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Nahian A, McFadden LM. Changes in Substance Use Diagnoses in the Great Plains during the COVID-19 Pandemic. Healthcare (Basel) 2024; 12:1630. [PMID: 39201189 PMCID: PMC11353988 DOI: 10.3390/healthcare12161630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/14/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
As drug overdose mortality rises in the United States, healthcare visits present critical opportunities to mitigate this trend. This study examines changes in healthcare visits for substance use disorders (SUDs) and remission prior to and during the COVID-19 pandemic in the Great Plains, with a focus on identifying the characteristics of those served. Data were analyzed from 109,671 patient visits (mode = one visit per patient), encompassing diverse demographics, including sex, age, race, ethnicity, and geographic location. Visits analyzed included those for Alcohol Use Disorder (AUD), Opioid Use Disorder (OUD), or Stimulant Use Disorder (StUD) and those in remission of these disorders between March 2019 and March 2021. Patient demographic information and geographic factors, like rurality and Medicaid expansion status, were considered, and logistic regression was utilized. Visits were primarily by White (70.83%) and Native American (21.39%) patients, non-Hispanic (91.70%) patients, and males (54.16%). Various demographic, geographic, and temporal trends were observed. Findings indicated that males were more likely to receive an AUD diagnosis, while females were more likely to receive an OUD or StUD diagnosis. Metropolitan-residing patients were more likely to receive an AUD diagnosis, while non-metropolitan patients were more likely to receive an OUD diagnosis. Remission odds increased for StUD during the pandemic but decreased for AUD and OUD. These findings illuminate the demographic and geographic patterns of SUD-related healthcare visits, suggesting critical touchpoints for intervention. The results emphasize the urgent need for targeted healthcare strategies, especially in rural and underserved areas, to address persistent health disparities.
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Affiliation(s)
- Ahmed Nahian
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine at Seton Hill, Lynch Hall, 20 Seton Hill Dr, Greensburg, PA 15601, USA
| | - Lisa M. McFadden
- Division of Basic Biomedical Sciences, University of South Dakota, 414 E. Clarke St., Vermillion, SD 57069, USA
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Assaf RD, Hamad R, Javanbakht M, Arah OA, Shoptaw SJ, Cooper ZD, Gorbach PM. Associations of U.S. state-level COVID-19 policies intensity with cannabis sharing behaviors in 2020. Harm Reduct J 2024; 21:82. [PMID: 38622670 PMCID: PMC11020667 DOI: 10.1186/s12954-024-00987-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Cannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves. METHODS This study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used Poisson regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic. RESULTS Participants (n = 925) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (74.9%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (16.7, IQR 12.3-21.5) compared to those who did not share (18.6, IQR 15.3-25.3). In adjusted models, the prevalence ratio of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score was 0.97 (95% CI 0.93, 1.01). CONCLUSIONS Fewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.
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Affiliation(s)
- Ryan D Assaf
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
- Department of Medicine, Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, University of California, San Francisco, CA, USA.
| | - Rita Hamad
- Department of Medicine, Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, University of California, San Francisco, CA, USA
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Statistics, University of California, Los Angeles, CA, USA
| | - Steven J Shoptaw
- Center for Behavioral and Addiction Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Family Medicine and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ziva D Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Pamina M Gorbach
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Melchiorre MG, Cerea S, Socci M, Lamura G. The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services. PLoS One 2024; 19:e0298074. [PMID: 38489312 PMCID: PMC10942073 DOI: 10.1371/journal.pone.0298074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/18/2024] [Indexed: 03/17/2024] Open
Abstract
The study aimed to explore and compare effects of lockdown, due to the COVID-19 pandemic in 2020, on frail older people living alone at home in Brescia and Ancona, two urban cities located respectively in Northern and Central Italy. This country was the Western epicenter of the first wave of the pandemic (February-May 2020), which affected the two cities differently as for infections, with a more severe impact on the former. A follow-up study of the IN-AGE research project (2019) was carried out in July-September 2020, by means of telephone interviews, involving 41 respondents. Semi-structured questions focused on the effects of the first wave of the pandemic on their mobility and functional limitations, available care arrangements, and access to health services. The lockdown and social distancing measures overall negatively impacted on frail older people living alone, to a different extent in Ancona and Brescia, with a better resilience of home care services in Brescia, and a greater support from the family in Ancona, where however major problems in accessing health services also emerged. Even though the study was exploratory only, with a small sample that cannot be considered as representative of the population, and despite differences between the two cities, findings overall suggested that enhancing home care services, and supporting older people in accessing health services, could allow ageing in place, especially in emergency times.
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Affiliation(s)
- Maria Gabriella Melchiorre
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Ancona, Italy
| | - Stefania Cerea
- Social Policy Laboratory, Department of Architecture and Urban Studies, Polytechnic University of Milan, Milan, Italy
| | - Marco Socci
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Ancona, Italy
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Ancona, Italy
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Lee J, Tayara A, Warren JD, Kuyeb B, McKee E, Velazquez A, Paul O, Lewis AF. COVID-19 impact on facial trauma: Insights from Mississippi's only level 1 trauma center. Am J Otolaryngol 2024; 45:104086. [PMID: 37948818 DOI: 10.1016/j.amjoto.2023.104086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Our primary aim was to understand and describe the impact of COVID-19 on the incidence and etiology of facial trauma in the state of Mississippi. METHODS Retrospective review of facial trauma-related Emergency Department encounters in Mississippi from March 11, 2019 to March 10, 2021, divided into three time periods using the state of Mississippi's Governor's Office Executive Orders. Chi-square tests and segmented linear regressions were used for analysis. RESULTS Patients presenting with facial trauma were typically male, 18-44 years old, and lived in urban zip codes. Insurance payors significantly differed across time periods. There were no significant differences in self-inflicted assault or accidental injury between the 3 time periods, with pre- and pandemic patients more likely to be self-pay while patients during recovery being more likely to have private insurance. During the pandemic, facial trauma from a family member, partner or spouse, or other person in the household significantly increased. CONCLUSION Similar accidental facial trauma trends may reflect lower adherence to social distancing guidelines. The increase in facial trauma perpetrated by family members is consistent with reported increases in domestic violence during the pandemic. While overall facial trauma demographic patterns did not change significantly during the COVID-19 pandemic, there were notable changes in the etiology and insurance payor of facial trauma cases. LAY SUMMARY The COVID-19 pandemic impacted healthcare systems worldwide, and our study seeks to understand how the pandemic affected incidence of facial trauma. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Jason Lee
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, United States of America.
| | - Alia Tayara
- School of Medicine, University of Mississippi Medical Center, United States of America.
| | - James D Warren
- School of Medicine, University of Mississippi Medical Center, United States of America.
| | - Boris Kuyeb
- School of Medicine, University of Mississippi Medical Center, United States of America.
| | - Elizabeth McKee
- School of Medicine, University of Mississippi Medical Center, United States of America.
| | - Alexander Velazquez
- School of Medicine, University of Mississippi Medical Center, United States of America.
| | - Oishika Paul
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, United States of America.
| | - Andrea F Lewis
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, United States of America.
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Murphy C, Lim WW, Mills C, Wong JY, Chen D, Xie Y, Li M, Gould S, Xin H, Cheung JK, Bhatt S, Cowling BJ, Donnelly CA. Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230132. [PMID: 37611629 PMCID: PMC10446910 DOI: 10.1098/rsta.2023.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Caitriona Murphy
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Wey Wen Lim
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathal Mills
- Department of Statistics, University of Oxford, Oxford, UK
| | - Jessica Y. Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Yanmy Xie
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Mingwei Li
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hualei Xin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Justin K. Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin J. Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Christl A. Donnelly
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Assaf RD, Hamad R, Javanbakht M, Arah OA, Shoptaw SJ, Cooper ZD, Gorbach PM. Associations of U.S. state-level COVID-19 policies intensity with cannabis sharing behaviors in 2020. RESEARCH SQUARE 2023:rs.3.rs-3211086. [PMID: 37577641 PMCID: PMC10418562 DOI: 10.21203/rs.3.rs-3211086/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Cannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves. Methods This study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used logistic regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic. Results Participants (n = 975) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (75.1%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (15.3, IQR 11.3-19.0) compared to those who did not share (16.3, IQR 13.7-22.7). In adjusted models, the odds of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score were 0.78 (95% CI 0.58, 1.04). Conclusions Fewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.
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Affiliation(s)
- Ryan D Assaf
- Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco
| | - Rita Hamad
- Social Policies for Health Equity Research (SPHERE) Program, Department of Social and Behavioral Sciences, Harvard School of Public Health
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Steven J Shoptaw
- Family Medicine and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Ziva D Cooper
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
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Kato MA, Zurakowski D, Adams A, Soelberg J, Staffa SJ, Bradford VA, Efune PN, Rodgers McCormick ME, Grivoyannis AD, Rossmann Beel E, Correll LR, Cheon EC, Tan GM, Thomas JJ, Fernandez AM, Teng HC, Khanna N, Raman VT, Brzenski AB, Frugoni BJ, Sheth MM, Rugnath RM, Meier PM. Prevalence of COVID-19 and Risk Factors for Infection Among Pediatric Anesthesia Patients: A Report From the PEACOC Research Network. Anesth Analg 2023; 137:383-391. [PMID: 36269171 DOI: 10.1213/ane.0000000000006227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Pediatric Anesthesia COVID-19 Collaborative (PEACOC) is a research network to advance the care of children during the pandemic. Here we calculate the prevalence of coronavirus disease 2019 (COVID-19) among children undergoing anesthesia, look at prevalence in the population data from the Centers for Disease Control and Prevention (CDC), and assess independent risk factors for infection. METHODS This was a multicenter, retrospective, observational study. Children aged 28 days to 18 years scheduled for anesthesia services at 12 centers requiring universal COVID-19 testing from March 29, 2020 to June 30, 2020 were included. COVID-19 positivity rates among those tested were plotted and trends were assessed using the Cochran Armitage test of trend. Independent risk factors were explored using multivariable logistic regression. RESULTS Data were collected and analyzed on 33,320 anesthesia encounters including 265 children with COVID-19. Over the study period, the rates of infections in the pediatric anesthesia population did not demonstrate a significant trend. In the general population, there was a significant downward trend in infection rates ( P < .001). In exploratory analysis, multivariable risk factors for a COVID-19 positive test were Black/African American race, Hispanic ethnicity, American Society of Anesthesiologists (ASA) physical status III or above, overweight and obese body mass index (BMI), orthopedic cases, abdominal cases, emergency cases, absence of injury and trauma, and West region (all P < .05). CONCLUSIONS Rates of COVID-19 in pediatric anesthesia patients were consistently lower than in the general population. Independent risk factors of a positive test for children were identified. This is the first time universal testing for a single infectious disease was undertaken on a wide scale. As such, the association of infection with surgical case type or emergency case status is unprecedented.
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Affiliation(s)
- Meredith A Kato
- From the Department of Anesthesiology & Perioperative Medicine, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - AmandaMarie Adams
- From the Department of Anesthesiology & Perioperative Medicine, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon
| | - Julie Soelberg
- From the Department of Anesthesiology & Perioperative Medicine, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Victoria A Bradford
- Department of Anesthesiology, Albert B. Chandler Hospital, University of Kentucky, Lexington Kentucky
| | - Proshad N Efune
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Megan E Rodgers McCormick
- Department of Anesthesiology, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Anastasia D Grivoyannis
- Department of Anesthesia & Critical Care Medicine, Johns Hopkins Hospital, John Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth Rossmann Beel
- Department of Pediatric Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Lynnie R Correll
- Department of Anesthesiology and Perioperative Medicine, Golisano Children's Hospital, University of Rochester, Rochester, New York
| | - Eric C Cheon
- Department of Pediatric Anesthesiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Gee Mei Tan
- Department of Pediatric Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - James J Thomas
- Department of Pediatric Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - Allison M Fernandez
- Department of Anesthesia, Pain and Perioperative Medicine, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Howard C Teng
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Neha Khanna
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Ohio State College of Medicine, Columbus, Ohio
| | - Vidya T Raman
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Ohio State College of Medicine, Columbus, Ohio
| | - Alyssa B Brzenski
- Department of Anesthesiology, Rady Children's Hospital, University of California San Diego Medical Center, San Diego, California
| | - Brian J Frugoni
- Department of Anesthesiology, Rady Children's Hospital, University of California San Diego Medical Center, San Diego, California
| | - Michelle M Sheth
- Department of Anesthesiology, Children's Hospital of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi
| | - Rahil M Rugnath
- Department of Anesthesiology, Children's Hospital of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi
| | - Petra M Meier
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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El Jai M, Zhar M, Ouazar D, Akhrif I, Saidou N. Socio-economic analysis of short-term trends of COVID-19: modeling and data analytics. BMC Public Health 2022; 22:1633. [PMID: 36038843 PMCID: PMC9421639 DOI: 10.1186/s12889-022-13788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 caused a worldwide outbreak leading the majority of human activities to a rough breakdown. Many stakeholders proposed multiple interventions to slow down the disease and number of papers were devoted to the understanding the pandemic, but to a less extend some were oriented socio-economic analysis. In this paper, a socio-economic analysis is proposed to investigate the early-age effect of socio-economic factors on COVID-19 spread. METHODS Fifty-two countries were selected for this study. A cascade algorithm was developed to extract the R0 number and the day J*; these latter should decrease as the pandemic flattens. Subsequently, R0 and J* were modeled according to socio-economic factors using multilinear stepwise-regression. RESULTS The findings demonstrated that low values of days before lockdown should flatten the pandemic by reducing J*. Hopefully, DBLD is only parameter to be tuned in the short-term; the other socio-economic parameters cannot easily be handled as they are annually updated. Furthermore, it was highlighted that the elderly is also a major influencing factor especially because it is involved in the interactions terms in R0 model. Simulations proved that the health care system could improve the pandemic damping for low elderly. In contrast, above a given elderly, the reproduction number R0 cannot be reduced even for developed countries (showing high HCI values), meaning that the disease's severity cannot be smoothed regardless the performance of the corresponding health care system; non-pharmaceutical interventions are then expected to be more efficient than corrective measures. DISCUSSION The relationship between the socio-economic factors and the pandemic parameters R0 and J* exhibits complex relations compared to the models that are proposed in the literature. The quadratic regression model proposed here has discriminated the most influencing parameters within the following approximated order, DLBL, HCI, Elderly, Tav, CO2, and WC as first order, interaction, and second order terms. CONCLUSIONS This modeling allowed the emergence of interaction terms that don't appear in similar studies; this led to emphasize more complex relationship between the infection spread and the socio-economic factors. Future works will focus on enriching the datasets and the optimization of the controlled parameters to short-term slowdown of similar pandemics.
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Affiliation(s)
- Mostapha El Jai
- Euromed Center of Research, Euromed Polytechnic School, Euromed University of Fes, Fes, Morocco. .,Ecole Nationale Supérieure d'Arts & Métiers, Moulay Ismail University, Meknes, Morocco.
| | - Mehdi Zhar
- Euromed Center of Research, Euromed Polytechnic School, Euromed University of Fes, Fes, Morocco.,IMS Team, SIME Lab, ENSIAS, Mohammed V University, Rabat, Morocco
| | - Driss Ouazar
- Mohamadia School of Engineers, Mohamed V University, Rabat, Morocco
| | - Iatimad Akhrif
- Euromed Center of Research, Euromed Polytechnic School, Euromed University of Fes, Fes, Morocco
| | - Nourddin Saidou
- Euromed Center of Research, INSA-Euromed, Euromed University of Fes, Fes, Morocco
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Qi F, Barragan D, Rodriguez MG, Lu J. Evaluating spatial accessibility to COVID-19 vaccine resources in diversely populated counties in the United States. Front Public Health 2022; 10:895538. [PMID: 35958838 PMCID: PMC9358221 DOI: 10.3389/fpubh.2022.895538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/27/2022] [Indexed: 12/05/2022] Open
Abstract
This study examines the accessibility to COVID-19 vaccination resources in two counties surrounding Newark, NJ in the New York Metropolitan Area, United States. The study area represents diverse population makeups. COVID-19 vaccines were made available by different types of vaccination sites including county mass vaccination sites, medical facilities and pharmacies, and a FEMA community vaccination center in spring 2021. We used the two-step floating catchment area method to measure accessibility and calculated the average accessibility scores of different population groups. We examined the patterns and tested the significance of the differences in accessibility across population groups. The results showed clear spatial heterogeneity in the accessibility to vaccine resources with the existing infrastructure (medical/pharmacy vaccine sites). Accessibility patterns changed with the introduction of county mass sites and the FEMA community site. The county mass vaccination sites in one county greatly increased accessibilities for populations of minority and poverty. The FEMA community site in the other county accomplished the same. Both the local health department and the federal government played an important role in mitigating pre-existing inequalities during the vaccination campaign. Our study shows that social determinants of health need to be addressed and taken into explicit consideration when planning resource distribution during the pandemic.
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Affiliation(s)
- Feng Qi
- School of Environmental and Sustainability Sciences, Kean University, Union, NJ, United States
- *Correspondence: Feng Qi
| | - Daniela Barragan
- School of Environmental and Sustainability Sciences, Kean University, Union, NJ, United States
| | | | - Jiongcheng Lu
- Gobal Business School for Health, University College London, London, United Kingdom
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10
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Wang R, Wang J, Hu T, Zhou XH. Population-Level Effectiveness of COVID-19 Vaccination Program in the United States: Causal Analysis Based on Structural Nested Mean Model. Vaccines (Basel) 2022; 10:726. [PMID: 35632481 PMCID: PMC9144931 DOI: 10.3390/vaccines10050726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/04/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
Though COVID-19 vaccines have shown high efficacy, real-world effectiveness at the population level remains unclear. Based on the longitudinal data on vaccination coverage and daily infection cases from fifty states in the United States from March to May 2021, causal analyses were conducted using structural nested mean models to estimate the population-level effectiveness of the COVID-19 vaccination program against infection with the original strain. We found that in the US, every 1% increase of vaccination coverage rate reduced the weekly growth rate of COVID-19 confirmed cases by 1.02% (95% CI: 0.26%, 1.69%), and the estimated population-level effectiveness of the COVID-19 program was 63.9% (95% CI: 18.0%, 87.5%). In comparison to a no-vaccination scenario, the COVID-19 vaccination campaign averted 8.05 million infections through the study period. Scenario analyses show that a vaccination program with doubled vaccination speed or with more rapid vaccination speed at the early stages of the campaign would avert more infections and increase vaccine effectiveness. The COVID-19 vaccination program demonstrated a high population-level effectiveness and significantly reduced the disease burden in the US. Accelerating vaccine rollout, especially at an early stage of the campaign, is crucial for reducing COVID-19 infections.
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Affiliation(s)
- Rui Wang
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100191, China;
- China Center for Health Development Studies, Peking University, Beijing 100191, China
| | - Taojun Hu
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
| | - Xiao-Hua Zhou
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
- Beijing International Center for Mathematical Research, Peking University, Beijing 100871, China
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Damara FA, Muchamad GR, Anton A, Ramdhani AN, Channel IC, Faried A. Epidemiological Pattern of Traumatic Brain Injury in the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. World Neurosurg 2022; 161:e698-e709. [PMID: 35227924 PMCID: PMC8881220 DOI: 10.1016/j.wneu.2022.02.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although the incidence of traumatic brain injury (TBI) has decreased since the beginning of the coronavirus disease 2019 (COVID-19) pandemic and severe acute respiratory syndrome coronavirus 2 is still evolving, the number of TBI cases has still greatly increased in multiple countries. In the present systematic review and meta-analysis, we evaluated the epidemiological characteristics of patients with TBI before and during the COVID-19 pandemic. METHODS We conducted a systematic literature search of original studies, short reports, and research letters from databases on studies that contained data about the severity, mortality, presence of neurological deficits, radiological diagnosis, cause of injury, and type of management of TBI during a specified period within the pandemic compared with before the pandemic. RESULTS A total of 18,490 subjects from 13 studies were included in the present study. The results of the meta-analysis showed a higher TBI mortality rate during the COVID-19 pandemic in the low-to-middle income countries (odds ratio, 1.65; 95% confidence interval, 1.12-2.41; P < 0.05; I2 = 40.8%; P = 0.18). The proportion of subdural hemorrhage was decreased, and the proportion of subarachnoid hemorrhage was increased in low- to middle-income and high-income countries, respectively. The proportion of assaults as the cause of TBI had increased during the pandemic (odds ratio, 1.40; 95% confidence interval, 1.06-1.86; P = 0.02; I2 = 20.8%; P = 0.28). We did not find any significant differences in the incidence of surgical intervention for TBI during the pandemic. CONCLUSIONS Our results have indicated that during the COVID-19 pandemic, the TBI mortality rate had increased in low- to middle-income countries. The rate of assault as the cause of TBI had also increased during the pandemic.
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Affiliation(s)
- Fachreza Aryo Damara
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Galih Ricci Muchamad
- Department of Medicine, Faculty of Medicine, Universitas Diponegoro - Kariadi General Hospital, Semarang, Indonesia
| | - Anton Anton
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Alfya Nandika Ramdhani
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Ivan Christian Channel
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Ahmad Faried
- Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
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Moderating Effect of a Cross-Level Social Distancing Policy on the Disparity of COVID-19 Transmission in the United States. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2022. [DOI: 10.3390/ijgi11040229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Currently, coronavirus disease 2019 (COVID-19) remains a global pandemic, but the prevention and control of the disease in various countries have also entered the normalization stage. To achieve economic recovery and avoid a waste of resources, different regions have developed prevention and control strategies according to their social, economic, and medical conditions and culture. COVID-19 disparities under the interaction of various factors, including interventions, need to be analyzed in advance for effective and precise prevention and control. Considering the United States as the study case, we investigated statistical and spatial disparities based on the impact of the county-level social vulnerability index (SVI) on the COVID-19 infection rate. The county-level COVID-19 infection rate showed very significant heterogeneity between states, where 67% of county-level disparities in COVID-19 infection rates come from differences between states. A hierarchical linear model (HLM) was adopted to examine the moderating effects of state-level social distancing policies on the influence of the county-level SVI on COVID-19 infection rates, considering the variation in data at a unified level and the interaction of various data at different levels. Although previous studies have shown that various social distancing policies inhibit COVID-19 transmission to varying degrees, this study explored the reasons for the disparities in COVID-19 transmission under various policies. For example, we revealed that the state-level restrictions on the internal movement policy significantly attenuate the positive effect of county-level economic vulnerability indicators on COVID-19 infection rates, indirectly inhibiting COVID-19 transmission. We also found that not all regions are suitable for the strictest social distancing policies. We considered the moderating effect of multilevel covariates on the results, allowing us to identify the causes of significant group differences across regions and to tailor measures of varying intensity more easily. This study is also necessary to accomplish targeted preventative measures and to allocate resources.
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