccination seem to have shaped the pandemic development in Europe, but the influence of geographical position is still debated. This study aims to verify whether the pandemic spread through Europe following a particular direction, during the period between the start of the pandemic and November 2021. The existence of a spatial gradient for epidemic intensity is also hypothesized. METHODS Daily COVID-19 epidemiological data were extracted from Our World in Data COVID-19 database, which also included vaccination and non-pharmacological interventions data. Latitude and longitude of each country's centroid were used as geographic variables. Epidemic periods were delimited from epidemic surge data. Multivariable linear and Cox's regression models were performed for each epidemic period to test if geographical variables influenced surge dates. Generalized additive models (GAM) were used to test the spatial gradient hypothesis with three epidemic intensity measures. RESULTS Linear models suggest a possible west-east shift in the first epidemic period and features a significant association of NPIs with epidemic surge delay. Neither latitude nor longitude had significant associations with epidemic surge timing in both second and third periods. Latitude displays strong negative associations with all epidemic intensity measures in GAM models. Vaccination was also negatively associated with intensity. CONCLUSIONS A longitudinal spread of the pandemic in Europe seems plausible, particularly concerning the first wave. However, a recurrent trend was not observed. Southern Europe countries may have experienced increased transmissibility and incidence, despite climatic conditions apparently unfavourable to the virus.
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Affiliation(s)
| | - David Garcia-Garcia
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Inmaculada Leon
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rebeca Ramis-Prieto
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Vickers DM, Baral S, Mishra S, Kwong JC, Sundaram M, Katz A, Calzavara A, Maheu-Giroux M, Buckeridge DL, Williamson T. Stringency of containment and closures on the growth of SARS-CoV-2 in Canada prior to accelerated vaccine roll-out. Int J Infect Dis 2022; 118:73-82. [PMID: 35202783 PMCID: PMC8863413 DOI: 10.1016/j.ijid.2022.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Many studies have examined the effectiveness of non-pharmaceutical interventions (NPIs) on SARS-CoV-2 transmission worldwide. However, less attention has been devoted to understanding the limits of NPIs across the course of the pandemic and along a continuum of their stringency. In this study, we explore the relationship between the growth of SARS-CoV-2 cases and an NPI stringency index across Canada before the accelerated vaccine roll-out. METHODS We conducted an ecological time-series study of daily SARS-CoV-2 case growth in Canada from February 2020 to February 2021. Our outcome was a back-projected version of the daily growth ratio in a stringency period (i.e., a 10-point range of the stringency index) relative to the last day of the previous period. We examined the trends in case growth using a linear mixed-effects model accounting for stringency period, province, and mobility in public domains. RESULTS Case growth declined rapidly by 20-60% and plateaued within the first month of the first wave, irrespective of the starting values of the stringency index. When stringency periods increased, changes in case growth were not immediate and were faster in the first wave than in the second. In the first wave, the largest decreasing trends from our mixed effects model occurred in both early and late stringency periods, depending on the province, at a geometric mean index value of 30⋅1 out of 100. When compared with the first wave, the stringency periods in the second wave possessed little association with case growth. CONCLUSIONS The minimal association in the first wave, and the lack thereof in the second, is compatible with the hypothesis that NPIs do not, per se, lead to a decline in case growth. Instead, the correlations we observed might be better explained by a combination of underlying behaviors of the populations in each province and the natural dynamics of SARS-CoV-2. Although there exist alternative explanations for the equivocal relationship between NPIs and case growth, the onus of providing evidence shifts to demonstrating how NPIs can consistently have flat association, despite incrementally high stringency.
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Affiliation(s)
- David M. Vickers
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Corresponding author: David M. Vickers, PhD, Centre for Health Informatics, 5th Floor, TRW Building, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada, Phone: +001 403 771 6893
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, United States
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada,Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jeffrey C. Kwong
- ICES, Toronto, ON, Canada,Public Health Ontario, ON, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada,Department of Family and Community Medicine, University of Toronto, ON, Canada
| | - Maria Sundaram
- ICES, Toronto, ON, Canada,Centre for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Alan Katz
- Departments of Community Health Sciences and Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - David L. Buckeridge
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Tyler Williamson
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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