Each and every one of us will recall the severe acute respiratory syndrome (SARS) coronavirus (CoV-2) pandemic, and the national and international political hesitations in its management. Fall 2019, in the city of Wuhan, Hubei province, China, an outbreak of unusual viral pneumonia due to a new emerging coronavirus named as SARS-CoV-2 started, generating late February a modern pandemic called COVID-19, posing very serious threat to global public health and the world economy (Hu et al. 2021). As we are getting out from this pandemic, and even if viral variants are still circulating, what have we learned and retained from this difficult period, shaking our certainties and reminding us of past images of devastating plagues? The COVID-19 pandemic highlighted the importance of early action, widespread testing, open data sharing, and strong public responses (The Lancet Infectious Diseases 2024). It has also highlighted that the animal origin of SARS-CoV-2 was still unknown and the existence of a reservoir host not really demonstrated (Cohen 2021). Beyond this, the COVID-19 pandemic has also revealed the importance of early and continuous surveillance, also raised questions about the role of meteorological conditions on the dispersion and viability of this virus, and highlighted the devastating effects of social inequality. We all remember some medical doctors who became modern preachers announcing the end of the pandemic because of unfavorable weather conditions coming for viral spread!

However, epidemiological studies analyzing the role of different parameters, and effects of national and regional restrictions at local or regional scales on COVID-19 are still rare. In this investigation entitled “Spatial and temporal epidemiology of SARS-3 CoV-2 virus lineages in Teesside, UK, in 2020: effects of socio-economic deprivation, weather, and lockdown on lineage dynamics”, Moss and collaborators’ aim is to analyze how a range of parameters, using both generalized linear mixed- and Bayesian spatial modeling, affected positive cases in the Teesside subregion of North East England during 2020 (Moss et al. 2024). Also, the authors wanted to understand the impacts of national and local government interventions introduced this year affected disease conditions in this subregion showing high levels of deprivation due to deindustrialisation in the latter half of the 20th century. 

According to Moss et al. (2024), the UK government decided for a heterogenous ”tier” system of local restrictions in England during the second wave associated with a more stringent national lockdown. The intention was to be more responsive and appropriate to the different English local contexts. The authors take us through a detailed statistical analysis to show that disease patterns in Teesside were associated with demographic parameters, social deprivation, weather conditions (essentially temperature) and governmental health interventions. Interestingly, findings lead to the conclusion that local tier interventions by public authorities was less effective at reducing COVID-19 cases in Teesside than a strict, long-term national lockdown.  A closer look at the spatio-temporal dynamics of the eight most common SARS-CoV-2 lineages circulating in Teesside in 2020 reveals complex dynamic behaviours differing to those of the total positive cases, certainly due to environmental and demographic stochasticity, and sublocal heterogenous social and economic conditions.

Overall, we recommend reading this study, which reveals the complexity of dealing with epidemics and pandemics, and highlights the importance of sound national political decisions and difficulties to proceed to local adjustments, i.e. tier system, in epidemic and pandemic control. 

The present recommendation is resulting from thorough reviews produced by Samuel Alizon and two anonymous reviewers, and which I thank very much for their review works here. 

References

Jon COHEN. 2021. Prophet in purgatory. Science 374, 1040-1045. https://www.science.org/doi/epdf/10.1126/science.acx9661

Ben HU, Hua GUO, Peng ZHOU, Zheng-Li SHI. 2021. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol 19, 141-54. https://doi.org/10.1038/s41579-020-00459-7 

The Lancet Infectious Diseases. 2024. Have we learned anything? Editorial. The Lancet Infectious Diseases 24, 793. https://doi.org/10.1016/S1473-3099(24)00439-0

E.D. Moss, S.P. Rushton, P. Baker, M. Bashton, M.R. Crown, R.N. dos Santos, A. Nelson, S.J. O’Brien, Z. Richards, R.A. Sanderson, W.C. Yew, G.R. Young, C.M. McCann, D.L. Smith (2024) Spatial and temporal epidemiology of SARS-CoV-2 virus lineages in Teesside, UK, in 2020: effects of socio-economic deprivation, weather, and lockdown on lineage dynamics. medRxiv, ver.5 peer-reviewed and recommended by PCI Infections. https://doi.org/10.1101/2022.02.05.22269279