Heat-related mortality in Portugal amplified during the COVID-19 pandemic

2021 ◽  
Author(s):  
Pedro M. Sousa ◽  
Ricardo M. Trigo ◽  
Ana Russo ◽  
João L. Geirinhas ◽  
Ana Rodrigues ◽  
...  
Keyword(s):  
Amplification Factor ◽  
Absolute Temperature ◽  
Emergency Admissions ◽  
Public Health Policies ◽  
Mortality Burden ◽  
High Death ◽  
Very High ◽  
Hot Spells ◽  
Related Mortality ◽  
Significant Mortality

<p>The warmest July ever in Portugal was observed during 2020, leading to the highest number of total deaths in July months (10430) since consistent records became available in 2009. This record summed up to the very high death toll throughout the year, characterized by the COVID-19 pandemic. As a combined result of these factors, cumulated deaths during 2020 are also the largest in the records available since 2009 (123753), corresponding to an excess of ~12000 deaths (~11% above the baseline). COVID-19 was responsible for the largest fraction of anomalous mortality during the spring months (62% of the excess during March-May) and from autumn onwards (85% of the excess during October-December). However, during the warmer season, the direct impact of the pandemic decreased substantially (as in the rest of Europe) and other causes were the main trigger for the observed excessive mortality (~3500 versus 553 COVID-19 deaths). Prolonged hot spells, occurring between June 21 and August 7, triggered persistent mortality anomalies in the upper tertile (>310 deaths/day) reaching its peak in mid-July (+45% deaths/day). Two other shorter hot spells occurring outside summer months (May and September) also appear to have contributed to significant mortality anomalies.</p><p>July 2020 registered an overall temperature anomaly of +2.6ºC over continental Portugal, and a cumulated anomaly of +127ºC. The lethality rate associated to these cumulated anomalies (+14 deaths per cumulated ºC) was higher than that observed in recent relevant heat-related mortality episodes, even those with higher absolute temperature anomalies, such as in 2013 and 2018. Rates comparable to those observed in 2020 in Portugal are only found far back in tragic heatwaves like those experienced in June 1981 or August 2003. In fact, the 2003 European heatwaves triggered significant changes in public health policies, in order to minimize the mortality burden associated to hot spells, which resulted in lower lethality rates, until 2020. These results are further supported by a statistical model developed to estimate expected deaths due to cold/heat (calibrated for 2009-2019: r=0.84; ME=7%), estimating an amplification of at least 50% in heat-related deaths during 2020 compared to pre-pandemic years. We argue that the significant decrease observed in emergency admissions (ER) and disruption in health-care since the start of the pandemic helps explaining this amplification factor. A ~2/3 decrease in total ERs was observed at the peak of the COVID-19 crisis, never returning to normal pre-pandemic levels. Furthermore, in average cases classified as emergent and very urgent in triage remained below 80% of previous reference levels throughout the 2020 summer, particularly the latter.</p><p>The authors would like to acknowledge the financial support  FCT through project UIDB/50019/2020 – IDL.</p>

scholarly journals Advancing public health policy making through research on the political strategies of alcohol industry actors

2019 ◽  
Vol 42 (2) ◽  
pp. 262-269 ◽  
Author(s):  
Jim McCambridge ◽  
Kypros Kypri ◽  
Trevor A Sheldon ◽  
Mary Madden ◽  
Thomas F Babor
Keyword(s):  
Public Health ◽  
Political Influence ◽  
Health Policies ◽  
The Political ◽  
Evidence Based ◽  
Public Health Policies ◽  
Alcohol Policies ◽  
Alcohol Industry ◽  
Mortality Burden ◽  
Global Influence

Abstract Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.

scholarly journals Long-term trends in the ambient PM<sub>2.5</sub>- and O<sub>3</sub>-related mortality burdens in the United States under emission reductions from 1990 to 2010

2018 ◽  
Vol 18 (20) ◽  
pp. 15003-15016 ◽  
Author(s):  
Yuqiang Zhang ◽  
J. Jason West ◽  
Rohit Mathur ◽  
Jia Xing ◽  
Christian Hogrefe ◽  
...  
Keyword(s):  
United States ◽  
Air Quality ◽  
The United States ◽  
Mortality Rates ◽  
Annual Variability ◽  
Mortality Burden ◽  
Pollutant Concentrations ◽  
Baseline Mortality ◽  
The Us ◽  
Related Mortality

Abstract. Concentrations of both fine particulate matter (PM2.5) and ozone (O3) in the United States (US) have decreased significantly since 1990, mainly because of air quality regulations. Exposure to these air pollutants is associated with premature death. Here we quantify the annual mortality burdens from PM2.5 and O3 in the US from 1990 to 2010, estimate trends and inter-annual variability, and evaluate the contributions to those trends from changes in pollutant concentrations, population, and baseline mortality rates. We use a fine-resolution (36 km) self-consistent 21-year simulation of air pollutant concentrations in the US from 1990 to 2010, a health impact function, and annual county-level population and baseline mortality rate estimates. From 1990 to 2010, the modeled population-weighted annual PM2.5 decreased by 39 %, and summertime (April to September) 1 h average daily maximum O3 decreased by 9 % from 1990 to 2010. The PM2.5-related mortality burden from ischemic heart disease, chronic obstructive pulmonary disease, lung cancer, and stroke steadily decreased by 54 % from 123 700 deaths year−1 (95 % confidence interval, 70 800–178 100) in 1990 to 58 600 deaths year−1 (24 900–98 500) in 2010. The PM2.5-related mortality burden would have decreased by only 24 % from 1990 to 2010 if the PM2.5 concentrations had stayed at the 1990 level, due to decreases in baseline mortality rates for major diseases affected by PM2.5. The mortality burden associated with O3 from chronic respiratory disease increased by 13 % from 10 900 deaths year−1 (3700–17 500) in 1990 to 12 300 deaths year−1 (4100–19 800) in 2010, mainly caused by increases in the baseline mortality rates and population, despite decreases in O3 concentration. The O3-related mortality burden would have increased by 55 % from 1990 to 2010 if the O3 concentrations had stayed at the 1990 level. The detrended annual O3 mortality burden has larger inter-annual variability (coefficient of variation of 12 %) than the PM2.5-related burden (4 %), mainly from the inter-annual variation of O3 concentration. We conclude that air quality improvements have significantly decreased the mortality burden, avoiding roughly 35 800 (38 %) PM2.5-related deaths and 4600 (27 %) O3-related deaths in 2010, compared to the case if air quality had stayed at 1990 levels (at 2010 baseline mortality rates and population).

scholarly journals Snowglow—The Amplification of Skyglow by Snow and Clouds can Exceed Full Moon Illuminance in Suburban Areas

2019 ◽  
Vol 5 (8) ◽  
pp. 69 ◽  
Author(s):  
Jechow ◽  
Hölker
Keyword(s):  
Amplification Factor ◽  
Full Moon ◽  
The Arctic ◽  
Atmospheric Conditions ◽  
Light At Night ◽  
Suburban Areas ◽  
Clear Sky ◽  
First Results ◽  
Work First ◽  
Very High

Artificial skyglow, the fraction of artificial light at night that is emitted upwards from Earth and subsequently scattered back within the atmosphere, depends on atmospheric conditions but also on the ground albedo. One effect that has not gained much attention so far is the amplification of skyglow by snow, particularly in combination with clouds. Snow, however, has a very high albedo and can become important when the direct upward emission is reduced when using shielded luminaires. In this work, first results of skyglow amplification by fresh snow and clouds measured with all-sky photometry in a suburban area are presented. Amplification factors for the zenith luminance of 188 for snow and clouds in combination and 33 for snow alone were found at this site. The maximum zenith luminance of nearly 250 mcd/m² measured with snow and clouds is a factor of 1000 higher than the commonly used clear sky reference of 0.25 mcd/m². Compared with our darkest zenith luminance of 0.07 mcd/m² measured for overcast conditions in a very remote area, this leads to an overall amplification factor of ca. 3500. Horizontal illuminance measurements show values of up to 0.79 lx, exceeding maximum possible full-moon illuminance levels by more than a factor of two. Additional measurements near the Arctic Circle for clear and overcast conditions are presented and strategies for further studies are discussed. We propose the term “snowglow” to describe the amplification of skyglow by snow with and without clouds.

scholarly journals General Anaesthesia Related Mortality in a Limited Resource Settings Region: A Retrospective Study in Two Teaching Hospitals of Butembo

2020 ◽  
Author(s):  
Furaha Nzanzu Blaise Pascal ◽  
Agnes Malisawa ◽  
Andreas Barratt-Due ◽  
Felix Namboya ◽  
Gregor Pollach
Keyword(s):  
General Anaesthesia ◽  
Limited Resource ◽  
Emergency Operation ◽  
Teaching Hospitals ◽  
High Morbidity ◽  
Adult Age ◽  
Risk Of Death ◽  
Very High ◽  
Risk Practice ◽  
Related Mortality

Abstract Background: General anaesthesia (GA) in developing countries is still a high-risk practice, especially in Africa, accompanied with high morbidity and mortality. No study has yet been conducted in Butembo to determine the mortality related to GA practice. The main objective of this study was to assess mortality related to GA in Butembo. Methods: This study was a retrospective analytic study of patients who underwent surgery under GA in the 2 main teaching hospitals of Butembo from January 2011 to December 2015. Data were collected from patients file, anaesthesia registries and were analysed with SPSS 26. Results: From a total of 921patients, male and female patients were 539 (58.5%) 382 (41.5%) respectively. A total of 83 (9.0%) patients died. The overall perioperative mortality rate was 90 per 1,000. From the 83 deaths, 38 occurred within 24h representing GA related mortality of 41 per 1,000. There was a global drop in mortality from 2011 to 2015. The risk factors of death were neonate and senior adult age, emergency operation, ASA physical status more than 2 and single deranged vital sign preoperatively. The occurrence of any complication during GA increased the risk of death. Anaesthesia duration more than 120 minutes increased mortality as well as visceral surgeries/laparotomies. Ketamine was the most employed agent. Conclusion: GA related mortality is very high in Butembo. Improved GA services and outcomes can be obtained by training more anaesthesia providers, proper patients monitoring, enhanced the infrastructure, better equipment and drugs procurement.

scholarly journals Long-term trends in the PM<sub>2.5</sub>- and O<sub>3</sub>-related mortality burdens in the United States under emission reductions from 1990 to 2010

2018 ◽  
Author(s):  
Yuqiang Zhang ◽  
J. Jason West ◽  
Rohit Mathur ◽  
Jia Xing ◽  
Christian Hogrefe ◽  
...  
Keyword(s):  
United States ◽  
Air Quality ◽  
The United States ◽  
Mortality Rates ◽  
Annual Variability ◽  
Mortality Burden ◽  
Pollutant Concentrations ◽  
Baseline Mortality ◽  
The Us ◽  
Related Mortality

Abstract. Concentrations of both fine particulate matter (PM2.5) and ozone (O3) in the United States (US) have decreased significantly since 1990, mainly because of air quality regulations. These air pollutants are associated with premature death. Here we quantify the annual mortality burdens from PM2.5 and O3 in the US from 1990 to 2010, estimate trends and inter-annual variability, and evaluate the contributions to those trends from changes in pollutant concentrations, population, and baseline mortality rates. We use a fine-resolution (36 km) self-consistent 21-year simulation of air pollutant concentrations in the US from 1990 to 2010, a health impact function, and annual county-level population and baseline mortality rate estimates. From 1990 to 2010, the modeled population-weighted annual PM2.5 decreased by 39 %, and summertime (April to September) 1hr average daily maximum O3 decreased by 9 % from 1990 to 2010. The PM2.5-related mortality burden from ischemic heart disease, chronic obstructive pulmonary disease, lung cancer, and stroke, steadily decreased by 53 % from 123,700 deaths yr−1 (95 % confidence interval, 70,800–178,100) in 1990 to 58,600 deaths −1 (24,900–98,500) in 2010. The PM2.5 -related mortality burden would have decreased by only 24 % from 1990 to 2010 if the PM2.5 concentrations had stayed at the 1990 level, due to decreases in baseline mortality rates for major diseases affected by PM2.5. The mortality burden associated with O3 from chronic respiratory disease increased by 13 % from 10,900 deaths −1 (3,700–17,500) in 1990 to 12,300 deaths −1 (4,100–19,800) in 2010, mainly caused by increases in the baseline mortality rates and population, despite decreases in O3 concentration. The O3-related mortality burden would have increased by 55 % from 1990 to 2010 if the O3 concentrations had stayed at the 1990 level. The detrended annual O3 mortality burden has larger inter-annual variability (coefficient of variation of 12 %) than the PM2.5-related burden (4 %), mainly from the inter-annual variation of O3 concentration. We conclude that air quality improvements have significantly decreased the mortality burden, avoiding roughly 35,800 (38 %) PM2.5-related deaths and 4,600 (27 %) O3-related deaths in 2010, compared to the case if air quality had stayed at 1990 levels.

scholarly journals IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study

2015 ◽  
Vol 70 (7) ◽  
pp. 2129-2132 ◽  
Author(s):  
Sarah Shalhoub ◽  
Fayssal Farahat ◽  
Abdullah Al-Jiffri ◽  
Raed Simhairi ◽  
Omar Shamma ◽  
...  
Keyword(s):  
Middle East ◽  
Mortality Rate ◽  
Prognostic Indicator ◽  
Middle East Respiratory Syndrome ◽  
Rt Pcr ◽  
Respiratory Sample ◽  
Viral Shedding ◽  
Related Mortality ◽  
Overall Mortality ◽  
Significant Mortality

Abstract Objectives Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with significant mortality. We examined the utility of plasma MERS-CoV PCR as a prognostic indicator and compared the efficacies of IFN-α2a and IFN-β1a when combined with ribavirin in reducing MERS-CoV-related mortality rates. Methods We retrospectively analysed 32 patients with confirmed MERS-CoV infection, admitted between April 2014 and June 2014, by positive respiratory sample RT–PCR. Plasma MERS-CoV RT–PCR was performed at the time of diagnosis for 19 patients. Results The overall mortality rate was 69% (22/32). Ninety percent (9/10) of patients with positive plasma MERS-CoV PCR died compared with 44% (4/9) of those with negative plasma MERS-CoV PCR. Mortality rate in patients who received IFN-α2a was 85% (11/13) compared with 64% (7/11) in those who received IFN-β1a (P = 0.24). The mortality rate in patients with renal failure (14), including 8 on haemodialysis, was 100%. Age &gt;50 years and diabetes mellitus were found to be significantly associated with mortality (OR = 26.1; 95% CI 3.58–190.76; P = 0.001 and OR = 15.74; 95% CI 2.46–100.67; P = 0.004, respectively). The median duration of viral shedding in patients who recovered was 11 days (range 6–38 days). Absence of fever was noted in 5/32 patients. Conclusions Plasma MERS-CoV RT–PCR may serve as an effective tool to predict MERS-CoV-associated mortality. Older age and comorbid conditions may have contributed to the lack of efficacy of IFN-α2a or IFN-β1a with ribavirin in treating MERS-CoV. Absence of fever should not exclude MERS-CoV.

scholarly journals Seasonal variations of temperature-related mortality burden from cardiovascular disease and myocardial infarction in China

2017 ◽  
Vol 224 ◽  
pp. 400-406 ◽  
Author(s):  
Jun Yang ◽  
Maigeng Zhou ◽  
Chun-Quan Ou ◽  
Peng Yin ◽  
Mengmeng Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Seasonal Variations ◽  
Mortality Burden ◽  
Related Mortality

scholarly journals Estimation of ambient PM2.5-related mortality burden in China by 2030 under climate and population change scenarios: A modeling study

2021 ◽  
Vol 156 ◽  
pp. 106733
Author(s):  
Jiayue Xu ◽  
Minghong Yao ◽  
Wenjing Wu ◽  
Xue Qiao ◽  
Hongliang Zhang ◽  
...  
Keyword(s):  
Population Change ◽  
Mortality Burden ◽  
Related Mortality ◽  
Modeling Study

scholarly journals Value-based pricing of a COVID-19 vaccine

2021 ◽  
Author(s):  
Afschin Gandjour
Keyword(s):  
Time Horizon ◽  
Decision Model ◽  
Mitigation Strategy ◽  
Mitigation Measures ◽  
Base Case ◽  
Short Term ◽  
A Value ◽  
Mortality Burden ◽  
Herd Protection ◽  
Related Mortality

AbstractAimThe purpose of this study is to determine the value-based price of a COVID-19 vaccine from a societal perspective in Germany.MethodsA decision model was constructed using, e.g., information on age-specific fatality rates, intensive care unit (ICU) costs and outcomes, and herd protection threshold. Three strategies were analysed: vaccination (with 95% and 50% efficacy), a mitigation strategy, and no intervention. The base-case time horizon was 5 years. The value of a vaccine included savings from avoiding COVID-19 mitigation measures and health benefits from avoiding COVID-19 related mortality. The value of an additional life year was borrowed from new, innovative oncological drugs, as cancer reflects a condition with a similar morbidity and mortality burden in the general population in the short term as COVID-19.ResultsA vaccine with a 95% efficacy dominates the mitigation strategy strictly. The value-based price (€1494) is thus determined by the comparison between vaccination and no intervention. This price is particularly sensitive to the probability of ICU admission and the herd protection threshold. In contrast, the value of a vaccine with 50% efficacy is more ambiguous.ConclusionThis study yields a value-based price for a COVID-19 vaccine with 95% efficacy, which is more than 50 times greater than the purchasing price.

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