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Paredes MI, Perofsky AC, Frisbie L, Moncla LH, Roychoudhury P, Xie H, Bakhash SAM, Kong K, Arnould I, Nguyen TV, Wendm ST, Hajian P, Ellis S, Mathias PC, Greninger AL, Starita LM, Frazar CD, Ryke E, Zhong W, Gamboa L, Threlkeld M, Lee J, Stone J, McDermot E, Truong M, Shendure J, Oltean HN, Viboud C, Chu H, Müller NF, Bedford T. Local-scale phylodynamics reveal differential community impact of SARS-CoV-2 in a metropolitan US county. PLoS Pathog 2024; 20:e1012117. [PMID: 38530853 PMCID: PMC10997136 DOI: 10.1371/journal.ppat.1012117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/05/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
SARS-CoV-2 transmission is largely driven by heterogeneous dynamics at a local scale, leaving local health departments to design interventions with limited information. We analyzed SARS-CoV-2 genomes sampled between February 2020 and March 2022 jointly with epidemiological and cell phone mobility data to investigate fine scale spatiotemporal SARS-CoV-2 transmission dynamics in King County, Washington, a diverse, metropolitan US county. We applied an approximate structured coalescent approach to model transmission within and between North King County and South King County alongside the rate of outside introductions into the county. Our phylodynamic analyses reveal that following stay-at-home orders, the epidemic trajectories of North and South King County began to diverge. We find that South King County consistently had more reported and estimated cases, COVID-19 hospitalizations, and longer persistence of local viral transmission when compared to North King County, where viral importations from outside drove a larger proportion of new cases. Using mobility and demographic data, we also find that South King County experienced a more modest and less sustained reduction in mobility following stay-at-home orders than North King County, while also bearing more socioeconomic inequities that might contribute to a disproportionate burden of SARS-CoV-2 transmission. Overall, our findings suggest a role for local-scale phylodynamics in understanding the heterogeneous transmission landscape.
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Affiliation(s)
- Miguel I. Paredes
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Amanda C. Perofsky
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Lauren Frisbie
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Louise H. Moncla
- The University of Pennsylvania, Department of Pathobiology, Philadelphia, Pennsylvania, United States of America
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Shah A. Mohamed Bakhash
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Kevin Kong
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Isabel Arnould
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Tien V. Nguyen
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Seffir T. Wendm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Pooneh Hajian
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Sean Ellis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Patrick C. Mathias
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Alexander L. Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Lea M. Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Chris D. Frazar
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Erica Ryke
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Weizhi Zhong
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
| | - Machiko Threlkeld
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Jeremy Stone
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
| | - Evan McDermot
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
| | - Melissa Truong
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
- Howard Hughes Medical Institute, Seattle, Washington, United States of America
| | - Hanna N. Oltean
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Helen Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, United States of America
| | - Nicola F. Müller
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Trevor Bedford
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
- Howard Hughes Medical Institute, Seattle, Washington, United States of America
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Paredes MI, Perofsky AC, Frisbie L, Moncla LH, Roychoudhury P, Xie H, Mohamed Bakhash SA, Kong K, Arnould I, Nguyen TV, Wendm ST, Hajian P, Ellis S, Mathias PC, Greninger AL, Starita LM, Frazar CD, Ryke E, Zhong W, Gamboa L, Threlkeld M, Lee J, Stone J, McDermot E, Truong M, Shendure J, Oltean HN, Viboud C, Chu H, Müller NF, Bedford T. Local-Scale phylodynamics reveal differential community impact of SARS-CoV-2 in metropolitan US county. medRxiv 2022:2022.12.15.22283536. [PMID: 36561171 PMCID: PMC9774227 DOI: 10.1101/2022.12.15.22283536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
SARS-CoV-2 transmission is largely driven by heterogeneous dynamics at a local scale, leaving local health departments to design interventions with limited information. We analyzed SARS-CoV-2 genomes sampled between February 2020 and March 2022 jointly with epidemiological and cell phone mobility data to investigate fine scale spatiotemporal SARS-CoV-2 transmission dynamics in King County, Washington, a diverse, metropolitan US county. We applied an approximate structured coalescent approach to model transmission within and between North King County and South King County alongside the rate of outside introductions into the county. Our phylodynamic analyses reveal that following stay-at-home orders, the epidemic trajectories of North and South King County began to diverge. We find that South King County consistently had more reported and estimated cases, COVID-19 hospitalizations, and longer persistence of local viral transmission when compared to North King County, where viral importations from outside drove a larger proportion of new cases. Using mobility and demographic data, we also find that South King County experienced a more modest and less sustained reduction in mobility following stay-at-home orders than North King County, while also bearing more socioeconomic inequities that might contribute to a disproportionate burden of SARS-CoV-2 transmission. Overall, our findings suggest a role for local-scale phylodynamics in understanding the heterogeneous transmission landscape.
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Affiliation(s)
- Miguel I. Paredes
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Amanda C. Perofsky
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Lauren Frisbie
- Washington State Department of Health, Shoreline, WA USA
| | - Louise H. Moncla
- The University of Pennsylvania, Department of Pathobiology, Philadelphia, PA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | | | - Kevin Kong
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Isabel Arnould
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Tien V. Nguyen
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Seffir T. Wendm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Pooneh Hajian
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Sean Ellis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Patrick C. Mathias
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Alexander L. Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Lea M. Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Chris D. Frazar
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Erica Ryke
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Weizhi Zhong
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
| | - Machiko Threlkeld
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jeremy Stone
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
| | - Evan McDermot
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
| | - Melissa Truong
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, Seattle, WA, USA
| | | | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Helen Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
| | - Nicola F. Müller
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Trevor Bedford
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, Seattle, WA, USA
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Paredes MI, Lunn SM, Famulare M, Frisbie LA, Painter I, Burstein R, Roychoudhury P, Xie H, Mohamed Bakhash SA, Perez R, Lukes M, Ellis S, Sathees S, Mathias PC, Greninger A, Starita LM, Frazar CD, Ryke E, Zhong W, Gamboa L, Threlkeld M, Lee J, McDermot E, Truong M, Nickerson DA, Bates DL, Hartman ME, Haugen E, Nguyen TN, Richards JD, Rodriguez JL, Stamatoyannopoulos JA, Thorland E, Melly G, Dykema PE, MacKellar DC, Gray HK, Singh A, Peterson JM, Russell D, Marcela Torres L, Lindquist S, Bedford T, Allen KJ, Oltean HN. Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: a retrospective cohort study. Clin Infect Dis 2022; 75:e536-e544. [PMID: 35412591 PMCID: PMC9047245 DOI: 10.1093/cid/ciac279] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
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Affiliation(s)
- Miguel I Paredes
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Michael Famulare
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA
| | | | - Ian Painter
- Washington State Department of Health, Shoreline, WA USA
| | - Roy Burstein
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Shah A Mohamed Bakhash
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Ricardo Perez
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Maria Lukes
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Sean Ellis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Saraswathi Sathees
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Patrick C Mathias
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Alexander Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Chris D Frazar
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Erica Ryke
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Weizhi Zhong
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Machiko Threlkeld
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Evan McDermot
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Melissa Truong
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Daniel L Bates
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | - Matthew E Hartman
- Altius Institute for Biomedical Sciences, Seattle, WA USA.,Department of Cardiovascular Services, Swedish Medical Center, Seattle, WA USA
| | - Eric Haugen
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | | | | | | | | | - Eric Thorland
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | - Geoff Melly
- Washington State Department of Health, Shoreline, WA USA
| | | | | | - Hannah K Gray
- Washington State Department of Health, Shoreline, WA USA
| | - Avi Singh
- Washington State Department of Health, Shoreline, WA USA
| | | | - Denny Russell
- Washington State Department of Health, Shoreline, WA USA
| | | | | | - Trevor Bedford
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Howard Hughes Medical Institute, Seattle, WA USA
| | | | - Hanna N Oltean
- Washington State Department of Health, Shoreline, WA USA
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Breaux∗ D, Baker∗ J, Threlkeld M, Omer I, Vanhoozer D. Focused Bloodstream Infection Prevention Success Using a Team-Based Unit-Level Approach. Am J Infect Control 2004. [DOI: 10.1016/j.ajic.2004.04.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Breaux∗ D, Baker J, Threlkeld M, Omer I, Taylor E, DeShazer L. A Unit-Based Council Develops a Team Approach To Reduce Methicillin-Resistant Staphylococcus aureus Infections in the Intensive Care Unit. Am J Infect Control 2004. [DOI: 10.1016/j.ajic.2004.04.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smith CR, Petty BG, Hendrix CW, Kernan WN, Garver PL, Fox K, Beamer A, Carbone K, Threlkeld M, Lietman PS. Ceftriaxone compared with cefotaxime for serious bacterial infections. J Infect Dis 1989; 160:442-7. [PMID: 2668428 DOI: 10.1093/infdis/160.3.442] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Ceftriaxone was compared with cefotaxime for the treatment of serious bacterial infections in a prospective, randomized, double-blind clinical trial. The dose of ceftriaxone was 2 g once a day, and the dose of cefotaxime was 2 g every 4 h. Metronidazole was added if anaerobic infection was suspected. Explicit criteria were used to define infections, clinical response, and adverse effects. Ceftriaxone was given to 88 patients and cefotaxime to 83. The two treatment groups did not differ in types of infection, infecting organisms, and severity of underlying disease. The response rate was 81% (71/88) for ceftriaxone and 80% (66/83) for cefotaxime. The power of the study to detect a 15% difference in response rate at P less than .1 was 90%. The frequency of diarrhea, thrombophlebitis, prothrombin time, prolongation, colonization, and superinfection did not differ between treatment groups. Ceftriaxone 2 g once a day was as safe and effective as cefotaxime 2 g every 4 h for suspected serious bacterial infections.
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Affiliation(s)
- C R Smith
- Division of Clinical Pharmacology and Internal Medicine, Johns Hopkins University, Baltimore, Maryland
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