Euro 2020

Euro 2020

The 2021 UEFA European Football Championship, commonly referred to as UEFA Euro 2021 or simply Euro 2021, is scheduled to be the 16th UEFA European Championship, the quadrennial international men's football championship of Europe organised by the Union of European Football Associations (UEFA).[1]

The tournament, to be held in 12 cities in 12 UEFA countries, was originally scheduled to take place from 12 June to 12 July 2020. On 17 March 2020, UEFA announced that the tournament would be delayed by a year due to the 2020 coronavirus pandemic in Europe, and proposed it take place from 11 June to 11 July 2021. The competition was postponed in order to reduce pressure on the public services in affected countries and to provide space in the calendar for the completion of domestic leagues which had been suspended.[2]

Former UEFA President Michel Platini said the tournament is being hosted in several nations as a "romantic" one-off event to celebrate the 60th "birthday" of the European Championship competition.[3] Having the largest capacity of any of the stadiums entered for the competition, Wembley Stadium in London is scheduled to host the semi-finals and final for the second time, having done so before at the 1996 tournament in the stadium's former incarnation. The Stadio Olimpico in Rome was chosen to host the opening game, involving Turkey and hosts Italy.

Portugal are the defending champions, having won the 2016 edition. For the first time, the video assistant referee (VAR) system will be used at the UEFA European Championship

While some countries had already expressed an interest in bidding to host the tournament,[5][6][7][8][9][10][11][12] then-UEFA President Michel Platini suggested at a press conference on 30 June 2012, a day before the UEFA Euro 2012 Final, that instead of having one host country (or joint hosting by multiple countries), the tournament could be spread over "12 or 13 cities" across the continent.[13] At the time, UEFA already used a similar system for the UEFA European Under-17 Championship's Elite Round, where each of the seven groups is hosted by a different country.

European format decision

On 6 December 2012, UEFA announced the tournament would be held in multiple cities across Europe to mark the 60th anniversary of the tournament.[14][15] The selection of the host cities did not guarantee an automatic qualifying berth to the national team of that country.

UEFA reasoned that the pan-European staging of the tournament was the logical decision at a time of financial difficulty across Europe.[16][17] Reaction to UEFA's plan was mixed across Europe.[18] Critics have cited the expanded format (from 31 matches featuring 16 nations to 51 featuring 24) and its associated additional costs as the decisive factor for only one nation (Turkey) having put forward a serious bid.[19]

Bidding venues

The final list of bids was published by UEFA on 26 April 2014, with a decision on the hosts being made by the UEFA Executive Committee on 19 September 2014. There were two bids for the Finals Package (of which one was successful, marked with blue for semi-finals and final) and 19 bids for the Standard Package (of which 12 were initially successful, marked with green for quarter-finals and group stage, and yellow for round of 16 and group stage); Brussels, marked with red, were initially selected but removed from the list of venues by UEFA on 7 December 2017 and the planned games there were moved to Wembley

Effects of the coronavirus pandemic

In 2020, the pandemic in Europe of coronavirus disease 2019 (COVID-19) raised concerns regarding its potential impact on players, staff and visitors to the twelve host cities.[23] At the UEFA Congress in early March, UEFA president Aleksander Čeferin said the organisation was confident that the situation could be dealt with, while general secretary Theodore Theodoridis stated that UEFA was maintaining contact with the World Health Organization and national governments regarding the coronavirus.[24] The impact of the coronavirus grew in March, as numerous domestic and UEFA competition matches began taking place behind closed doors. By 13 March 2020, upcoming UEFA competition fixtures were postponed, while major European leagues were suspended, including the Bundesliga, La Liga, Ligue 1, Premier League and Serie A.[25] UEFA announced that a videoconference would be held on 17 March with representatives of its 55 member associations, along with a FIFPro representative and the boards of the European Club Association and European Leagues, to discuss the response to the outbreak for domestic and European competitions, including Euro 2020.[26] At the meeting, UEFA announced that the tournament would be postponed to the following year, proposing that it take place from 11 June to 11 July 2021.[2] Though this window was previously reserved for the expanded FIFA Club World Cup, the FIFA Council will discuss rescheduling the Club World Cup for a later date.[27] The postponement allows for pressure to be reduced on the public services in affected countries, while also providing space in the calendar for domestic European leagues which had been suspended to complete their seasons.

Qualification

There is no automatic qualifying berth, and all 55 UEFA national teams, including the 12 national teams whose countries are scheduled to stage matches, must compete in the qualifiers for the 24 places at the finals tournament.[28][29] As the host cities were appointed by UEFA in September 2014, before the qualifiers, it is possible for the national teams from the host cities to fail to qualify for the finals tournament.

The qualifying draw was held on 2 December 2018 at the Convention Centre Dublin in Dublin, Republic of Ireland.[30]

The main qualifying process started in March 2019, instead of immediately in September 2018 following the 2018 FIFA World Cup, and ended in November 2019. The format remains largely the same, although only 20 of the 24 spots for the finals tournament are to be decided from the main qualifying process, leaving four spots still to be decided. Following the admission of Kosovo to UEFA in May 2016, it was announced that the 55 members at the time would be drawn into ten groups after the completion of the UEFA Nations League (five groups of five teams and five groups of six teams, with the four participants of the UEFA Nations League Finals guaranteed to be drawn into groups of five teams), with the top two teams in each group qualifying. The qualifiers were played on double matchdays in March, June, September, October and November 2019.[31]

With the creation of the UEFA Nations League starting in 2018,[32][31][33][34] the 2018–19 UEFA Nations League is to be linked with UEFA Euro qualifying, providing teams another chance to qualify for the tournament. Four teams from each division that have not already qualified for the Euro finals are to compete in the play-offs for each division. The winners of the play-offs for each division, to be decided by two one-off semi-finals (the best-ranked team vs. the fourth-best-ranked team, and the second-best-ranked team vs. the third-best-ranked team, played at home of higher ranked teams) and one one-off final (with the venue drawn in advance between the two semi-finals winners), are scheduled to join the 20 teams that have already qualified for the Euro finals.[34]

Qualified teams

Of the currently 20 teams that have qualified for the tournament, 17 are returning from the 2016 edition. Among them are Belgium and Italy, who both recorded flawless qualifying campaigns (10 wins in 10 matches),[35][36] defending European champions Portugal and world champions France, with Germany also qualifying for a record 13th straight European Championship.[37] Finland will make their European Championship debut, having never previously qualified for a major tournament.[38] The Netherlands and Denmark returned after missing out in 2016, with the Dutch featuring in a major tournament for the first time since 2014.[39][40] For the first time, Austria and Wales reached successive European Championship tournaments.[41][42] Greece, winners in 2004, were the only former champions which failed to qualify, missing their second straight European Championship and third consecutive major tournament.[43]

Of the twelve host countries, seven managed to qualify directly for the tournament. Four will enter the play-offs, with a maximum of three being able to qualify, while Azerbaijan were entirely eliminated following the qualifying group stage

Tom Brady

Tom Brady

Thomas Edward Patrick Brady Jr. (born August 3, 1977) is an American football quarterback for the New England Patriots of the National Football League (NFL). Brady has played in a record nine Super Bowls, winning six of them (XXXVI, XXXVIII, XXXIX, XLIX, LI, and LIII), the most of any player in NFL history. He has won a record four Super Bowl MVP awards (XXXVI, XXXVIII, XLIX, and LI) as well as three NFL MVP awards (2007, 2010, 2017).[a] Due to his numerous records and accolades, many sports writers, commentators, and players (current and former) consider Brady to be the greatest quarterback of all time.[discuss][2][3][4][5][6][7]

After playing college football for the University of Michigan, Brady was drafted 199th overall by the Patriots in the sixth round of the 2000 NFL Draft. Due to his late selection, Brady is considered the biggest "steal" in the history of the NFL Draft.[8][9][10] He went on to become the team's starting quarterback in his second season after an injury to Drew Bledsoe, and has been with the Patriots for 20 seasons, the NFL record for seasons as quarterback for one team.[b] He is one of only two quarterbacks to win a Super Bowl in their first season as a starter.[c]

The only quarterback to reach 200 regular-season wins,[14] Brady has never had a losing season as a starting quarterback. He has led his team to more division titles (16) than any other quarterback in NFL history. With a postseason record of 30–11, he is first all-time in playoff wins and appearances for an NFL player, including an NFL-record eight consecutive AFC championship games between 2011 and 2018 (and 13 overall). Brady has also been selected to 14 Pro Bowls, which ties the NFL record for most selections.

For regular season and postseason combined, Brady is first all-time in career passing yards and touchdown passes. He is one of only two players in NFL history to amass 70,000 passing yards and 1,000 rushing yards.[d] Brady is second all-time in career regular season passing yards, second in career touchdown passes, and tied for fifth in career passer rating. He is first in postseason career completions, passing yards, and passing touchdowns, and is fifteenth in postseason career passer rating. He also tied the record for the longest touchdown pass at 99 yards to Wes Welker.[16]

For his alleged involvement in the Deflategate football-tampering scandal, Brady was suspended for the first four games of the 2016 season.[17] Brady and the Patriots won two of the next three Super Bowls, making him the record holder for most Super Bowl wins by a player, and the oldest quarterback to win a Super Bowl, at 41

Early life

Brady was born in San Mateo, California, on August 3, 1977, the only son and fourth child of Galynn Patricia (née Johnson) and Thomas Brady Sr.[19] He has three older sisters, Nancy, Julie, and Maureen,[20] and was raised as a Catholic. His father is of Irish descent, while his mother has German, Norwegian, Polish, and Swedish ancestry.[21] Two of Brady's great-great-grandparents on his father's side, John and Bridget Brady, were Irish refugees from the Great Famine who moved to San Francisco from Boston before the American Civil War. They were accompanied by Bridget's sister Ann and her husband Lawrence Meegan, the parents of the 19th-century American Major League Baseball player "Steady" Pete Meegan. Brady's great-uncle Michael Buckley Jr. was the first American prisoner of war in World War II.[21][22][23][24][25][26]

In the 1980s, Brady regularly attended San Francisco 49ers games at Candlestick Park, where he was a fan of quarterback Joe Montana; Brady has called Montana his idol and one of his inspirations.[27] At age four, Brady attended the 1981 NFC Championship, against the Dallas Cowboys, in which Montana threw The Catch to Dwight Clark.[28] As a child, Brady attended football camp at the College of San Mateo, where he was taught to throw the football by camp counselor and future NFL/AFL quarterback Tony Graziani.[29] Despite the rivalry between both teams, Brady grew up as a Los Angeles Lakers and Boston Celtics fan.[30]

Brady attended Junípero Serra High School in San Mateo, where he graduated in 1995; the ceremony was held at St. Mary's Cathedral.[31] He played football, basketball, and baseball in high school. He played against Bellarmine College Preparatory rival Pat Burrell in both football and baseball.[32] Brady began his football career as the backup quarterback on the Padres junior varsity team. At first, Brady was not good enough to start on the 0–8 JV team, which had not scored a touchdown all year.[33] Brady ascended to the starting position when the starting quarterback was injured. He became the varsity starter in his junior year and held the position until he graduated.[34] By Brady's senior year, he was striving to be noticed by college coaches. He created highlight tapes and sent them to schools he considered attending.[35] This led to strong interest from many football programs around the nation.

The process of recruiting was much different during Brady's time, and athletes' rankings were not as prominent. In terms of recruiting in the 2000s, Brady would have been considered a four-star recruit. In essence, he was a highly rated prospect.[36] Brady was also on Blue Chip Illustrated as well as a Prep Football Report All-American selection.[37] After his recruiting process, he narrowed down his list to five schools.[38] "Probably the ones that we did hear from and ultimately pared the list to were Cal–Berkeley, UCLA, USC, Michigan, and Illinois”, his father said.[38] As a Cal fan, his father hoped that Brady would attend the nearby Cal, where Brady was a silent commit,[39] and that he would be able to watch his son play.[40][41]

Brady was also known as a great baseball player in high school.[42] He was a left-handed-batting catcher with power. His skills impressed MLB scouts, and he was drafted in the 18th round of the 1995 MLB Draft by the Montreal Expos.[33][43] The Expos projected Brady as a potential All-Star, and offered him money typical of that offered to a late second-round or early third-round pick.[44] Nevertheless, Brady was determined to play football at the next level. He was always more passionate about football; when he found that there was significant interest in him, he decided to take the road of football.[38] Brady was recruited by Michigan assistant Bill Harris, and he signed to play for the University of Michigan in 1995.[45][46] He finished his high-school football career by completing 236 of 447 passes for 3,702 yards and 31 touchdowns. He also won All-State and All-Far West honors and the team's Most Valuable Player Award.[37]

During the summers of 1998 and 1999, Brady was an intern at Merrill Lynch.[47] He was inducted into the Junípero Serra High School Hall of Fame in 2003, joining fellow Serra High graduates Barry Bonds, Lynn Swann, Gregg Jefferies, Jim Fregosi, and his older sister Maureen, among many others.[37] When Brady revisited two weeks after Super Bowl XLVI, in 2012, school administrators announced that they had named the football stadium Brady Family Stadium.[48]

College career

Brady played college football at the University of Michigan from 1995 to 1999.[49][50] He was a backup quarterback for his first two years, while teammate and future NFL quarterback Brian Griese led the 1997 Wolverines to an undefeated season, which was capped by a victory in the Rose Bowl and a share of the national championship.[51] When he enrolled at Michigan, Brady was seventh on the depth chart, and he had an intense struggle to get some playing time. At one point, Brady hired a sports psychologist to help him cope with frustration and anxiety, and even considered transferring to California.[52][53] He worked closely with assistant athletic director Greg Harden, who met with Brady every week to build his confidence and to maximize his performance on the field.[54] Brady told 60 Minutes in 2014: "He will always be somebody I rely on for sound advice and mentorship. He has helped me with my own personal struggles in both athletics and in life. Greg really pushed me in a direction that I wasn't sure I could go."[55]

Under Michigan head coach Lloyd Carr, Brady battled for the starting job with Drew Henson[50] and ultimately started every game in the 1998 and 1999 seasons. During his first full year as starter, he set new Michigan records for most pass attempts and completions in a season, for a total of 214.[56] Brady was All-Big Ten honorable mention both seasons, and was the team captain in his senior year. The Wolverines won 20 of 25 games when he started, and he set a school record for completions in a 31–16 loss against Ohio State in 1998, a season in which Michigan shared the Big Ten Conference title.[57] Brady capped that season with a 45–31 win over Arkansas in the Citrus Bowl.[58]

In the 1999 season, Brady had to once again hold off Henson for the starting job. The two players platooned during the season's first seven games, with Brady playing the first quarter, Henson the second and Carr then deciding upon a quarterback for the second half. The 1999 Michigan Wolverines started with a 5–0 record, including a 26–22 win over Notre Dame, and a road win against eventual powerhouse Wisconsin. Against Michigan State, Brady was not chosen to play the second half; however, he was reinserted into the game with Michigan down by 17 points, and he nearly led Michigan all the way back before losing 34–31.[59] After a 300-yard passing game the following week, Carr went exclusively with Brady for the remainder of the season. Brady went on to lead Michigan to multiple 4th-quarter comebacks, including a remarkable 31–27 win against Penn State, and leading them out of a close game against Indiana, 34–31, heading into the regular season's final game, winners of three straight, earning him the moniker of "Comeback Kid".[60]

Michigan concluded the regular season against Ohio State; this was a dramatic game with a trip to the Orange Bowl on the line. With five minutes left, tied 17–17, Brady led Michigan to the winning score.[61] He led Michigan to an overtime win in the Orange Bowl over Alabama, throwing for 369 yards, four touchdowns, leading the team back from a pair of 14-point deficits in regulation (14–0 in the first half, and 28–14 in the second). He threw the game-winning score on a bootleg to tight end Shawn Thompson. Michigan won the game when Alabama missed an extra point following its own touchdown.[62][63]

In the two seasons that Brady started at Michigan, he posted a 20–5 record, including wins at the Citrus Bowl (1999) and the Orange Bowl (2000). Brady finished his career ranking third in Michigan history with 710 attempts and 442 completions, fourth with 5,351 yards and 62.3 completion percentage, and fifth with 35 touchdown passes

Overview

A lightly regarded prospect coming out of college,[68][69] Brady was selected by the New England Patriots with the 199th overall pick in the sixth round of 2000 NFL Draft and has since spent his entire 20-season career with the Patriots. Brady's tenure with the Patriots is an NFL record for the longest time playing quarterback for one franchise. Despite his less-than-stellar physical abilities as seen at his NFL Scouting Combine performance,[70] Brady's success as a passer has been attributed to his work ethic, pocket awareness, and intelligence.[71]

Since Brady became their starting quarterback in 2001, the Patriots have never had a losing season and have won 17 division titles. The Patriots played in 13 AFC Championship Games from 2001 to 2018—including eight in a row from 2011 to 2018—and won nine of them. Brady and Patriots head coach Bill Belichick have combined to form the most successful quarterback-head coach tandem in NFL history, winning more regular season games and postseason games than any other such duo[72] as well as appearing in nine Super Bowls. All of these events set new NFL records.[73]

In his second season, Brady took over as the starting quarterback after Drew Bledsoe was injured.[74] He led the Patriots to first place in the AFC East[75] and a victory over the favored St. Louis Rams[76][77] in Super Bowl XXXVI, winning his first Super Bowl MVP award. Despite the Patriots' missing the playoffs the following season, Brady would then lead them to back-to-back Super Bowl championships in 2003 and 2004, winning Super Bowl MVP honors again in 2003. Along the way, the Patriots won an NFL-record 21 consecutive games (including the playoffs) between the 2003 and 2004 seasons.[78] The 2005 season was Brady's first to throw for 4,000 yards and lead the NFL in passing.[79] That postseason, Brady would win his 10th consecutive playoff game, another NFL postseason record.[80]

Although Brady and the Patriots continued to win often, they did not return to the Super Bowl until the 2007 season. That year, Brady not only set an NFL record with 50 touchdown passes[81] but he would also lead the Patriots to a 16–0 finish,[82] the first perfect regular-season record since the Miami Dolphins finished 14–0 in 1972.[83][84] Brady would win his first career NFL MVP Award, winning 49 out of 50 votes.[85] The Associated Press also named him Male Athlete of the Year, the first such award given to an NFL player since Joe Montana won it in 1989 and 1990.[86] However, the Patriots suffered their first Super Bowl loss with Brady as quarterback, dropping a 17–14 decision to the New York Giants in Super Bowl XLII.[87]

Brady missed virtually the entire following season due to a knee injury in the season opener.[88] But he would come back strong in the 2009 season to be named the league's Comeback Player of the Year.[89] In 2010, Brady set the NFL record for consecutive passes without an interception (358)[90] and broke his own record for the highest season touchdown-to-interception ratio (among players who have started a full season) at 9:1, currently the third best TD:INT ratio for a single season by a quarterback.[91] Brady would win his second league MVP award with all 50 votes in his favor.[92] He was the first unanimous NFL MVP since Giants linebacker Lawrence Taylor won the award in 1986.[93] He and Joe Montana are the only players in NFL history to win multiple NFL MVP and Super Bowl MVP awards.[94][95] Brady was also named the top player by his peers in the first NFL Top 100 list, released in 2011.[96]

In the 2011 season, Brady led the Patriots to their first AFC Championship since 2007 and appeared in the Super Bowl for a fifth time; but the Patriots would lose again to the Giants.[97] Following AFC Championship Game losses in the following two seasons, Brady and the Patriots made their sixth trip to the Super Bowl after the 2014 season (Brady's 15th as a professional). There, he led the Patriots to a fourth-quarter comeback[98] over the defending champion Seattle Seahawks. He won his fourth Super Bowl trophy and was named Super Bowl MVP for the third time.[99]

Despite missing the first four games of the 2016 season, Brady would lead the Patriots to win 11 out of the 12 remaining regular season games (to finish 14–2) and two postseason games to make his seventh Super Bowl appearance. Brady and the Patriots would overcome a 28–3, 3rd quarter deficit against the Atlanta Falcons to force overtime, winning 34–28 to give Brady his fifth Super Bowl title.[100] He earned his fourth Super Bowl MVP award after setting title-game records for appearances, pass attempts, completions, passing yards and fourth-quarter comebacks.[101] In his eighth appearance, capping the 2017 season, Brady threw for 505 yards, setting a record for most passing yards in a Super Bowl, but the Patriots lost to the Philadelphia Eagles. The Patriots won Super Bowl LIII in 2018, earning Brady his sixth super bowl title, becoming the first player in history to have won six Super Bowls.[102]

Over his career, Brady has won three league MVP awards, six Super Bowls, and four Super Bowl MVP Awards. A 14-time Pro Bowler, Brady has also twice led the NFL in passing yards.[103][104] As of November 2017, he owns the third-highest career passer rating (97.9) among quarterbacks with at least 1,500 career passing attempts.[105] He has thrown for more passing yards and touchdowns than any other quarterback in NFL postseason history; he also has won more playoff games than any other quarterback. As a result of his highly successful career, Brady is rated among the greatest quarterbacks of all time.[106]

Brady's name has become associated with two NFL rules, which sports reporters have called the "Brady rules". One is the tuck rule that was in effect from 1999 through 2013.[107] The other is a rule about low hits enacted in 2009: "A defender cannot initiate a roll or lunge and forcibly hit the passer in the knee area or below, even if he is being contacted by another player."[108]

New England Patriots

2000 season: Rookie year

Brady was selected with pick number 199, a compensatory pick, in the sixth round of the 2000 NFL Draft.[109] He and his family had believed that Brady would be drafted in the second or third round; they watched the draft on television, stunned as six other quarterbacks were drafted before he was. Brady was so embarrassed that he briefly left the family home during the sixth round, and cried when recalling the experience for an interview 11 years later. When the Patriots notified him that he would be drafted, Brady was grateful that, he later said, he would not "have to be an insurance salesman".[110] According to Michael Holley's book Patriot Reign, the Patriots were considering Brady and Tim Rattay, both of whom had received positive reviews from then-quarterbacks coach Dick Rehbein.[111] Ultimately, the Patriots front office chose Brady. Considering his subsequent success, many analysts have called Brady the best NFL draft pick of all time.[112][113][114][115] Patriots owner Robert Kraft recalled: “I still have the image of Tom Brady coming down the old Foxboro Stadium steps with that pizza box under his arm, a skinny beanpole, and when he introduced himself to me and said 'Hi Mr. Kraft,' he was about to say who he was, but I said 'I know who you are, you're Tom Brady. You're our sixth round draft choice,'” recalled Kraft. “And he looked me in the eye and said 'I'm the best decision this organization has ever made.' It looks like he could be right.”[116]

Brady started the season as the fourth-string quarterback, behind starter Drew Bledsoe and backups John Friesz and Michael Bishop; by season's end, he was number two on the depth chart behind Bledsoe.[117] During his rookie season, he was 1-for-3 passing, for six yards.[118] Tight end Rod Rutledge caught Brady's first and only completed pass of the season in a 34–9 loss to the Detroit Lions on November 23.[119][120]

2001 season

With Bledsoe as the starting quarterback, the Patriots opened the season with a 23–17 road loss to the Cincinnati Bengals.[118] In their second game and home opener on September 23, the Patriots squared off against their AFC East rivals, the New York Jets. Bledsoe was again the starter; in the fourth quarter, he suffered internal bleeding after a hit from Jets linebacker Mo Lewis. Bledsoe returned for the next series, but was replaced with Brady for the Patriots' final series of the game. Brady completed five of ten passes for 46 yards, but New York held on to win, 10–3, and the Patriots fell to 0–2 on the season.[121] Brady was named the starter for the season's third game, against the Indianapolis Colts. In his first two games as starter, Brady posted unspectacular passer ratings of 79.6 and 58.7, respectively, in a 44–13 victory over the Colts (in their last season in the AFC East) and a 30–10 loss to the Miami Dolphins.[122][123][124]

In the Patriots' fifth game, Brady began to find his stride. Trailing the visiting San Diego Chargers 26–16 in the fourth quarter, he led the Patriots on two scoring drives to force overtime, and another in overtime to set up a winning field goal. Brady finished the game with 33 of 54, for 364 yards, and two touchdowns, and was named AFC Offensive Player of the Week for the first time in his career.[125][126] The following week, Brady again played well during the rematch at Indianapolis, with a passer rating of 148.3 in a 38–17 win.[127] The Patriots went on to win eleven of the fourteen games Brady started, and six straight to finish the regular season, winning the AFC East and entering the 2001–02 NFL playoffs with a first-round bye.[128] In that stretch was a Week 11 34–17 victory over the New Orleans Saints where he was 19 of 26 for 258 passing yards and four touchdowns to earn his second AFC Offensive Player of the Week nod in 2001.[129] In Week 15, against the Miami Dolphins, he recorded a 23-yard reception from Kevin Faulk on a trick play.[130] Brady finished the 2001 season with 2,843 passing yards and 18 touchdowns and earned an invitation to the 2002 Pro Bowl.[118][131]

2001 postseason

In Brady's first playoff game, he threw for 312 yards against the Oakland Raiders and led the Patriots back from a ten-point fourth-quarter deficit to send the game to overtime, where they won on an Adam Vinatieri field goal. A controversial play occurred in the fourth quarter of that game. Trailing by three points, Brady lost control of the ball after being hit by Raiders cornerback and former Michigan teammate Charles Woodson. Oakland initially recovered the ball, but, citing the "tuck rule," which states that any forward throwing motion by a quarterback begins a pass even if the quarterback loses possession of the ball as he is attempting to tuck it back toward his body, referee Walt Coleman overturned the call on instant replay, ruling it an incomplete pass rather than a fumble.[132] Brady finished the game 32-of-52 for 312 passing yards and one interception.[133]

In the AFC Championship Game against the Pittsburgh Steelers, Brady injured his knee, and was relieved by Bledsoe.[134] The Patriots won the game by a score of 24–17 and were immediately installed by Las Vegas oddsmakers as 14-point underdogs against the NFC champion St. Louis Rams in Super Bowl XXXVI.[135][136]

Brady returned from his knee injury in the AFC Championship Game to start in the Super Bowl a week later at the Louisiana Superdome in New Orleans. Despite being heavy underdogs, the Patriots played well, holding the Rams' high powered offense in check through the first three quarters. The Rams rallied from a 17–3 deficit to tie the game with 1:30 left in regulation. The Patriots then got the ball back at their own 17-yard line with no timeouts remaining. Sportscaster and former Super Bowl-winning coach John Madden said he thought the Patriots should run out the clock and try to win the game in overtime.[137] Instead, Brady drove the Patriots' offense down the field to the Rams' 31-yard line before spiking the ball with seven seconds left. Kicker Adam Vinatieri converted a 48-yard field goal as time expired to give the Patriots a 20–17 win and their first ever league championship.[138] Brady was named MVP of Super Bowl XXXVI while throwing for 145 yards, one touchdown, and no interceptions. At the age of 24 years and six months, Brady surpassed Joe Namath in Super Bowl III and Joe Montana in Super Bowl XVI, who were both 25 years, seven months, and 13 days old at the time of their victories, to earn the title of youngest quarterback to win a Super Bowl.[139][140] A possible quarterback controversy was averted when Bledsoe was traded to the Buffalo Bills during the offseason; this event cemented Brady's status as the starting quarterback.[141]

2002 season

In the 2002 season opener, Brady had 294 passing yards and three touchdowns in the 30–14 victory over the Pittsburgh Steelers to earn his third AFC Offensive Player of the Week title.[142][143] In Week 9, in a 38–7 victory over the Buffalo Bills, he had 265 passing yards and three touchdowns to earn another AFC Offensive Player of the Week nod.[144][145] Brady and the Patriots finished the year at 9–7, tied with the New York Jets and Miami Dolphins for the best record in the division; however, the Jets won the division on the third tiebreaker, and the Patriots missed the playoffs.[146]

Though Brady posted a career-low single-season passer rating of 85.7 and a career-high of 14 interceptions, he threw for a league-leading 28 touchdown passes and 921 more yards than in the 2001 season.[122]

2003 season

After opening the 2003 NFL season with a 2–2 start, Brady led the Patriots to twelve consecutive victories to finish the regular season in winning the AFC East.[147] In Week 9, against the Denver Broncos, he had 350 passing yards, three touchdowns, and one interception in the 30–26 victory to earn his fifth AFC Offensive Player of the Week honor.[148][149] In Week 14, a 12–0 victory against the Miami Dolphins, he recorded a 36-yard punt in the game.[150] Statistically, Brady's strongest game of the season was in Week 17 against the division rival Buffalo Bills, when he achieved a season-high quarterback rating of 122.9, and was named AFC Offensive Player of the Week.[122][151] Brady finished with 3,620 passing yards and 23 touchdowns,[118] and was third in NFL MVP voting to co-winners Peyton Manning and Steve McNair.[152]

2003 postseason

In the first two rounds of the playoffs, the Patriots defeated the Tennessee Titans in the Divisional Round by a score of 17–14. In the win, Brady was 21 of 41 for 201 passing yards and one passing touchdown.[153] In the following round, they defeated Indianapolis Colts in the AFC Championship by a score of 24–14. Brady completed 22 of 37 passes for 237 yards, one passing touchdown, and an interception.[154] On February 1, 2004, Brady led the Patriots to a 32–29 victory over the NFC champion Carolina Panthers in Super Bowl XXXVIII and was named Super Bowl MVP for the second time. During the game, Brady threw for 354 yards with three touchdowns and set the record for most completions by a quarterback in a Super Bowl with 32. With 1:08 left in the fourth quarter and the score tied 29–29, Brady engineered a drive with five pass completions to put the Patriots in position for the game-winning 41-yard field goal by Vinatieri.[155][156]

2004 season

During the 2004 season, Brady helped the Patriots set an NFL record with 21 straight wins dating from the previous year, an accomplishment honored in the Pro Football Hall of Fame (though for official records, the NFL considers it an 18-game regular season winning streak; it does not count playoff games).[157] New England finished with a 14–2 record, equaling their 2003 record and the best regular-season record ever for a defending champion.[158] The Patriots also won the AFC East divisional title for the third time in four years.[159] Brady threw for 3,692 yards and 28 touchdowns, with a 92.6 passer rating, and was voted to his second Pro Bowl.[118]

2004 postseason

In the playoffs, Brady led the Patriots to victories over the Indianapolis Colts in the Divisional Round by a score of 20–3 and the Pittsburgh Steelers in the AFC Championship by a score of 41–27.[160] Brady played his best game of the year in Pittsburgh despite requiring intravenous treatment the previous night when he ran a temperature of 103°.[161] Against the NFL's best defense,[160] he recorded a quarterback passer rating of 130.5, his highest of the season.[122] On February 6, 2005, the Patriots narrowly defeated the Philadelphia Eagles, 24–21, to win Super Bowl XXXIX at Alltel Stadium in Jacksonville, Florida. Brady threw for 236 yards and two touchdowns[162] while capturing the Patriots' third championship in four years. They became the first franchise since the Dallas Cowboys in 1992–1995 to win three Super Bowls in four years.[163]

2005 season

During the 2005 season, injuries suffered by running backs Corey Dillon, Patrick Pass, and Kevin Faulk forced the Patriots to rely more on Brady's passing.[164][165] Brady also had to adjust to new center Russ Hochstein and running back Heath Evans. On October 9, in a 31–28 victory over the Atlanta Falcons, he had 350 passing yards, three touchdowns, and one interception to earn AFC Offensive Player of the Week honors.[166][167] Brady finished first in the league with 4,110 passing yards and third in the league with 26 touchdowns.[118] At 92.3, his 2005 passer rating was the second-highest of his career at the time, although he equaled his career high for interceptions with 14.[122] He rushed for 89 yards and fumbled a career-low four times.[122] He and the Patriots finished with a 10–6 record, winning their third straight AFC East title.[168] He was named to his third Pro Bowl at the end of the season.[169]

2005 postseason

In the playoffs, Brady recorded 201 passing yards and three passing touchdowns to help lead the Patriots to a 28–3 victory over the Jacksonville Jaguars in the Wild Card Round. On January 14, 2006, the Patriots lost 27–13 to the Denver Broncos at INVESCO Field in the Divisional Round.[170][171] Brady threw for 341 yards in the game with one touchdown and two interceptions, in the first playoff loss of his career after ten playoff victories.[172] After the season's end, it was revealed that Brady had been playing with a sports hernia since December. Linebacker Willie McGinest commented on it and said he knew, but Brady continued playing

ربو

ربو

هو مرض التهابي مُزمن شائِع، يُصيب الشُعب الهوائية في الرئتين. يَتميز بحدوثِ أعراضٍ مُتغيرةٍ مُتكررة، مع حدوثِ تشنجٍ قصبي وانسدادٍ في المسلك الهوائي قابلٍ للانعكاس، كما تشمل الأعراض نوباتٍ من الأزيز والسُعال وضيق النفس والصدر، وقد تحدثُ هذه النوبات عدةَ مراتٍ في اليوم أو في الأسبوع، وقد تَزدادُ سواءً في الليل أو مع ممارسةِ الرياضة، وهذا كُله يعتمد على الشَخص المُصاب.

يُعتقد أنَّ الربو يحدث بسبب مجموعةِ عوامل وراثية وبيئية، ويُعتبر التعرض لتلوث الهواء ومولدات الحساسية من العوامل البيئية، كما أنَّ الأسبرين ومحصرات البيتا من العوامل المُثيرة لحدوث الربو. عادةً ما يعتمد تشخيص الربو على نمط الأعراض والاستجابة للعلاج على طول الوقت، كما يُستخدم قياس التنفس في التشخيص. يُصنف الربو بناءً على تكرار الأعراض، والحجم الزفيري القسري في ثانية واحدة (FEV1)، ومعدل ذروة التدفق الزفيري، وقد يُصنف أيضًا اعتمادًا على التأتب أو عدم التأتب، حيثُ يُشير التأتب إلى الجاهزية لحدوث فرط التحسس من النمط الأول.

لا يوجد عِلاج جذريّ للرَّبو، لكن يمكن منع الأعراض بتجنُّب المُحرِّضات مثل المُسْتَأرِجات والمُهَيِّجات وباستعمال الستِيرويداتِ القِشْرِيَّة الاستنشاقيَّة. يمكن استعمال ناهضات بيتا مديدة المَفعول (LABA) أو العوامِل المُضادَّة للوكوترين بالتشارُك مع الستِيرويداتِ القِشْرِيَّة الاستنشاقيَّة إذا لم نستطع التحكُّم بأعراض الرَّبو. وعادةً ما تُعالَج الأعراض المُتفاقِمة السُّوء بسرعة باستعمال ناهضات-بيتا2 الأَدْرينِيَّة قصيرة المفعول مثل سالبوتامول والستِيرويداتِ القِشْرِيَّة الفمويَّة، وفي الحالات الشديدة تعطى الستِيرويداتِ القِشْرِيَّة الوريديَّة وكبريتات المغنسيوم وقد تلزم الإقامة بالمُستشفى.

تخطَّى عدد مرضى الرَّبو في عام 2015 عالميًّا 358 مِليون شخص مقارنةً بـ 183 مليون في عام 1990، حيث سَبَّب حوالي 397,100 حالة وفاة سنة 2015، وحدث أغلبها في الدُّول النَّامية. غالبًا ما يبدأ المرض في مرحلة الطفولة. ولقد زادت مُعَدَّلات حدوث نوبات الرَّبو على نحوٍ مَلحوظ منذ الستينيَّات ~1960. عَرَف المِصريون القُدماء الرَّبو، وأُخِذَت التسمية الإنجليزية «asthma» من الكلمة الإغريقيّة ἅσθμα وتلفظ «ásthma» والَّتي تعني «اللُّهاث»

يَتميز الربو بحدوثِ نوباتٍ مُتكررة من الأزيز والسُعال وضيق النفس والصدر، كما قد تُنتج الرئتين البَلغَم عن طريق السُعال ولكن غالبًا يَصعُب ظهوره، أما أثناءِ الشِفاء من النوبة، فإنهُ قد يبدو شبيهًا بالقيح؛ بسببِ المستوياتِ العالية لخلايا الدمِ البيضاء والتي تُسمى الحَمِضات. عادةً ما تكونُ الأعراضُ أسوأ في الليل وفي الصباحِ الباكر، أو تزدادُ سوءً أثناء التمرينِ أو التعرضِ لهواءٍ بارد. بعضُ المُصابين بالربو نادرًا ما تحدثُ لهم الأعراض، ولكن بعضٌ آخر قد تحدث لهم أعراضٍ ملحوظة ومستمرة.

حالاتٌ طبية مرتبطة

تحدثُ بعضُ الحالات الصِحية الأُخرى بشكلٍ مُتكررٍ في الأشخاصِ الذين يعانون من الربو، ومنها الارتجاعُ المعدي المريئي والتهاب الجيوب وانقطاع النفس الانسدادي النومي، كما أنهُ من الشائعِ حدوث الاضطرابات النفسية أيضًا، حيثُ إنَّ اضطرابات القلق تحدثُ في 16–52% واضطرابات المزاج في 14–41%، وعلى الرغم من ذلك، إلا أنهُ من غير المعروف إن كان الربو يُسبب الاضطرابات النفسية؛ أمَّ أنّ الاضطرابات النفسية تُسبب الربو. الأشخاص المُصابون بالربو، وخاصةً إذا كان الربو غير مضبوط جيدًا، فإنهُم مُعرضون بشكلٍ كبير لردودِ فعلٍ سيئة تُجاه المواد الظليلة (العتيمة للأشعة).

الأسباب

يَحدث الربو نتيجةً لمجموعةٍ من ردودِ الفعل البيئية والوراثية المُعقدة غير المفهومة كاملًا، حيثُ تؤثرُ على حدةِ واستجابة الربو للعلاج. يُعتقدُ بأنَّ الزيادةَ الأخيرة في معدلاتِ الربو؛ ترجعُ إلى تَغيُراتٍ في عواملِ التخلق المتوالي (عواملُ وراثية تختلفُ عن تلكَ العوامل المرتبطة بتسلسل الحمض النووي الريبوزي منقوص الأكسجين) وفي بيئة المعيشة. عادةً ما يرتبطُ ظهور الربو قبل سن 12 عامًا بعواملِ جينية، أما ظُهوره بعد 12 عامًا يكونُ بسببِ عوامل بيئية.

البيئية

تَرتبطُ العديدُ من العواملِ البيئية مع تَطور وتفاقم الربو، وتتضمن مولداتِ الحساسية وملوثاتِ الهواء والمواد الكيمائية البيئية الأُخرى. يرتبطُ التدخينُ أثناءَ الحمل وبعدَ الولادة بخطرِ حدودثِ أعراضٍ مُشابهةٍ للربو. يُعتبر انخفاضُ جودةِ الهواء بسببِ بعض العواملِ كالتلوث الناجمِ عن المركبات أو ارتفاعُ مستوياتِ الأوزون، من العواملِ المؤثرةِ على تطورِ الربو وزيادةِ شدته، حيثُ وجدَ أنَّ أكثرَ من نصفِ حالات الأطفال المُصابين بالربو في الولايات المتحدة تحدثُ في المناطقِ ذات جودةِ الهواءِ الأقل من معاييرِ وكالة حماية البيئة الأمريكية، ويزدادُ انخفاضُ جودةِ الهواء في المجتمعاتِ ذاتِ الدخل المنخفض والأقليات.

قد يكونُ التعرضُ للمركباتِ العضوية المُتطايرة في الأماكنِ المُغلقة من مُحفزاتٍ حدوث الربو، فمثلًا، التعرضُ للفورمالدهيد لهُ صلةٌ إيجابية مع حدوثِ الربو، كما أن بعض الفثالات الموجودة في أنواعٍ مُعينة من الكلوريدات مُتعددة الفاينيل ترتبطُ مع حدوثِ الربو في الأطفال والبالغين، أما العلاقة بينَ التعرضُ لمبيدات الآفات وحدوث الربو، فلا تزالُ غير واضحة حتى الآن.

تُوجد علاقةٌ بين الربو واستعمال دواء الأسيتامينوفين (الباراسيتامول)، ولكن جميع الأدلة لا تدعمُ ذلك، ولكنها تدعمُ دورًا سببيًا. وجدت مُراجعة سنة 2014 أنَّ هذه العلاقة قد اختفت عندَ أخذِ حدوث العدوى التنفسية في الاعتبار، كما أنَّ استخدام الأمِ له أثناءَ الحمل يرتبط مع زيادةِ خطر حدوث التوتر النفسي أثناءَ الحمل.

يرتبطُ حدوث الربو مع التعرضِ لمولدات الحساسية في الأماكنِ المُغلقة، والتي تتضمن العَفن وعثة الغبار والصراصير والوَبَغ الحيواني (أجزء من فراء أو ريش الحيوانات). وُجدت طرقٌ لتقليل فعالية عثِ الغبار، بحيث تُصبح غير فعالة في إظهار أعراض المواضيع الحساسة. أنواعٌ معينة من عداوى الفيروسات التنفسية مثل الفيروس الأنفي والفيروس المخلوي التنفسي، قد تزيدُ من خطرِ حدوث الربو في الأطفال الصغار، ولكن أنواعٌ أخرى من العداوى قد تُقلل من خطرِ حدوث الربو.

الفرضية الصحية

تُحاول الفرضية الصحية تفسيرَ زيادةِ معدلاتِ الربو عالميًا، كنتيجةٍ مُباشرةٍ غير مقصودة لانخفاضِ التعرض للبكتيريا والفيروسات غير المُسببة للمرض في مرحلةِ الطفولة. اقتُرحَ أنَّ انخفاض التعرض للبكتيريا والفيروسات حدثَ كنتيجةٍ جزئيةٍ لزيادةِ النظافة وانخفاضِ حجم الأسرة في المُجتمعات الحديثة، كما أنَّ التعرض لذيفان البكتيريا الداخلي في مرحلة الطفولة المُبكرة، قد يُساعدُ على منع حدوث الربو، ولكن التعرض في سنٍ أكبر قد يُحفز حدوث التضيق القَصبي. هُناك أدلةٌ أخرى تدعم الفرضية الصحية، وتتضمن انخفاضَ معدلاتِ الربو في المزارعِ والأسر التي تمتلكُ حيواناتٍ أليفة.

يرتبطُ استعمالُ المضادات الحيوية مُبكرًا في الحياة مع حدوث الربو. أيضًا وجد أنَّ الولادة القيصرية ترتبط مع زيادةِ خطر حدوث الربو (حوالي 20-80%)؛ تُعزى هذه الزيادة إلى نقصِ المستعمراتِ البكتيرية الطبيعية والتي يكتَسِبها المَولود أثناء مروره عبر قناةِ الولادة. هُناك أيضًا علاقةٌ بين الربو ومستوى ترفِ حياة الفرد، والتي قد ترتبط بالفرضية الصحية؛ لأنَّ الأفراد الأقل ترفًا غالبًا ما يكونون أكثرَ عُرضةً للبكتيريا والفيروسات.

الجينية

يُعد التاريخ العائلي من عواملِ خطر حدوثِ الربو، كما أنَّ هُناك العديد من الجينات المؤَثِرة. إذا كانَ أحد التوأمَين المُتماثلَين مُصابًا، فإنَّ احتمال إصابة الآخر بالمرض حوالي 25%. في نهايةِ عام 2005، حُدد ارتباطُ 25 جين بالربو في ست مجموعاتٍ سكانية مُنفصلة أو أكثر، وتتضمن ناقلة سلفيد الجلوتاثيون مو 1 (GSTM1) وإنترلوكين-10 (IL10) والبروتين المرتبط بالخلايا اللمفاوية التائية السامة 4 (CTLA-4) والنوع الخامس من كازال مثبط بروتياز السيرين (SPINK5) ومخلق لوكوتريين سي4 (LTC4S) ومستقبل الإنترلوكين-2 (IL4R) ونطاق الديسنتجرين والبروتيناز الفلزي المحتوي على البروتين 33 (ADAM33) وغيرها. ترتبط العديدُ من هذه الجينات مع الجهازِ المناعي أو الالتهاب المُحور، وعلى الرغم من تدعيم قائمة الجينات هذه بدراساتٍ مُتكررة كثيرة، إلا أنَّ النتائج لم تكن مُتسقة بين جميع السُكان الذين اختُبروا. في عام 2006 رُبط أكثر من 100 جين مع الربو في دراسةِ الترابط الجيني وحده، كما يُمكن العثور على أكثر من ذلك باستمرار الدراسة.

قد تُسبب بعضُ المتغيرات الجينية الربو فقط في حالِ اجتماعِها مع تعرضٍ بيئيٍ مُحدد، ومثالُ ذلك تعدد أشكال النوكليوتيدات المفردة في منطقةِ عنقود تمايز 14 (CD14) والتعرضُ لذيفانٍ داخلي (منتَجٌ بكتيري)، حيثُ إنَّ التعرض للذيفانِ الداخلي يُمكن أن يحدثَ من عدةِ مصادرَ بيئية والتي تتضمنُ التدخين والكلاب والمزارع، وبعد ذلك يُحدد خطرُ الإصابة بالربو عن طريقِ جيناتِ الشخص ومستوى تعرضه للذيفان الداخلي.

حالات طبية

التأتب هيَ حالةٌ تتضمن ثالوثًا طبيًا من الربو والتهاب الجلد التأتبي وحساسية الأنف، وتُعتبر الأمراض التأتبية أقوى عاملِ خطرٍ لحدوث الربو، ويزداد الخطرُ كثيرًا في حال وجودِ إكزيما وحمى الكلأ. يرتبطُ الربو مع الورام الحبيبي والتهاب الأوعية (المعروف سابقًا باسم متلازمة شيرغ-ستراوس)، وهو مرضٌ مناعيٌ ذاتي مع التهابٍ وعائي. قد يُعاني بعض الأفراد المُصابون بأنواعٍ معنية من الشرى من أعراضِ الربو.

هُناك علاقةٌ مُتبادلة بين السمنة وخطرِ حدوث الربو مع زيادة كلٍ منهما في السنواتِ الأخيرة، حيثُ قد تكونُ هناك العديد من العوامل التي تلعبُ دورًا، ومنها انخفاضُ وظائف الجهاز التنفسي نتيجةً لتراكمِ الدهون، أيضًا حقيقة أنَّ الأنسجة الدهنية تؤدي إلى حالةٍ معززة للالتهاب.

يُمكن للأدوية مُحصرة البيتا مثل البروبرانولول أن تُحفز حدوث الربو في الأشخاص المُعرضين للإصابة، وعلى الرغمِ من ذلك فإنَّ محصرات البيتا قلبية الانتقاء تظهر آمنةً مع الأشخاص المُصابين بحالةٍ طفيفة أو متوسطة من المرض. تتضمن الأدوية الأخرى التي قد تُسبب مشاكلًا لدى مُصابي الربو مثبطات الإنزيم المحول للأنجيوتنسين والأسبرين والأدوية اللاستيرويدية المضادة للالتهاب، كما أنَّ استعمال الأدوية الكابتة للحمض (مثبطات مضخة البروتون ومضادات مستقبلات الهستامين 2) خلال فترةِ الحمل، قد يرتبطُ مع زيادة خطرِ حدوث الربو لدى الطفل.

التفاقم

يُصاب بعضُ الأشخاصِ بدايةً بحالةِ الربو المُستقر والتي تستمر لأسابيع أو أشهر، ثم تتطور فجأةً إلى نوبة من الربو الحاد، وتختلفُ ردودُ فعل الأفراد نتيجةً لبعضِ العوامل المُختلفة، حيثُ قد تتفاقم الحالة لدى البعض بشكلٍ شديد؛ نتيجةً لعواملِ محفزة مُختلفة.

هُناك بعض العوامل المنزلية والتي قد تُساعد في تفاقمِ الربو ومنها الغبار ووبغ الحيوان (خاصةً شعر الكلاب والقطط) والعفن والصراصير المولدة للحساسية. تُعتبر العطور من الأسباب الرئيسية لحدوثِ هجمات الربو الحادة في النساء والأطفال. يُمكن للعدواى الفيروسية والبكتيرية التي تصيب الجهاز التنفسي العلوي أن تزيد من سوء المرض. قد يزيدُ الضغط النفسي من سوءِ الأعراض، حيث يُعتقدُ أنَّ الضغط النفسي يُأثرُ على جهازِ المناعة، وبالتالي يزيدُ من الاستجابة الالتهابية للمسلَكِ الهوائي لمسبباتِ الحساسية والمُهيجات.

الفيزيولوجيا المرضية

Asthma

Asthma

 is a common long-term inflammatory disease of the airways of the lungs.[3] It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms.[10][11] Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath.[2] These may occur a few times a day or a few times per week.[3] Depending on the person, asthma symptoms may become worse at night or with exercise.[3]

Asthma is thought to be caused by a combination of genetic and environmental factors.[4] Environmental factors include exposure to air pollution and allergens.[3] Other potential triggers include medications such as aspirin and beta blockers.[3] Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing.[5] Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate.[12] It may also be classified as atopic or non-atopic, where atopy refers to a predisposition toward developing a type 1 hypersensitivity reaction.[13][14]

There is no cure for asthma.[3] Symptoms can be prevented by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids.[6][15] Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled.[16][17] Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta-2 agonist such as salbutamol and corticosteroids taken by mouth.[7] In very severe cases, intravenous corticosteroids, magnesium sulfate, and hospitalization may be required.[18]

In 2015, 358 million people globally had asthma, up from 183 million in 1990.[8][19] It caused about 397,100 deaths in 2015,[9] most of which occurred in the developing world.[3] Asthma often begins in childhood,[3] and the rates have increased significantly since the 1960s.[20] Asthma was recognized as early as Ancient Egypt.[21] The word "asthma" is from the Greek ἅσθμα, ásthma, which means "panting"

Asthma is characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing.[23] Sputum may be produced from the lung by coughing but is often hard to bring up.[24] During recovery from an asthma attack (exacerbation), it may appear pus-like due to high levels of white blood cells called eosinophils.[25] Symptoms are usually worse at night and in the early morning or in response to exercise or cold air.[26] Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may react frequently and readily and experience persistent symptoms.[27]

Associated conditions

A number of other health conditions occur more frequently in people with asthma, including gastro-esophageal reflux disease (GERD), rhinosinusitis, and obstructive sleep apnea.[28] Psychological disorders are also more common,[29] with anxiety disorders occurring in between 16–52% and mood disorders in 14–41%.[30] It is not known whether asthma causes psychological problems or psychological problems lead to asthma.[31] Those with asthma, especially if it is poorly controlled, are at increased risk for radiocontrast reactions.[32]

Cavities occur more often in people with asthma.[33] This may be related to the effect of beta 2 agonists decreasing saliva.[34] These medications may also increase the risk of dental erosions.[34]

Causes

Asthma is caused by a combination of complex and incompletely understood environmental and genetic interactions.[4][35] These influence both its severity and its responsiveness to treatment.[36] It is believed that the recent increased rates of asthma are due to changing epigenetics (heritable factors other than those related to the DNA sequence) and a changing living environment.[37] Asthma that starts before the age of 12 years old is more likely due to genetic influence, while onset after age 12 is more likely due to environmental influence.[38]

Environmental

Many environmental factors have been associated with asthma's development and exacerbation, including, allergens, air pollution, and other environmental chemicals.[39] Smoking during pregnancy and after delivery is associated with a greater risk of asthma-like symptoms.[40] Low air quality from environmental factors such as traffic pollution or high ozone levels[41] has been associated with both asthma development and increased asthma severity.[42] Over half of cases in children in the United States occur in areas when air quality is below the EPA standards.[43] Low air quality is more common in low-income and minority communities.[44]

Exposure to indoor volatile organic compounds may be a trigger for asthma; formaldehyde exposure, for example, has a positive association.[45] Phthalates in certain types of PVC are associated with asthma in both children and adults.[46][47] While exposure to pesticides is linked to the development of asthma, a cause and effect relationship has yet to be established.[48][49]

The majority of the evidence does not support a causal role between acetaminophen (paracetamol) or antibiotic use and asthma.[50][51] A 2014 systematic review found that the association between acetaminophen use and asthma disappeared when respiratory infections were taken into account.[52] Acetaminophen use by a mother during pregnancy is also associated with an increased risk of the child developing asthma.[53] Maternal psychological stress during pregnancy is a risk factor for the child to develop asthma.[54]

Asthma is associated with exposure to indoor allergens.[55] Common indoor allergens include dust mites, cockroaches, animal dander (fragments of fur or feathers), and mold.[56][57] Efforts to decrease dust mites have been found to be ineffective on symptoms in sensitized subjects.[58][59] Weak evidence suggests that efforts to decrease mold by repairing buildings may help improve asthma symptoms in adults.[60] Certain viral respiratory infections, such as respiratory syncytial virus and rhinovirus,[22] may increase the risk of developing asthma when acquired as young children.[61] Certain other infections, however, may decrease the risk.[22]

Hygiene hypothesis

The hygiene hypothesis attempts to explain the increased rates of asthma worldwide as a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses.[62][63] It has been proposed that the reduced exposure to bacteria and viruses is due, in part, to increased cleanliness and decreased family size in modern societies.[64] Exposure to bacterial endotoxin in early childhood may prevent the development of asthma, but exposure at an older age may provoke bronchoconstriction.[65] Evidence supporting the hygiene hypothesis includes lower rates of asthma on farms and in households with pets.[64]

Use of antibiotics in early life has been linked to the development of asthma.[66] Also, delivery via caesarean section is associated with an increased risk (estimated at 20–80%) of asthma – this increased risk is attributed to the lack of healthy bacterial colonization that the newborn would have acquired from passage through the birth canal.[67][68] There is a link between asthma and the degree of affluence which may be related to the hygiene hypothesis as less affluent individuals often have more exposure to bacteria and viruses.[69]

Genetic

Family history is a risk factor for asthma, with many different genes being implicated.[71] If one identical twin is affected, the probability of the other having the disease is approximately 25%.[71] By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1, IL10, CTLA-4, SPINK5, LTC4S, IL4R and ADAM33, among others.[72] Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested.[72] In 2006 over 100 genes were associated with asthma in one genetic association study alone;[72] more continue to be found.[73]

Some genetic variants may only cause asthma when they are combined with specific environmental exposures.[4] An example is a specific single nucleotide polymorphism in the CD14 region and exposure to endotoxin (a bacterial product). Endotoxin exposure can come from several environmental sources including tobacco smoke, dogs, and farms. Risk for asthma, then, is determined by both a person's genetics and the level of endotoxin exposure.[70]

Medical conditions

A triad of atopic eczema, allergic rhinitis and asthma is called atopy.[74] The strongest risk factor for developing asthma is a history of atopic disease;[61] with asthma occurring at a much greater rate in those who have either eczema or hay fever.[75] Asthma has been associated with eosinophilic granulomatosis with polyangiitis (formerly known as Churg–Strauss syndrome), an autoimmune disease and vasculitis.[76] Individuals with certain types of urticaria may also experience symptoms of asthma.[74]

There is a correlation between obesity and the risk of asthma with both having increased in recent years.[77][78] Several factors may be at play including decreased respiratory function due to a buildup of fat and the fact that adipose tissue leads to a pro-inflammatory state.[79]

Beta blocker medications such as propranolol can trigger asthma in those who are susceptible.[80] Cardioselective beta-blockers, however, appear safe in those with mild or moderate disease.[81][82] Other medications that can cause problems in asthmatics are angiotensin-converting enzyme inhibitors, aspirin, and NSAIDs.[83] Use of acid suppressing medication (proton pump inhibitors and H2 blockers) during pregnancy is associated with an increased risk of asthma in the child.[84]

Exacerbation

Some individuals will have stable asthma for weeks or months and then suddenly develop an episode of acute asthma. Different individuals react to various factors in different ways.[85] Most individuals can develop severe exacerbation from a number of triggering agents.[85]

Home factors that can lead to exacerbation of asthma include dust, animal dander (especially cat and dog hair), cockroach allergens and mold.[85][86] Perfumes are a common cause of acute attacks in women and children. Both viral and bacterial infections of the upper respiratory tract can worsen the disease.[85] Psychological stress may worsen symptoms – it is thought that stress alters the immune system and thus increases the airway inflammatory response to allergens and irritants.[42][87]

Asthma exacerbations in school‐aged children peak in autumn, shortly after children return to school. This might reflect a combination of factors, including poor treatment adherence, increased allergen and viral exposure, and altered immune tolerance. There is limited evidence to guide possible approaches to reducing autumn exacerbations, but while costly, seasonal omalizumab treatment from four to six weeks before school return may reduce autumn asthma exacerbations.[88]

Pathophysiology

Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway and the classic symptoms of wheezing. The narrowing is typically reversible with or without treatment. Occasionally the airways themselves change.[23] Typical changes in the airways include an increase in eosinophils and thickening of the lamina reticularis. Chronically the airways' smooth muscle may increase in size along with an increase in the numbers of mucous glands. Other cell types involved include: T lymphocytes, macrophages, and neutrophils. There may also be involvement of other components of the immune system including: cytokines, chemokines, histamine, and leukotrienes among others.

Diagnosis

While asthma is a well-recognized condition, there is not one universal agreed upon definition.[22] It is defined by the Global Initiative for Asthma as "a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment".[23]

There is currently no precise test for the diagnosis, which is typically based on the pattern of symptoms and response to therapy over time.[5][22] A diagnosis of asthma should be suspected if there is a history of recurrent wheezing, coughing or difficulty breathing and these symptoms occur or worsen due to exercise, viral infections, allergens or air pollution.[89] Spirometry is then used to confirm the diagnosis.[89] In children under the age of six the diagnosis is more difficult as they are too young for spirometry.[90]

Spirometry

Spirometry is recommended to aid in diagnosis and management.[91][92] It is the single best test for asthma. If the FEV1 measured by this technique improves more than 12% and increases by at least 200 milliliters following administration of a bronchodilator such as salbutamol, this is supportive of the diagnosis. It however may be normal in those with a history of mild asthma, not currently acting up.[22] As caffeine is a bronchodilator in people with asthma, the use of caffeine before a lung function test may interfere with the results.[93] Single-breath diffusing capacity can help differentiate asthma from COPD.[22] It is reasonable to perform spirometry every one or two years to follow how well a person's asthma is controlled.[94]

Others

The methacholine challenge involves the inhalation of increasing concentrations of a substance that causes airway narrowing in those predisposed. If negative it means that a person does not have asthma; if positive, however, it is not specific for the disease.[22]

Other supportive evidence includes: a ≥20% difference in peak expiratory flow rate on at least three days in a week for at least two weeks, a ≥20% improvement of peak flow following treatment with either salbutamol, inhaled corticosteroids or prednisone, or a ≥20% decrease in peak flow following exposure to a trigger.[95] Testing peak expiratory flow is more variable than spirometry, however, and thus not recommended for routine diagnosis. It may be useful for daily self-monitoring in those with moderate to severe disease and for checking the effectiveness of new medications. It may also be helpful in guiding treatment in those with acute exacerbations.[96]

Classification

Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate.[12] Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic).[13] While asthma is classified based on severity, at the moment there is no clear method for classifying different subgroups of asthma beyond this system.[97] Finding ways to identify subgroups that respond well to different types of treatments is a current critical goal of asthma research.[97]

Although asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary disease, as this term refers specifically to combinations of disease that are irreversible such as bronchiectasis and emphysema.[98] Unlike these diseases, the airway obstruction in asthma is usually reversible; however, if left untreated, the chronic inflammation from asthma can lead the lungs to become irreversibly obstructed due to airway remodeling.[99] In contrast to emphysema, asthma affects the bronchi, not the alveoli.[100]

Asthma exacerbation

An acute asthma exacerbation is commonly referred to as an asthma attack. The classic symptoms are shortness of breath, wheezing, and chest tightness.[22] The wheezing is most often when breathing out.[102] While these are the primary symptoms of asthma,[103] some people present primarily with coughing, and in severe cases, air motion may be significantly impaired such that no wheezing is heard.[101] In children, chest pain is often present.[104]

Signs occurring during an asthma attack include the use of accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck), there may be a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest.[105] A blue color of the skin and nails may occur from lack of oxygen.[106]

In a mild exacerbation the peak expiratory flow rate (PEFR) is ≥200 L/min, or ≥50% of the predicted best.[107] Moderate is defined as between 80 and 200 L/min, or 25% and 50% of the predicted best, while severe is defined as ≤ 80 L/min, or ≤25% of the predicted best.[107]

Acute severe asthma, previously known as status asthmaticus, is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids.[108] Half of cases are due to infections with others caused by allergen, air pollution, or insufficient or inappropriate medication use.[108]

Brittle asthma is a kind of asthma distinguishable by recurrent, severe attacks.[101] Type 1 brittle asthma is a disease with wide peak flow variability, despite intense medication. Type 2 brittle asthma is background well-controlled asthma with sudden severe exacerbations.[101]

Exercise-induced

Exercise can trigger bronchoconstriction both in people with or without asthma.[109] It occurs in most people with asthma and up to 20% of people without asthma.[109] Exercise-induced bronchoconstriction is common in professional athletes. The highest rates are among cyclists (up to 45%), swimmers, and cross-country skiers.[110] While it may occur with any weather conditions, it is more common when it is dry and cold.[111] Inhaled beta2-agonists do not appear to improve athletic performance among those without asthma,[112] however, oral doses may improve endurance and strength.[113][114]

Occupational

Asthma as a result of (or worsened by) workplace exposures is a commonly reported occupational disease.[115] Many cases, however, are not reported or recognized as such.[116][117] It is estimated that 5–25% of asthma cases in adults are work-related. A few hundred different agents have been implicated, with the most common being: isocyanates, grain and wood dust, colophony, soldering flux, latex, animals, and aldehydes. The employment associated with the highest risk of problems include: those who spray paint, bakers and those who process food, nurses, chemical workers, those who work with animals, welders, hairdressers and timber workers.[115]

Aspirin-induced asthma

Aspirin-exacerbated respiratory disease (AERD), also known as aspirin-induced asthma, affects up to 9% of asthmatics.[118] AERD consists of asthma, nasal polyps, sinus disease, and respiratory reactions to aspirin and other NSAID medications (such as ibuprofen and naproxen).[119] People often also develop loss of smell and most experience respiratory reactions to alcohol.[120]

Alcohol-induced asthma

Alcohol may worsen asthmatic symptoms in up to a third of people.[121] This may be even more common in some ethnic groups such as the Japanese and those with aspirin-induced asthma.[121] Other studies have found improvement in asthmatic symptoms from alcohol.[121]

Non-atopic asthma

Non-atopic asthma, also known as intrinsic or non-allergic, makes up between 10 and 33% of cases. There is negative skin test to common inhalant allergens and normal serum concentrations of IgE. Often it starts later in life, and women are more commonly affected than men. Usual treatments may not work as well.[122]

Differential diagnosis

Many other conditions can cause symptoms similar to those of asthma. In children, other upper airway diseases such as allergic rhinitis and sinusitis should be considered as well as other causes of airway obstruction including foreign body aspiration, tracheal stenosis, laryngotracheomalacia, vascular rings, enlarged lymph nodes or neck masses.[123] Bronchiolitis and other viral infections may also produce wheezing.[124] In adults, COPD, congestive heart failure, airway masses, as well as drug-induced coughing due to ACE inhibitors should be considered. In both populations vocal cord dysfunction may present similarly.[123]

Chronic obstructive pulmonary disease can coexist with asthma and can occur as a complication of chronic asthma. After the age of 65, most people with obstructive airway disease will have asthma and COPD. In this setting, COPD can be differentiated by increased airway neutrophils, abnormally increased wall thickness, and increased smooth muscle in the bronchi. However, this level of investigation is not performed due to COPD and asthma sharing similar principles of management: corticosteroids, long-acting beta-agonists, and smoking cessation.[125] It closely resembles asthma in symptoms, is correlated with more exposure to cigarette smoke, an older age, less symptom reversibility after bronchodilator administration, and decreased likelihood of family history of atopy

Cineworld

Cineworld

is the world’s second largest cinema chain, with 9,518 screens across 790 sites[3] in 11 countries:[4] the UK, the US, Canada, Ireland, Poland, Romania, Israel, Hungary, Czechia, Bulgaria and Slovakia.[3][5] The group’s primary brands are Regal[6] (in the US), Cineworld and Picturehouse (in the UK & Ireland), Cinema City (throughout Europe) and Yes Planet (in Israel).

As of March 2018, Cineworld was the leading cinema operator in the UK by box office market share (based on revenue),[7] with 99 cinemas and over 1,017 screens,[8] including Ireland’s single largest multiplex by screens and customer base.[9] Cineworld Glasgow Renfrew Street is the tallest cinema in the world and the busiest, by customer base, in the UK.[10] The Cineworld site with the greatest number of screens is located at Valley Centertainment in Sheffield, which has 20.[11] It is listed on the London Stock Exchange and is a constituent of the FTSE 250 Index.

Cineworld was founded by Steve Wiener in 1995.[12][13] The first Cineworld theater opened in Stevenage, Hertfordshire in July 1996.[14] A second theater opened in Wakefield, West Yorkshire, in December 1996 and the third opened in Shrewsbury, Shropshire, in 1998.[15] In 2004, Cineworld was acquired by Blackstone private equity group for £120m.[12] The following year, Cineworld acquired the UK and Ireland operations of French cinema company UGC.[16]

In December 2012, Cineworld acquired the Picturehouse Cinema chain, adding 21 cinemas to its portfolio, including The Little Theatre in Bath, Brighton’s Duke of York’s cinema, the Cameo, Edinburgh, the Phoenix in Oxford and the Ritzy Cinema in Brixton.[17]

The Blackstone Group, which had invested in Cineworld when it was privately owned, sold its entire remaining 20% shareholding in November 2010.[18] In August 2013, The Guardian revealed that Cineworld employs 80% of its 4,300 staff on zero hour contracts.[19] In October 2013, the Chester location was closed due to the landowner wanting to develop the land into a supermarket.[20]

In 2014 Cineworld's Picturehouse chain was subject to industrial action owing to its refusal to pay the London living wage to its staff. The workforce attracted the support of Eric Cantona.[21] On 27 February 2014 Cineworld completed the takeover of Cinema City International N.V..[22] As of March 2015, the Greidinger family (who owned a controlling 54% stake in Cinema City International) held a controlling bloc as the largest shareholders in the enlarged company.[23]

In 2015, Picturehouse unveiled their new West End flagship site, ‘Picturehouse Central’,[24] a 1,000 seat, seven-screen cinema on Shaftesbury Avenue near Piccadilly Circus in central London. In August 2016 Cineworld acquired six cinemas[25] from Empire Cinemas, including the Empire Theatre in London's West End, and 4 other locations in Basildon, Poole, Bromley and Hemel Hempstead. Empire Newcastle was also acquired by Cineworld the following year.[26]

In November 2017, Cineworld began merger talks with the US theater chain Regal Cinemas.[27] On 5 December, it was officially announced that Cineworld would buy Regal for US$3.6 billion (£2.7 billion), creating the world's second largest cinema group. It would also allow Cineworld access to the US market, the largest in the world.[28][29] The acquisition was completed in 2018.[5]

In 2018, a record 308 million people attended Cineworld movie theaters, creating a 7.2 percent increase in revenue.[5]

A Cineplex theatre in Canada

In March 2019, Cineworld and Eagle Pictures invested in Spyglass Media Group.[30]

On 16 December 2019, Cineworld announced its proposed acquisition of Cineplex Entertainment—Canada's largest cinema chain—for approximately US$2.1 billion. Cineworld plans to integrate its operations with Regal to achieve cost and revenue synergies. This will make it North America's largest cinema chain which was formerly held by Loews Cineplex Entertainment.[31] The deal was approved by shareholders in February 2020. The name Cineplex would continue for the Canadian operation, according to CEO Moshe (Mooky) Greidinger.[32]

Cinemas

Across the Cineworld estate there are seven different ways in which their customers can watch a movie: 2D, 3D, 4DX,[33] IMAX, Superscreen,[34] VIP and ScreenX. Prices are set according to the format the customer chooses, and not the movie they choose. As of April 2018, across the European estate there are 38 4DX screens, 35 IMAX screens and 12 VIP auditoriums.[35] Out of 45 cinemas[36] in the world that are fitted with IMAX with Laser projection systems, two are in the UK, both belonging to Cineworld, located in Leicester Square[37] and Sheffield.[38] In April 2018, IMAX And Cineworld Group signed an agreement to install 55 new IMAX with Laser experience in Cineworld and Regal IMAX locations.[39]

In 2012, Cineworld began a trial of a premium service, The Screening Rooms. Located next to the Cheltenham cinema, The Screening Rooms offers considerably larger, leather seating, premium food, and 'table' service.[40][41]

Cineworld was the only cinema chain in the United Kingdom to operate a 'strict no food and drink policy'[42] on items that have been bought elsewhere,[41] but in November 2012 the food policy was changed and now states that "neither alcohol nor hot food may be brought onto the premises".[43] In early 2014, Cineworld introduced an allocated seating system, starting as a trial in selected sites including Wembley and rolling out to all their cinemas by the summer.[44] The move was controversial and a Twitter campaign was created against this policy.[45] Cineworld have responded to the criticism stating that it gives customers peace of mind along with other benefits.[46]

Cineworld continues to expand and enhance their estate, with an extensive ongoing build and refurbishment programme. In 2017, the company opened nine new cinema locations with a total of 109 screens; four of which were in the UK and five in the rest of Europe. A further 75 screens were scheduled to open in 2018 in addition.[47] Throughout 2018 the company opened 13 new locations with 108 screens in total, six in the United States, six in the United Kingdom and one in Romania

Virgin Atlantic

Virgin Atlantic

Virgin Atlantic, a trading name of Virgin Atlantic Airways Limited and Virgin Atlantic International Limited, is a British airline with its head office in Crawley, England. The airline was established in 1984 as British Atlantic Airways, and was originally planned by its co-founders Randolph Fields and Alan Hellary to fly between London and the Falkland Islands. Soon after changing the name to Virgin Atlantic Airways, Fields sold his shares in the company after disagreements with Sir Richard Branson over the management of the company. The maiden flight from Gatwick Airport to Newark Liberty International Airport took place on 22 June 1984.

The airline along with Virgin Holidays is controlled by a holding company, Virgin Atlantic Limited, which is 51% owned by the Virgin Group and 49% by Delta Air Lines. It is administratively separate from other Virgin-branded airlines. Virgin Atlantic Airways Limited and Virgin Atlantic International Limited both hold Civil Aviation Authority (CAA) Type A Operating Licences (AOC numbers 534[5] and 2435 respectively),[5] both of which permit these airlines, operating as Virgin Atlantic Airways, to carry passengers, cargo and mail on aircraft with 20 or more seats.[6]

Virgin Atlantic uses a mixed fleet of Airbus and Boeing wide-body aircraft and operates to destinations in North America, the Caribbean, Africa, the Middle East and Asia from its main bases in London (Heathrow and Gatwick), and its secondary base at Manchester. The airline also operates seasonal flights from Glasgow and Belfast. Virgin Atlantic aircraft consist of three cabins: Economy, Premium (formerly Premium economy)[7] and Upper Class (business).

In July 2017, Virgin Atlantic announced its intention to form a joint venture with Air France–KLM, but in December 2019, it was announced that the joint venture would not include a stake in Virgin Atlantic

Virgin Atlantic has its origins in a joint endeavour by Randolph Fields, an American-born lawyer, and Alan Hellary, a former chief pilot for British private airline Laker Airways. Following the collapse of Laker Airways in 1982, Field and Hellary decided to establish a new company, initially named British Atlantic Airways, as a successor.[9] Reportedly, Fields had formed a concept for an airline that would operate between London and the Falkland Islands during June 1982, when the Falklands War had just finished.[10] Seeking out expertise in the field, Fields got in contact with Hellary, who had already been considering options for establishing a regular commercial service to the Falklands. In turn, Hellary was in contact with several out-of-work colleagues from the collapse of Laker Airways; as such, the pair decided to refine their ambitions.

However, it was soon determined that the short runway at Port Stanley Airport, and the time it would take to improve it, would render a route to the Falklands commercially unviable, thus the idea of such a service was dropped. In its place, Hellary and Fields commenced efforts to secure a licence to operate a route Gatwick Airport, London and John F. Kennedy International Airport, New York City. During May 1983, a three-day inquiry was conducted, which chose to reject the application following objections from British Airways, British Caledonian and BAA.

Hellary and Fields then applied for a licence between Gatwick and Newark, New Jersey, using a 380-seat McDonnell Douglas DC-10.[9] However, faced with the prospect of direct competition from rival operator PEOPLExpress, a post-deregulation "no frills" discount airline based at Newark, they decided to secure more funding before proceeding. Fields met British entrepreneur Richard Branson at a party in London during which he proposed a business partnership. After protracted and testy negotiations, Fields agreed to a reduced stake of 25% in the airline (which was renamed Virgin Atlantic) and became its first chairman. Following disagreements over operations, Fields agreed to be bought out for an initial sum of £1 million with further payment on Virgin's first dividend. As a result of a High Court action, this additional payment was received shortly before Fields' death in 1997.

Formative years

On 22 June 1984, Virgin Atlantic operated its inaugural scheduled service, flown between Gatwick and Newark using a leased Boeing 747-200 (registration G-VIRG), christened Maiden Voyager,[9] which had been formerly operated by Aerolíneas Argentinas. From the onset, its activities were augmented by leveraging existing Virgin Group resources, such as tickets being sold at Virgin Megastores record shops.[11]

Part of Richard Branson's declared approach to business is to either succeed within the first year or exit the market; this ethos includes a one-year limit being expressed upon everything associated with starting up operations.[12] Virgin Atlantic became profitable within the first 12 months, aided by sister company Virgin Records' ability to finance the lease of a secondhand Boeing 747. The firm had timed its operations to take advantage of a full summer, from June to September, which was typically the most profitable period of the year.

In November 1984 the airline launched a service between Gatwick Airport and Maastricht Aachen Airport in the Netherlands using a chartered BAC One-Eleven.[13]

In 1986 the airline added another Boeing 747 to its fleet and started a scheduled route from Gatwick to Miami. Additional aircraft were quickly acquired and new routes launched from Gatwick, such as to New York JFK in 1988, Tokyo Narita in 1989, Los Angeles in 1990, Boston in 1991, and Orlando in 1992. During 1987, Virgin Atlantic launched a service between Luton and Dublin using secondhand Viscount turboprop aircraft, but this route was withdrawn around 1990. During 1988, Club Air operated two Boeing 727 jet aircraft on behalf of Virgin; these served the Luton to Dublin route until about 1990.

Competition

Before Virgin Atlantic started operations, British Airways had been the only airline from the United Kingdom serving long-haul routes to destinations in North America, the Caribbean and the Far East since the BA-BCal merger in the late 1980s. In 1991, Virgin was given permission to operate from Heathrow following the abolition of the London Air Traffic Distribution Rules (TDRs), which had governed the distribution of traffic between Heathrow and Gatwick airports since 1978, primarily to bolster the profitability of Gatwick. Airlines without an international scheduled service from Heathrow prior to 1 April 1977 were obliged to operate from Gatwick. However, airlines that did not already operate at Heathrow were still able to begin domestic scheduled services there provided BAA, which then ran both Heathrow and Gatwick on behalf of the UK government, and the Secretary of State for Transport granted permission.

The Civil Aviation Authority also transferred two pairs of unused landing slots that British Airways held at Tokyo's Narita Airport to Virgin to let it increase its frequency between Heathrow and Tokyo from four to six weekly round trips, making it easier for Virgin to compete against British Airways. The then-chairman of BA Lord King called the CAA's decision, which the government had endorsed, "a confiscation of his company's property".[14]

In the year to October 1993, Virgin Atlantic declared a loss of £9.3m. The decision to abolish the London TDRs and to let Virgin Atlantic operate at Heathrow in competition with British Airways became the trigger for BA's so-called "dirty tricks" campaign against Virgin. During 1993, BA's public relations director, David Burnside, published an article in BA News, British Airways' internal magazine, which argued that Branson's protests against British Airways were a publicity stunt. Branson sued British Airways for libel, using the services of George Carman QC. BA settled out of court when its lawyers discovered the lengths to which the company had gone in trying to kill off Virgin. British Airways had to pay a legal bill of up to £3 million, damages to Branson of £500,000 and a further £110,000 to his airline. Branson reportedly donated the proceeds from the case to Virgin Atlantic staff.[15][16]

During the 1990s, Virgin Atlantic jets were painted with "No Way BA/AA" as a declaration of its opposition to the attempted merger between British Airways and American Airlines.[17] In 1997, following British Airways' announcement that it was to remove the Union Flag from its tailfins in favour of world images, Virgin introduced a Union Flag design on the winglets of its aircraft and changed the red dress on the Scarlet Lady on the nose of aircraft to the union flag with the tag line "Britain's Flag Carrier". This was a tongue-in-cheek challenge to BA's traditional role as the UK's flag carrier.[18]

In June 2006, US and UK competition authorities investigated alleged price fixing between Virgin Atlantic and British Airways over passenger fuel surcharges.[19] In August 2007, BA was fined £271 million by the UK Office of Fair Trading (OFT) and the US Department of Justice.[20] However, the Chief Executive of Virgin Atlantic, Steve Ridgway, was forced to admit that the company had been a party to the agreement, had been aware of the price fixing and had taken no steps whatsoever to stop the price fixing.[21] The company escaped a similar fine to that levied on British Airways only by virtue of the immunity it had earlier negotiated with the regulators.

In April 2010, a tip-off from Cathay Pacific led to the Office of Fair Trading (OFT) investigating alleged price fixing between Virgin Atlantic and Cathay Pacific on flights to Hong Kong between 2002 and 2006. Cathay Pacific received immunity from prosecution for reporting the alleged offence. A maximum fine, if found guilty, was 10% of turnover which based on the £2.5 billion in sales for the year to February 2009 would have been £250 million.[22] At the time, the OFT stressed that it should not be assumed that the parties involved had broken the law.[23] The OFT cleared both airlines in December 2012, concluding there were "no grounds for action".[24]

Recent years

In May 2014 Virgin Atlantic ended flights to Sydney. In September 2014 Virgin Atlantic announced plans to scrap flights to Tokyo, Mumbai, Vancouver and Cape Town, and to codeshare transatlantic flights with Delta Air Lines; the company was also reported to be considering axing its new Little Red domestic airline after suffering heavy losses.[25] On 6 October 2014, Virgin Atlantic confirmed that Little Red services between London and Manchester would end in March 2015, and that the Scottish routes would be terminated in September 2015.[26] Passengers used the routes from point to point as opposed to using it as a connection for longer haul Virgin Atlantic flights. The former BMI routes continued with rival airline British Airways.

In June 2015, Richard Branson admitted that Virgin Atlantic would be in "real trouble" without strategic support from Delta Air Lines. With cumulative losses between 2010 and 2013 amounting to £233 million, the future of the 30-year-old airline was in doubt.[27] In the same month, the airline announced it would cut 500 jobs to establish a more efficient management structure.[28]

In July 2017, Virgin Atlantic announced its intention to form a joint venture with Air France-KLM. Under the agreement, Air France-KLM would acquire a 31% stake in Virgin Atlantic currently held by Virgin Group for £220 million, subject to execution of definitive agreements and receipt of final shareholder, board, and regulatory approvals. Virgin Atlantic would retain its independence as a UK airline with a UK operating certificate, and would continue to fly under the Virgin brand.[29][30]

In late 2018, Virgin Atlantic were rated 83rd in the world in energy efficiency, behind many of their competitors.[31]

In 2019, Virgin Atlantic began to allow its female flight attendants to not wear makeup and have a choice to wear trousers rather than a skirt.[32]

In September 2019, it was announced Virgin Atlantic had outlined plans for a massive expansion of its network to create a "second flag carrier" in the UK, should slot reforms being considered for a larger Heathrow airport work in its favour. The airline would seek to serve 103 destinations – comprising domestic, European and long-haul services – up from the 19 points it planned to serve in 2020, all of which are long-haul. Of the 84 new destinations planned, 12 are domestic, 37 are European and 35 are international. The 35 new international destinations include Addis Ababa, Austin, Beijing, Bogotá, Buenos Aires, Cape Town, Karachi, Mexico City, Singapore, Sydney and Tokyo. Most of the routes would be new to Virgin Atlantic, although it has served several of the long-haul destinations – such as Cape Town, Karachi, Sydney, Tokyo and Vancouver – in the past.[33] It was confirmed that Flybe would have been a key part of Virgin Atlantic's plans for domestic and intra-European services, which involved the rebranding of Flybe as "Virgin Connect" from early 2020, however the plans fell through when Flybe filed for administration and ceased operations in March 2020.[34][35][36]

In December 2019, Sir Richard Branson announced that he would be scrapping the 31% sale of the airline to Air France-KLM and that Virgin Group would retain its 51% shareholding.[37]

Corporate affairs

Virgin Atlantic's head office, known as The VHQ, is located on a business park in Crawley, England, near Gatwick Airport[38] and also houses the corporate offices of Virgin Holidays.[39] The company operates several offices and call centres around the United Kingdom, including a large office in Swansea, Wales, which is a base for reservations and sales, baggage claims and tracing, 'live chat' web support and a customer relations department.

International offices are located at Atlanta, Johannesburg, Barbados, Shanghai, Hong Kong, Greater Delhi, Lagos and Dubai.[40]

Ownership

Virgin Group sold a 49% stake in the airline to Singapore Airlines in 1999 for £600 million.[41] On 14 May 2008, Singapore Airlines formally announced an invitation for offers for its Virgin Atlantic stake, and publicly acknowledged that its stake in the airline had "underperformed".[42]

In November 2010 it was reported that Virgin Atlantic had appointed Deutsche Bank to begin a strategic review of options for the airline following the tie-up between British Airways and American Airlines.[43] By February 2011 it was confirmed that SkyTeam members Air France-KLM and Delta Air Lines had appointed Goldman Sachs to advise them on a joint potential approach for Virgin Atlantic. Etihad Airways was also reported to be considering a deal,[44] and Willie Walsh, chief executive of International Airlines Group, stated that they would be interested in the airline, but only for the lucrative take-off and landing slots it holds at Heathrow Airport.[45]

On 11 December 2012, Delta Air Lines confirmed the purchase of Singapore Airlines' 49% stake in Virgin Atlantic for £224 million, with plans to develop a transatlantic joint venture. Regulatory approval from the United States and European Union was granted on 20 June 2013,[46] and the purchase was completed on 24 June.[47] In December 2012, International Airlines Group CEO, Willie Walsh, suggested that the loss-making company would be history within five years. "I can't see Delta wanting to operate the Virgin brand because if they do what does that say about the Delta brand? I just don't see that the guy [Branson] has anything that stands out in terms of what he has achieved in the industry."[48]

In July 2017, Virgin Group agreed to sell a 31% stake in the airline to Air France-KLM for £220 million, leaving it with a 20% holding.[30] The deal fell through in late 2019.[49]

Business trends

The key trends for Virgin Atlantic are shown below (from 2014 onwards, figures are for year ending December; earlier figures are for year ending February, and exclude Virgin Nigeria operations 2005–2008):

Virgin Atlantic aircraft operate with a three-class cabin configuration: Economy, Premium (formerly Premium economy),[7] and Upper Class - the business class product. Premium has a separate check-in area, priority boarding and a wider seat with more legroom. Upper Class features a seat that converts into a fully flat bed and access to chauffeur drive.[63] Virgin Atlantic was the first airline to offer personal entertainment for all passengers in all classes.[citation needed]

The airline's frequent-flyer program is styled 'the Flying Club'.

Virgin Atlantic operates 10 lounges worldwide. It has nine 'Clubhouse' locations – London (Heathrow and Gatwick), New York-JFK, Newark, Boston, Washington D. C., San Francisco, Los Angeles and Johannesburg.[64] It also maintains a Revivals arrival lounge in London Heathrow. They are accessible for passengers travelling in Upper Class and Flying Club Gold tier members.

Little Red

British Midland International provided domestic and European feeder traffic into Heathrow Airport in partnership with Virgin[65] until it was purchased by British Airways' parent company International Airlines Group in 2011. The Lufthansa-owned airline had faced heavy annual losses of more than £100 million. Under the terms of the takeover, IAG had to relinquish some former BMI domestic slots at Heathrow. Virgin Atlantic purchased enough slots in 2012 to enable it to launch a domestic service on 31 March 2013, under the Little Red brand, operating a total of 12 daily services from London to Aberdeen (three), Edinburgh (six), and Manchester (three).[66] The airline wet-leased four Airbus Airbus A320-200s from Aer Lingus, operating with Virgin Atlantic livery, under a three-year contract.[67][68]

In September 2014, it was reported that Virgin was considering closing its domestic brand after suffering heavy losses,[69] with Civil Aviation Authority figures confirming an average seat occupancy level of just 37.6% in 2013.[25] The 12 daily pairs of take-off and landing slots at Heathrow cannot be sold to be used for long-haul routes.[70]

On 6 October 2014, Virgin confirmed that the Little Red service would cease; flights to Manchester ended on 28 March 2015 and flights to Edinburgh and Aberdeen ended on 26 September 2015.[71]

Virgin Atlantic International Limited

On 13 April 2015, Virgin Atlantic incorporated a new subsidiary – Virgin Atlantic International Limited (VAIL).[72] In November 2015, VAIL obtained its own Air Operators Certificate and Operating Licence, and commenced operations with two former Virgin Atlantic Airways Limited operated Airbus A330-300 aircraft taking over routes previously operated by Virgin Atlantic Limited between London Gatwick and Barbados, St Lucia, Antigua, Grenada and Tobago.[73] These flights are operated on behalf of Virgin Atlantic.[74]

Upon incorporation as an AOC holder, the majority of Virgin Atlantic's landing slots at London Heathrow Airport were transferred to VAIL, allowing Virgin to access the value of the carriers' slots by 'mortgaging' them through open investment from capital markets, the first time in Europe a company has used airport take-off and landing slots to generate money in this way.[75][76]

Flybe takeover bid

On 11 January 2019, Virgin Atlantic formed the Connect Airways consortium with Stobart Aviation and Cyrus Capital, to make a takeover bid for Flybe.[77][78] The deal would see the consortium combine Flybe and Stobart Air with Virgin Atlantic to create an integrated carrier operating under the Virgin Atlantic brand.[79] Flybe and Stobart Air would however retain their own Air Operator Certificates.[80] On 15 January 2019, Connect Airways announced an increased offer, which Flybe's board accepted.[81] On 21 February 2019, the Flybe Group confirmed that its operating assets, including the airline and the website, had indeed been transferred to Connect Airways, despite a last-minute rival bid.[82] However, despite the investment of £135 million from Connect Airways into Flybe, the airline filed for administration and ceased operations with immediate effect in March 2020, following reduced demand that Virgin Atlantic attributed to the 2019–20 coronavirus outbreak and the UK government failing to grant a £100 million loan.