Interpreting, analysing and modelling COVID-19 mortality data.

We present results on the mortality statistics of the COVID-19 epidemic in a number of countries. Our data analysis suggests classifying countries in five groups, (1) Western countries, (2) East Block, (3) developed Southeast Asian countries, (4) Northern Hemisphere developing countries and (5) Southern Hemisphere countries. Comparing the number of deaths per million inhabitants, a pattern emerges in which the Western countries exhibit the largest mortality rate. Furthermore, comparing the running cumulative death tolls as the same level of outbreak progress in different countries reveals several subgroups within the Western countries and further emphasises the difference between the five groups. Analysing the relationship between deaths per million and life expectancy in different countries, taken as a proxy of the preponderance of elderly people in the population, a main reason behind the relatively more severe COVID-19 epidemic in the Western countries is found to be their larger population of elderly people, with exceptions such as Norway and Japan, for which other factors seem to dominate. Our comparison between countries at the same level of outbreak progress allows us to identify and quantify a measure of efficiency of the level of stringency of confinement measures. We find that increasing the stringency from 20 to 60 decreases the death count by about 50 lives per million in a time window of 20  days. Finally, we perform logistic equation analyses of deaths as a means of tracking the dynamics of outbreaks in the "first wave" and estimating the associated ultimate mortality, using four different models to identify model error and robustness of results. This quantitative analysis allows us to assess the outbreak progress in different countries, differentiating between those that are at a quite advanced stage and close to the end of the epidemic from those that are still in the middle of it. This raises many questions in terms of organisation, preparedness, governance structure and so on.

The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations.

The COVID-19 pandemic severely affected people's mental health all over the world. This review aims to present a comprehensive overview of the literature related to the effects of COVID-19 lockdown measures and COVID-19 infection on cognitive functioning in both healthy people and people with neurological conditions by considering only standardized tests. We performed a narrative review of the literature via two databases, PUBMED and SCOPUS, from December 2019 to December 2022. In total, 62 out of 1356 articles were selected and organized into three time periods: short-term (1-4 months), medium-term (5-8 months), and long-term (9-12 months), according to the time in which the tests were performed. Regardless of the time period, most studies showed a general worsening in cognitive performance in people with neurological conditions due to COVID-19 lockdown measures and in healthy individuals recovered from COVID-19 infection. Our review is the first to highlight the importance of considering standardized tests as reliable measures to quantify the presence of cognitive deficits due to COVID-19. Indeed, we believe that they provide an objective measure of the cognitive difficulties encountered in the different populations, while allowing clinicians to plan rehabilitation treatments that can be of great help to many patients who still, nowadays, experience post-COVID-19 symptoms.

Age and Living Situation as Key Factors in Understanding Changes in Alcohol Use during COVID-19 Confinement.

(1) The aim of the present study was to evaluate and characterize changes in alcohol use during the COVID-19 confinement in a sample of Spanish adults, analyzing their age and living situation as defining life cycle variables. (2) Method: Data from 3779 individuals were collected through a set of online surveys. AUDIT-C was used to measure the frequency of consumption, the average daily consumption, intensive consumption, risky consumption, and Standard Drink Units. (3) Results: Although alcohol consumption during confinement showed a significant general decline, age revealed important differences, with the decline being more pronounced in adults from 18 to 29 years old. The living situation also showed significant differences. The largest decreases in alcohol consumption were found in those who lived with their parents or other relatives, whereas those who lived alone or with a partner even increased their level of consumption. In addition, the data show a significant interaction between these two variables and gender. (4) Conclusions: Age and cohabitation processes are key factors in understanding the life situation of each individual during confinement and, consequently, in explaining consumption patterns. The results obtained provide interesting recommendations for designing prevention policies in both normal and crisis circumstances, emphasizing the need to understand alcohol use from a psychosocial perspective.

Vitamin Nature: How Coronavirus Disease 2019 Has Highlighted Factors Contributing to the Frequency of Nature Visits in Flanders, Belgium.

Visiting nature is positively associated with physical and mental well-being. The role of nature became more pronounced during the coronavirus outbreak in the spring of 2020. Countries all over the world implemented confinement measures to reduce the transmission of the virus. These included but were not limited to the cancelation of public events, schools, and non-essential businesses and the prohibition of non-essential travels. However, going outside to exercise was recommended by the Belgian government. During this period, we conducted an online survey to determine if people visit nature more frequently than before and to identify the factors that contribute to this. The results are based on data from 11,352 participants in Flanders, Belgium. With the use of a bivariate and multiple regression analysis, results indicate that people visit nature more frequently than before and that nature helped to maintain social relationships during the coronavirus period. Gardens were reported to be the most popular place, followed by parks. More than half of the people experienced nature in a more positive way, and the belief that nature visits are important for general health increased. In addition, we found a positive association between nature visits and home satisfaction, as well as a positive association with subjective mental and physical health. Lastly, we identified several demographic factors contributing to the frequency of nature visits such as age, gender, and socioeconomic status. Our findings indicate the importance of nature visits for general well-being and highlight the need for nearby green infrastructure.

Assessment of Impact of Containment During the COVID-19 Epidemic and Coping Behaviours Using Newly Developed Assessment Tools.

Background: The confinement measures during COVID-19 had a massive effect on physical and psychological health in public. This study assessed the impact of containment and coping behaviour among the Malaysia public during the COVID-19 pandemic. Questions assessing the impact of containment and coping behaviours were developed and psychometrically tested. Methods: Exploratory factor analysis (EFA) was conducted with the items using principal component analysis extraction and Varimax rotation. Partial least squares structural equation modelling was used to determine the relationship between coping and impact. Results: The 13-item of impact and 10-item coping instruments were developed with three dimensions identified through EFA. Both scales demonstrated excellent composite reliability and good convergent validity. The survey findings revealed that the impact on individual psychological aspects was prominent, followed by well-being and lifestyle. Mindfulness and physical coping strategies were most commonly reported. Coping through seeking help from health professionals and hotlines had a positive direct effect on well-being and lifestyle (b = 0.231, p < 0.001), psychological (B = 0.132, p < 0.001), and employment-related (0.194, p < 0.001) impacts. Coping through mindfulness practise had a negative effect on well-being and lifestyle-related impact (B = -0.180, p < 0.001) and employment-related impact (B = -0.096, p = 0.008). Conclusions: Despite some limitation, the scales for measuring impact and coping behaviours have the potential to be used as a measurement tool in future studies. Findings highlight the enormous impact of the pandemic on psychological well-being and lifestyles. Health authorities should support individual coping as it was found to be an important resilience-related factor to mitigate the impacts of containment during the pandemic.

Changes in Alcohol Consumption Pattern Based on Gender during COVID-19 Confinement in Spain.

(1) The goal of this study was to analyze the prevalence and pattern of alcohol consumption (frequency of consumption, average daily consumption, and risky consumption) before and during confinement due to the coronavirus disease (COVID-19) in the adult population and based on gender. (2) Methods: Data from 3779 individuals were collected via a set of online surveys. The AUDIT alcohol consumption questions (AUDIT-C) were used to measure the frequency of consumption, the average daily consumption, intensive consumption, risky consumption, and standard drink units. (3) Results: During confinement, the prevalence of alcohol consumption declined in both males and females, but only intensive consumption showed significant differences, with a greater reduction in males. The number of females who consumed alcohol four or more times per week doubled, whereas the number of males who did so was multiplied by a factor of 1.5; in both females and males, the percentage who presented intensive consumption doubled. The percentage of females with risky consumption was higher than that of males both before and during confinement. In addition to gender, the interaction between age and the employment situation explain consumption before and during confinement. (4) Conclusions: During confinement due to COVID-19, alcohol consumption declined in both sexes, but alcohol-risk consumers increased their frequency of use. The interaction between gender, age, and employment situation was related to these changes. These findings are relevant for guiding public health and health-risk management policies related to alcohol consumption in environmental situations similar to COVID-19.

[Impact of confinement measures on the Covid-19 pandemic on alcohol risk consumption.] / Impacto de las medidas de confinamiento durante la pandemia de Covid-19 en el consumo de riesgo de alcohol.

OBJECTIVE: The public health strategies adopted for the containment of COVID-19 have generated psychosocial stressors that act as risk factors for alcohol consumption. The objectives of this study were to establish whether alcohol risk consumption varied during COVID-19 confinement, and how these variations manifested as a function of different sociodemographic variables. METHODS: The study was conducted during confinement with 3,779 participants in Spain. We used an online survey with sociodemographic variables (sex, age and employment situation) and AUDIT-C. Frequency and mean difference analysis were performed (Student t, ANOVA and Kruskal-Wallis) to establish intra-group variations before the pandemic compared to during confinement, and intergroup for each time period, reporting effect size. RESULTS: Alcohol risky consumption presented high prevalence rates before confinement (25,9% of alcohol consumers), showing a general decrease during confinement (15,1%), both in men (X2=224,829; p<0,001) and women (X2=214,324; p<0,001). Women had higher risk consumption rates both before the pandemic (X2=13,124; p<0,001; d=1,067) and during confinement (X2=26,316; p<0,001; d=2,85); however, men reported higher score in AUDIT-C before the pandemic (t(2343)=-7,887; p<0,001; d=0,322) and during confinement (t(2343)=-5,664; p<0,001; d=0,231). Considering age, significant differences in prevalence among groups were found before the pandemic (X2=22,889; p<0,001) and during confinement (X2=38,302; p<0,001), with the age range 18-24 showing less prevalence. Differences among age groups were also found in the risky consumption scores during confinement (F(5,2338)=43,849; p=0,001), increasing with age. With regards to the employment situation, differences before the pandemic (KW(5,2933)=13,467; p=0,019; E2R=0,44), and during confinement (KW(5,2933)=149,818; p<0,001; E2R=0,51) were also found. Self-employed workers showed a higher score in alcohol risky consumption with respect to full-time employees (p=0,047). CONCLUSIONS: The alcohol risky consumption decreased in a generalized way during the confinement by COVID-19, but the changes in prevalence and risk index were dependent on sociodemographic variables. It is recommended that these findings are considered in the design of public health policies and strategies.

OBJETIVO: Las estrategias de salud pública adoptadas para la contención del COVID-19 han generado estresores psicosociales que actúan como factores de riesgo del consumo de alcohol. Los objetivos del estudio fueron establecer si el consumo de riesgo de alcohol varió durante el confinamiento por COVID-19 durante los meses de abril y mayo de 2020, y cómo estas variaciones se manifestaban en función de distintas variables sociodemográficas. METODOS: El estudio se desarrolló durante el confinamiento con 3.779 participantes en España. Se utilizó una encuesta online con variables sociodemográficas (sexo, edad y situación laboral) y el AUDIT-C. Se realizó análisis de frecuencias y diferencia de medias (t de Student, ANOVA y Kruskal-Wallis) para establecer las variaciones a nivel intragrupo entre antes de la pandemia y durante el confinamiento, e intergrupo para cada periodo temporal, reportando tamaño del efecto. RESULTADOS: El consumo de riesgo de alcohol presentó una prevalencia elevada antes del confinamiento (25,9% de los consumidores de alcohol), mostrando un descenso durante el confinamiento (15,1%), tanto en hombres (X2=224,829; p<0,001) como en mujeres (X2=214,324; p<0,001). Las mujeres presentaron una mayor prevalencia de consumo de riesgo antes de la pandemia (X2=13,124; p<0,001; d=1,067) como durante el confinamiento (X2=26,316; p<0,001; d=2,85); sin embargo, los hombres reportaron mayores puntuaciones que las mujeres en el AUDIT-C antes de la pandemia (t(2343)=-7,887; p<0,001; d=0,322) y durante el confinamiento (t(2343)=-5,664; p<0,001; d=0,231). A nivel de edad, se encontraron diferencias significativas de prevalencia entre los distintos grupos antes de la pandemia (X2=22,889; p<0,001) y durante el confinamiento (X2=38,302; p<0,001), siendo el rango de 18-24 años el de menor prevalencia. También se observaron diferencias entre los grupos de edad en las puntuaciones de consumo de riesgo durante el confinamiento (F(5,2338)=43,849; p=0,001), aumentando conforme es mayor la edad. Respecto a la situación laboral, existen diferencias tanto antes de la pandemia (KW(5,2933)=13,467; p=0,019; E2R=0,44), como durante el confinamiento (KW(5,2933)=149,818; p<0,001; E2R=0,51). Ser trabajador autónomo mostró una mayor puntuación de consumo de riesgo de alcohol con respecto a ser trabajador a tiempo completo (p=0,047). CONCLUSIONES: El consumo de riesgo de alcohol desciende de manera generalizada durante el confinamiento por COVID-19, pero los cambios en prevalencia y probabilidad de ser consumidor de riesgo de alcohol son dependientes de variables sociodemográficas. Se recomienda contemplar estos hallazgos en el diseño de políticas y estrategias de salud pública.

Measuring the impact of COVID-19 confinement measures on human mobility using mobile positioning data. A European regional analysis.

This work presents a mobility indicator derived from fully anonymised and aggregated mobile positioning data. Even though the indicator does not provide information about the behaviour of individuals, it captures valuable insights into the mobility patterns of the population in the EU and it is expected to inform responses against the COVID-19 pandemic. Spatio-temporal harmonisation is carried out so that the indicator can provide mobility estimates comparable across European countries. The indicators are provided at a high spatial granularity (up to NUTS3). As an application, the indicator is used to study the impact of COVID-19 confinement measure on mobility in Europe. It is found that a large proportion of the change in mobility patterns can be explained by these measures. The paper also presents a comparative analysis between mobility and the infection reproduction number R t over time. These findings will support policymakers in formulating the best data-driven approaches for coming out of confinement, mapping the socio-economic effects of the lockdown measures and building future scenarios in case of new outbreaks.