The Great War (1914-1918): a demographic catastrophe. Immediate and long-term consequences of the Second World War on the French population

Since the start of the third millennium, France has witnessed two significant mortality crises: the first, due to the period of excessively high temperatures experienced in August 2003;and the second, due to the still ongoing effects of the COVID-19 pandemic. These events have resulted in considerable numbers of excess deaths. But, compared with the demographic consequences of the First World War over the short, medium and long term, they appear almost anecdotal. This educational fact file looks in detail at the effects of the 1914-1918 war on the French population. The first part of the file paints a picture of the demographic situation in Metropolitan France just prior to the conflict, before we move on to look at the scale of the loss of life, which wiped out generations of young men (part 2), the significant reduction in fertility due to the separation of couples during the conflict (part 3), and the major and permanent consequences of excess deaths and a lower birth rate on the population pyramid of France (part 4). Lastly, in part 5, we conclude by putting the significance of the crises associated with the heatwave of 2003 and the COVID-19 pandemic into perspective. © 2022 Authors. All rights reserved.

Heatwaves and mortality in Queensland 2010-2019: implications for a homogenous state-wide approach.

Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.

Estimation of excess mortality in French and Spanish regions during the first wave of Covid-19: application of the "after/before" method

Estimates of excess deaths have been widely used to measure the overall impact of the COVID-19 pandemic on mortality. We investigate the validity of a method-the later/earlier method- developed for forecasting the number of deaths one would expect if no shock occurred. We apply this method to estimate excess mortality during the first COVID-19 wave in France and Spain (February-June 2020), stratified by age, sex, and region. Although both countries recorded similar numbers of COVID-19 deaths, Spain had higher excess mortality. The results are informative about differences in COVID-19 vulnerability for population subgroups and spatial areas: adults aged 75-85 were the hardest hit;Ile-de-France (Paris region) in France and Comunidad de Madrid in Spain had the highest excess mortality. Applicable to other demographic phenomena, the later/earlier method is simple, requires fewer assumptions than other forecasting methods, and is less biased and more accurate than the 5-year-average method.

Heatwave Mortality in Summer 2020 in England: An Observational Study.

High ambient temperatures pose a significant risk to health. This study investigates the heatwave mortality in the summer of 2020 during the SARS-CoV-2 coronavirus (COVID-19) pandemic and related countermeasures. The heatwaves in 2020 caused more deaths than have been reported since the Heatwave Plan for England was introduced in 2004. The total and cause-specific mortality in 2020 was compared to previous heatwave events in England. The findings will help inform summer preparedness and planning in future years as society learns to live with COVID-19. Heatwave excess mortality in 2020 was similar to deaths occurring at home, in hospitals, and in care homes in the 65+ years group, and was comparable to the increases in previous years (2016-2018). The third heatwave in 2020 caused significant mortality in the younger age group (0-64) which has not been observed in previous years. Significant excess mortality was observed for cardiovascular disease, respiratory disease, and Alzheimer's and Dementia across all three heatwaves in persons aged 65+ years. There was no evidence that the heatwaves affected the proportional increase of people dying at home and not seeking heat-related health care. The most significant spike in daily mortality in August 2020 was associated with a period of high night-time temperatures. The results provide additional evidence that contextual factors are important for managing heatwave risks, particularly the importance of overheating in dwellings. The findings also suggest more action is also needed to address the vulnerability in the community and in health care settings during the acute response phase of a heatwave.

Predicting Deep Body Temperature (Tb) from Forehead Skin Temperature: Tb or Not Tb?

There is a need to rapidly screen individuals for heat strain and fever using skin temperature (Tsk) as an index of deep body temperature (Tb). This study's aim was to assess whether Tsk could serve as an accurate and valid index of Tb during a simulated heatwave. Seven participants maintained a continuous schedule over 9-days, in 3-day parts; pre-/post-HW (25.4 °C), simulated-HW (35.4 °C). Contact thermistors measured Tsk (Tforehead, Tfinger); radio pills measured gastrointestinal temperature (Tgi). Proximal-distal temperature gradients (ΔTforehead-finger) were also measured. Measurements were grouped into ambient conditions: 22, 25, and 35 °C. Tgi and Tforehead only displayed a significant relationship in 22 °C (r: 0.591; p < 0.001) and 25 °C (r: 0.408; p < 0.001) conditions. A linear regression of all conditions identified Tforehead and ΔTforehead-finger as significant predictors of Tgi (r2: 0.588; F: 125.771; p < 0.001), producing a root mean square error of 0.26 °C. Additional residual analysis identified Tforehead to be responsible for a plateau in Tgi prediction above 37 °C. Contact Tforehead was shown to be a statistically suitable indicator of Tgi in non-HW conditions; however, an error of ~1 °C makes this physiologically redundant. The measurement of multiple sites may improve Tb prediction, though it is still physiologically unsuitable, especially at higher ambient temperatures.

Have health inequities, the COVID-19 pandemic and climate change led to the deadliest heatwave in France since 2003?

OBJECTIVES: Between 2015 and 2019, 5700 excess deaths were observed during heatwaves in France. The summer of 2020 combined exceptionally high temperatures with the COVID-19 pandemic. The associated health impacts of this unique situation are described in this study. STUDY DESIGN: This is an observational study based on indicators of the French heat prevention plan. METHODS: Mortality and morbidity data during heatwaves were compared between 2020 and previous years, alongside COVID-19 in-hospital mortality. RESULTS: In total, 1921 additional deaths (+18.2%) were observed during the 2020 heatwaves, which is the largest number of deaths observed since 2003. Less than 100 deaths were attributed to COVID-19 during the heatwaves of 2020. CONCLUSIONS: Exceptionally high temperatures driven by climate change, combined with health inequities exacerbated by the COVID-19 outbreak, may have increased vulnerability to heat in 2020.

Air quality and meteorological patterns of an early spring heatwave event in an industrialized area of Attica, Greece.

Heatwaves-excessively hot ambient conditions that are considered a serious threat to human health-are often associated with poor air quality. The aim of this study was to examine the impact of an early heatwave episode in an industrialized plain in the eastern Mediterranean region (Thriasio, Greece) on human thermal discomfort and urban air quality. The heatwave occurred in mid (15-20) May 2020, shortly after some of the restrictions that were improsed to halt the spread of coronavirus disease 2019 (COVID-19) in Greece were lifted (on 4 May). The discomfort index (DI) and the daily air quality index (DAQI) were calculated on an hourly basis throughout spring 2020 (March, April, May) using data from two stations that measure meteorological parameters and air pollutant concentrations in the Thriasio Plain. The analysis showed that the air temperature increased during 7-17 May to levels that were more than 10 °C above the monthly average value (25.8 °C). The maximum measured air temperature was 38 °C (on 17 May). The results showed a high level of thermal discomfort. The DI exceeded the threshold of 24 °C for several hours during 13-20 May. Increased air pollution levels were also identified. The average DAQI was estimated as 0.83 ± 0.1 and 1.14 ± 0.2 at two monitoring stations in the region of interest during the heatwave. Particulate matter (diameter < 10 µm) appeared to contribute significantly to the poor air quality. Significant correlations between the air temperature, DI, and AQSI were also identified.