Population vulnerability to COVID-19 in Europe: A burden of disease analysis

Background: Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19. Methods: Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability. Results: Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made, the highest rates were observed for Bulgaria, Czechia, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were: Bulgaria; Portugal; Latvia; Lithuania; Greece; Germany; Estonia; and Sweden. Conclusion: Routine estimates of population structures and non-fatal burden of disease measures can be usefully combined to create composite indicators of vulnerability for rapid assessments, in this case to severe health consequences from COVID-19. Countries with available results for sub-national regions within their country, or national burden of disease studies that also use sub-national levels for burden quantifications, should consider using non-fatal burden of disease estimates to estimate geographical vulnerability to COVID-19

Investigating nuclear structure near N=32 and N=34: Precision mass measurements of neutron-rich Ca, Ti, and V isotopes

Nuclear mass measurements of isotopes are key to improving our understanding of nuclear structure across the chart of nuclides, in particular, for the determination of the appearance or disappearance of nuclear shell closures. We present high-precision mass measurements of neutron-rich Ca, Ti, and V isotopes performed at TRIUMF's Ion Trap for Atomic and Nuclear science (TITAN) and the Low Energy Beam and Ion Trap (LEBIT) facilities. These measurements were made using the TITAN multiple-reflection time-of-flight mass spectrometer (MR-ToF-MS) and the LEBIT 9.4T Penning trap mass spectrometer. In total, 13 masses were measured, 8 of which represent increases in precision over previous measurements. These measurements refine trends in the mass surface around N=32 and N=34, and support the disappearance of the N=32 shell closure with increasing proton number. Additionally, our data do not support the presence of a shell closure at N=34.Nuclear mass measurements of isotopes are key to improving our understanding of nuclear structure across the chart of nuclides, in particular for the determination of the appearance or disappearance of nuclear shell closures. We present high-precision mass measurements of neutron-rich Ca, Ti and V isotopes performed at the TITAN and LEBIT facilities. These measurements were made using the TITAN multiple-reflection time-of-flight mass spectrometer (MR-ToF-MS) and the LEBIT 9.4T Penning trap mass spectrometer. In total, 13 masses were measured, eight of which represent increases in precision over previous measurements. These measurements refine trends in the mass surface around $N = 32$ and $N = 34$, and support the disappearance of the $N = 32$ shell closure with increasing proton number. Additionally, our data does not support the presence of a shell closure at $N = 34$

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Erratum: Population vulnerability to COVID-19 in Europe: a burden of disease analysis (Archives of Public Health (2020) 78 (47) DOI: 10.1186/s13690-020-00433-y)

Following publication of the original article [1], the authors identified an error in the author name of Brecht Devleesschauwer. The incorrect author name is: Brecht Devleeschauwer The correct author name is: Brecht Devleesschauwer The author group has been updated above and the original article [1] has been corrected