Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic.

Effect of lockdown amid COVID-19 pandemic on air quality of the megacity Delhi, India.

https://www.pure.ed.ac.uk/ws/files/207070130/Suicide_trends_in_the_early_months_of_the_COVID_19_pandemic.pdf

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries.

The goal of this piece is to survey the developing and rapidly growing literature on the economic consequences of COVID-19 and the governmental responses, and to synthetize the insights emerging from a very large number of studies. This survey: (i) provides an overview of the data sets and the techniques employed to measure social distancing and COVID-19 cases and deaths; (ii) reviews the literature on the determinants of compliance with and the effectiveness of social distancing; (iii) mentions the macroeconomic and financial impacts including the modelling of plausible mechanisms; (iv) summarizes the literature on the socioeconomic consequences of COVID-19, focusing on those aspects related to labor, health, gender, discrimination, and the environment; and (v) summarizes the literature on public policy responses.

https://www.econstor.eu/bitstream/10419/222316/1/GLO-DP-0601.pdf

A literature review of the economics of COVID-19

To prevent the escalation of COVID-19 transmission, China locked down one-third of its cities, which strictly curtailed personal mobility and economic activities. Using comprehensive daily air quality data in China, we evaluated the impacts of these measures in terms of the Air Quality Index (AQI) and the concentrations of particulate matter with a diameter of less than 2.5 μm (PM2.5). To infer their causal relationships, we employed difference-in-differences models that compare cities with and without lockdown policies. We found that city lockdowns led to a sizeable improvement in air quality. Within weeks, the AQI in the locked-down cities was brought down by 19.84 points (PM2.5 down by 14.07 µg m−3) relative to the control group. In addition, air quality in cities without formal lockdowns also improved because of the enforcement of other types of counter-virus measures. The AQI in those cities was brought down by 6.34 points (PM2.5 down by 7.05 µg m−3) relative to the previous year. The lockdown effects are larger in colder, richer and more industrialized cities. Despite these improvements, PM2.5 concentrations during the lockdown periods remained four times higher than the World Health Organization recommendations, suggesting much further effort is needed. Existing environmental policies could obtain similar air quality improvements at a much lower economic cost, making city lockdowns an unsustainable option to address environmental issues. Urban air quality remained remarkably worse than WHO recommended levels in cities during the first COVID-19 lockdown in China, despite substantial pollution reductions and the high costs of the measure.

/pdf/the-short-term-impacts-of-covid-19-lockdown-on-urban-air-59dqbpq6g9.pdf

The short-term impacts of COVID-19 lockdown on urban air pollution in China

There is increasing concern that the coronavirus disease 2019 (COVID-19) pandemic could harm psychological health and exacerbate suicide risk. Here, based on month-level records of suicides covering the entire Japanese population in 1,848 administrative units, we assessed whether suicide mortality changed during the pandemic. Using difference-in-difference estimation, we found that monthly suicide rates declined by 14% during the first 5 months of the pandemic (February to June 2020). This could be due to a number of complex reasons, including the government's generous subsidies, reduced working hours and school closure. By contrast, monthly suicide rates increased by 16% during the second wave (July to October 2020), with a larger increase among females (37%) and children and adolescents (49%). Although adverse impacts of the COVID-19 pandemic may remain in the long term, its modifiers (such as government subsidies) may not be sustained. Thus, effective suicide prevention-particularly among vulnerable populations-should be an important public health consideration.

/pdf/increase-in-suicide-following-an-initial-decline-during-the-12x0zrwp86.pdf

Increase in suicide following an initial decline during the COVID-19 pandemic in Japan.

The rapid spread of COVID-19 is a global public health challenge. To prevent the escalation of its transmission, China locked down one-third of its cities and strictly restricted personal mobility and economic activities. Using timely and comprehensive air quality data in China, we show that these counter-COVID-19 measures led to a remarkable improvement in air quality. Within weeks, the Air Quality Index and PM2.5 concentrations were brought down by 25%. The effects are larger in colder, richer, and more industrialized cities. We estimate that such improvement would avert 24,000 to 36,000 premature deaths from air pollution on a monthly basis.

/pdf/covid-19-city-lockdowns-and-air-pollution-evidence-from-szx3ibj45l.pdf

COVID-19, City Lockdowns, And Air Pollution: Evidence from China

There is an emerging concern that the COVID-19 pandemic could harm psychological health and exacerbate suicide risk. Utilising month-level suicide records covering the entire Japanese population in 1,849 administrative units, we assessed whether suicide mortality changed during the pandemic. Employing difference-in-difference estimation, we found that monthly suicide rates declined by 12% during the initial five months (February to June 2020), which could have been mainly driven by the government’s generous subsidies, reduced working hours, and school closure. In stark contrast, monthly suicide rates increased by 13% in the second wave (July to September 2020), with the magnitude greater among females (29%) and children (49%). The adverse impact of the COVID-19 pandemic may remain, while its modifiers (e.g. government subsidies) may not be sustained for long, suggesting that suicide deaths could keep rising. Hence, effective suicide prevention, particularly among vulnerable populations, should be an important public health consideration.

/pdf/suicide-during-the-covid-19-pandemic-in-japan-3xtlkf4xrq.pdf

Suicide during the COVID-19 pandemic in Japan

Following the Fukushima nuclear accident, Japan gradually shut down all its nuclear power plants, causing a country-wide power shortage. In response, the government launched large-scale campaigns that aimed to reduce summer electricity consumption by as much as 15% in some regions. Because electricity use plays a key role in mitigating climate impacts, such policies could potentially damage the population’s health. Exploiting the different electricity-saving targets set by different regions, we show that the reduction in electricity consumption indeed increased heat-related mortality, particularly during extremely hot days. This unintended consequence suggests that there exists a trade-off between climate adaptation and energy saving.

/pdf/energy-saving-can-kill-evidence-from-the-fukushima-nuclear-1b3cqzxnr0.pdf

Takanao Tanaka

Papers

The short-term impacts of COVID-19 lockdown on urban air pollution in China

Increase in suicide following an initial decline during the COVID-19 pandemic in Japan.

COVID-19, City Lockdowns, And Air Pollution: Evidence from China

Suicide during the COVID-19 pandemic in Japan

Energy Saving Can Kill: Evidence from the Fukushima Nuclear Accident