Smoke and COVID-19 case fatality ratios during California wildfires

Abstract Background: Recent evidence has shown an association between wildfire smoke and COVID-19 cases and deaths. The San Francisco Bay Area, in California (USA), experienced two major concurrent public health threats in 2020: the COVID-19 pandemic and dense smoke emitted by wildfires. This provides a unprecedented context to unravel the role of acute air pollution exposure on COVID-19 severity. Methods: A smoke product provided by the National Oceanic and Atmospheric Association Hazard Mapping System was used to identify counties exposed to heavy smoke in summer and fall of 2020. Daily COVID-19 cases and deaths for the United States were downloaded at the county-level from the CDC COVID Data Tracker. Synthetic control methods were used to estimate the causal effect of the wildfire smoke on daily COVID-19 case fatality ratios, adjusting for population mobility. Results: Evidence of an impact of wildfire smoke on COVID-19 case fatality ratios was observed, with precise estimates in Alameda and San Francisco. Up to 58 (95% CI: 29, 87) additional deaths for every 1,000 COVID-19 incident daily cases attributable to wildfire smoke was estimated in Alameda in early September. Conclusions: Findings indicated that extreme weather events such as wildfires smoke can drive increased vulnerability to infectious diseases, highlighting the need to further study these colliding crises. Understanding the environmental drivers of COVID-19 mortality can be used to protect vulnerable populations from these potentially concomitant public health threats.

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Health and Climate Change

Oxford Research Encyclopedia of Environmental Science ◽

10.1093/acrefore/9780199389414.013.83 ◽

2015 ◽

Cited By ~ 1

Author(s):

Nicholas Watts

Keyword(s):

Public Health ◽

Climate Change ◽

Health System ◽

Adaptive Capacity ◽

Social Systems ◽

The United States ◽

Extreme Weather Events ◽

Policy Responses ◽

Mass Migration ◽

Climate Change And Health

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Environmental Science. Please check back later for the full article. There are three important linkages to explore between climate change and health in terms of potential policy responses. The first of these linkages relates to the impacts on health resulting from climate change. In 2009, The Lancet described climate change as “the greatest global health threat of the 21st century,” referencing the direct and indirect effects it is having on public health. While a number of impacts are directly observable (i.e., an increased frequency and severity of many extreme weather events), others are more indirect, being mediated through environmental and social systems (i.e., the health complications associated with mass migration or violent conflict). Further, it is well understood that resilience and adaptive capacity play an important role in reducing these impacts—often leaving low-income communities worse off than most. The second important linkage between climate change and health relates to the co-benefits of mitigation and adaptation. Policy responses to climate change will inevitably come with both intended and unforseen externalities and “side-effects” (both positive and negative). Traditional public health tools, such as health impact assessment, can be valuable in identifying and understanding these co-benefits to better guide policy. Indeed, many of the mitigation solutions yield substantial benefits for public health: switching away from coal-fired power plants as an energy choice improves cardiovascular and respiratory health; designing cities which are cycle- and pedestrian-friendly increases rates of physical activity (helping to tackle obesity, diabetes, many cancers, and heart disease) while also reducing greenhouse gas emissions from vehicles. Finally, the health system itself has an important role in responding directly to climate change. This is frequently understood in terms of a health facility’s ability to withstand and respond to the impacts of climate change, and to the adaptive capacity of the health system itself. But there is also a role for the health system to play in reducing its own emissions. In countries like the United Kingdom and the United States, the formal health system is responsible for as much as 3–8% of national emissions, and has subsequently made commitments to reduce its environmental impact. A 2013 review of the UK National Health Service’s carbon footprint indicated that as much as 60% of this came from procurement, 17% from building energy, and 13% from health system–related transport. A number of the solutions available are often designed in a way that improves patient outcomes and satisfaction, while reducing the costs of healthcare. In low- and middle-income countries, the focus is placed on ensuring access to reliable electricity, a task well suited to decentralized micro-grids with sustainable power generation. Academic literature on the topic of health and climate change has expanded rapidly in recent years and includes the 2009 and 2015 Lancet Commissions on health and climate change, the 2010 series on the health co-benefits of mitigation, and the 2014 Intergovernmental Panel on Climate Change’s 5th Assessment Report.

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LB9. Rising High Rate of Invasive Group A Streptococcus Infections Among Persons Experiencing Homelessness in San Francisco, 2010–2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy229.2183 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S762-S762

Author(s):

Tara Scheuer ◽

Tanya Libby ◽

Chris Van Beneden ◽

James Watt ◽

Arthur Reingold ◽

...

Keyword(s):

United States ◽

San Francisco ◽

Group A Streptococcus ◽

Disease Incidence ◽

Case Fatality ◽

The United States ◽

Invasive Group ◽

Incidence Trends ◽

Disease Case ◽

Group A

Abstract Background Rates of invasive group A Streptococcus (iGAS) disease in the United States have risen since 2014; reasons remain unclear. Outbreaks of iGAS infection among persons experiencing homelessness (PEH) and persons who inject drugs in Europe, Canada, and the United States have been described. Using active, population-based surveillance data from California’s Emerging Infections Program, we describe incidence trends and characteristics of iGAS infection among PEH and persons not experiencing homelessness (PNEH) in San Francisco (SF) County during 2010–2017. Methods We defined an iGAS case as infection with GAS isolated from a normally sterile site (e.g., blood) in an SF resident. We calculated annual iGAS disease incidence rates (cases per 100,000 population) for PEH and PNEH using denominators from SF’s Department of Homelessness and Supportive Housing and the State of California Department of Finance. Demographic, clinical, and exposure characteristics of PEH and PNEH were compared by chi-square or t-test. Results We identified 673 iGAS cases in SF during 2010–2017. Among these, 34% (229/673) were among PEH. Annual iGAS incidence among PEH rose from ~300 (2010–2014) to 547 (95% CI: 379–714) per 100,000 in 2017 (P < 0.001, Cochran-Armitage trend test); rates peaked at 758 (95% CI: 561–955) in 2016. Annual iGAS incidence in PNEH rose from a mean of 5 in 2010–2013 to 9.3 (95% CI: 7.3–11.4) per 100,000 in 2017 (P < 0.001). Annual iGAS incidence in PEH was 42–72 times that in PNEH. PEH with iGAS infections were significantly younger and more likely to be male, white, and uninsured or enrolled in Medicaid (P < 0.05 for each) compared with PNEH with iGAS disease. Case fatality ratios, ICU admission, infection type, and length of hospital stay did not differ significantly. Smoking, current injection drug use, current alcohol abuse, and AIDS diagnosis were significantly more common among PEH with iGAS. Obesity, diabetes, and cancer were significantly more common among PNEH with iGAS. Conclusion In San Francisco, iGAS rates among both PEH and PNEH have risen significantly. Incidence of iGAS is strikingly higher in PEH than in PNEH and exposures differed between PEH and PNEH with iGAS. This information could inform development of disease control and prevention strategies. Disclosures All authors: No reported disclosures.

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A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA

Journal of Drug Issues ◽

10.1177/0022042616679829 ◽

2016 ◽

Vol 47 (2) ◽

pp. 164-184 ◽

Cited By ~ 18

Author(s):

Amos Irwin ◽

Ehsan Jozaghi ◽

Ricky N. Bluthenthal ◽

Alex H. Kral

Keyword(s):

Public Health ◽

United States ◽

San Francisco ◽

Cost Benefit Analysis ◽

Cost Benefit ◽

Cost Effective ◽

The United States ◽

Local Public Health ◽

Supervised Injection ◽

Overdose Deaths

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

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Somewhere to go: Assessing the impact of public restroom interventions on reports of open defecation in San Francisco, California from 2014 to 2020

10.21203/rs.3.rs-936620/v1 ◽

2021 ◽

Author(s):

Heather Kathleen Amato ◽

Douglas Martin ◽

Christopher Michael Hoover ◽

Jay Paul Graham

Keyword(s):

Public Health ◽

San Francisco ◽

Fecal Contamination ◽

The United States ◽

Public Health Issue ◽

Intervention Period ◽

Interrupted Time Series Analysis ◽

Post Intervention ◽

Open Defecation ◽

The Impact

Abstract Background Open defecation due to a lack of access to sanitation facilities remains a public health issue in the United States. People experiencing homelessness face barriers to accessing sanitation facilities, and are often forced to practice open defecation on streets and sidewalks. Exposed feces may contain harmful pathogens posing a significant threat to public health, especially among unhoused persons living near open defecation sites. The City of San Francisco’s Department of Public Works implemented the Pit Stop Program to provide the unhoused and the general public with improved access to sanitation with the goal of reducing fecal contamination on streets and sidewalks. The objective of this study was to assess the impact of these public restroom interventions on reports of exposed feces in San Francisco, California. Methods We evaluated the impact of various public restroom interventions implemented from January 1, 2014 to January 1, 2020 on reports of exposed feces, captured through a 311 municipal service. Publicly available 311 reports of exposed feces were spatially and temporally matched to 31 Pit Stop restroom interventions in ten San Francisco neighborhoods. We conducted an interrupted time-series analysis to compare pre- versus post-intervention rates of feces reports near the restrooms. Results Feces reports declined by 12.47 reports per week after the installation of 13 Pit Stop restrooms (p-value = 0.0002). The rate of reports per week declined from the six-month pre-intervention period to the post-intervention period (slope change=-0.024 [95% CI=-0.033, -0.014]). Reports also declined after new restroom installations in the Mission and Golden Gate Park, and after the provision of attendants in the Mission, Castro/Upper Market, and Financial District/South Beach. Conclusions Increased access to public toilets and the addition of restroom attendants reduced fecal contamination in San Francisco, especially in neighborhoods with people experiencing homelessness. Programs that improve access to public restrooms should be evaluated at the neighborhood level in order to tailor sanitation interventions to neighborhood-specific needs.

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COVID-19, Australia: Epidemiology Report 12: Reporting week ending 23:59 AEST 19 April 2020

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.36 ◽

2020 ◽

Vol 44 ◽

Cited By ~ 4

Author(s):

Keyword(s):

Public Health ◽

Disease Transmission ◽

Case Fatality ◽

The United States ◽

International Travel ◽

World Health ◽

Public Health Response ◽

Public Health Action ◽

Case Ascertainment ◽

Overseas Travel

Confirmed cases in Australia notified up to 19 April 2020: notifications = 6,606; deaths = 69. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of the disease. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked. The distribution of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.0%) compared to the World Health Organization’s globally-reported rate (6.8%) and to other comparable high-income countries such as the United States of America (4.7%) and the United Kingdom (13.5%). The low CFR is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment enables public health response and reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.

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Global Pandemic Trends of COVID-19 in 2020

10.21203/rs.3.rs-625008/v1 ◽

2021 ◽

Author(s):

Hai-Zhen Chen ◽

Bo Cai ◽

Jian-Guo Chen

Keyword(s):

Public Health ◽

United States ◽

Mortality Rate ◽

Incidence Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

The United States ◽

Cumulative Number ◽

Fatality Rate ◽

The World

Abstract Background: The novel coronavirus pneumonia (COVID-19) has been global threaten to public health. This paper provides perspective to the decision-making for public health control of the pandemic or the spread of epidemic.Methods: According to the WHO global reported database, we developed and used the number of cumulative cases, and the number of cumulative deaths to calculate and analyze rates of incidence, mortality, and fatality by country, with respect to the 30 highest outbreak (Top 30) countries.Results： As of December 31, 2020, of the global population of 7.585 billion, the cumulative number of reported cases was 81,475,053, and the cumulative number of deaths was 1,798,050. The incidence rate of COVID-19 was 1074.13 per 100,000 population, the mortality rate was 23.70 per 100,000, and the case fatality rate was 2.21%. Among the Top 30 countries, the five countries with the highest number of reported cumulative cases were, in rank, the United States (19,346,790 cases), India (10,266,674), Brazil (7,563,551), Russia (3,159,297) and France (2,556,708), and the five countries with the highest number of cumulative deaths were the United States (335,789 cases), Brazil (192,681), India (148,738), Mexico (123,845) and Italy (73,604). Globally, the countries with the highest incidence rate were, in rank, Andorra, Luxembourg, Montenegro, San Marino, and Czechia; the countries with the highest mortality rate were, in rank, San Marino, Belgium, Slovenia, Italy, and North Macedonia. The highest fatality rate was found in Yemen, Mexico, Montserrat, Isle of Man, and Ecuador, respectively. In China, 96,673 cases of COVID-19 and 4788 deaths were reported in 2020, ranking the 78th and the 43rd, respectively, in the world. The incidence rate and mortality rate were 6.90/105 and 0.34/105, respectively, ranking 207th and 188th in the world. The case fatality rate was 4.95%, ranking 11th in the world.Conclusions： The COVID-19 prevalence is still on the rise, and the turning points of incidence and mortality are not yet forecasted. Personal protection, anti-epidemic measures and efforts from public health personnel, medical professionals, biotechnology R&D personnel, effectiveness of the vaccination programs and the governments, are the important factors to determine the future prevalence of this coronavirus disease.

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SARS-CoV-2 Vaccine Hesitancy in a Sample of US Adults: Role of Perceived Satisfaction With Health, Access to Healthcare, and Attention to COVID-19 News

Frontiers in Public Health ◽

10.3389/fpubh.2021.665724 ◽

2021 ◽

Vol 9 ◽

Author(s):

Sarah Bauerle Bass ◽

Maureen Wilson-Genderson ◽

Dina T. Garcia ◽

Aderonke A. Akinkugbe ◽

Maghboeba Mosavel

Keyword(s):

Public Health ◽

New York ◽

San Francisco ◽

Healthcare Access ◽

The United States ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Rates

Understanding which communities are most likely to be vaccine hesitant is necessary to increase vaccination rates to control the spread of SARS-CoV-2. This cross-sectional survey of adults (n = 501) from three cities in the United States (Miami, FL, New York City, NY, San Francisco, CA) assessed the role of satisfaction with health and healthcare access and consumption of COVID-19 news, previously un-studied variables related to vaccine hesitancy. Multilevel logistic regression tested the relationship between vaccine hesitancy and study variables. Thirteen percent indicated they would not get vaccinated. Black race (OR 2.6; 95% CI: 1.38–5.3), income (OR = 0.64; 95% CI: 0.50–0.83), inattention to COVID-19 news (OR = 1.6; 95% CI: 1.1–2.5), satisfaction with health (OR 0.72; 95% CI: 0.52–0.99), and healthcare access (OR = 1.7; 95% CI: 1.2–2.7) were associated with vaccine hesitancy. Public health officials should consider these variables when designing public health communication about the vaccine to ensure better uptake.

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COVID-19, Australia: Epidemiology Report 13: Reporting week ending 23:59 AEST 26 April 2020

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.35 ◽

2020 ◽

Vol 44 ◽

Cited By ~ 1

Author(s):

Keyword(s):

Public Health ◽

Disease Transmission ◽

Case Fatality ◽

The United States ◽

International Travel ◽

World Health ◽

Public Health Response ◽

Public Health Action ◽

Case Ascertainment ◽

Overseas Travel

Confirmed cases in Australia notified up to 26 April 2020: notifications = 6,711; deaths = 77. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of COVID-19 in Australia. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked to another case. The ratio of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.1%) compared to the World Health Organization’s globally-reported rate (6.9%) and to other comparable high-income countries such as the United States of America (5.1%) and the United Kingdom (13.7%). The lower CFR in Australia is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment and prompt identification of contacts enables an effective public health response and a reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.

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Significant and sustained decrease in non-SARS-CoV-2 respiratory viral infections during COVID-19 public health interventions.

10.1101/2021.05.11.21256147 ◽

2021 ◽

Author(s):

Jeffrey D. Whitman ◽

Phong Pham ◽

Caryn Bern ◽

Elaine M. Dekker ◽

Barbara L. Haller ◽

...

Keyword(s):

Public Health ◽

San Francisco ◽

Viral Infections ◽

Respiratory Infections ◽

The United States ◽

Health Interventions ◽

Respiratory Pathogen ◽

Public Health Interventions ◽

Bay Area ◽

Respiratory Viral Infections

Public health interventions to decrease the spread of SARS-CoV-2 were largely implemented in the United States during spring 2020. This study evaluates the additional effects of these interventions on non-SARS-CoV-2 respiratory viral infections from a single healthcare system in the San Francisco Bay Area. The results of a respiratory pathogen multiplex polymerase chain reaction panel intended for inpatient admissions were analyzed by month between 2019 and 2020. We found major decreases in the proportion and diversity of non-SARS-CoV-2 respiratory viral illnesses in all months following masking and shelter-in-place ordinances. These findings suggest real-world effectiveness of nonpharmaceutical interventions on droplet-transmitted respiratory infections.

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Regional differences in COVID-19 attack and case fatality rates in the first quarter of 2020: a comparative study

IMC Journal of Medical Science ◽

10.3329/imcjms.v14i2.52825 ◽

2021 ◽

Vol 14 (2) ◽

pp. 1-10

Author(s):

Most Zannatul Ferdous ◽

Lakshmi Rani Kundu ◽

Marjia Sultana ◽

Sheikh Jafia Jafrin

Keyword(s):

Public Health ◽

North America ◽

South America ◽

Case Fatality ◽

The United States ◽

World Health ◽

Study Results ◽

The World ◽

Mixed Approach ◽

Health Organization

Background and Objective: The COVID-19 (Coronavirus disease 2019) outbreak has become a public health threat all over the world. From December 31, 2019 to March 19, 2020, 146 countries were affected. Evidence on the management approaches of current COVID-19 pandemic is still limited though the numbers of affected countries are increasing as the days go by. This study was aimed at determining the attack rate (AR) and case fatality rate (CFR) of Covid-19 in six different regions around the world in the first quarter of 2020. An attempt was also made to provide an overview of the ongoing situation of COVID-19. Methods: The design of the study was mixed approach where a retrospective analysis of surveillance data of six different regions around the world were collected from COVID-19 dashboard of World Health organization, between 31 December 2019 to 19 March 2020 (Time: 2:00 pm. BST [CET: 9 am]). Besides, other different validated sources (example: Worldometer, Center for Disease Control and Prevention) were used to assess the ongoing situation regarding COVID-19. A statistical software SPSS version 26 was used to analyze the data. Results: There were a total of 207,860 confirmed cases and 8779 deaths across six different regions around the world from 31 December 2019 to 19 March 2020, with the highest AR of 9.92/100,000 population in Europe region, followed by Asia (2.7/ 100,000), Australia (1.75/100,000), North America (1.42/100,000), South America (0.23/100,000) and Africa (0.06/100,000) regions. Study results revealed statistically significant association between attack rates and the six regions of the world (p=0.002), meaning that AR varied in the regions around the world. The CFR was high in Europe region (4.81%), followed by Asia (4.06%), Africa (2.72%), South America (1.41%), Australia (1.12%), and North America (0.69%) regions. Data reviewed from different countries revealed that the highest number of cases was confirmed in the United States, followed by Spain and Italy. The findings revealed that the reported confirmed cases varied widely in different regions of the world. Conclusion: The severity and variation in -geographical distribution of COVID-19 cases and deaths suggest that urgent response from various government and public health authorities should be taken and research regarding underlying factors determining this severity should be sought for. Ibrahim Med. Coll. J. 2020; 14(2): 1-10

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