COVID-19 mortality rates in the European Union, Switzerland, and the UK: effect of timeliness, lockdown rigidity, and population density
COVID-19 mortality rates in the European Union, Switzerland, and the UK: effect of timeliness, lockdown rigidity, and population density
复制标题
DOI：
10.23736/s0026-4806.20.06702-6
复制
发表时间：
2020-08-01
期刊：
影响因子：
4.7
通讯作者：
Soriano, Joan B.
中科院分区：
文献类型：
--
作者：
Gerli, Alberto G.;Centanni, Stefano;Soriano, Joan B.
背景：迄今为止，欧洲在COVID-19死亡率方面的经验与在中国和亚洲观察到的不同。我们旨在预测欧盟（EU） 27个国家以及瑞士和英国的死亡率趋势，这些国家的封锁日期和隔离干预措施各不相同，并探讨其决定因素。方法：我们对covid -19相关死亡率的预测模型进行了调整，该模型基于疫情爆发后最初几周内观察到的死亡率和每个国家各自封锁的日期。它首先应用于三个国家（意大利、德国和西班牙）的训练集，然后应用于欧盟以及英国和瑞士。此外，我们在预测中探讨了封锁的时效性和刚性（按五级分级）以及人口密度的影响。我们报告了r(2)，以及预期死亡与观察死亡的百分比变化，所有这些都遵循TRIPOD指导。结果：我们确定了死亡人数的均匀分布，并发现采用封锁后24天的中位数达到最大每日死亡人数。引人注目的是，截至2020年4月25日，根据疫情爆发后采取封锁措施的时间，在欧洲不同国家观察到的累计死亡人数分为三波：一周后、一周内，甚至在疫情爆发之前（r(2)=0.876）。相比之下，无论是与封城刚性还是人口密度都没有观察到相关性。结论：欧洲的经验证实，早期有效的封锁干预措施是最大限度地减少COVID-19死亡人数的关键。
BACKGROUND: To date, the European experience with COVID-19 mortality has been different to that observed in China and Asia. We aimed to forecast mortality trends in the 27 countries of the European Union (EU), plus Switzerland and the UK, where lockdown dates and confinement interventions have been heterogeneous, and to explore its determinants.METHODS: We have adapted our predictive model of COVID-19-related mortality, which rested on the observed mortality within the first weeks of the outbreak and the date of the respective lockdown in each country. It was applied in a training set of three countries (Italy, Germany and Spain), and then applied to the EU plus the UK and Switzerland. In addition, we explored the effects of timeliness and rigidity of the lockdown (on a five-step scale) and population density in our forecasts. We report r(2), and percent variation of expected versus observed deaths, all following TRIPOD guidance.RESULTS: We identified a homogeneous distribution of deaths, and found a median of 24 days after lockdown adoption to reach the maximum daily deaths. Strikingly, cumulative deaths up to April 25th, 2020 observed in Europe separated countries in three waves, according to the time lockdown measures were adopted following the onset of the outbreak: after a week, within a week, or even prior to the outbreak (r(2)=0.876). In contrast, no correlation neither with lockdown rigidity nor population density were observed.CONCLUSIONS: The European experience confirms that early, effective interventions of lockdown are fundamental to minimizing the COVID-19 death toll.