scholarly journals A Bayesian framework for estimating the risk ratio of hospitalization for people with comorbidity infected by SARS-CoV-2 virus

Author(s):  
Xiang Gao ◽  
Qunfeng Dong

Abstract Objective Estimating the hospitalization risk for people with comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance. Traditional biostatistical methods for risk estimations require: (i) the number of infected people who were not hospitalized, which may be severely undercounted since many infected people were not tested; (ii) comorbidity information for people not hospitalized, which may not always be readily available. We aim to overcome these limitations by developing a Bayesian approach to estimate the risk ratio of hospitalization for COVID-19 patients with comorbidities. Materials and Methods We derived a Bayesian approach to estimate the posterior distribution of the risk ratio using the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence of comorbidities in the general population. We applied our approach to 2 large-scale datasets in the United States: 2491 patients in the COVID-NET, and 5700 patients in New York hospitals. Results Our results consistently indicated that cardiovascular diseases carried the highest hospitalization risk for COVID-19 patients, followed by diabetes, chronic respiratory disease, hypertension, and obesity, respectively. Discussion Our approach only needs (i) the number of hospitalized COVID-19 patients and their comorbidity information, which can be reliably obtained using hospital records, and (ii) the prevalence of the comorbidity of interest in the general population, which is regularly documented by public health agencies for common medical conditions. Conclusion We developed a novel Bayesian approach to estimate the hospitalization risk for people with comorbidities infected with the SARS-CoV-2 virus.

2020 ◽  
Author(s):  
Xiang Gao ◽  
Qunfeng Dong

Estimating the hospitalization risk for people with certain comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance based on risk stratification. Traditional biostatistical methods require knowing both the number of infected people who were hospitalized and the number of infected people who were not hospitalized. However, the latter may be undercounted, as it is limited to only those who were tested for viral infection. In addition, comorbidity information for people not hospitalized may not always be readily available for traditional biostatistical analyses. To overcome these limitations, we developed a Bayesian approach that only requires the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence of comorbidities in the general population. By applying our approach to two different large-scale datasets in the U.S., our results consistently indicated that cardiovascular diseases carried the highest hospitalization risk for COVID-19 patients, followed by diabetes, chronic respiratory disease, hypertension, and obesity, respectively.


2020 ◽  
Author(s):  
Raid Amin ◽  
Terri Hall ◽  
Jacob Church ◽  
Daniela Schlierf ◽  
Martin Kulldorff

AbstractBackgroundCOVID-19 is a new coronavirus that has spread from person to person throughout the world. Geographical disease surveillance is a powerful tool to monitor the spread of epidemics and pandemic, providing important information on the location of new hot-spots, assisting public health agencies to implement targeted approaches to minimize mortality.MethodsCounty level data from January 22-April 28 was downloaded from USAfacts.org to create heat maps with ArcMap™ for diagnosed COVID-19 cases and mortality. The data was analyzed using spatial and space-time scan statistics and the SaTScan™ software, to detect geographical cluster with high incidence and mortality, adjusting for multiple testing. Analyses were adjusted for age. While the spatial clusters represent counties with unusually high counts of COVID-19 when averaged over the time period January 22-April 20, the space-time clusters allow us to identify groups of counties in which there exists a significant change over time.ResultsThere were several statistically significant COVID-19 clusters for both incidence and mortality. Top clusters with high rates included the areas in and around New York City, New Orleans and Chicago, but there were also several small rural clusters. Top clusters for a recent surge in incidence and mortality included large parts of the Midwest, the Mid-Atlantic Region, and several smaller areas in and around New York and New England.ConclusionsSpatial and space-time surveillance of COVID-19 can be useful for public health departments in their efforts to minimize mortality from the disease. It can also be applied to smaller regions with more granular data.


2021 ◽  
pp. e1-e5
Author(s):  
Paul C. Erwin ◽  
Kenneth W. Mucheck ◽  
Ross C. Brownson

In the United States, public health is largely the responsibility of state governments’ implementing authority specified in their constitutions or reserved to states under the 10th Amendment to the US Constitution. The public health–related powers granted to the federal government are substantially less and derive primarily from the Commerce Clause (Article 1, Section 8) of the US Constitution. In public health emergencies over the past several decades, however, the Centers for Disease Control and Prevention (CDC) has played a major role in providing guidance, resources, and other support to state and local public health departments, for example, in large foodborne disease outbreaks, in response to major natural disasters, and especially in response to large-scale infectious disease threats (e.g., West Nile virus, severe acute respiratory syndrome, and H1N1 influenza).1 (Am J Public Health. Published online ahead of print January 28, 2021: e1–e5. https://doi.org/10.2105/AJPH.2020.306111 )


2002 ◽  
Vol 30 (2) ◽  
pp. 212-223 ◽  
Author(s):  
Eleanor D. Kinney

Today, public health regulation at all levels faces unprecedented challenges both at home and abroad. The September 11, 2001 attacks on New York and Washington, D.C., by the Al Qaeda terrorist network and the anthrax bioterrorism that followed shortly thereafter have put public health regulation at the forefront of homeland security. The anthrax scare, in particular, has greatly tested the American public health system, calling into question whether the United States and its component states and localities are prepared to handle a major outbreak of infectious disease, such as smallpox, in a future bioterrorist action. While the response of public health agencies was commendable, especially in light of the magnitude of the assaults, it is manifestly clear that the American public health system will be hard pressed to meet similar challenges that may lie ahead.The events of fall 2001 follow a period of major challenges for public health. The AIDS pandemic has killed millions of people throughout the globe, especially in Africa and other parts of the developing world.


PEDIATRICS ◽  
1953 ◽  
Vol 12 (3S) ◽  
pp. 1-6

THIS report covers only that segment of child health care provided through organized community agencies, official or voluntary. According to the American Academy of Pediatrics' Study, about 22 percent of all the health care children received during an average day in 1946 for the nation as a whole was under such administrative arrangements. Most of the 22 percent represented hospital care, which is discussed in Chapter II. Only about 1.5 percent of total care on an average day represented care in child health clinics sponsored by public health agencies. Origin of Public Services for Children At the turn of the 20th century, bacteriology and immunology began to place in the hands of health officials the weapons to control communicable diseases and to prevent many deaths among children. These weapons made possible the development of planned, community-wide programs to prevent infant mortality and to improve child health. The earliest efforts were made in cities, partly because high mortality and morbidity rates were obvious in urban areas and partly because health departments were first organized in major cities. Moreover, these localities usually had adequate numbers of philanthropic citizens interested in helping to create and support private as well as public health agencies. New York was one of the first cities in the United States to demonstrate how existing knowledge could be organized for widespread use to save the lives of babies in crowded sections. In 1893, Jacobi, one of the first American pediatricians, encouraged a New York philanthropist to establish milk stations for distributing pasteurized milk for New York infants to help prevent infantile diarrhea. By 1902, there were 14 such stations in New York.


2021 ◽  
pp. 000276422199283
Author(s):  
Serena Tagliacozzo ◽  
Frederike Albrecht ◽  
N. Emel Ganapati

Communicating during a crisis can be challenging for public agencies as their communication ecology becomes increasingly complex while the need for fast and reliable public communication remains high. Using the lens of communication ecology, this study examines the online communication of national public health agencies during the COVID-19 pandemic in Italy, Sweden, and the United States. Based on content analysis of Twitter data ( n = 856) and agency press releases ( n = 95), this article investigates two main questions: (1) How, and to what extent, did national public health agencies coordinate their online communication with other agencies and organizations? (2) How was online communication from the agencies diversified in terms of targeting specific organizations and social groups? Our findings indicate that public health agencies relied heavily on internal scientific expertise and predominately coordinated their communication efforts with national government agencies. Furthermore, our analysis reveals that agencies in each country differed in how they diversify information; however, all agencies provided tailored information to at least some organizations and social groups. Across the three countries, information tailored for several vulnerable groups (e.g., pregnant women, people with disabilities, immigrants, and homeless populations) was largely absent, which may contribute to negative consequences for these groups.


2016 ◽  
Vol 10 (4) ◽  
pp. 631-632 ◽  
Author(s):  
Mary Anne Duncan ◽  
Maureen F. Orr

AbstractWhen a large chemical incident occurs and people are injured, public health agencies need to be able to provide guidance and respond to questions from the public, the media, and public officials. Because of this urgent need for information to support appropriate public health action, the Agency for Toxic Substances and Disease Registry (ATSDR) of the US Department of Health and Human Services has developed the Assessment of Chemical Exposures (ACE) Toolkit. The ACE Toolkit, available on the ATSDR website, offers materials including surveys, consent forms, databases, and training materials that state and local health personnel can use to rapidly conduct an epidemiologic investigation after a large-scale acute chemical release. All materials are readily adaptable to the many different chemical incident scenarios that may occur and the data needs of the responding agency. An expert ACE team is available to provide technical assistance on site or remotely. (Disaster Med Public Health Preparedness. 2016;10:631–632)


2017 ◽  
Vol 4 (1) ◽  
pp. 16
Author(s):  
William Milczarski ◽  
Peter Tuckel ◽  
Richard Maisel

Purpose: To provide an updated and comparative analysis of injury-related falls from bicycles, skateboards, roller skates and non-motorized scooters.Methods: The study uses two national databases – the Nationwide Emergency Department Sample and the Nationwide Inpatient Sample  – and subnational databases for New York, California, and Maryland.  Univariate and multivariate analyses (negative binomial regression) are performed to identify effects of age, gender, racial-ethnic background, and region on the incidence of injury-related falls from each of the four devices.Results: The rate of injuries due to falls from bicycles far surpasses the rates due to falls from the other devices.  When a measure of “exposure” is taken into consideration, however, the rate of injuries from skateboards outstrips the rates from bicycles or roller skates.  The profile of patients who are injured from falls from each of the four devices is distinctive.  Asian-Americans are greatly underrepresented among those who suffer a fall-related injury from any of the four devices.  The incidence of injuries attributable to falls varies considerably by geographic region.Conclusions: Public health officials need to be mindful that while certain activities such as scootering might be gaining in popularity, the number of injuries sustained from bicycles still dwarfs the number attributable to falls from skateboards, roller skates, and scooters combined.  Thus special attention needs to be paid to both prevent falls from bicycles and specific treatment modalities.  It is important for public health officials to gather injury data at the local level to allocate prevention and treatment resources more efficiently.


2021 ◽  
Author(s):  
Tara Alpert ◽  
Erica Lasek-Nesselquist ◽  
Anderson F. Brito ◽  
Andrew L. Valesano ◽  
Jessica Rothman ◽  
...  

SummaryThe emergence and spread of SARS-CoV-2 lineage B.1.1.7, first detected in the United Kingdom, has become a national public health concern in the United States because of its increased transmissibility. Over 500 COVID-19 cases associated with this variant have been detected since December 2020, but its local establishment and pathways of spread are relatively unknown. Using travel, genomic, and diagnostic testing data, we highlight the primary ports of entry for B.1.1.7 in the US and locations of possible underreporting of B.1.1.7 cases. New York, which receives the most international travel from the UK, is likely one of the key hubs for introductions and domestic spread. Finally, we provide evidence for increased community transmission in several states. Thus, genomic surveillance for B.1.1.7 and other variants urgently needs to be enhanced to better inform the public health response.


2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )


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