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Factors determining the diffusion of COVID-19 and suggested strategy to prevent
future accelerated viral infectivity similar to COVID
#MMPMID32498152
Coccia M
Sci Total Environ
2020[Aug]; 729
(?): 138474
PMID32498152
show ga
This study has two goals. The first is to explain the geo-environmental
determinants of the accelerated diffusion of COVID-19 that is generating a high
level of deaths. The second is to suggest a strategy to cope with future epidemic
threats similar to COVID-19 having an accelerated viral infectivity in society.
Using data on sample of N = 55 Italian province capitals, and data of infected
individuals at as of April 7th, 2020, results reveal that the accelerate and vast
diffusion of COVID-19 in North Italy has a high association with air pollution of
cities measured with days exceeding the limits set for PM(10) (particulate matter
10 ?m or less in diameter) or ozone. In particular, hinterland cities with
average high number of days exceeding the limits set for PM(10) (and also having
a low wind speed) have a very high number of infected people on 7th April 2020
(arithmetic mean is about 2200 infected individuals, with average polluted days
greater than 80 days per year), whereas coastal cities also having days exceeding
the limits set for PM(10) or ozone but with high wind speed have about 944.70
average infected individuals, with about 60 average polluted days per year;
moreover, cities having more than 100 days of air pollution (exceeding the limits
set for PM(10)), they have a very high average number of infected people (about
3350 infected individuals, 7th April 2020), whereas cities having less than
100 days of air pollution per year, they have a lower average number of infected
people (about 1014 individuals). The findings here also suggest that to minimize
the impact of future epidemics similar to COVID-19, the max number of days per
year that Italian provincial capitals or similar industrialized cities can exceed
the limits set for PM(10) or for ozone, considering their meteorological
conditions, is about 48 days. Moreover, results here reveal that the explanatory
variable of air pollution in cities seems to be a more important predictor in the
initial phase of diffusion of viral infectivity (on 17th March 2020, b(1) = 1.27,
p < 0.001) than interpersonal contacts (b(2) = 0.31, p < 0.05). In the second
phase of maturity of the transmission dynamics of COVID-19, air pollution reduces
intensity (on 7th April 2020 with b'(1) = 0.81, p < 0.001) also because of the
indirect effect of lockdown, whereas regression coefficient of transmission based
on interpersonal contacts has a stable level (b'(2) = 0.31, p < 0.01). This
result reveals that accelerated transmission dynamics of COVID-19 is due to
mainly to the mechanism of "air pollution-to-human transmission" (airborne viral
infectivity) rather than "human-to-human transmission". Overall, then,
transmission dynamics of viral infectivity, such as COVID-19, is due to systemic
causes: general factors that are the same for all regions (e.g., biological
characteristics of virus, incubation period, etc.) and specific factors which are
different for each region and/or city (e.g., complex interaction between air
pollution, meteorological conditions and biological characteristics of viral
infectivity) and health level of individuals (habits, immune system, age, sex,
etc.). Lessons learned for COVID-19 in the case study here suggest that a
proactive strategy to cope with future epidemics is also to apply especially an
environmental and sustainable policy based on reduction of levels of air
pollution mainly in hinterland and polluting cities- (having low wind speed, high
percentage of moisture and number of fog days) -that seem to have an environment
that foster a fast transmission dynamics of viral infectivity in society. Hence,
in the presence of polluting industrialization in regions that can trigger the
mechanism of air pollution-to-human transmission dynamics of viral infectivity,
this study must conclude that a comprehensive strategy to prevent future
epidemics similar to COVID-19 has to be also designed in environmental and
socioeconomic terms, that is also based on sustainability science and
environmental science, and not only in terms of biology, medicine, healthcare and
health sector.
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