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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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Moreira-Soto A, Bruno A, de Mora D, Paez M, Garces J, Wulf B, Sander AL, Olmedo M, Basantes Mantilla MJ, Gonzalez Gonzalez M, Orlando SA, Salgado Cisneros S, Zevallos JC, Drexler JF. Virological evidence of the impact of non-pharmaceutical interventions against COVID-19 in Ecuador, a resource-limited setting. Emerg Microbes Infect 2023; 12:2259001. [PMID: 37698611 PMCID: PMC10563623 DOI: 10.1080/22221751.2023.2259001] [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: 05/14/2023] [Accepted: 09/10/2023] [Indexed: 09/13/2023]
Abstract
Ecuador had substantial COVID-19-mortality during 2020 despite early implementation of non-pharmaceutical interventions (NPIs). Resource-limited settings like Ecuador have high proportions of informal labour which entail high human mobility, questioning efficacy of NPIs. We performed a retrospective observational study in Ecuador's national reference laboratory for viral respiratory infections during March 2020-February 2021 using stored respiratory specimens from 1950 patients, corresponding to 2.3% of all samples analysed within the Ecuadorian national surveillance system per week. During 2020, detection of SARS-CoV-2 (Pearson correlation; r = -0.74; p = 0.01) and other respiratory viruses (Pearson correlation; r = -0.68; p = 0.02) by real-time RT-PCR correlated negatively with NPIs stringency. Among respiratory viruses, adenoviruses (Fisher's exact-test; p = 0.026), parainfluenzaviruses (p = 0.04), enteroviruses (p < 0.0001) and metapneumoviruses (p < 0.0001) occurred significantly more frequently during months of absent or non-stringent NPIs (characterized by <55% stringency according to the Oxford stringency index data for Ecuador). Phylogenomic analyses of 632 newly characterized SARS-CoV-2 genomes revealed 100 near-parallel SARS-CoV-2 introductions during early 2020 in the absence of NPIs. NPI stringency correlated negatively with the number of circulating SARS-CoV-2 lineages during 2020 (r = -0.69; p = 0.02). Phylogeographic reconstructions showed differential SARS-CoV-2 dispersion patterns during 2020, with more short-distance transitions potentially associated with recreational activity during non-stringent NPIs. There were also fewer geographic transitions during strict NPIs (n = 450) than during non-stringent or absent NPIs (n = 580). Virological evidence supports that NPIs had an effect on virus spread and distribution in Ecuador, providing a template for future epidemics in resource-limited settings and contributing to a balanced assessment of societal costs entailed by strict NPIs.
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Affiliation(s)
- Andres Moreira-Soto
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
- Tropical Disease Research Program, School of Veterinary Medicine, Universidad Nacional, Costa Rica, Costa Rica
| | - Alfredo Bruno
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Universidad Agraria del Ecuador, Guayaquil, Ecuador
| | - Doménica de Mora
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Michelle Paez
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Jimmy Garces
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Ben Wulf
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Anna-Lena Sander
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Maritza Olmedo
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | | | - Manuel Gonzalez Gonzalez
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Universidad ECOTEC, Km 13.5 Samborondon, Samborondon, EC092302, Ecuador
| | - Solon Alberto Orlando
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Health Science Faculty, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | - Juan Carlos Zevallos
- Health Science Faculty, Universidad Espíritu Santo, Guayaquil, Ecuador
- Alianza para la Investigación de Enfermedades Emergentes (AIE), Quito, Ecuador
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), Associated Partner Site Charité, Berlin, Germany
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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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Badr HS, Zaitchik BF, Kerr GH, Nguyen NLH, Chen YT, Hinson P, Colston JM, Kosek MN, Dong E, Du H, Marshall M, Nixon K, Mohegh A, Goldberg DL, Anenberg SC, Gardner LM. Unified real-time environmental-epidemiological data for multiscale modeling of the COVID-19 pandemic. Sci Data 2023; 10:367. [PMID: 37286690 PMCID: PMC10245354 DOI: 10.1038/s41597-023-02276-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
An impressive number of COVID-19 data catalogs exist. However, none are fully optimized for data science applications. Inconsistent naming and data conventions, uneven quality control, and lack of alignment between disease data and potential predictors pose barriers to robust modeling and analysis. To address this gap, we generated a unified dataset that integrates and implements quality checks of the data from numerous leading sources of COVID-19 epidemiological and environmental data. We use a globally consistent hierarchy of administrative units to facilitate analysis within and across countries. The dataset applies this unified hierarchy to align COVID-19 epidemiological data with a number of other data types relevant to understanding and predicting COVID-19 risk, including hydrometeorological data, air quality, information on COVID-19 control policies, vaccine data, and key demographic characteristics.
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Affiliation(s)
- Hamada S Badr
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Benjamin F Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA.
| | - Gaige H Kerr
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Nhat-Lan H Nguyen
- College of Arts and Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Yen-Ting Chen
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Patrick Hinson
- College of Arts and Sciences, University of Virginia, Charlottesville, VA, 22903, USA
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Josh M Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Ensheng Dong
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Hongru Du
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Maximilian Marshall
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Kristen Nixon
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Arash Mohegh
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
- Health & Exposure Assessment Branch, California Air Resources Board, Sacramento, CA, 95812, USA
| | - Daniel L Goldberg
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Susan C Anenberg
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Lauren M Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
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Fernández D, Giné-Vázquez I, Morena M, Koyanagi AI, Janko MM, Haro JM, Panagiotakos D, Molassiotis A, Pan WK, Tyrovolas S. Government interventions and control policies to contain the first COVID-19 outbreak: An analysis of evidence. Scand J Public Health 2023:14034948231156969. [PMID: 36883722 PMCID: PMC9996153 DOI: 10.1177/14034948231156969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND The overarching aim of this study was to evaluate the effectiveness over time of government interventions and policy restrictions and the impact of determinants on spread and mortality during the first-wave of the COVID-19 pandemic, globally, regionally and by country-income level, up to 18 May 2020. METHODS We created a global database merging World Health Organization daily case reports (from 218 countries/territories) with other socio-demographic and population health measures from 21 January to 18 May 2020. A four-level government policy interventions score (low to very high) was created based on the Oxford Stringency Index. RESULTS Our results support the use of very high government interventions to suppress both COVID-19 spread and mortality effectively during wave one globally compared to other policy levels of control. Similar trends in virus propagation and mortality were observed in all country-income levels and specific regions. CONCLUSIONS
Rapid implementation of government interventions was needed to contain the first wave of the COVID-19 outbreak and to reduce COVID-19-related mortality.
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Affiliation(s)
- Daniel Fernández
- Serra Húnter fellow. Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Spain.,Institute of Mathematics of UPC-BarcelonaTech (IMTech), Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
| | - Iago Giné-Vázquez
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Marianthi Morena
- Nutrition and Dietetics Department, Harokopio University, Greece
| | - A I Koyanagi
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain.,ICREA, Spain
| | | | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, UK
| | - William K Pan
- Global Health Institute, Duke University, USA.,Nicholas School of the Environment, Duke University, USA
| | - Stefanos Tyrovolas
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain.,WHO Collaborating Centre for Community Health Services (WHOCC), School of Nursing, The Hong Kong Polytechnic University, China
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Wei CF, Lan FY, Hsu YT, Lowery N, Dibona L, Akkeh R, Kales SN, Yang J. Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States. Front Public Health 2022; 10:878208. [PMID: 35677773 PMCID: PMC9169416 DOI: 10.3389/fpubh.2022.878208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety enhancement and emergency preparedness planning for essential workers. Methods We conducted a retrospective analysis of visits at a community-based SARS-CoV-2 testing site in the greater Boston area between March 18th and June 19th, 2020, for individuals between 14 and 65 years of age. Nasopharyngeal swab specimen, medical review, and self-administered questionnaire were obtained, and SARS-CoV-2 infection was determined with real-time, reverse transcriptase-polymerase chain reaction (RT-PCR). Medical record-verified job classification, customer-facing, and work patterns were extracted from each individual's response through chart review and validated by licensed clinicians. The occupational patterns were coded by occupational medicine physicians with pre-specified criteria and were analyzed with logistic regression and inverse probability weighting. Results Among the 780 individuals included in the final analysis, working in healthcare-related jobs was associated with a four-fold increase in risk of SARS-CoV-2 infection (Adjusted OR: 4.00, 95% CI: 1.45–11.02). Individuals with customer-facing jobs had a two times risk increase (Adjusted OR: 1.97, 95% CI: 1.12–3.45) in having a positive SARS-CoV-2 RT-PCR assay result compared to participants with non-customer facing positions. Conclusions In this U.S. community-based population during the initial wave of the pandemic, a significant increase in risk of SARS-CoV-2 infection was observed in those employed in the healthcare sector or with customer-facing positions. Further research is warranted to determine if these correlations continued with the buildup of population immunity together with the attenuation of SARS-CoV-2 virulence.
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Affiliation(s)
- Chih-Fu Wei
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Yu-Tien Hsu
- Department of Social and Behavioral Science, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
| | - Nina Lowery
- Manet Community Health Center, Quincy, MA, United States
| | - Lauren Dibona
- Manet Community Health Center, Quincy, MA, United States
| | - Ream Akkeh
- Manet Community Health Center, Quincy, MA, United States
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.,Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Justin Yang
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.,Manet Community Health Center, Quincy, MA, United States.,Department of Employee and Occupational Health, Atrius Health, Boston, MA, United States.,Department of General Internal Medicine, Boston University School of Medicine, Boston, MA, United States
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