scholarly journals Compound risks of hurricane evacuation amid the COVID-19 pandemic in the United States

2020 ◽  
Author(s):  
Sen Pei ◽  
Kristina A. Dahl ◽  
Teresa K. Yamana ◽  
Rachel Licker ◽  
Jeffrey Shaman
Keyword(s):  
Public Health ◽  
United States ◽  
Large Scale ◽  
The United States ◽  
Hurricane Evacuation ◽  
Storm Activity ◽  
Transmission Rates ◽  
Hurricane Season ◽  
Major Hurricane ◽  
Virus Exposure

Current projections and unprecedented storm activity to date suggest the 2020 Atlantic hurricane season will be extremely active and that a major hurricane could make landfall during the global COVID-19 pandemic. Such an event would necessitate a large-scale evacuation, with implications for the trajectory of the pandemic. Here we model how a hypothetical hurricane evacuation from four counties in southeast Florida would affect COVID-19 case levels. We find that hurricane evacuation increases the total number of COVID-19 cases in both origin and destination locations; however, if transmission rates in destination counties can be kept from rising during evacuation, excess evacuation-induced case numbers can be minimized by directing evacuees to counties experiencing lower COVID-19 transmission rates. Ultimately, the number of excess COVID-19 cases produced by the evacuation depends on the ability of destination counties to meet evacuee needs while minimizing virus exposure through public health directives.

scholarly journals The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ying Han ◽  
Wei Yan ◽  
Yongbo Zheng ◽  
Muhammad Zahid Khan ◽  
Kai Yuan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Severe Pain ◽  
Large Scale ◽  
Social Economic ◽  
The United States ◽  
Therapeutic Strategies ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Overdose Deaths

Abstract Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

Challenge of Hospital Emergency Preparedness: Analysis and Recommendations

2009 ◽  
Vol 3 (S1) ◽  
pp. S74-S82 ◽  
Author(s):  
Joseph A. Barbera ◽  
Dale J. Yeatts ◽  
Anthony G. Macintyre
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Natural Disasters ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Large Scale ◽  
The United States ◽  
Public Health Care ◽  
Medical Emergency

ABSTRACTIn the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S74–S82)

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.

scholarly journals SeqSero2: Rapid and Improved Salmonella Serotype Determination Using Whole-Genome Sequencing Data

2019 ◽  
Vol 85 (23) ◽  
Author(s):  
Shaokang Zhang ◽  
Hendrik C. den Bakker ◽  
Shaoting Li ◽  
Jessica Chen ◽  
Blake A. Dinsmore ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Large Scale ◽  
Draft Genome ◽  
The United States ◽  
Whole Genome Sequencing Data ◽  
Whole Genome ◽  
Link Type

ABSTRACT SeqSero, launched in 2015, is a software tool for Salmonella serotype determination from whole-genome sequencing (WGS) data. Despite its routine use in public health and food safety laboratories in the United States and other countries, the original SeqSero pipeline is relatively slow (minutes per genome using sequencing reads), is not optimized for draft genome assemblies, and may assign multiple serotypes for a strain. Here, we present SeqSero2 (github.com/denglab/SeqSero2; denglab.info/SeqSero2), an algorithmic transformation and functional update of the original SeqSero. Major improvements include (i) additional sequence markers for identification of Salmonella species and subspecies and certain serotypes, (ii) a k-mer based algorithm for rapid serotype prediction from raw reads (seconds per genome) and improved serotype prediction from assemblies, and (iii) a targeted assembly approach for specific retrieval of serotype determinants from WGS for serotype prediction, new allele discovery, and prediction troubleshooting. Evaluated using 5,794 genomes representing 364 common U.S. serotypes, including 2,280 human isolates of 117 serotypes from the National Antimicrobial Resistance Monitoring System, SeqSero2 is up to 50 times faster than the original SeqSero while maintaining equivalent accuracy for raw reads and substantially improving accuracy for assemblies. SeqSero2 further suggested that 3% of the tested genomes contained reads from multiple serotypes, indicating a use for contamination detection. In addition to short reads, SeqSero2 demonstrated potential for accurate and rapid serotype prediction directly from long nanopore reads despite base call errors. Testing of 40 nanopore-sequenced genomes of 17 serotypes yielded a single H antigen misidentification. IMPORTANCE Serotyping is the basis of public health surveillance of Salmonella. It remains a first-line subtyping method even as surveillance continues to be transformed by whole-genome sequencing. SeqSero allows the integration of Salmonella serotyping into a whole-genome-sequencing-based laboratory workflow while maintaining continuity with the classic serotyping scheme. SeqSero2, informed by extensive testing and application of SeqSero in the United States and other countries, incorporates important improvements and updates that further strengthen its application in routine and large-scale surveillance of Salmonella by whole-genome sequencing.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 357-361
Keyword(s):  
Public Health ◽  
United States ◽  
Health Authority ◽  
Large Scale ◽  
Epidemiologic Study ◽  
The United States ◽  
Medical Social Work ◽  
Average Annual Incidence ◽  
Health Nursing ◽  
Specific Diagnostic Test

GEOGRAPHIC variation in the incidence of poliomyelitis is not well understood and many of the factors involved have not been properly evaluated. A large scale study of two important phases of this problem has recently been reported by Alexander G. Gilliam, Fay M. Hemphill and Jean H. Gerende (Pub. Health Rep. 64:1575 and 1584, 1949). These investigators studied the reported incidence of poliomyelitis in all the 3,095 counties in the United States and analyzed the data chiefly from the standpoint of variations in average annual incidence and the frequency with which epidemics recurred in a given locality. The problem is complicated, as in many other diseases, by lack of a generally available specific diagnostic test. There is usually little question about the manifest cases with paralysis. Abortive and nonparalytic cases, however, constitute a large variable. In any large scale epidemiologic study one is forced to rely on reports of cases as received by the health authority. While there is provision for correcting these reports if subsequent events cause a change in diagnosis it is obvious that in any locality interest and awareness will largely determine the number of cases reported when there is no paralysis. "It appears necessary to emphasize that in most States in this country no distinction is made between paralytic and nonparalytic poliomyelitis in cases officially reported.

Science and Medicine in the United States of America

2012 ◽  
Author(s):  
Edmund Ramsden
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
United States Of America ◽  
Rapid Growth ◽  
Large Scale ◽  
Medical Science ◽  
The United States ◽  
Biomedical Sciences ◽  
Democratic State

This article begins with great optimism expressed by Tocqueville for America's future as the embodiment of the democratic state. It discusses the opportunity to express the liberal political ideals, arguing that its success was based on a community of common sensibility. An understanding of society and politics endowed the historian with the power to help remake health care. This article explores and compares the ways in which medicine is developed and applied in a number of different social, cultural, and physical contexts. It shows rapid growth, from a period in which European ideas, methods, and structures were adapted to the American context, to one in which the United States is at the forefront of large-scale initiatives in public health, disease control, and innovation in the biomedical sciences. Finally, it mentions the contradiction, most notably between profound faith in the technical capacities of medical science and equally profound dissatisfaction with the provision of health care.

scholarly journals USACE PREPARATION AND RESPONSE TO 2017 HURRICANES HARVEY, IRMA, AND MARIA

2018 ◽  
pp. 83
Author(s):  
Mary A. Cialone ◽  
Jane M. Smith ◽  
Julie D. Rosati ◽  
Michael L. Follum ◽  
Chris Massey ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Army Corps ◽  
Army Corps Of Engineers ◽  
Corps Of Engineers ◽  
The People ◽  
Hurricane Season ◽  
Major Hurricane ◽  
The Caribbean ◽  
The U.S

The year 2017 was an extremely active hurricane season with five hurricanes that reached major hurricane strength (Category 3 or higher) on the United States (U.S) or the Caribbean coast. This paper focuses on the U.S. Army Corps of Engineers (USACE) preparation and response to the three most destructive events (Hurricanes Harvey, Irma, and Maria). Each of these storms posed unique challenges to the people and infrastructure in its path.

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

10.2196/25174 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e25174
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.

scholarly journals Effects of Large-Scale Oceanic Phenomena on Non-Cholera Vibriosis Incidence in the United States: Implications for Climate Change

2019 ◽  
Author(s):  
Chloë Logar-Henderson ◽  
Rebecca Ling ◽  
Ashleigh R. Tuite ◽  
David N. Fisman
Keyword(s):  
Public Health ◽  
Climate Change ◽  
United States ◽  
Large Scale ◽  
Disease Incidence ◽  
The United States ◽  
Ocean Warming ◽  
Rate Of Change ◽  
Health Concern ◽  
Increased Risk

AbstractPurposeEpidemics of diarrhea caused by toxigenic strains of Vibrio cholerae are of global public health concern, but non-cholera Vibrio (NCV) species are also important causes of disease. These pathogens are thermophilic, and climate change could increase the risk of NCV infection. The El Niño Southern Oscillation (ENSO) is a “natural experiment” that may presage ocean warming effects on disease incidence.MethodWe obtained vibriosis case counts in the United States by digitizing annual reports from the U.S. Cholera and Other Vibrio Illness Surveillance system. Trends and environmental impacts (of ENSO and the North Atlantic Oscillation) were evaluated using negative binomial and distributed nonlinear lag models. Associations between latitude and changing risk were evaluated with meta-regression.ResultsTrend models demonstrated significant seasonality (P < 0.001) and a 7% annual increase in disease risk from 1999 to 2014 (annual IRR 1.071, 95% CI 1.061-1.081). Distributed lag models demonstrated increased vibriosis risk following ENSO conditions over the subsequent 12 months (integrated RR 1.940, 95% CI 1.298-2.901). The rate of change in vibriosis risk increased with state latitude (RR per 10° increase 1.066, 95% CI 1.027-1.107).ConclusionVibriosis risk in the United States appears to be impacted by irregular large-scale ocean warming and exhibits a north-south gradient in rate of change as would be expected if changing disease incidence is attributable to ocean warming. Vulnerable populations, which include high-income countries with well-developed public health systems, may experience increased risk of this disease as a result of climate change.

scholarly journals Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: Methodology and feasibility analysis (Preprint)

2020 ◽  
Author(s):  
Shahmir H. Ali ◽  
Joshua Foreman ◽  
Ariadna Capasso ◽  
Abbey M. Jones ◽  
Yesim Tozan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Social Media ◽  
Large Scale ◽  
Online Survey ◽  
Cost Optimization ◽  
The United States ◽  
Rapid Onset ◽  
Future Research ◽  
Beliefs And Practices

BACKGROUND The COVID-19 pandemic has evolved into one of the most impactful health crises in modern history. The rapid onset and evolution of the pandemic has compelled researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms, such as Facebook, have been explored as a recruitment tool for research in other settings; however, their feasibility for collecting data on population beliefs and practices during infectious disease epidemics, such as COVID-19, and their capacity to yield nationally representative samples in these contexts remain unexplored. OBJECTIVE This study has two aims 1) describe the methodology used to recruit a nationwide sample of adults residing in the United States to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges. METHODS A Facebook advertisement campaign was used to disseminate the link to an online Qualtrics survey between March 20-30, 2020. Two supplementary male-only and racial minority- targeted advertisements with otherwise identical characteristics to the original advertisement were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement’s reach and response trends. RESULTS The advertisements cumulatively reached 236,017 individuals and resulted in 9,609 clicks (4.07% reach). In total, 6,602 participant responses were recorded (68.7% of those who clicked on the advertisement). Total cost of the advertisement was $906, resulting in costs of $0.09 per click, $0.14 per response (all surveys), and $0.18 per full response (completed surveys). Implementation of the supplementary male-only advertisement successfully improved the cumulative percentage of male respondents from approximately 20% to 40%. CONCLUSIONS The social media advertisement campaign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. However, significant limitations included gender and racial skewing, which may have resulted from Facebook’s cost optimization algorithms, and advertisement review challenges. Future research should attempt to address such challenges. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data on knowledge, beliefs and practices related to significant public health problems, including rapidly evolving pandemics such as COVID-19.

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