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Passive immunotherapy with plasma derived from convalescent patients recovering from SARS-CoV-2 infection can be a promising approach in the treatment of COVID-19 patients. It is important that blood establishments are ready to satisfy requests for immune plasma by defining the requirements applicable to plasma donors and the standards for preparation, qualification, storage, distribution, and control of product use. This Position paper aims to give recommendations on the biological characteristics of a plasma preparation from convalescent donors and to support the evaluation of this therapeutic approach in more rigorous investigations.

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19.La pandemia de COVID-19 ha cambiado la vida en Europa y en todo el mundo. La pandemia afecta tanto a los individuos como a la sociedad en general en muchos ámbitos, incluida la salud física y psicológica, la economía y el bienestar general. Las medidas tomadas para contrarrestar la pandemia han alterado significativamente la vida diaria y, junto con la amenaza de contraer el coronavirus y las incertidumbres que rodean los desarrollos futuros, crearon un complejo sistema de estresores con un impacto negativo en la salud mental pública. En este artículo se pretende esbozar la estrategia de la ESTSS para abordar los problemas de salud mental relacionados con COVID-19 y se centra en: 1. Políticas informadas en trauma, 2. capacitación, 3. investigación colaborativa, 4. e intercambio de conocimientos. Para facilitar la implementación de un enfoque basado en el trauma y las medidas apropiadas, la ESTSS ha desarrollado un conjunto de herramientas de recomendaciones sobre salud mental y asistencia psicosocial que se proporcionará durante las diferentes fases de la crisis y sus consecuencias. Para fomentar la capacitación, la ESTSS ofrece un programa de certificación basado en un plan de estudios en psicotraumatología y la formación on-line correspondiente a la comunidad europea de profesionales de la salud mental. Para asegurar enfoques y métodos basados en la evidencia adaptados a las circunstancias actuales, la ESTSS ha iniciado un proyecto de investigación paneuropeo con cooperación internacional, destinado a estudiar las consecuencias de la pandemia en la salud mental, con enfoque en el trauma psicológico y otras reacciones relacionadas con el estrés. Para fomentar intercambio de conocimiento, la European Journal of Psychotraumatology (EJPT), la revista oficial de ESTSS, publica un número especial sobre COVID-19.COVID-19疫情改变了欧洲乃至全球的生活。疫情影响着个人和整个社会, 涉及众多领域, 包括身心健康, 经济和一般福利。为应对疫情采取的措施已大大改变了人们的日常生活, 并且随着冠状病毒感染的威胁及未来发展的不确定性, 造成了一个复杂的应激源系统, 对公共心理健康产生了负面影响。本文旨在概述ESTSS解决COVID-19相关心理健康问题的策略, 并重点关注:1.创伤知情政策, 2.能力建设, 3.合作研究以及 4.知识交流。为了促进创伤知情方法和适当措施的实行, ESTSS开发了一套工具包, 包含可在危机不同阶段及之后提供的关心理健康和社会心理援助的建议。为了促进能力建设, ESTSS提供了基于精神创伤学课程的认证计划, 并向欧洲精神卫生专业人员社区提供了相应的在线培训。为了确保采取针对当前情况定制的循证方法, ESTSS与国际合作启动了一项泛欧研究项目, 旨在研究疫情的心理健康后果, 重点关注心理创伤和其他应激相关反应。为了促进知识交流, ESTSS的官方杂志《欧洲精神创伤学杂志》 (EJPT) 正在出版COVID-19相关特刊。.

With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts.

Today Cultural Creative Industries are at the core of the European identity, recognised as an indispensable driver of growth and jobs and cherished as facilitator of innovation throughout the economy. Because of the “Coronavirus” lock-up measurements this major European motor is stalling. First data from the CCI across Europe, provided by approximately 7.000 survey participants, indicate that the shutdown is not merely a pause of economic activities which will continue as they were before stopped. The governments lock-down because of the COVID-19 virus turned an economic slump into a system crisis: While around 60% of those surveyed have already experienced or anticipate a drop in sales of over 30%, numerous companies point out that they expect significantly higher failures in the future. Due to the design of the study and the bias of the respondents the estimated magnitude, still to be regarded as a conservative assessment, amounts to worrying numbers: CCIs from having an it’s a 5.3% share of the total European Gross Value Added (GVA), (Doerflinger 2016) expect to lose a sum of €273 Bn in turnover until the end of 2020. Based on this estimation the ECBNetwork concludes that the critical time where the crisis starts to affect the European creative sector spans from beginning of April to the beginning of June. This indicates a tight timeframe for governments and European measures to be taken to avoid a complete collapse of the European creative industries sector. Given this system crisis of Cultural Creative Industries, Europe's societies, cities and economies, are endangered. CCI turn noise to music, letters to poetry, stones to architectures, and places into venues for diverse cultures and platform of the freedom of expressions. CCI are the base for free press, open society and citizen controlled democracy. CCI are innovators and change makers for the future of smart cities and green economy. If CCI are stalling, the Europe we know today will suffer a heart attack. Given the severity of this European crisis ECBN issues this white paper with four scenarios where the CCI might stand by the end 2020 and from where we may have to restart the CCI. This white paper aims to raise awareness that the restart of the Cultural Creative Industries is central to the future of European society. It calls on the European policy makers to engage in a vigorous debate for the best ways to restart the Cultural Creative Industries in a sustainable, innovative way to turn this historical system crisis to a once in a century chance to move forward to a more sustainable and inclusive Society than before. &nbsp

Patients with multiple myeloma (MM) seem to be at increased risk for more severe COVID-19 infection and associated complications due to their immunocompromised state, the older age and comorbidities. The European Myeloma Network has provided an expert consensus statement in order to guide therapeutic decisions in the era of the COVID-19 pandemic. Patient education for personal hygiene and social distancing measures, along with treatment individualization, telemedicine and continuous surveillance for early diagnosis of COVID-19 are essential. In countries or local communities where COVID-19 infection is widely spread, MM patients should have a PCR test of nasopharyngeal swab for SARS-CoV-2 before hospital admission, starting a new treatment line, cell apheresis or ASCT in order to avoid ward or community spread and infections. Oral agent-based regimens should be considered, especially for the elderly and frail patients with standard risk disease, whereas de-intensified regimens for dexamethasone, bortezomib, carfilzomib and daratumumab should be used based on patient risk and response. Treatment initiation should not be postponed for patients with end organ damage, myeloma emergencies and aggressive relapses. Autologous (and especially allogeneic) transplantation should be delayed and extended induction should be administered, especially in standard risk patients and those with adequate MM response to induction. Watchful waiting should be considered for standard risk relapsed patients with low tumor burden, and slow biochemical relapses. The conduction of clinical trials should continue with appropriate adaptations to the current circumstances. Patients with MM and symptomatic COVID-19 disease should interrupt anti-myeloma treatment until recovery. For patients with positive PCR test for SARS-CoV-2, but with no symptoms for COVID-19, a 14-day quarantine should be considered if myeloma-related events allow the delay of treatment. The need for surveillance for drug interactions due to polypharmacy is highlighted. The participation in international COVID-19 cancer registries is greatly encouraged.

Non-pharmaceutical interventions aimed at reducing the spread of COVID-19 rely largely on voluntary compliance among the target population to be effective, since such measures, which are aimed at the entire population, are very hard to enforce. In this paper, we focus on the impact of different work ethics on the spread of COVID-19. There are indeed reasons to believe that populations with different attitudes toward work will react differently to stay-at-home orders and other policies that forbid people from working. By means of a quantitative analysis, using hybrid model estimators, we test the impact of different work ethics on COVID-19 diffusion in a sample of 30 European countries. Results show that the more a population holds certain beliefs about work-namely, that it is humiliating to receive money without working, that people who do not work become lazy, and that work always comes first-the higher contagion rates of COVID-19 are, ceteris paribus. On the other hand, the more a population perceives work as a social duty, the lower contagion rates are. All this suggests that different work ethics matter in the containment of COVID-19.

The COVID-19 pandemic highlights the need for effective infectious disease outbreak prevention. This could entail installing an integrated, international early warning system, aiming to contain and mitigate infectious diseases outbreaks. The amount of resources governments should spend on such preventive measures can be informed by the value citizens attach to such a system. This was already recognized in 2018, when a contingent valuation willingness to pay (WTP) experiment was fielded, eliciting the WTP for such a system in six European countries. We replicated that experiment in the spring of 2020 to test whether and how WTP had changed during an actual pandemic (COVID-19), taking into account differences in infection rates and stringency of measures by government between countries. Overall, we found significant increases in WTP between the two time points, with mean WTP for an early warning system increasing by about 50% (median 30%), from around €20 to €30 per month. However, there were marked differences between countries and subpopulations, and changes were only partially explained by COVID-19 burden. We discuss possible explanations for and implication of our findings. Supplementary Information The online version contains supplementary material available at 10.1007/s10198-021-01353-6.

Background: The COVID-19-related deaths are growing rapidly around the world, especially in Europe and the United States. Purpose: In this study we attempt to measure the association of these variables with case fatality rate (CFR) and recovery rate (RR) using up-to-date data from around the world. Methods: Data were collected from eight global databases. According to the raw data of countries, the CFR and RR and their relationship with different predictors was compared for countries with 1000 or more cases of COVID-19 confirmed cases. Results: There were no significant correlation between the CFR and number of hospital beds per 1000 people, proportion of population aged 65 and older ages, and the number of CT per one million inhabitants. Furthermore, based on the continents-based subgroup univariate regression analysis, the population (R2=0.37, P=0.047), GPD (R2=0.80, P, Journal of Preventive Medicine and Hygiene, Vol. 62 No. 2 (2021): 2021622

Backgrounds SARS‐CoV‐2 is affecting different countries all over the world, with significant variation in infection‐rate and death‐ratio. We have previously shown a presence of a possible relationship between different variables including the Bacillus Calmette–Guérin (BCG) vaccine, average age, gender, and malaria treatment, and the rate of spread, severity and mortality of COVID‐19 disease. This paper focuses on developing machine learning models for this relationship. Methods We have used real‐datasets collected from the Johns Hopkins University Center for Systems Science and Engineering and the European Centre for Disease Prevention and Control to develop a model from China data as the baseline country. From this model, we predicted and forecasted different countries' daily confirmed‐cases and daily death‐cases and examined if there was any possible effect of the variables mentioned above. Results The model was trained based on China data as a baseline model for daily confirmed‐cases and daily death‐cases. This machine learning application succeeded in modelling and forecasting daily confirmed‐cases and daily death‐cases. The modelling and forecasting of viral spread resulted in four different regions; these regions were dependent on the malarial treatments, BCG vaccination, weather conditions, and average age. However, the lack of social distancing resulted in variation in the effect of these factors, for example, double‐humped spread and mortality cases curves and sudden increases in the spread and mortality cases in different countries. The process of machine learning for time‐series prediction and forecasting, especially in the pandemic COVID‐19 domain, proved usefulness in modelling and forecasting the end status of the virus spreading based on specific regional and health support variables. Conclusion From the experimental results, we confirm that COVID‐19 has a very low spread in the African countries with all the four variables (average young age, hot weather, BCG vaccine and malaria treatment); a very high spread in European countries and the USA with no variable (old people, cold weather, no BCG vaccine and no malaria). The effect of the variables could be on the spread or the severity to the extent that the infected subject might not have symptoms or the case is mild and can be missed as a confirmed‐case. Social distancing decreases the effect of these factors.

The coronavirus pandemic has shed light on the detrimental impact of neoliberal policies on public health and well-being and as a result, there have been calls for increases in public spending to rectify the lack of public health services. However, neoliberal right-wing parties have dismissed such calls, pointing instead to Asian countries as examples in successfully controlling the pandemic without high public health spending, attributing this to the entrepreneurial orientation of their governments, as opposed to their public services. This article refutes this idea, instead charting the reasons that Asian countries have better controlled the pandemic including prior experience of pandemics, cultural factors, and various successful public health policies. The article concludes by looking at the example of Trump and demonstrating the inadequacies of the business model for dealing with the coronavirus pandemic.

This study aimed to characterize the clinical profile of patients with brief psychotic disorders (BPD) triggered by the psychosocial distress derived from the COVID-19 crisis. A multicenter study was conducted from March 14 to May 14, 2020 (the peak weeks of the pandemic in Europe). All consecutive patients presenting non-affective psychotic episodes with a duration of untreated psychosis of less than 1 month and whose onset was related to the COVID-19 crisis were recruited, but only those patients meeting Diagnostic Statistical Manual 5th edition (DSM-5) criteria for "BPD with marked stressors" (DSM-5 code: 298.8) during follow-up were finally included. Patients' sociodemographic and clinical characteristics were collected at baseline and summarized with descriptive statistics. During the study period, 57 individuals with short-lived psychotic episodes related to the emotional stress of the COVID-19 pandemic were identified, of whom 33 met DSM-5 criteria for "BPD with marked stressors". The mean age was 42.33 ± 14.04 years, the gender distribution was almost the same, and the majority were rated as having good premorbid adjustment. About a quarter of the patients exhibited suicidal symptoms and almost half presented first-rank schizophrenia symptoms. None of them were COVID-19 positive, but in more than half of the cases, the topic of their psychotic features was COVID-19-related. The coronavirus pandemic is triggering a significant number of BPD cases. Their risk of suicidal behavior, their high relapse rate, and their low temporal stability make it necessary to closely monitor these patients over time.

Often presented as a global pandemic spreading all over the world, COVID-19, however, hit not only countries but also regions differently. The objective of this paper is to focus on the spatial heterogeneity in the spread of the COVID-19 pandemic and to contribute to an understanding of the channels by which it spread, focusing on the regional socioeconomic dimension. For this, we use a dataset covering 125 European regions in 12 countries. Considering that the impact of the COVID-19 crisis differed sharply not only across countries but also across regions within the same country, the empirical strategy is based, on the one hand, on an exploratory analysis of spatial autocorrelations, which makes it possible to identify regional clusters of the disease. On the other hand, we use spatial regression models to capture the diffusion effect and the role of different families of regional factors in this process. We find that the share of older people in the population, GDP per capita, distance from achieving EU objectives, and the unemployment rate are correlated with high COVID-19 death rates. In contrast, the number of medical practitioners and hospital beds and the level of social trust are correlated with low COVID-19 death rates.

Background In early March 2020, a SARS-CoV-2 outbreak in the ski resort Ischgl in Austria triggered the spread of SARS-CoV-2 throughout Austria and Northern Europe. In a previous study, we found that the seroprevalence in the adult population of Ischgl had reached 45% by the end of April, representing an exceptionally high level of local seropositivity in Europe. We performed a follow-up study in Ischgl, which is the first to show persistence of immunity and protection against SARS-CoV-2 and some of its variants at a community level. Methods Of the 1259 adults that participated in the baseline study, 801 have been included in the follow-up in November 2020. The study involved the analysis of binding and neutralizing antibodies and T cell responses. In addition, the incidence of SARS-CoV-2 and its variants in Ischgl was compared to the incidence in similar municipalities in Tyrol until April 2021. Findings For the 801 individuals that participated in both studies, the seroprevalence declined from 51.4% (95% confidence interval (CI) 47.9-54.9) to 45.4% (95% CI 42.0-49.0). Median antibody concentrations dropped considerably (5.345, 95% CI 4.833 - 6.123 to 2.298, 95% CI 2.141 - 2.527) but antibody avidity increased (17.02, 95% CI 16.49 - 17.94 to 42.46, 95% CI 41.06 - 46.26). Only one person had lost detectable antibodies and T cell responses. In parallel to this persistent immunity, we observed that Ischgl was relatively spared, compared to similar municipalities, from the prominent second COVID-19 wave that hit Austria in November 2020. In addition, we used sequencing data to show that the local immunity acquired from wild-type infections also helped to curb infections from variants of SARS-CoV-2 which spread in Austria since January 2021. Interpretation The relatively high level of seroprevalence (40-45%) in Ischgl persisted and might have been associated with the observed protection of Ischgl residents against virus infection during the second COVID-19 wave as well as against variant spread in 2021. Funding Funding was provided by the government of Tyrol and the FWF Austrian Science Fund.

In recent years, the medical literature from a wide range of medical specialities has exploded with publications on the theme of emotional distress, stress and burnout in the practice of medicine. Improving the work-life of health care providers is necessary to optimise health system performance. COVID-19 has caused considerable additional pressure on health services across Europe and there have been calls for interventions to address the psychological and occupational stress caused by the pandemic. Although there is an ongoing need to monitor these factors among family physicians, and other staff working in primary care across Europe, we must also identify supports and promote them. Further research is needed to explore causative factors and provide convincing evidence in relation to effective interventions.

Background: Simulation study results suggest that COVID-19 contact tracing apps have the potential to achieve pandemic control. Concordantly, high app adoption rates were a stipulated prerequisite for success. Early studies on potential adoption were encouraging. Several factors predicting adoption rates were investigated, especially pertaining to user characteristics. Since then, several countries have released COVID-19 contact tracing apps.Objective: This study’s primary aim is to investigate the quality characteristics of national European COVID-19 contact tracing apps, thereby shifting attention from user to app characteristics. The secondary aim is to investigate associations between app quality and adoption. Finally, app features contributing to higher app quality were identified.Methods: Eligible COVID-19 contact tracing apps were those released by national health authorities of European Union member states, former member states, and countries of the European Free Trade Association, all countries with comparable legal standards concerning personal data protection and app use voluntariness. The Mobile App Rating Scale was used to assess app quality. An interdisciplinary team, consisting of two health and two human–computer interaction scientists, independently conducted Mobile App Rating Scale ratings. To investigate associations between app quality and adoption rates and infection rates, Bayesian linear regression analyses were conducted.Results: We discovered 21 national COVID-19 contact tracing apps, all demonstrating high quality overall and high-level functionality, aesthetics, and information quality. However, the average app adoption rate of 22.9% (SD 12.5%) was below the level recommended by simulation studies. Lower levels of engagement-oriented app design were detected, with substantial variations between apps. By regression analyses, the best-case adoption rate was calculated by assuming apps achieve the highest ratings. The mean best-case adoption rates for engagement and overall app quality were 39.5% and 43.6%, respectively. Higher adoption rates were associated with lower cumulative infection rates. Overall, we identified 5 feature categories (symptom assessment and monitoring, regularly updated information, individualization, tracing, and communication) and 14 individual features that contributed to higher app quality. These 14 features were a symptom checker, a symptom diary, statistics on COVID-19, app use, public health instructions and restrictions, information of burden on health care system, assigning personal data, regional updates, control over tracing activity, contact diary, venue check-in, chats, helplines, and app-sharing capacity.Conclusions: European national health authorities have generally released high quality COVID-19 contact tracing apps, with regard to functionality, aesthetics, and information quality. However, the app’s engagement-oriented design generally was of lower quality, even though regression analyses results identify engagement as a promising optimization target to increase adoption rates. Associations between higher app adoption and lower infection rates are consistent with simulation study results, albeit acknowledging that app use might be part of a broader set of protective attitudes and behaviors for self and others. Various features were identified that could guide further engagement-enhancing app development. Background: Simulation study results suggest that COVID-19 contact tracing apps have the potential to achieve pandemic control. Concordantly, high app adoption rates were a stipulated prerequisite for success. Early studies on potential adoption were encouraging. Several factors predicting adoption rates were investigated, especially pertaining to user characteristics. Since then, several countries have released COVID-19 contact tracing apps.Objective: This study’s primary aim is to investigate the quality characteristics of national European COVID-19 contact tracing apps, thereby shifting attention from user to app characteristics. The secondary aim is to investigate associations between app quality and adoption. Finally, app features contributing to higher app quality were identified.Methods: Eligible COVID-19 contact tracing apps were those released by national health authorities of European Union member states, former member states, and countries of the European Free Trade Association, all countries with comparable legal standards concerning personal data protection and app use voluntariness. The Mobile App Rating Scale was used to assess app quality. An interdisciplinary team, consisting of two health and two human–computer interaction scientists, independently conducted Mobile App Rating Scale ratings. To investigate associations between app quality and adoption rates and infection rates, Bayesian linear regression analyses were conducted.Results: We discovered 21 national COVID-19 contact tracing apps, all demonstrating high quality overall and high-level functionality, aesthetics, and information quality. However, the average app adoption rate of 22.9% (SD 12.5%) was below the level recommended by simulation studies. Lower levels of engagement-oriented app design were detected, with substantial variations between apps. By regression analyses, the best-case adoption rate was calculated by assuming apps achieve the highest ratings. The mean best-case adoption rates for engagement and overall app quality were 39.5% and 43.6%, respectively. Higher adoption rates were associated with lower cumulative infection rates. Overall, we identified 5 feature categories (symptom assessment and monitoring, regularly updated information, individualization, tracing, and communication) and 14 individual features that contributed to higher app quality. These 14 features were a symptom checker, a symptom diary, statistics on COVID-19, app use, public health instructions and restrictions, information of burden on health care system, assigning personal data, regional updates, control over tracing activity, contact diary, venue check-in, chats, helplines, and app-sharing capacity.Conclusions: European national health authorities have generally released high quality COVID-19 contact tracing apps, with regard to functionality, aesthetics, and information quality. However, the app’s engagement-oriented design generally was of lower quality, even though regression analyses results identify engagement as a promising optimization target to increase adoption rates. Associations between higher app adoption and lower infection rates are consistent with simulation study results, albeit acknowledging that app use might be part of a broader set of protective attitudes and behaviors for self and others. Various features were identified that could guide further engagement-enhancing app development.