Instituto Universitário de Lisboa (ISCTE-IUL), Business Research Unit (BRU-IUL), Lisboa, Portugal.
BMC Public Health. 2022 Dec 2;22(1):2245. doi: 10.1186/s12889-022-14454-5.
COVID-19 is a pandemic of unprecedented proportions in recent human history. To date, the world has paid a high toll in terms of human lives lost, and on economic, financial, and social repercussions. In Europe, countries tried to mobilize all resources available to contain the COVID-19 effects, but the outcomes are diverse across countries. There have also been massive efforts geared towards finding safe and effective vaccines and to distribute them massively to the population. The main objective of this paper is to describe the COVID-19 prevalence in Europe. Secondly, it aims to identify epidemiological typologies allowing to distinguish the countries in terms of their response to the pandemic, and finally assess the effect of vaccination on pandemic control.
The study covers 30 European countries: EU 27 in addition to Norway, Switzerland, and United Kingdom. Four epidemiological variables are analyzed at two distinct moments, at the end of 2020 and at the beginning of 2022: total number of cases per million, total number of deaths per million, total number of tests per thousand, and case fatality rate. In a second step, it uses a fuzzy approach, namely archetypal analysis, to identify epidemiological typologies, and positions countries by their response to the pandemic. Finally, it assesses how vaccination, stringency measures, booster doses and population age affect the case fatality rate, using a multiple regression model.
The outcomes unveil four epidemiological typologies for both periods. The clearest sign of change in the two periods concerns the case fatality rate that is found to be low in a single typology in 2020 but occurs in three typologies in 2022, although to different degrees. There is also statistical evidence of the positive impact of the primary vaccination on mortality reduction; however, the same does not hold for the booster dose and stringency measures.
The study shows that primary vaccination is the most effective measure to reduce mortality by COVID-19 suggesting that vaccination provides hope for an end to the pandemic. However, a worldwide access to vaccination is needed to make this happen.
COVID-19 是人类历史上罕见的大流行疾病。迄今为止,全球在生命损失、经济、金融和社会影响方面付出了高昂的代价。在欧洲,各国试图调动所有可用资源来遏制 COVID-19 的影响,但各国的结果却各不相同。各国还投入了大量精力来寻找安全有效的疫苗,并大规模向民众分发。本文的主要目的是描述欧洲 COVID-19 的流行情况。其次,它旨在确定流行病学分类,以区分各国对大流行的反应,并最终评估疫苗接种对大流行控制的影响。
本研究涵盖了 30 个欧洲国家:欧盟 27 个成员国,以及挪威、瑞士和英国。在两个不同的时间点(2020 年底和 2022 年初),分析了四个流行病学变量:每百万人口的病例总数、每百万人口的死亡总数、每千人的检测总数和病死率。在第二步中,它使用模糊方法,即原型分析,来识别流行病学分类,并根据各国对大流行的反应来定位国家。最后,它使用多元回归模型评估疫苗接种、严格措施、加强剂量和人口年龄如何影响病死率。
结果揭示了两个时期的四种流行病学分类。两个时期最明显的变化迹象是病死率,2020 年病死率在单一分类中较低,但在 2022 年出现了三种分类,尽管程度不同。也有统计证据表明,初级疫苗接种对降低死亡率有积极影响;然而,加强剂量和严格措施却没有这种效果。
本研究表明,初级疫苗接种是降低 COVID-19 死亡率的最有效措施,这表明疫苗接种为大流行的结束带来了希望。然而,需要全球获得疫苗接种才能实现这一目标。