Capturing the spatiotemporal spread of COVID-19 in 30 European countries during 2020 – 2022

Capturing the spatiotemporal spread of COVID-19 in 30 European countries during 2020 – 2022 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Capturing the spatiotemporal spread of COVID-19 in 30 European countries during 2020 – 2022 Thi Huyen Trang Nguyen, Niel Hens, Christel Faes This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6770961/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Oct, 2025 Read the published version in BMC Public Health → Version 1 posted 13 You are reading this latest preprint version Abstract Background: While the COVID-19 pandemic has been burdensome globally, it has fostered extensive data collection at various spatiotemporal resolutions. These data heightened researchers' interest in investigating multiple facets of the pandemic. In Europe, key factors shaping disease transmission vary among countries, leading to a gap in understanding how the epidemic evolved and spread across countries as a whole. We endeavor to understand the similarities and differences in the spatiotemporal spread of the COVID-19 pandemic in 30 EU/EEA countries between March 2020 and December 2022. Method: We utilized a multivariate endemic-epidemic model to conduct a space-time analysis across 30 countries, using weekly aggregated COVID-19 case counts from week 13-2020 to week 50-2022. Our analysis considered the discrepancies in population size, the primary course and three booster vaccine doses, taking into account waning immunity, the Stringency Index as a surrogate for non-pharmaceutical interventions adopted in each country, and the circulation of various viral variants. We employed a power law approximation for spatial interactions between countries. Results: We found that within-country transmission was dominant across all countries over almost three years of observation. This work also underscored a basic transmission mechanism, whereby infections introduced by between-country transmission could be of great importance in subsequent local transmission. Furthermore, there were indications of the transition to endemicity since the beginning of 2022, particularly in light of the evolving variants of concern. Conclusion: Our study highlighted the benefit of the endemic-epidemic framework to elucidate the COVID-19 disease spread over a large spatial and temporal scale, using a wide range of epidemiological information. Insights derived from this study are beneficial for those interested in seeking an overview of the emergency phase of the COVID-19 pandemic in the EU/EEA region. spatiotemporal COVID-19 Europe endemic-epidemic Full Text Additional Declarations No competing interests reported. Supplementary Files AppendixTables.xlsx Cite Share Download PDF Status: Published Journal Publication published 21 Oct, 2025 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 17 Jul, 2025 Reviews received at journal 04 Jul, 2025 Reviews received at journal 02 Jul, 2025 Reviewers agreed at journal 19 Jun, 2025 Reviewers agreed at journal 19 Jun, 2025 Reviewers agreed at journal 18 Jun, 2025 Reviewers agreed at journal 17 Jun, 2025 Reviewers agreed at journal 14 Jun, 2025 Reviewers invited by journal 13 Jun, 2025 Editor invited by journal 03 Jun, 2025 Editor assigned by journal 30 May, 2025 Submission checks completed at journal 30 May, 2025 First submitted to journal 28 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6770961","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":472228358,"identity":"92a98647-dc95-4acb-9036-acea73724e63","order_by":0,"name":"Thi Huyen Trang Nguyen","email":"data:image/png;base64,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","orcid":"","institution":"Hasselt University","correspondingAuthor":true,"prefix":"","firstName":"Thi","middleName":"Huyen Trang","lastName":"Nguyen","suffix":""},{"id":472228360,"identity":"d1505a55-1a0c-4855-bd07-ba6c83fee3ad","order_by":1,"name":"Niel Hens","email":"","orcid":"","institution":"Hasselt University","correspondingAuthor":false,"prefix":"","firstName":"Niel","middleName":"","lastName":"Hens","suffix":""},{"id":472228361,"identity":"7968db9d-e895-42ce-ae59-51b95e6a314f","order_by":2,"name":"Christel Faes","email":"","orcid":"","institution":"Hasselt University","correspondingAuthor":false,"prefix":"","firstName":"Christel","middleName":"","lastName":"Faes","suffix":""}],"badges":[],"createdAt":"2025-05-28 20:38:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6770961/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6770961/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-24795-6","type":"published","date":"2025-10-21T16:16:34+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":94490584,"identity":"3c6bd0b1-beb2-47e7-8319-ec558f21f6be","added_by":"auto","created_at":"2025-10-27 17:12:40","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":7326013,"visible":true,"origin":"","legend":"","description":"","filename":"manuscriptrevised.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6770961/v1_covered_9d00e047-09e6-45c4-afe3-7eb519802785.pdf"},{"id":84764006,"identity":"82e98d40-036c-4ca7-89b9-4961c3312c74","added_by":"auto","created_at":"2025-06-17 06:44:53","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":76464,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixTables.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-6770961/v1/08501d1af4967e206a49cc6a.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Capturing the spatiotemporal spread of COVID-19 in 30 European countries during 2020 – 2022","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"spatiotemporal, COVID-19, Europe, endemic-epidemic","lastPublishedDoi":"10.21203/rs.3.rs-6770961/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6770961/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eWhile the COVID-19 pandemic has been burdensome globally, it has fostered extensive data collection at various spatiotemporal resolutions. 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