scholarly journals Forecasting COVID-19 impact on hospital bed-days, ICU-days, ventilator-days and deaths by US state in the next 4 months

2020 ◽  
Author(s):  
◽  
Christopher JL Murray
Keyword(s):  
United States ◽  
Health Service ◽  
Statistical Model ◽  
The United States ◽  
Excess Demand ◽  
Data Availability ◽  
Hospital Services ◽  
Peak Demand ◽  
Social Distancing ◽  
The Us

AbstractImportanceThis study presents the first set of estimates of predicted health service utilization and deaths due to COVID-19 by day for the next 4 months for each state in the US.ObjectiveTo determine the extent and timing of deaths and excess demand for hospital services due to COVID-19 in the US.Design, Setting, and ParticipantsThis study used data on confirmed COVID-19 deaths by day from WHO websites and local and national governments; data on hospital capacity and utilization for US states; and observed COVID-19 utilization data from select locations to develop a statistical model forecasting deaths and hospital utilization against capacity by state for the US over the next 4 months.Exposure(s)COVID-19.Main outcome(s) and measure(s)Deaths, bed and ICU occupancy, and ventilator use.ResultsCompared to licensed capacity and average annual occupancy rates, excess demand from COVID-19 at the peak of the pandemic in the second week of April is predicted to be 64,175 (95% UI 7,977 to 251,059) total beds and 17,380 (95% UI 2,432 to 57,955) ICU beds. At the peak of the pandemic, ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674). The date of peak excess demand by state varies from the second week of April through May. We estimate that there will be a total of 81,114 (95% UI 38,242 to 162,106) deaths from COVID-19 over the next 4 months in the US. Deaths from COVID-19 are estimated to drop below 10 deaths per day between May 31 and June 6.Conclusions and RelevanceIn addition to a large number of deaths from COVID-19, the epidemic in the US will place a load well beyond the current capacity of hospitals to manage, especially for ICU care. These estimates can help inform the development and implementation of strategies to mitigate this gap, including reducing non-COVID-19 demand for services and temporarily increasing system capacity. These are urgently needed given that peak volumes are estimated to be only three weeks away. The estimated excess demand on hospital systems is predicated on the enactment of social distancing measures in all states that have not done so already within the next week and maintenance of these measures throughout the epidemic, emphasizing the importance of implementing, enforcing, and maintaining these measures to mitigate hospital system overload and prevent deaths.Data availability statementA full list of data citations are available by contacting the corresponding author.Funding StatementBill & Melinda Gates Foundation and the State of WashingtonKey PointsQuestionAssuming social distancing measures are maintained, what are the forecasted gaps in available health service resources and number of deaths from the COVID-19 pandemic for each state in the United States?FindingsUsing a statistical model, we predict excess demand will be 64,175 (95% UI 7,977 to 251,059) total beds and 17,380 (95% UI 2,432 to 57,955) ICU beds at the peak of COVID-19. Peak ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674) ventilators. Peak demand will be in the second week of April. We estimate 81,114 (95% UI 38,242 to 162,106) deaths in the United States from COVID-19 over the next 4 months.MeaningEven with social distancing measures enacted and sustained, the peak demand for hospital services due to the COVID-19 pandemic is likely going to exceed capacity substantially. Alongside the implementation and enforcement of social distancing measures, there is an urgent need to develop and implement plans to reduce non-COVID-19 demand for and temporarily increase capacity of health facilities.

scholarly journals The US Public Health Service House-to-House Canvass Survey of the Morbidity and Mortality of the 1918 Influenza Pandemic

2020 ◽  
pp. e1-e8
Author(s):  
Alfredo Morabia
Keyword(s):  
Public Health ◽  
United States ◽  
Health Service ◽  
Cumulative Incidence ◽  
Public Health Service ◽  
San Antonio ◽  
Influenza Pandemic ◽  
The United States ◽  
Population Based ◽  
The Us

Between November 20, 1918, and March 12, 1919, the US Public Health Service carried out a vast population-based survey to assess the incidence rate and mortality of the influenza pandemic among 146 203 persons in 18 localities across the United States. The survey attempted to retrospectively assess all self-reported or diagnosed cases of influenza since August 1, 1918. It indicated that the cumulative incidence of symptomatic influenza over 6 months had been 29.4% (range = 15% in Louisville, KY, to 53.3% in San Antonio, TX). The overall case fatality rate (CFR) was 1.70%, and it ranged from 0.78% in San Antonio to 3.14% in New London, Connecticut. Localities with high cumulative incidence were not necessarily those with high CFR. Overall, assuming the survey missed asymptomatic cases, between August 1, 1918, and February 21, 1919, maybe more than 50% of the population was infected, and about 1% of the infected died. Eight months into the COVID-19 pandemic, the United States has not yet launched a survey that would provide population-based estimates of incidence and CFRs analogous to those generated by the 1918 US Public Health Service house-to-house canvass survey of influenza. Published online ahead of print December 8, 2020: 1–8. https://doi.org/10.2105/AJPH.2020.306025 )

scholarly journals The US Public’s Perception of the Threat of COVID-19 During the Rapid Spread of the COVID-19 Outbreak: Cross-Sectional Survey Study

10.2196/23400 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23400
Author(s):  
Xiaolei Xiu ◽  
Anran Wang ◽  
Qing Qian ◽  
Sizhu Wu
Keyword(s):  
United States ◽  
Close Contact ◽  
The United States ◽  
The Self ◽  
Medical Conditions ◽  
Effective Response ◽  
Social Distancing ◽  
Rapid Spread ◽  
The Us ◽  
And Behaviors

Background The rapid spread of the COVID-19 pandemic in the United States has made people uncertain about their perceptions of the threat of COVID-19 and COVID-19 response measures. To mount an effective response to this epidemic, it is necessary to understand the public's perceptions, behaviors, and attitudes. Objective We aimed to test the hypothesis that people’s perceptions of the threat of COVID-19 influence their attitudes and behaviors. Methods This study used an open dataset of web-based questionnaires about COVID-19. The questionnaires were provided by Nexoid United Kingdom. We selected the results of a questionnaire on COVID-19–related behaviors, attitudes, and perceptions among the US public. The questionnaire was conducted from March 29 to April 20, 2020. A total of 24,547 people who lived in the United States took part in the survey. Results In this study, the average self-assessed probability of contracting COVID-19 was 33.2%, and 49.9% (12,244/24,547) of the respondents thought that their chances of contracting COVID-19 were less than 30%. The self-assessed probability of contracting COVID-19 among women was 1.35 times that of males. A 5% increase in perceived infection risk was significantly associated with being 1.02 times (OR 1.02, 95% CI 1.02-1.02; P<.001) more likely to report having close contact with >10 people, and being 1.01 times (OR 1.01, 95% CI 1.01-1.01; P<.001) more likely to report that cohabitants disagreed with taking steps to reduce the risk of contracting COVID-19. However, there was no significant association between participants who lived with more than 5 cohabitants or less than 5 cohabitants (P=.85). Generally, participants who lived in states with 1001-10,000 COVID-19 cases, were aged 20-40 years, were obese, smoked, drank alcohol, never used drugs, and had no underlying medical conditions were more likely to be in close contact with >10 people. Most participants (21,017/24,547, 85.6%) agreed with washing their hands and maintaining social distancing, but only 20.2% (4958/24,547) of participants often wore masks. Additionally, male participants and participants aged <20 years typically disagreed with washing their hands, maintaining social distancing, and wearing masks. Conclusions This survey is the first attempt to describe the determinants of the US public’s perception of the threat of COVID-19 on a large scale. The self-assessed probability of contracting COVID-19 differed significantly based on the respondents’ genders, states of residence, ages, body mass indices, smoking habits, alcohol consumption habits, drug use habits, underlying medical conditions, environments, and behaviors. These findings can be used as references by public health policy makers and health care workers who want to identify populations that need to be educated on COVID-19 prevention and health.

scholarly journals Forecasting the Spread of COVID-19 under Different Reopening Strategies

2020 ◽  
Author(s):  
Meng Liu ◽  
Raphael Thomadsen ◽  
Song Yao
Keyword(s):  
United States ◽  
Growth Rate ◽  
Population Density ◽  
The United States ◽  
Sir Model ◽  
Social Distancing ◽  
Mobility Data ◽  
The Social ◽  
The Us ◽  
Case Data

ABSTRACTWe combine COVID-19 case data with demographic and mobility data to estimate a modified susceptible-infected-recovered (SIR) model for the spread of this disease in the United States. We find that the incidence of infectious COVID-19 individuals has a concave effect on contagion, as would be expected if people have inter-related social networks. We also demonstrate that social distancing and population density have large effects on the rate of contagion. The social distancing in late March and April substantially reduced the number of COVID-19 cases. However, the concave contagion pattern means that when social distancing measures are lifted, the growth rate is considerable but will not be exponential as predicted by standard SIR models. Furthermore, counties with the lowest population density could likely avoid high levels of contagion even with no social distancing. We forecast rates of new cases for COVID-19 under different social distancing norms and find that if social distancing is eliminated there will be a massive increase in the cases of COVID-19, about double what would occur if the US only restored to 50% of the way to normalcy.

scholarly journals Forecasting the spread of COVID-19 under different reopening strategies

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Meng Liu ◽  
Raphael Thomadsen ◽  
Song Yao
Keyword(s):  
United States ◽  
Social Networks ◽  
Exponential Growth ◽  
The United States ◽  
Sir Model ◽  
Disease Spread ◽  
Social Distancing ◽  
Mobility Data ◽  
The Us ◽  
Case Data

AbstractWe combine COVID-19 case data with mobility data to estimate a modified susceptible-infected-recovered (SIR) model in the United States. In contrast to a standard SIR model, we find that the incidence of COVID-19 spread is concave in the number of infectious individuals, as would be expected if people have inter-related social networks. This concave shape has a significant impact on forecasted COVID-19 cases. In particular, our model forecasts that the number of COVID-19 cases would only have an exponential growth for a brief period at the beginning of the contagion event or right after a reopening, but would quickly settle into a prolonged period of time with stable, slightly declining levels of disease spread. This pattern is consistent with observed levels of COVID-19 cases in the US, but inconsistent with standard SIR modeling. We forecast rates of new cases for COVID-19 under different social distancing norms and find that if social distancing is eliminated there will be a massive increase in the cases of COVID-19.

Icon and taboo: single-payer politics in Canada and the US

2019 ◽  
Vol 35 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Carolyn Hughes Tuohy
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Profession ◽  
Private Insurance ◽  
The United States ◽  
Hospital Services ◽  
Popular Support ◽  
Single Payer ◽  
The Us ◽  
Political Economies

AbstractIn 1965 and 1966, the United States and Canada adopted single-payer models of government insurance for physician and hospital services – universal in Canada, but restricted to certain population groups in the US. At the time, the American and Canadian political economies of health care and landscapes of public opinion were remarkably similar, and the different policy designs must be understood as products of the distinctive macro-level politics of the day. Subsequently, however, the different scopes of single-payer coverage would drive the two systems in different directions. In Canada, the single-payer system became entrenched in popular support and in the nexus of interest it created between the medical profession and the state. In the US, Medicare became similarly entrenched in popular support, but did so as part of the larger multi-payer private insurance system. In the process universal single-payer coverage became politically iconic in Canada and taboo in the US.

scholarly journals Social Distancing Has Merely Stabilized COVID-19 in the US

2020 ◽  
Author(s):  
Aaron B. Wagner ◽  
Elaine L. Hill ◽  
Sean E. Ryan ◽  
Ziteng Sun ◽  
Grace Deng ◽  
...  
Keyword(s):  
United States ◽  
Reproduction Number ◽  
The United States ◽  
Policy Implications ◽  
Significant Evidence ◽  
Social Distancing ◽  
Point Estimates ◽  
The Us ◽  
The World

AbstractSocial distancing measures, with varying degrees of restriction, have been imposed around the world in order to stem the spread of COVID-19. In this work we analyze the effect of current social distancing measures in the United States. We quantify the reduction in doubling rate, by state, that is associated with social distancing. We find that social distancing is associated with a statistically-significant reduction in the doubling rate for all but three states. At the same time, we do not find significant evidence that social distancing has resulted in a reduction in the number of daily confirmed cases. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including point estimates of the effective reproduction number, R, both with and without social distancing. We also discuss the policy implications of our findings.

scholarly journals Projected COVID-19 epidemic in the United States in the context of the effectiveness of a potential vaccine and implications for social distancing and face mask use

2020 ◽  
Author(s):  
Mingwang Shen ◽  
Jian Zu ◽  
Christopher K. Fairley ◽  
José A. Pagán ◽  
Li An ◽  
...  
Keyword(s):  
United States ◽  
Negative Impact ◽  
Social Contact ◽  
Face Mask ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Phase Iii ◽  
Effective Vaccine ◽  
Social Distancing ◽  
The Us

ABSTRACTBackgroundMultiple candidates of COVID-19 vaccines have entered Phase III clinical trials in the United States (US). There is growing optimism that social distancing restrictions and face mask requirements could be eased with widespread vaccine adoption soon.MethodsWe developed a dynamic compartmental model of COVID-19 transmission for the four most severely affected states (New York, Texas, Florida, and California). We evaluated the vaccine effectiveness and coverage required to suppress the COVID-19 epidemic in scenarios when social contact was to return to pre-pandemic levels and face mask use was reduced. Daily and cumulative COVID-19 infection and death cases were obtained from the Johns Hopkins University Coronavirus resource center and used for model calibration.ResultsWithout a vaccine, the spread of COVID-19 could be suppressed in these states by maintaining strict social distancing measures and face mask use levels. But relaxing social distancing restrictions to the pre-pandemic level without changing the current face mask use would lead to a new COVID-19 outbreak, resulting in 0.8-4 million infections and 15,000-240,000 deaths across these four states over the next 12 months. In this scenario, introducing a vaccine would partially offset this negative impact even if the vaccine effectiveness and coverage are relatively low. However, if face mask use is reduced by 50%, a vaccine that is only 50% effective (weak vaccine) would require coverage of 55-94% to suppress the epidemic in these states. A vaccine that is 80% effective (moderate vaccine) would only require 32-57% coverage to suppress the epidemic. In contrast, if face mask usage stops completely, a weak vaccine would not suppress the epidemic, and further major outbreaks would occur. A moderate vaccine with coverage of 48-78% or a strong vaccine (100% effective) with coverage of 33-58% would be required to suppress the epidemic. Delaying vaccination rollout for 1-2 months would not substantially alter the epidemic trend if the current interventions are maintained.ConclusionsThe degree to which the US population can relax social distancing restrictions and face mask use will depend greatly on the effectiveness and coverage of a potential COVID-19 vaccine if future epidemics are to be prevented. Only a highly effective vaccine will enable the US population to return to life as it was before the pandemic.

Is Trump a Symptom or a Cause? Economic, Political and Ideological Foundations of the COVID-19 Outbreak in the United States (First Draft)

2021 ◽  
Author(s):  
Zhihan Cui ◽  
Sherry Jueyu Wu ◽  
Lu Liu ◽  
Yu Ding ◽  
Thomas Talhelm ◽  
...  
Keyword(s):  
United States ◽  
Explanatory Power ◽  
Safety Net ◽  
The United States ◽  
Social Safety Net ◽  
Social Distancing ◽  
American Conservatism ◽  
Level Data ◽  
The Us ◽  
Social Safety Nets

The US is amongst the worst-performing countries at combating COVID-19. And within the US, red (Republican) states have significantly higher cases per capita than blue (Democratic) states. We use cross-country, state, and county-level data to provide a comprehensive analysis of economic, political, and psychological factors contributing to these differences. An inferior social safety net and American conservatism systematically correlate with the realization and effectiveness of non-pharmaceutical interventions such as social distancing and mask wearing from April to September. Economic inequality and weak social safety nets drive the economically vulnerable to work outside their homes, increasing mobility and reducing social distancing during early stages of the pandemic. Conservative ideology, anti-intellectualism, and evangelicalism drive people to politicize social distancing and mask wearing. Both factors predict a premature reopening in many states, and have a strong correlation with the drifting of COVID-19 epicenters to red states over the course of 2020. These factors have more explanatory power than partisanship in the first half year of the COVID-19 outbreak in the United States. However, from October on, closer to the presidential elections, partisanship is a better predictor of anti-COVID measures and explains well the regional variances of confirmed cases across states and counties. This indicates that partisanship is not the solely important factor in determining COVID-19 response and outcome, but its impact is likely to have been magnified as time goes by.

scholarly journals Impacts of social distancing policies on mobility and COVID-19 case growth in the US

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Gregory A. Wellenius ◽  
Swapnil Vispute ◽  
Valeria Espinosa ◽  
Alex Fabrikant ◽  
Thomas C. Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Infection Control ◽  
State Level ◽  
The United States ◽  
Social Consequences ◽  
Social Distancing ◽  
Mobility Data ◽  
The Us ◽  
Public Health Officials

AbstractSocial distancing remains an important strategy to combat the COVID-19 pandemic in the United States. However, the impacts of specific state-level policies on mobility and subsequent COVID-19 case trajectories have not been completely quantified. Using anonymized and aggregated mobility data from opted-in Google users, we found that state-level emergency declarations resulted in a 9.9% reduction in time spent away from places of residence. Implementation of one or more social distancing policies resulted in an additional 24.5% reduction in mobility the following week, and subsequent shelter-in-place mandates yielded an additional 29.0% reduction. Decreases in mobility were associated with substantial reductions in case growth two to four weeks later. For example, a 10% reduction in mobility was associated with a 17.5% reduction in case growth two weeks later. Given the continued reliance on social distancing policies to limit the spread of COVID-19, these results may be helpful to public health officials trying to balance infection control with the economic and social consequences of these policies.

scholarly journals How many COVID-19 cases could have been prevented in the US if its interventions were as effective as those in China and South Korea?

2020 ◽  
Author(s):  
Kai Liu ◽  
Yukun Song ◽  
Menghui Li ◽  
Zhesi Shen ◽  
Ming Wang ◽  
...  
Keyword(s):  
United States ◽  
South Korea ◽  
Large Scale ◽  
Early Stage ◽  
The United States ◽  
Actual Number ◽  
Social Distancing ◽  
Effective Interventions ◽  
The Us ◽  
The World

AbstractThe COVID-19 [1] pandemic has forced governments to take measures to contain the spread of the disease [2]; however, the effects have varied significantly from one country to another contingent on governments’ responses. Countries that have flattened their coronavirus curves prove that interventions can bring COVID-19 under control. These achievements hold lessons, such as the strict social distancing and coordinated efforts of all government levels in China and massive testing in South Korea, for other countries battling the coronavirus around the world. In this work, we attempt to estimate how many COVID-19 cases could have been prevented in the United States (US) when compared with the US’s actual number of cases assuming that on a certain date, the US took China-like or South Korea-like interventions and that these interventions would have been as effective in the US as in China and South Korea. We found that if that date was at the early stage of the outbreak (March 10), more than 99% (1.15 million) fewer infected cases could be expected by the end of the epidemic. This number decreases to 66.03% and 73.06% fewer infected cases with the China-like scenario and the South Korea-like scenario, respectively, if actions were taken on April 1, highlighting the need to respond quickly and effectively to fight the virus. Furthermore, we found that although interventions in both China and South Korea allowed the COVID-19 outbreak to be managed, the epidemic could still oscillate without strict large-scale ‘lockdown’ measures, as shown in South Korea. Our results demonstrate that early effective interventions can save considerably more people from infection and provide a worldwide alert regard the need for swift response.

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