scholarly journals Early COVID-19 Interventions Failed to Replicate 1918 St. Louis vs. Philadelphia Outcomes in the United States

2020 ◽  
Author(s):  
Aliea M. Jalali ◽  
Brent M. Peterson ◽  
Thushara Galbadage
Keyword(s):  
Public Health ◽  
United States ◽  
State Level ◽  
The United States ◽  
The State ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Public Health Response ◽  
Health Response ◽  
The Us

The Coronavirus disease 2019 (COVID-19) pandemic has elicited an abrupt pause in the United States in multiple sectors of commerce and social activity. As the US faces this health crisis, the magnitude, and rigor of their initial public health response was unprecedented. As a response, the entire nation shutdown at the state-level for the duration of approximately one to three months. These public health interventions, however, were not arbitrarily decided, but rather, implemented as a result of evidence-based practices. These practices were a result of lessons learned during the 1918 influenza pandemic and the city-level non-pharmaceutical interventions (NPIs) taken across the US. During the 1918 pandemic, two model cities, St. Louis, MO, and Philadelphia, PA, carried out two different approaches to address the spreading disease, which resulted in two distinctly different outcomes. Our group has evaluated the state-level public health response adopted by states across the US, with a focus on New York, California, Florida, and Texas, and compared the effectiveness of reducing the spread of COVID-19. Our assessments show that while the states mentioned above benefited from the implementations of early preventative measures, they inadequately replicated the desired outcomes observed in St. Louis during the 1918 crisis. Our study indicates that there are other factors, including health disparities that may influence the effectiveness of public health interventions applied. Identifying more specific health determinants may help implement targeted interventions aimed at preventing the spread of COVID-19 and improving health equity.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.Methods: Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R t and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%).Conclusions: This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
The Us ◽  
The Impact ◽  
Individualized Decision

Abstract The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain. Methods Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between Rt and NPIs through a generalized linear model (GLM). Results Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46–57%), wearing (face) masks 29% (15–42%), gathering ban (more than 10 people) 19% (14–24%), non-essential business closure 16% (10–21%), declaration of emergency 13% (8–17%), interstate travel restriction 11% (5–16%), school closure 10% (7–14%), initial business closure 10% (6–14%), and gathering ban (more than 50 people) 7% (2–11%). Conclusions This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Delayed Interventions, Low Compliance, and Health Disparities Amplified the Early Spread of COVID-19

2020 ◽  
Author(s):  
Aliea M. Jalali ◽  
Sumaia G. Khoury ◽  
JongWon See ◽  
Alexis M. Gulsvig ◽  
Brent M. Peterson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
State Level ◽  
The United States ◽  
Health Interventions ◽  
Systematic Evaluation ◽  
Public Health Interventions ◽  
Multivariate Statistical ◽  
The Us ◽  
At Home

AbstractThe United States (US) public health interventions were rigorous and rapid, yet failed to arrest the spread of the Coronavirus Disease 2019 (COVID-19) pandemic as infections spread throughout the US. Many factors have contributed to the spread of COVID-19, and the success of public health interventions depends on the level of community adherence to preventative measures. Public health professionals must also understand regional demographic variation in health disparities and determinants to target interventions more effectively. In this study, a systematic evaluation of three significant interventions employed in the US, and their effectiveness in slowing the early spread of COVID-19 was conducted. Next, community-level compliance with a state-level stay at home orders was assessed to determine COVID-19 spread behavior. Finally, health disparities that may have contributed to the disproportionate acceleration of early COVID-19 spread between certain counties were characterized. The contribution of these factors for the disproportionate spread of the disease was analyzed using both univariate and multivariate statistical analyses. Results of this investigation show that delayed implementation of public health interventions, a low level of compliance with the stay at home orders, in conjunction with health disparities, significantly contributed to the early spread of the COVID-19 pandemic.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain. Methods: Based on the reported cases, the effective reproduction number (B) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between a and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in c. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%). Conclusions: This retrospective assessment of NPIs on k has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals A collaborative multiyear, multimodel assessment of seasonal influenza forecasting in the United States

2019 ◽  
Vol 116 (8) ◽  
pp. 3146-3154 ◽  
Author(s):  
Nicholas G. Reich ◽  
Logan C. Brooks ◽  
Spencer J. Fox ◽  
Sasikiran Kandula ◽  
Craig J. McGowan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Real Time ◽  
Forecast Accuracy ◽  
The United States ◽  
Public Health Response ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Response ◽  
Health Decision

Influenza infects an estimated 9–35 million individuals each year in the United States and is a contributing cause for between 12,000 and 56,000 deaths annually. Seasonal outbreaks of influenza are common in temperate regions of the world, with highest incidence typically occurring in colder and drier months of the year. Real-time forecasts of influenza transmission can inform public health response to outbreaks. We present the results of a multiinstitution collaborative effort to standardize the collection and evaluation of forecasting models for influenza in the United States for the 2010/2011 through 2016/2017 influenza seasons. For these seven seasons, we assembled weekly real-time forecasts of seven targets of public health interest from 22 different models. We compared forecast accuracy of each model relative to a historical baseline seasonal average. Across all regions of the United States, over half of the models showed consistently better performance than the historical baseline when forecasting incidence of influenza-like illness 1 wk, 2 wk, and 3 wk ahead of available data and when forecasting the timing and magnitude of the seasonal peak. In some regions, delays in data reporting were strongly and negatively associated with forecast accuracy. More timely reporting and an improved overall accessibility to novel and traditional data sources are needed to improve forecasting accuracy and its integration with real-time public health decision making.

scholarly journals Crisis Standards of Care Implementation at the State Level in the United States

2020 ◽  
Vol 35 (6) ◽  
pp. 599-603 ◽  
Author(s):  
Colton Margus ◽  
Ritu R. Sarin ◽  
Michael Molloy ◽  
Gregory R. Ciottone
Keyword(s):  
United States ◽  
Large Scale ◽  
State Level ◽  
The United States ◽  
The State ◽  
Pediatric Care ◽  
Standards Of Care ◽  
Institute Of Medicine ◽  
Full Spectrum ◽  
The Us

AbstractIntroduction:In 2009, the Institute of Medicine published guidelines for implementation of Crisis Standards of Care (CSC) at the state level in the United States (US). Based in part on the then concern for H1N1 pandemic, there was a recognized need for additional planning at the state level to maintain health system preparedness and conventional care standards when available resources become scarce. Despite the availability of this framework, in the years since and despite repeated large-scale domestic events, implementation remains mixed.Problem:Coronavirus disease 2019 (COVID-19) rejuvenates concern for how health systems can maintain quality care when faced with unrelenting burden. This study seeks to outline which states in the US have developed CSC and which areas of care have thus far been addressed.Methods:An online search was conducted for all 50 states in 2015 and again in 2020. For states without CSC plans online, state officials were contacted by email and phone. Public protocols were reviewed to assess for operational implementation capabilities, specifically highlighting guidance on ventilator use, burn management, sequential organ failure assessment (SOFA) score, pediatric standards, and reliance on influenza planning.Results:Thirty-six states in the US were actively developing (17) or had already developed (19) official CSC guidance. Fourteen states had no publicly acknowledged effort. Eleven of the 17 public plans had updated within five years, with a majority addressing ventilator usage (16/17), influenza planning (14/17), and pediatric care (15/17), but substantially fewer addressing care for burn patients (9/17).Conclusion:Many states lacked publicly available guidance on maintaining standards of care during disasters, and many states with specific care guidelines had not sufficiently addressed the full spectrum of hazard to which their health care systems remain vulnerable.

scholarly journals Clinical Response, Outbreak Investigation, and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review

2015 ◽  
Vol 10 (1) ◽  
pp. 145-151 ◽  
Author(s):  
Kaja M. Abbas ◽  
Nargesalsadat Dorratoltaj ◽  
Margaret L. O’Dell ◽  
Paige Bordwine ◽  
Thomas M. Kerkering ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Systematic Review ◽  
Clinical Response ◽  
Policy Development ◽  
The United States ◽  
Outbreak Investigation ◽  
Public Health Response ◽  
Fungal Meningitis ◽  
Health Response

AbstractWe conducted a systematic review of the 2012–2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health.(Disaster Med Public Health Preparedness. 2016;10:145–151)

scholarly journals Public Health Interventions’ Effect on Hospital Use in Patients With COVID-19: Comparative Study (Preprint)

2020 ◽  
Author(s):  
Xiaofeng Wang ◽  
Rui Ren ◽  
Michael W Kattan ◽  
Lara Jehi ◽  
Zhenshun Cheng ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
New York State ◽  
The United States ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Social Distancing ◽  
Transmission Rates ◽  
Hospital Use

BACKGROUND Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future. OBJECTIVE We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions. METHODS This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied. RESULTS The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio’s transmission rates declined before the state’s “stay at home” order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (<0.0001), which indicates that they have little chance to get the infection again. CONCLUSIONS The series of public health interventions in three areas were temporally associated with the burden of COVID-19–attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.

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