The global scale, distribution and growth of aviation: Implications for climate change

Prior to the COVID-19 crisis, global air transport demand was expected to triple between 2020 and 2050. The pandemic, which reduced global air travel significantly, provides an opportunity to discuss the scale, distribution and growth of aviation until 2018, also with a view to consider the climate change implications of a return to volume growth. Industry statistics, data provided by supranational organizations, and national surveys are evaluated to develop a pre-pandemic understanding of air transport demand at global, regional, national and individual scales. Results suggest that the share of the world's population travelling by air in 2018 was 11%, with at most 4% taking international flights. Data also supports that a minor share of air travelers is responsible for a large share of warming: The percentile of the most frequent fliers – at most 1% of the world population - likely accounts for more than half of the total emissions from passenger air travel. Individual users of private aircraft can contribute to emissions of up to 7,500 t CO2 per year. Findings are specifically relevant with regard to the insight that a large share of global aviation emissions is not covered by policy agreements.

Monitoring Blood Supply in Germany: A Regulatory Perspective.

Background and Objectives: A sufficient supply of safe, high-quality blood components for transfusion is essential to the healthcare system in Germany. The requirements for the current reporting system are laid down in the German Transfusion Act. The present work elaborates on the advantages and limitations of the current reporting system and investigates the feasibility of a pilot project that collects specific data on blood supply based on weekly reports. Materials and Methods: Selected data on blood collection and supply from 2009 to 2021 derived from the §21 German Transfusion Act database were examined. In addition, a pilot study over a period of 12 months was conducted on a voluntary basis. The number of red blood cell (RBC) concentrates was documented and stock availability was calculated weekly. Results: From 2009 to 2021, the annual number of RBC concentrates decreased from 4.68 to 3.43 million, the per capita distribution decreased from 58 to 41 RBC concentrates per 1,000 inhabitants. These figures did not change significantly during the COVID-19 pandemic. The data of the 1-year pilot project represented 77% of the released RBC concentrates in Germany. Percentage share of O RhD positive RBC concentrates fluctuated between 35% and 22% and for O RhD negative concentrates between 17% and 5%. The availability of O RhD positive RBC concentrate stocks varied between 2.1 and 7.6 days. Conclusion: The data presented shows a decrease in annual RBC concentrate sales over an 11-year period and no further change over the past 2 years. A weekly monitoring of blood components detects acute problems in RBC provision and supply. Close monitoring seems helpful but should be combined with a nationwide supply strategy.

Emergency Use of Convalescent Plasma: Perception of the Regulatory Framework from a Clinical Perspective.

The pandemic spread of an infectious disease poses a plethora of challenges to society, clinicians, health care providers and regulating authorities. In order to mount a rapid response and to provide hope in a potentially catastrophic situation as the current COVID-19 pandemic, emergency plans, regulations and funding strategies have to be developed on regional, national and international levels. The speed needed to establish rapid response programs is challenged by the dynamics of the spread of the disease, the concurrent and competing development of different and potentially more effective treatment options, and not the least by regulatory uncertainty. Convalescent plasma, that is plasma collected from patients who have recovered from COVID-19 infections, has emerged as one of the first potential treatment options in the absence of drugs or vaccines with proven efficacy against SARS-CoV-2. The societal aspects of convalescent plasma and the public awareness gave an additional boost to the rapid employment of convalescent plasma donation platforms immediately after the SARS-CoV-2 outbreak. At the same time, uncertainty remains as to the efficacy of convalescent plasma. With evidence mostly limited to empirical reports, convalescent plasma has been used for decades for the prophylaxis and treatment of various infectious diseases. Clinical trials have addressed different infectious agents, stages of disease, target groups of patients and yielded sometimes inconclusive results. The aim of this short review is to delineate the regulatory background for the emergency use of convalescent plasma in the USA, in the European Union and in Germany, and the transition to the setting of clinical trials. In addition, we describe observations made in the process of collecting COVID-19 convalescent plasma (herein referred to as CCP), and formulate proposals to further improve the framework for rapid responses in future emergency situations.

[Update 2021: COVID-19 from the Perspective of Haematology and Haemostaseology]. / Update 2021: COVID-19 aus Sicht der Hämatologie und Hämostaseologie.

Infection with SARS-CoV-2 has a profound influence on the hematopoetic system that mediates clinical symptoms and mortality. Several studies have shown that treatment of the cytokine storm (CRS) with anti-inflammatory drugs like dexamethasone and tocilizumab can significantly improve survival. Systematic reviews confirm the safety of convalescent plasma administration and offer initial indications of its effectiveness in certain groups. COVID-associated coagulopathy (CAC) and vaccine-induced immune thrombotic thrombocytopenia (VITT) represent severe infection- or vaccination associated complications that require a specific diagnostic and therapeutic workup.

The global scale, distribution and growth of aviation: Implications for climate change.

Prior to the COVID-19 crisis, global air transport demand was expected to triple between 2020 and 2050. The pandemic, which reduced global air travel significantly, provides an opportunity to discuss the scale, distribution and growth of aviation until 2018, also with a view to consider the climate change implications of a return to volume growth. Industry statistics, data provided by supranational organizations, and national surveys are evaluated to develop a pre-pandemic understanding of air transport demand at global, regional, national and individual scales. Results suggest that the share of the world's population travelling by air in 2018 was 11%, with at most 4% taking international flights. Data also supports that a minor share of air travelers is responsible for a large share of warming: The percentile of the most frequent fliers - at most 1% of the world population - likely accounts for more than half of the total emissions from passenger air travel. Individual users of private aircraft can contribute to emissions of up to 7,500 t CO2 per year. Findings are specifically relevant with regard to the insight that a large share of global aviation emissions is not covered by policy agreements.

[COVID-19 from the Perspective of Haematology and Haemostaseology]. / COVID-19 aus Sicht der Hämatologie und Hämostaseologie.

Infection with SARS-COV-2 leads to a number of pathologies in the hematopoetic system that have significant impact on clinical symptoms and mortality. There are 3 stages of infection: (1) early upper respiratory tract infection with fever and lymphopenia (2) pulmonary phase and (3) hyperinflammatory phase with the clinical signs of organ failure such as ARDS/shock. Hyperinflammation, which is triggered by activation of T cells and monocytes/macrophages, is essential for organ pathologies. Interferon IFN-É£, tumor necrosis factor (TNF)-α, IL-10 and interleukin-6 (IL-6) play important roles as mediators of inflammation. In analogy to the cytokine release syndrome (CRS) after CAR-T cell therapy, the therapeutic activity of the IL-6 receptor antibody tocilizumab is investigated in clinical studies.The coagulation system is activated during the inflammatory phase of COVID infection, most likely on the pathophysiological basis of immune thrombosis. Clinically, there is a significantly increased incidence of venous (especially pulmonary artery embolism), but also arterial thromboembolism (TE). In laboratory chemistry, the D-dimer, fibrinogen but also vWF and FVIII are significantly increased. Guidelines for the prophylaxis and therapy of COVID-associated coagulopathy have been developed. Analogous to other viral infections, there are approaches to passive immunization using convalescent plasma. Its administration has shown promising activity in first uncontrolled case series and is currently being examined in clinical studies worldwide for its therapeutic activity.