Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study.

Jüni, Peter; Rothenbühler, Martina; Bobos, Pavlos; Thorpe, Kevin E; da Costa, Bruno R.; Fisman, David N; Slutsky, Arthur S; Gesink, Dionne (2020). Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study. CMAJ, 192(21), E566-E573. Canadian Medical Association 10.1503/cmaj.200920

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BACKGROUND It is unclear whether seasonal changes, school closures or other public health interventions will result in a slowdown of the current coronavirus disease 2019 (COVID-19) pandemic. We aimed to determine whether epidemic growth is globally associated with climate or public health interventions intended to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS We performed a prospective cohort study of all 144 geopolitical areas worldwide (375 609 cases) with at least 10 COVID-19 cases and local transmission by Mar. 20, 2020, excluding China, South Korea, Iran and Italy. Using weighted random-effects regression, we determined the association between epidemic growth (expressed as ratios of rate ratios [RRR] comparing cumulative counts of COVID-19 cases on Mar. 27, 2020, with cumulative counts on Mar. 20, 2020) and latitude, temperature, humidity, school closures, restrictions of mass gatherings, and measures of social distancing during an exposure period 14 days previously (Mar. 7 to 13, 2020). RESULTS In univariate analyses, there were few or no associations of epidemic growth with latitude and temperature, but weak negative associations with relative humidity (RRR per 10% 0.91, 95% confidence interval [CI] 0.85-0.96) and absolute humidity (RRR per 5 g/m3 0.92, 95% CI 0.85-0.99). Strong associations were found for restrictions of mass gatherings (RRR 0.65, 95% CI 0.53-0.79), school closures (RRR 0.63, 95% CI 0.52-0.78) and measures of social distancing (RRR 0.62, 95% CI 0.45-0.85). In a multivariable model, there was a strong association with the number of implemented public health interventions (p for trend = 0.001), whereas the association with absolute humidity was no longer significant. INTERPRETATION Epidemic growth of COVID-19 was not associated with latitude and temperature, but may be associated weakly with relative or absolute humidity. Conversely, public health interventions were strongly associated with reduced epidemic growth.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Da Costa, Bruno

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0820-3946

Publisher:

Canadian Medical Association

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

12 May 2020 15:21

Last Modified:

25 Jun 2020 01:32

Publisher DOI:

10.1503/cmaj.200920

PubMed ID:

32385067

BORIS DOI:

10.7892/boris.143968

URI:

https://boris.unibe.ch/id/eprint/143968

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