Background Non-pharmaceutical interventions (NPIs) were implemented worldwide to control the spread of SARS-CoV-2. Aim To evaluate the impact of tiered NPIs and a nationwide lockdown on reduction of COVID-19 incidence during the second and third epidemic waves in Portugal. Methods Surveillance data on laboratory-confirmed COVID-19 cases were used to conduct an interrupted time series analysis to estimate changes in daily incidence during a second wave tiered NPI period (9 November–18 December 2020), and a third wave lockdown period without (15–21 January 2021) and with school closure (22 January–10 February 2021). Results Significant changes in trends were observed for the overall incidence rate; declining trends were observed for tiered NPIs (−1.9% per day; incidence rate ratio (IRR): 0.981; 95% confidence interval (CI): 0.973–0.989) and a lockdown period without (−3.4% per day; IRR: 0.966; 95% CI: 0.935–0.998) and with school closure (−10.3% per day, IRR: 0.897; 95% CI: 0.846–0.951). Absolute effects associated with tiered NPIs and a lockdown on a subsequent 14-day period yielded 137 cases and 437 cases per 100,000 population potentially averted, respectively. Conclusion Our results indicate that tiered NPIs implemented during the second wave caused a decline in COVID-19 incidence, although modest. Moreover, a third wave lockdown without school closure was effective in reducing COVID-19 incidence, but the addition of school closure provided the strongest effect. These findings emphasise the importance of early and assertive decision-making to control the pandemic.
Excess mortality not directly related to the virus has been shown to have increased during the COVID-19 pandemic. However, changes in heat-related mortality during the pandemic have not been addressed in detail. Here, we performed an observational study crossing daily mortality data collected in Portugal (SICO/DGS) with high-resolution temperature series (ERA5/ECMWF), characterizing their relation in the pre-pandemic, and how it aggravated during 2020. The combined result of COVID-19 and extreme temperatures caused the largest annual mortality burden in recent decades (~ 12 000 excess deaths [~ 11% above baseline]). COVID-19 caused the largest fraction of excess mortality during March to May (62%) and from October onwards (85%). During summer, its direct impact was residual, and deaths not reported as COVID-19 dominated excess mortality (553 versus 3 968). A prolonged hot spell led mortality to the upper tertile, reaching its peak in mid-July (+ 45% deaths/day). The lethality ratio (+ 14 deaths per cumulated ºC) was higher than that observed in recent heatwaves. We used a statistical model to estimate expected deaths due to cold/heat, indicating an amplification of at least 50% in heat-related deaths during 2020 compared to pre-pandemic years. Our findings suggest mortality during 2020 has been indirectly amplified by the COVID-19 pandemic, due to the disruption of healthcare systems and fear of population in attending healthcare facilities (expressed in emergency room admissions decreases). While lockdown measures and healthcare systems reorganization prevented deaths directly related to the virus, a significant burden due to other causes represents a strong secondary impact. This was particularly relevant during summer hot spells, when the lethality ratio reached magnitudes not experienced since the 2003 heatwaves. This severe amplification of heat-related mortality during 2020 stresses the need to resume normal healthcare services and public health awareness. Supplementary Information The online version contains supplementary material available at 10.1007/s00484-021-02192-z.
Nanostructured dipeptide self-assemblies exhibiting quantum confinement are of great interest due to their potential applications in the field of materials science as optoelectronic materials for energy harvesting devices. Cyclic dipeptides are an emerging outstanding group of ring-shaped dipeptides, which, because of multiple interactions, self-assemble in supramolecular structures with different morphologies showing quantum confinement and photoluminescence. Chiral cyclic dipeptides may also display piezoelectricity and pyroelectricity properties with potential applications in new sources of nano energy. Among those, aromatic cyclo-dipeptides containing the amino acid tryptophan are wide-band gap semiconductors displaying the high mechanical rigidity, photoluminescence and piezoelectric properties to be used in power generation. In this work, we report the fabrication of hybrid systems based on chiral cyclo-dipeptide L-Tryptophan-L-Tryptophan incorporated into biopolymer electrospun fibers. The micro/nanofibers contain self-assembled nano-spheres embedded into the polymer matrix, are wide-band gap semiconductors with 4.0 eV band gap energy, and display blue photoluminescence as well as relevant piezoelectric and pyroelectric properties with coefficients as high as 57 CN−1 and 35×10−6 Cm−2K−1, respectively. Therefore, the fabricated hybrid mats are promising systems for future thermal sensing and energy harvesting applications.
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