Structural equation modeling to shed light on the controversial role of climate on the spread of SARS-CoV-2

The influence of weather and urban environment characteristics on upper respiratory tract infections: a systematic review

Background

Weather can independently affect the occurrence of respiratory tract infections (RTIs) in urban areas. Built environments of cities could further modify exposure to weather and consequently the risk of RTIs, but their combined effects on infections are not known.

Objectives

Our aim was to synthesize evidence of the influence of weather on RTIs in urban areas and to examine whether urban built environments are associated with both weather and RTIs.

Methods

A systematic search of Scopus, PubMed, and Web of Science databases was conducted on 9th of August 2022 following PRISMA guidelines. Studies were included in the review based on predefined criteria by screening 5,789 articles and reviewing reference lists of relevant studies. The quality of the studies was assessed using the AXIS appraisal tool, and the results analyzed by narrative synthesis.

Results

Twenty-one eligible studies focusing on COVID-19 and influenza transmissions, were included in the review. All studies were register based ecological studies by design. Low temperature (11/19 studies) was most often associated with increased risk of RTI. Humidity showed either negative (5/14 studies), positive (3/14 studies) or no (6/14 studies) relation with RTIs. The association between wind and solar radiation on infections was inconclusive. Population density was positively associated with RTIs (14/15 studies).

Conclusions

Our review shows that exposure to low temperature increases the occurrence of RTIs in urban areas, and where also high population density increases the infection risk. The study highlights the need to further assess the relationship between built environment characteristics, weather, and RTIs.

Identification of environmental, socioeconomic, water, sanitation, and hygiene (WaSH) factors associated with COVID-19 incidence in the Philippines: A nationwide modelling study

Despite the implementation of non-pharmaceutical interventions, the threat of coronavirus disease 2019 (COVID-19) remains significant on a global scale. Identifying external factors contributing to its spread is crucial, especially given the World Health Organization's recommendation emphasizing access to water, sanitation, and hygiene as essential in curbing COVID-19. There is a notable discrepancy in access to sanitation facilities, particularly evident in low- and middle-income countries. However, there is a lack of quantitative assessments regarding these factors. This study examines various environmental, socioeconomic, water, sanitation, and hygiene factors and their associations with COVID-19 incidence. All regions in the Philippines were categorized into clusters based on socioeconomic factors. A conceptual structural equation model (SEM) was developed using domain knowledge. The best-fitting SEM for each cluster was determined, and associations between factors and COVID-19 incidence were estimated. The correlation analysis revealed that rainfall, minimum temperature, and relative humidity were positively correlated with weekly COVID-19 incidence in urban regions. Maximum temperature, mean temperature, wind speed, and wind direction were negatively correlated with weekly COVID-19 incidence in rural regions, with time lags of 0, 3, and 7 weeks. In urban regions (Cluster 1), factors such as urbanization rate (1.00), area (-0.93), and population (0.54) were found to be associated with weekly COVID-19 incidence. Conversely, in rural regions (Cluster 2), factors including area (0.17), basic sanitation (0.84), and wind direction (0.83) showed associations with weekly COVID-19 incidence. These factors were causally associated with a latent variable reflecting the hidden confounders associated with COVID-19 incidence. It is important to note that sanitation factors were associated only in rural regions. Improving access to sanitation facilities in rural regions of the Philippines is imperative to effectively mitigate disease transmission in future pandemics. Identification of the causal effect of unobserved confounders with COVID-19 incidence is recommended for future research.

Actual conditions of person-to-object contact and a proposal for prevention measures during the COVID-19 pandemic

This study focused on human contact behavior with objects and discussed countermeasures during the COVID-19 pandemic across 15 location types. Reducing contact with objects and disinfecting items can be implemented at a relatively low cost. We created a protocol for organizing the objects, and 1260 subjects who went outside during a day between December 3-7, 2020 in Tokyo and Kanagawa, Japan were surveyed. The participants touched 7317 objects in total; the most common objects were doors, chairs, baskets, elevator equipment, and cash. One-way analysis of variance and Scheffé's multiple comparison test showed that supermarkets had the lowest mean and median values despite having the highest number of users, contact objects, and object types. Conversely, the values for hotels were the highest, significantly higher than that for other places, excluding amusement parks, workplaces, and schools and universities. Furthermore, the long-tailed frequency distribution of the number of objects suggests that the objects touched by many individuals are limited; thus, it is important to determine the objects to be prioritized for disinfection at each location. The data and protocol could inform infection countermeasures that properly address the contact realities as they pertain to people's behavior and objects.

Influence of weather factors on the incidence of COVID-19 in Spain

Introduction

Several studies have analyzed the influence of meteorological and geographical factors on the incidence of COVID-19. Seasonality could be important in the transmission of SARS-CoV-2. This study aims to evaluate the geographical pattern of COVID-19 in Spain and its relationship with different meteorological variables.

Methods

A provincial ecological study analyzing the influence of meteorological and geographical factors on the cumulative incidence of COVID-19 in the 52 (24 coastal and 28 inland) Spanish provinces during the first three waves was carried out. The cumulative incidence was calculated with data from the National Statistical Institute (INE) and the National Epidemiological Surveillance Network (RENAVE), while the meteorological variables were obtained from the Spanish Meteorological Agency (AEMET).

Results

The total cumulative incidence, in all three waves, was lower in the coastal provinces than in the inland ones (566 ± 181 vs. 782 ± 154; P = 2.5 × 10⁻⁵). The cumulative incidence correlated negatively with mean air temperature (r = −0.49; P = 2.2 × 10⁻⁴) and rainfall (r = −0.33; P = .01), and positively with altitude (r = 0.56; P = 1.4 × 10⁻⁵). The Spanish provinces with an average temperature <10 °C had almost twice the cumulative incidence than the provinces with temperatures >16 °C. The mean air temperature and rainfall were associated with the cumulative incidence of COVID-19, regardless of other factors (Beta Coefficient of −0.62; P = 3.7 × 10⁻⁷ and −0.47; P = 4.2 × 10⁻⁵ respectively)

Conclusions

Meteorological and geographical factors could influence the evolution of the pandemic in Spain. Knowledge regarding the seasonality of the virus would help to predict new waves of COVID-19 infections

Elucidating the role of environmental management of forests, air quality, solid waste and wastewater on the dissemination of SARS-CoV-2

The increasing frequency of zoonotic diseases is amongst several catastrophic repercussions of inadequate environmental management. Emergence, prevalence, and lethality of zoonotic diseases is intrinsically linked to environmental management which are currently at a destructive level globally. The effects of these links are complicated and interdependent, creating an urgent need of elucidating the role of environmental mismanagement to improve our resilience to future pandemics. This review focused on the pertinent role of forests, outdoor air, indoor air, solid waste and wastewater management in COVID-19 dissemination to analyze the opportunities prevailing to control infectious diseases considering relevant data from previous disease outbreaks. Global forest management is currently detrimental and hotspots of forest fragmentation have demonstrated to result in zoonotic disease emergences. Deforestation is reported to increase susceptibility to COVID-19 due to wildfire induced pollution and loss of forest ecosystem services. Detection of SARS-CoV-2 like viruses in multiple animal species also point to the impacts of biodiversity loss and forest fragmentation in relation to COVID-19. Available literature on air quality and COVID-19 have provided insights into the potential of air pollutants acting as plausible virus carrier and aggravating immune responses and expression of ACE2 receptors. SARS-CoV-2 is detected in outdoor air, indoor air, solid waste, wastewater and shown to prevail on solid surfaces and aerosols for prolonged hours. Furthermore, lack of protection measures and safe disposal options in waste management are evoking concerns especially in underdeveloped countries due to high infectivity of SARS-CoV-2. Inadequate legal framework and non-adherence to environmental regulations were observed to aggravate the postulated risks and vulnerability to future waves of pandemics. Our understanding underlines the urgent need to reinforce the fragile status of global environmental management systems through the development of strict legislative frameworks and enforcement by providing institutional, financial and technical supports.

A narrative review on the role of temperature and humidity in COVID-19: Transmission, persistence, and epidemiological evidence

Since December 2019, the 2019 coronavirus disease (COVID-19) outbreak has become a global pandemic. Understanding the role of environmental conditions is important in impeding the spread of COVID-19. Given that airborne spread and contact transmission are considered the main pathways for the spread of COVID-19, this narrative review first summarized the role of temperature and humidity in the airborne trajectory of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Meanwhile, we reviewed the persistence of the virus in aerosols and on inert surfaces and summarized how the persistence of SARS-CoV-2 is affected by temperature and humidity. We also examined the existing epidemiological evidence and addressed the limitations of these epidemiological studies. Although uncertainty remains, more evidence may support the idea that high temperature is slightly and negatively associated with COVID-19 growth, while the conclusion for humidity is still conflicting. Nonetheless, the spread of COVID-19 appears to have been controlled primarily by government interventions rather than environmental factors.

On the footsteps of Hippocrates, Sanctorius and Harvey to better understand the influence of cold on the occurrence of COVID-19 in European countries in 2020

COVID-19 pandemic has been characterized by a pattern of consecutive declines and regrowth in European countries in 2020. After being partially regressed during the summer, the reappearance of the infection during fall 2020 in many temperate countries strongly suggests that temperature and cold may play a role in influencing the infectivity and virulence of SARS-CoV-2. While promoting medicine as an art, Hippocrates interpreted with logical reasoning the occurrence of diseases such as epidemics, as a consequence of environmental factors, in particular climatic variations. During the Renaissance, Sanctorius was one of the first to perform quantitative measurements, and Harvey discovered the circulation of blood by performing experimental procedures in animals. We think that a reasoning mixing various observations, measurements and experiments is fundamental to understand how cold increases infectivity and virulence of SARS-CoV-2. By this review, we provide evidence linking cold, angiotensin-II, vasoconstriction, hypoxia and aerobic glycolysis (the Warburg effect) to explain how cold affects the epidemiology of COVID-19. Also, a low humidity increases virus transmissibility, while a warm atmosphere, a moderate airway humidity, and the production of vasodilator angiotensin 1-7 by ACE2 are less favorable to the virus entry and/or its development. The meteorological and environmental parameters impacting COVID-19 pandemic should be reintegrated into a whole perspective by taking into account the different factors influencing transmissibility, infectivity and virulence of SARS-CoV-2. To understand the modern enigma represented by COVID-19, an interdisciplinary approach is surely essential.

Influence of weather factors on the incidence of COVID-19 in Spain

INTRODUCTION

Several studies have analyzed the influence of meteorological and geographical factors on the incidence of COVID-19. Seasonality could be important in the transmission of SARS-CoV-2. This study aims to evaluate the geographical pattern of COVID-19 in Spain and its relationship with different meteorological variables.

METHODS

A provincial ecological study analyzing the influence of meteorological and geographical factors on the cumulative incidence of COVID-19 in the 52 (24 coastal and 28 inland) Spanish provinces during the first three waves was carried out. The cumulative incidence was calculated with data from the National Statistical Institute (INE) and the National Epidemiological Surveillance Network (RENAVE), while the meteorological variables were obtained from the Spanish Meteorological Agency (AEMET).

RESULTS

The total cumulative incidence, in all three waves, was lower in the coastal provinces than in the inland ones (566±181 vs. 782±154; p=2.5×10^-5). The cumulative incidence correlated negatively with mean air temperature (r=-0.49; p=2.2×10^-4) and rainfall (r=-0.33; p=0.01), and positively with altitude (r=0.56; p=1. 4×10^-5). The Spanish provinces with an average temperature <10°C had almost twice the cumulative incidence than the provinces with temperatures >16°C. The mean air temperature and rainfall were associated with the cumulative incidence of COVID-19, regardless of other factors (Beta Coefficient of -0.62; p=3.7×10^-7 and -0.47; p=4.2×10^-5 respectively).

CONCLUSIONS

Meteorological and geographical factors could influence the evolution of the pandemic in Spain. Knowledge regarding the seasonality of the virus would help to predict new waves of COVID-19 infections.

Spatio-temporal prediction of the COVID-19 pandemic in US counties: modeling with a deep LSTM neural network

Prediction of complex epidemiological systems such as COVID-19 is challenging on many grounds. Commonly used compartmental models struggle to handle an epidemiological process that evolves rapidly and is spatially heterogeneous. On the other hand, machine learning methods are limited at the beginning of the pandemics due to small data size for training. We propose a deep learning approach to predict future COVID-19 infection cases and deaths 1 to 4 weeks ahead at the fine granularity of US counties. The multi-variate Long Short-term Memory (LSTM) recurrent neural network is trained on multiple time series samples at the same time, including a mobility series. Results show that adding mobility as a variable and using multiple samples to train the network improve predictive performance both in terms of bias and of variance of the forecasts. We also show that the predicted results have similar accuracy and spatial patterns with a standard ensemble model used as benchmark. The model is attractive in many respects, including the fine geographic granularity of predictions and great predictive performance several weeks ahead. Furthermore, data requirement and computational intensity are reduced by substituting a single model to multiple models folded in an ensemble model.

Healthcare Management During a Pandemic: The Other Side of the Coin for the Treatment of Covid-19 Infection

BACKGROUND

World Health Organization (WHO) has increasingly improved the guidelines to tackle the spread of Coronavirus Disease 2019 (COVID-19) among the worldwide population. In this context, each country has introduced specific social, healthcare, political and macroeconomic measures to face COVID pandemic locally.

OBJECTIVE

The general aim of this comparative overview is to highlight the most significant effects of COVID-19 pandemic on the main healthcare systems. Also, we critically analyzed the macroeconomic variables and the most promising solutions to improve both healthcare system and its related risk management, taking into specific consideration the most industrialized countries.

METHOD

The main strategy has been built on a renewed concept of the hospital, rebuilding the old concepts of "triage" and "intensive care". Recently, COVID-19 hospitals have allowed to cater the patients affected by COVID-19. Moreover, the reshaping of several healthcare policies and requirements has led to several positive effects, such as the recruitment of a huge number of human resources in the healthcare systems. Nevertheless, several negative effects have also impacted the communities mostly subjected to infections.

CONCLUSION

Undoubtedly, the national healthcare systems have somehow addressed the people's needs, trying not to neglect the social, healthcare, economic and political aspects. In our overview, we have reported how the different actions taken in the last months, have resulted in different outcomes.