'We are not dealing with hard evidence, but we certainly have a sufficient empirical basis to formulate such hypotheses,’ says Professor Przemysław Śleszyński from the Institute of Geography and Spatial Organization at the Polish Academy of Sciences, one of the authors of the study published in the journal Population, Space and Place.

According to analyses presented by Śleszyński and his colleagues - Dr. Sławomir Kurek from the University of the National Education Commission in Kraków, Dr. Robert Krzysztofik from the University of Silesia in Sosnowiec and Dr. Jan Owsiński from the Systems Research Institute of the Polish Academy of Sciences in Warsaw - the mortality rate in the 'pre-pandemic' period in 44 European regions (out of 918 covered by the study) was significantly higher than in the corresponding period in 2016-2018.

The case of the French department of Territoire de Belfort is particularly interesting. In that administrative district, a high average death rate persisted for a long time in the analysed period - at the level of 148-151 percent of the values from previous years, and in the week between November 28 and December 4, 2019, it reached a record value of 204 percent. The region was also one of the first to detect the COVID-19 epidemic and one of the hardest hit by it in the winter and spring of 2020.

The situation was similar in Lombardy and the Madrid metropolitan area, which also saw significantly elevated excess deaths rates in the period before the pandemic was declared.

The research method used by Polish scientists consisted of collecting demographic data on deaths during consecutive weeks from October 2019 to March 2020 in European NUTS3 regions where the number of inhabitants exceeded 100,000 people. In total, nearly 1,000 of them were checked. The obtained information was then compared to the same periods of the previous three years.

'Such a long reference period was intended to maximally exclude random events that could occur locally in various regions, for example, as a result of environmental pollution, the population entering post-working age, heatwaves, etc.,’ the study authors say.

The results showed that SARS-CoV-2 could have reached Europe even before the first cases of COVID-19 were confirmed. 'Perhaps it was already in the fall of 2019,' says Professor Przemysław Śleszyński, 'and with an intensity leading to noticeable excess mortality due to this disease. Such a course of events cannot be ruled out.’

Even though the study was only circumstantial and not direct, the researchers point out reasons why its results should be taken seriously. The most important of them is the correlation of areas where a significant increase in mortality was previously recorded with those where the pandemic later took the greatest toll. Equally important is the fact that the acquired data have been compared with as many as three preceding years, which practically excludes (or at least marginalizes) the impact of changing socio-economic factors and weather conditions.

The authors of the study believe that the quite specific and differentiated effects of SARS-CoV-2 on the human body also strongly supports their hypothesis. Previous data showed that over 90 percent of infected middle-aged people had little or no symptoms of infection. Mainly the elderly and chronically ill were at risk of a more severe course of the disease and death.

'The unawareness of the existence of the virus and its impact on the deterioration of the health of people suffering from other serious diseases could therefore indirectly lead to the premature death of part of the population. The direct causes of death were those diseases, not the coronavirus itself. Geographical research, of course, cannot confirm this, but the proven correlation of the increase in the number of deaths with the increase in the number of confirmed cases of COVID-19 in the following months of 2020 is obvious,’ the scientists say.

'I clearly emphasise, however, that this is circumstantial evidence. We are not talking about certainties here,’ Professor Przemysław Śleszyński says. 

He adds that the method the researchers used does not allow them to draw conclusions about the origin or direction of the spread of the virus. Perhaps it needed time for its stronger and widespread development to occur as a result of favourable conditions, e.g. as a result of mutations. This hypothesis, indicating the slow evolutionary spread of SARS-CoV-2, may be of great importance because it opens the field to study its development in time and space.

The Polish study is not the only one suggesting a much earlier appearance of the SARS-CoV-2 virus in Europe. Numerous research groups have repeatedly analysed its potential evolution based on sewage monitoring, which is one of the best methods of tracking the course of the epidemic in various areas. For example, tests of urban sewage in Spain and Italy clearly showed that the virus DNA was already present in the summer of 2019 (a single study from the Barcelona area even indicated March 2019). Also, screening of volunteers for lung cancer from the same two countries, conducted between September 2019 and March 2020, showed antibodies to the coronavirus long before the pandemic was declared.

'Our results are consistent with these reports,’ Śleszyński says. 'They're just another piece of the growing body of evidence that this all must have started earlier.’

As for Poland, the number of deaths was approximately 20-30 percent higher in autumn 2019 and winter 2020 than in the three preceding years. However, according to the author of the publication, this result already indicates that something new, such as COVID-19, may have happened.

The authors add that there may be different causes of the increased number of excess deaths: air pollution, smog, flu. On the other hand, all these factors have been present every year in recent times. 'That is why what we found is such an important piece of evidence,’ says Professor Śleszyński.

According to the authors, more detailed research into the causes of death in the regions they have identified should be conducted to determine whether the increased mortality was actually caused by SARS-CoV-2. They write that 'providing such evidence seems very important especially because of the still unclear reasons for the emergence of the coronavirus study. If the suggested studies confirmed its presence at an earlier time in more places in the world, then this could mean that the pandemic was +hatched+ over a much longer period of time than it is currently accepted.’ (PAP)

PAP - Science in Poland, Katarzyna Czechowicz

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