Quantifying the impact of air pollution on Covid-19 hospitalisation and death rates in Scotland.

Better understanding the risk factors that exacerbate Covid-19 symptoms and lead to worse health outcomes is vitally important in the public health fight against the virus. One such risk factor that is currently under investigation is air pollution concentrations, with some studies finding statistically significant effects while other studies have found no consistent associations. The aim of this paper is to add to this global evidence base on the potential association between air pollution concentrations and Covid-19 hospitalisations and deaths, by presenting the first study on this topic at the small-area scale in Scotland, United Kingdom. Our study is one of the most comprehensive to date in terms of its temporal coverage, as it includes all hospitalisations and deaths in Scotland between 1st March 2020 and 31st July 2021. We quantify the effects of air pollution on Covid-19 outcomes using a small-area spatial ecological study design, with inference using Bayesian hierarchical models that allow for the residual spatial correlation present in the data. A key advantage of our study is its extensive sensitivity analyses, which examines the robustness of the results to our modelling assumptions. We find clear evidence that PM2.5 concentrations are associated with hospital admissions, with a 1 µgm-3 increase in concentrations being associated with between a 7.4% and a 9.3% increase in hospitalisations. In addition, we find some evidence that PM2.5 concentrations are associated with deaths, with a 1 µgm-3 increase in concentrations being associated with between a 2.9% and a 10.3% increase in deaths.

Unexposed populations and potential COVID-19 hospitalisations and deaths in European countries as per data up to 21 November 2021.

We estimate the potential remaining COVID-19 hospitalisation and death burdens in 19 European countries by estimating the proportion of each country's population that has acquired immunity to severe disease through infection or vaccination. Our results suggest many European countries could still face high burdens of hospitalisations and deaths, particularly those with lower vaccination coverage, less historical transmission and/or older populations. Continued non-pharmaceutical interventions and efforts to achieve high vaccination coverage are required in these countries to limit severe COVID-19 outcomes.