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COVID-19 is mostly considered to have ravaged places with high levels of inequality and poverty. Yet, in the case of Europe, the evidence for this is limited. In this paper we address this gap in our knowledge by exploring how regional variations in poverty, wealth and interpersonal inequality have shaped COVID-19-related excess mortality. The results show that during the first 18 months of the pandemic there is no link between inequality and poverty, on the one hand, and the lethality of the disease, on the other. The geographical concentration of wealthy people is related to more, not less, excess mortality. [ABSTRACT FROM AUTHOR]

This paper follows European countries as they struggled through the first wave of the Sars-CoV-2 pandemic. We analyze when countries were confronted with the virus, how long it took until the number of new infections peaked and at what level of infections that peak was achieved via social distancing and lockdown policies. Most European countries were able to successfully end the first wave of the pandemic – defined as a two-week incidence rate smaller than 10 cases per 100,000 people. We find that countries in which the virus made significant landfall later in time enjoyed a latecomer advantage that some of these countries squandered, however, by not responding quickly enough and that an early lockdown was more effective than a hard lockdown. [ABSTRACT FROM AUTHOR]

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Since 11 March 2020 when officially declared a global pandemic, Covid‐19 (or SARS‐COV2) has turned out to be a multifaceted disease differently affecting countries and individuals. What makes certain countries more vulnerable than others has attracted the interest of scientists from various disciplines. This paper intends to compare the impact of demographic parameters, population health conditions and policy actions on prevalence and fatality levels of Covid‐19 during the first 3 months since its declaration of global pandemic. A country‐level exploratory analysis has been conducted in order to assess how demography, national health conditions and measures taken interact and condition the disease outcomes. Analysis relies on publicly available data on Covid‐19 reported cases, deaths and number of persons tested. Those data are combined with demographic parameters (sex ratio, mean age, population density and life expectancy), health data (cardiovascular death rate, diabetes prevalence, share of smokers among males and females and number of hospital beds) and information about relative national policies aiming the management of the pandemic (lockdown timing and duration). Our analysis confirms the diversity of factors and the complexity of their interaction in explaining the propagation and fatality of the disease across Europe. Our findings question some well‐established attitudes concerning the role of demographic variables and public health conditions in the spread of the disease. [ABSTRACT FROM AUTHOR]

The current pandemic is sustained in dichotomies and distancing, as most of us awkwardly have recently experienced. Moreover, COVID-19 has definitely put the spotlight on social inequalities that are underpinning our society and it has highlighted the escalation of the state surveillance capability and new forms of oppression too. The discrimination ingrained in our societies, built on a historically defined regime of racialized oppression and structural disadvantage of racialized citizens and migrants, was produced well before the coronavirus, but it is now casting a different shade, reinforcing forms of exclusions, highlighting the pandemic as a political issue. Hence, this paper addresses a range of political perspectives of the lived experiences in and through social space with examples of narratives in language which capture the everyday political experiences of the pandemic within Europe. The kind of language used and its profound effect on the growing discourse regarding COVID-19 is the main focus in this paper. I here explore the intertwining of language and politics during the pandemic and bring out the countervailing narratives that seem to be in constant tension. I then ask where this takes us, not only in terms of scholarship and expansion of knowledge, but also with a pragmatic edge to it, trying to figure out how is it possible for us to achieve some sort of cognitive shift in our approach in order to learn from this challenge and from this new perspective. Methodologically, as well as looking at existing data, references to attitudes in general are made. A theoretical discussion on migration and language, and the kind of intersection between them, is offered, from the point of view of critical theory, before pointing to the metaphors used, the implications they allow, and how all these fit together, in the form of a concluding discussion. Metaphor or not, the power of language in its ramifications of articulations about the pandemic and the idea of distance underlines COVID-19 as a deeply political issue. [ABSTRACT FROM AUTHOR]

Acromegaly embraces typical complications of a pituitary tumor as well as GH (growth hormone) and IGF1 (insulin-like growth factor) excess-related cardio-metabolic and oncologic conditions; and associated medical, surgical treatment or even radiotherapy issues. We point out a few particular aspects concerning acromegaly issues amid COVID-19 pandemic. The review includes only full length, English published papers. One of the most important complications of long standing, untreated or un-responsive to therapy acromegaly is related to respiratory and otorhinolaryngology issues like sleep apnea; this becomes an important aspect causing pulmonary complications in patients with active coronavirus infection. In subjects who are not going through a COVID-19 infection, but they had a prior diagnostic of acromegaly, two main aspects of medical and surgical practice were noted: a massive reduction of surgical volume during the first year of pandemic, mostly during peak months of high infection rate in general population and the introduction of tele (digital) health care systems, of different protocols and various platforms mostly depending of medical center, rather than country or even continent related protocols. Associated central adrenal insufficiency requires a particular attention if COVID-19 positive. The data directly targeting the endocrinologists amid pandemic are very limited. ACROCOVID is a 2021 study that was internationally conducted based on a questionnaire that was applied to 84 endocrinologists (67% of them in Europe); 33% of acromegalic individuals had a delay on procedure because of insufficient COVID-19 assays and 54% of them due to inefficient provision for neurosurgery. Secondary diabetes mellitus (with a potential worsening in some patients due to pasireotide LAR) is at high risk for COVID-19 infection; the level of glycated hemoglobin A1c seems a good predictor at onset of infectious disease. Acromegaly might associate osteoporosis; coronavirus infection aggravates bone loss due to oxidative stress, inflammatory status, cytokine release, immobilization, glucocorticoid use. Acromegaly field concerning pandemic changes represents a complex, still ongoing matter involving both patients and multidisciplinary practitioners. [ABSTRACT FROM AUTHOR]

This paper examines the uneven geography of COVID‐19‐related excess mortality during the first wave of the pandemic in Europe, before assessing the factors behind the geographical differences in impact. The analysis of 206 regions across 23 European countries reveals a distinct COVID‐19 geography. Excess deaths were concentrated in a limited number of regions—expected deaths exceeded 20% in just 16 regions—with more than 40% of the regions considered experiencing no excess mortality during the first 6 months of 2020. Highly connected regions, in colder and dryer climates, with high air pollution levels, and relatively poorly endowed health systems witnessed the highest incidence of excess mortality. Institutional factors also played an important role. The first wave hit regions with a combination of weak and declining formal institutional quality and fragile informal institutions hardest. Low and declining national government effectiveness, together with a limited capacity to reach out across societal divides, and a frequent tendency to meet with friends and family were powerful drivers of regional excess mortality. [ABSTRACT FROM AUTHOR]

Objectives: The use of remdesivir (RDV) as the first drug approved for coronavirus disease 2019 (COVID-19) remains controversial. Based on the Lean European Open Survey on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected patients (LEOSS), we aim to contribute timing-focused complementary real-world insights to its evaluation. Methods: SARS-CoV-2 infected patients between January 2020 and December 2021 treated with RDV were matched 1:1 to controls considering sociodemographics, comorbidities and clinical status. Multiple imputations were used to account for missing data. Effects on fatal outcome were estimated using uni- and multivariable Cox regression models. Results: We included 9,687 patients. For those starting RDV administration in the complicated phase, Cox regression for fatal outcome showed an adjusted hazard ratio (aHR) of 0.59 (95%CI 0.41–0.83). Positive trends could be obtained for further scenarios: an aHR of 0.51 (95%CI 0.16–1.68) when RDV was initiated in uncomplicated and of 0.76 (95% CI 0.55–1.04) in a critical phase of disease. Patients receiving RDV with concomitant steroids exhibited a further reduction in aHR in both, the complicated (aHR 0.50, 95%CI 0.29–0.88) and critical phase (aHR 0.63, 95%CI 0.39–1.02). Conclusion: Our study results elucidate that RDV use, in particular when initiated in the complicated phase and accompanied by steroids is associated with improved mortality. However, given the limitations of non-randomized trials in estimating the magnitude of the benefit of an intervention, further randomized trials focusing on the timing of therapy initiation seem warranted. [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV-2 transmission dynamics have been greatly modulated by human contact behaviour. To curb the spread of the virus, global efforts focused on implementing both Non-Pharmaceutical Interventions (NPIs) and pharmaceutical interventions such as vaccination. This study was conducted to explore the influence of COVID-19 vaccination status and risk perceptions related to SARS-CoV-2 on the number of social contacts of individuals in 16 European countries. Methods: We used data from longitudinal surveys conducted in the 16 European countries to measure social contact behaviour in the course of the pandemic. The data consisted of representative panels of participants in terms of gender, age and region of residence in each country. The surveys were conducted in several rounds between December 2020 and September 2021 and comprised of 29,292 participants providing a total of 111,103 completed surveys. We employed a multilevel generalized linear mixed effects model to explore the influence of risk perceptions and COVID-19 vaccination status on the number of social contacts of individuals. Results: The results indicated that perceived severity played a significant role in social contact behaviour during the pandemic after controlling for other variables (p-value < 0.001). More specifically, participants who had low or neutral levels of perceived severity reported 1.25 (95% Confidence intervals (CI) 1.13 - 1.37) and 1.10 (95% CI 1.00 - 1.21) times more contacts compared to those who perceived COVID-19 to be a serious illness, respectively. Additionally, vaccination status was also a significant predictor of contacts (p-value < 0.001), with vaccinated individuals reporting 1.31 (95% CI 1.23 - 1.39) times higher number of contacts than the non-vaccinated. Furthermore, individual-level factors played a more substantial role in influencing contact behaviour than country-level factors. Conclusion: Our multi-country study yields significant insights on the importance of risk perceptions and vaccination in behavioral changes during a pandemic emergency. The apparent increase in social contact behaviour following vaccination would require urgent intervention in the event of emergence of an immune escaping variant. [ABSTRACT FROM AUTHOR]

Objectives: Loneliness is a major public health concern. Duration of loneliness is associated with severity of health outcomes, and further research is needed to direct interventions and social policy. This study aimed to identify predictors of the onset vs. the maintenance of loneliness in older adults before and during the pandemic using longitudinal data from the Survey of Health, Age, and Retirement in Europe (SHARE). Methods: Groupings of persistent, situational, and no loneliness were based on self-reports from an ordinary pre-pandemic SHARE wave and a peripandemic telephone interview. Predictors were identified and compared in three hierarchical binary regression analyses, with independent variables added in blocks of geographic region, demographics, pre-pandemic social network, pre-pandemic health, pandemic-related individual, and country level variables. Results: Self-reported loneliness levels for the persistent, situational, and no loneliness groups were stable and distinct through 7 years preceding the prepandemic baseline measure. Shared predictors were chronic diseases, female sex, depression, and no cohabitant partner. Persistent loneliness was uniquely predicted by low network satisfaction (OR: 2.04), functional limitations (OR: 1.40), and a longer country-level isolation period for older adults (OR: 1.24). Conclusion: Interventions may target persons with depression, functional limitations, chronic health issues, and no cohabitant partner. The added burden of the length of isolation on those who are already lonely should be taken into account when employing social policies that target older adults. Further research should distinguish between situational and persistent loneliness, and seek to identify predictors of chronic loneliness onset. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic led ADHD services to modify the clinical practice to reduce in-person contact as much as possible to minimise viral spread. This had far-reaching effects on day-to-day clinical practice as remote assessments were widely adopted. Despite the attenuation of the acute threat from COVID, many clinical services are retaining some remote practices. The lack of clear evidence-based guidance about the most appropriate way to conduct remote assessments meant that these changes were typically implemented in a localised, ad hoc, and un-coordinated way. Here, the European ADHD Guidelines Group (EAGG) discusses the strengths and weaknesses of remote assessment methods of children and adolescents with ADHD in a narrative review based on available data and expert opinions to highlight key recommendations for future studies and clinical practice. We conclude that going forward, despite remote working in clinical services functioning adequately during the pandemic, all required components of ADHD assessment should still be completed following national/international guidelines; however, the process may need adaptation. Social restrictions, including changes in education provision, can either mask or exacerbate features associated with ADHD and therefore assessment should carefully chart symptom profile and impairment prior to, as well as during an ongoing pandemic. While remote assessments are valuable in allowing clinical services to continue despite restrictions and may have benefits for routine care in the post-pandemic world, particular attention must be paid to those who may be at high risk but not be able to use/access remote technologies and prioritize these groups for conventional face-to-face assessments. [ABSTRACT FROM AUTHOR]

Owing to the vulnerability of patients with chronic kidney disease to infectious diseases, the coronavirus disease 2019 (COVID-19) pandemic has been particularly devastating for the nephrology community. Unfortunately, the possibility of future COVID-19 waves or outbreaks of other infectious diseases with pandemic potential cannot be ruled out. The nephrology community made tremendous efforts to contain the consequences of the COVID-19 pandemic. Despite this, the COVID-19 pandemic has highlighted several shortcomings in our response to the pandemic and has taught us important lessons that can be utilized to improve our preparedness for any future health crises of a similar nature. In this article we draw lessons from the European Renal Association COVID-19 Database (ERACODA) project, a pan-European collaboration initiated in March 2020 to understand the prognosis of COVID-19 in patients on kidney function replacement therapy. We discuss the challenges faced in generating timely and robust evidence for informed management of patients with kidney disease and give recommendations for our preparedness for the next pandemic in Europe. Limited collaboration, the absence of common data architecture and the sub-optimal quality of available data posed challenges in our response to COVID-19. Aligning different research initiatives, strengthening electronic health records, and involving experts in study design and data analysis will be important in our response to the next pandemic. The European Renal Association may take a leading role in aligning research initiatives via its engagement with other scientific societies, national registries, administrators and researchers. [ABSTRACT FROM AUTHOR]

Collisions between aircraft and wildlife (i.e., wildlife strikes) pose a serious threat toward the safety of aircraft, its crew, and passengers. The effects of COVID-19 related travel restrictions on wildlife strikes are unknown. With this study, we aim to address this information gap by assessing the changes of wildlife hazard management performance across European airports during the lockdown period (e.g., period of reduced operations and borders closure in spring 2020). We also sought to raise awareness of the importance of wildlife strike prevention in times of reduced operations. The objective of our study was to compare wildlife strike data before and during the lockdown based on the following criteria: (1) the number of wildlife strikes per 10,000 flights, (2) the groups of wildlife species involved, and (3) the lighting conditions. To conduct our research, we analyzed a dataset of 12,528 wildlife strikes, gathered from 157 civil airports across Europe for the period from March 2017 to February 2021. Our analysis revealed a wide variation in the wildlife strike rates during the lockdown (period of time from March 1, 2020 to February 28, 2021). Our study uncovered an increasing trend of the relative strike rates for almost all wildlife species categories and a slight trend toward more strikes occurring during daytime compared to nighttime. Our findings highlighted the need for continuous wildlife hazard management despite fluctuation in flights and provide potential for airports, airline operators, and other aviation stakeholders to reduce wildlife strike risk. [ABSTRACT FROM AUTHOR]

Studies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19-related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50 + with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE-COVID19 questionnaire on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Spain and Italy and lower in Denmark, Finland and Sweden. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours. [ABSTRACT FROM AUTHOR]

It has been shown that the COVID-19 pandemic affected some agricultural systems more than others, and even within geographic regions, not all farms were affected to the same extent. To build resilience of agricultural systems to future shocks, it is key to understand which farms were affected and why. In this study, we examined farmers' perceived robustness to COVID-19, a key resilience capacity. We conducted standardized farmer interviews (n = 257) in 15 case study areas across Europe, covering a large range of socio-ecological contexts and farm types. Interviews targeted perceived livelihood impacts of the COVID-19 pandemic on productivity, sales, price, labor availability, and supply chains in 2020, as well as farm(er) characteristics and farm management. Our study corroborates earlier evidence that most farms were not or only slightly affected by the first wave(s) of the pandemic in 2020, and that impacts varied widely by study region. However, a significant minority of farmers across Europe reported that the pandemic was "the worst crisis in a lifetime" (3%) or "the worst crisis in a decade" (7%). Statistical analysis showed that more specialized and intensive farms were more likely to have perceived negative impacts. From a societal perspective, this suggests that highly specialized, intensive farms face higher vulnerability to shocks that affect regional to global supply chains. Supporting farmers in the diversification of their production systems while decreasing dependence on service suppliers and supply chain actors may increase their robustness to future disruptions. [ABSTRACT FROM AUTHOR]

It is widely discussed that the pandemic has impacted educational inequalities across the world. However, in contrast to data on health or unemployment, data on education outcomes are not timely. Hence, we have extremely limited knowledge about pandemic-related learning losses at the national and cross-national levels. As it might take years to get suitable comparative data, this study uses the latest large-scale international achievement survey from before the pandemic, the Trends in International Mathematics and Science Study 2019, to answer two research questions. First, which European countries are most likely to have experienced higher learning loss among their children? Second, which European countries have most likely experienced the greatest increases in learning inequalities? Results based on 4th graders' school achievements indicate that educational inequalities between and within countries are likely to have augmented substantially throughout Europe. Some European countries are probably already facing an education crisis. [ABSTRACT FROM AUTHOR]

Issues Numerous studies have examined the impact of the COVID‐19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms. Approach: We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self‐reported changes in alcohol use associated with COVID‐19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations. We identified 646 reports, of which 56 general population studies were suitable for random‐effects meta‐analyses of proportional differences in alcohol use changes. Variations by time, sub‐region and study quality were assessed in subsequent meta‐regressions. Additional 16 reports identified were summarised narratively. Key Findings: Compiling reports measuring changes in overall alcohol use, slightly more individuals indicated a decrease than an increase in their alcohol use during the pandemic [3.8%, 95% confidence interval (CI) 0.00–7.6%]. Decreases were also reported more often than increases in drinking frequency (8.0%, 95% CI 2.7–13.2%), quantity consumed (12.2%, 95% CI 8.3–16.2%) and heavy episodic drinking (17.7%, 95% CI 13.6–21.8%). Among people with pre‐existing high drinking levels/alcohol use disorder, high‐level drinking patterns appear to have solidified or intensified. Implications: Pandemic‐related changes in alcohol use may be associated with pre‐pandemic drinking levels. Increases among high‐risk alcohol users are concerning, suggesting a need for ongoing monitoring and support from relevant health‐care services. Conclusion: Our findings suggest that more people reduced their alcohol use in Europe than increased it since the onset of the pandemic. However high‐quality studies examining specific change mechanisms at the population level are lacking. [ABSTRACT FROM AUTHOR]

The Covid‐19 pandemic has challenged the resilience of care organisations (and those dependent on them), especially when services are stopped or restricted. This study focuses on the experiences of care organisations that offer services to individuals in highly precarious situations in 10 European countries. It is based on 32 qualitative interviews and three workshops with managers and staff. The four key types of organisations reviewed largely had the same adaptation patterns in all countries. The most drastic changes were experienced by day centres, which had to suspend or digitise services, whereas night shelters and soup kitchens had to reorganise broadly their work; residential facilities were minimally affected. Given the drastic surge in demand for services, reliance on an overburdened (volunteer) workforce, and a lack of crisis plans, the care organisations with long‐term trust networks with clients and intra‐organisational cooperation adapted easier. The outcomes were worse for new clients, migrants, psychologically vulnerable people, and those with limited communicative abilities. [ABSTRACT FROM AUTHOR]

Due to the ongoing Covid-crisis, the number of workers benefiting from short-time work schemes was high, especially during lockdowns, another large group of workers started working from home, and others, unfortunately, lost their jobs. The current situation is unprecedented, because it is the only global recession driven solely by a pandemic and the decrease in life expectancy is the worst since World War II. This article first shows that the literature on the socioeconomic effects of the Covid-19 pandemic does not say much about working poverty. Applying a theoretical model presented in 2018 based on the four mechanisms that lead to working poverty (at the household level), this article considers the potential short- and mid-term implications of the pandemic for the working poor in Europe. It also proposes conceptual reflections about which working poverty indicators may improve our understanding of what has unfolded since the pandemic began. [ABSTRACT FROM AUTHOR]