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The drivers behind regional differences of SARS-CoV-2 spread on finer spatio-temporal scales are yet to be fully understood. Here we develop a data-driven modelling approach based on an age-structured compartmental model that compares 116 Austrian regions to a suitably chosen control set of regions to explain variations in local transmission rates through a combination of meteorological factors, non-pharmaceutical interventions and mobility. We find that more than 60% of the observed regional variations can be explained by these factors. Decreasing temperature and humidity, increasing cloudiness, precipitation and the absence of mitigation measures for public events are the strongest drivers for increased virus transmission, leading in combination to a doubling of the transmission rates compared to regions with more favourable weather. We conjecture that regions with little mitigation measures for large events that experience shifts toward unfavourable weather conditions are particularly predisposed as nucleation points for the next seasonal SARS-CoV-2 waves.

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Objective: The study aimed to evaluate centralised procurement of medicines (CPM) in Portugal.Methods: Data were collected through different methods, including a review of the literature and (procurement) documents and an analysis of selected bids. Thirty-seven faceto-face interviews with representatives of public authorities, users (hospitals and regional health administrations), patient associations and pharmaceutical industry were held in Portugal in Q1/2020. Results: CPM has contributed to improved transparency in processes and governance, to increased equity in access to medicines across the country and to lower workload for some users. The findings of the impact on medicine prices and availability are mixed. The benefits of CPM are undermined by some gaps: Lengthy, bureaucratic processes have resulted in delayed availability of medicines at the beginning of a year and in coping strategies of hospitals such as parallel individual procurements. The list of active ingredients under CPM has not been updated since 2016. The procurement agency does not routinely perform market consultations. Key performance indicators for CPM are lacking. Conclusions: Portuguese policy-makers are urged to develop an updated procurement strategy to provide guidance and clarity on the objectives of CPM, the role of the procurement agency and further authorities and key performance indicators.

Background Cooperation between the hospital sector and primary care is addressed under different names which hampers sharing and identifying existing practises and policies in this field. Purpose To get a better understanding of the concept of medicines management at the interface of the hospital and primary care sectors (hereafter called interface management). Materials and MethodsNarrative literature review searching Medline, EMBASE, GoogleScholar, Web of Science (ISI), supplemented by hand searching (snowballing) to detect grey literature and contacts with policy makers, researchers and hospital pharmacists to identify further references. Search terms included interface (management), seamless care, continuous care, transitional care, transition in combination with medication, medicines, drugs and pharmaceuticals. Interventions that did not address medicines were excluded; the search period was 1990 to September 2012. Results In English-language literature, the most commonly applied terms are seamless care, integrated care, comprehensive care, transmural care, transitional care and continuity of care for which, in most cases, generally accepted and repeatedly quoted definitions exist. A more recent terminology is ‘interface management’. In many cases, specific projects such as hospital discharge programmes are described without any explicit reference to overall concepts such as interface management or seamless care. Tools such as medicines reconciliation and/or patient counselling can be used to improve medicines management at the interface but they are not necessarily used as specific interface management measures. Conclusions Even in the English-language literature, the mechanisms of cooperation between the hospital sector and the primary care are referred to under different names. It is recommended to include specific interface management measures as search terms in a literature review on interface management since overall concepts such as seamless care and interface management are likely to yield few results. Terminology work to increase clarity in this field is needed. No conflict of interest.

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