scholarly journals Mask Wearing and Control of SARS-CoV-2 Transmission in the United States

2020 ◽  
Author(s):  
Benjamin Rader ◽  
Laura F White ◽  
Michael R Burns ◽  
Jack Chen ◽  
Joe Brilliant ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Grocery Store ◽  
Sensitivity Analyses ◽  
Reproductive Number ◽  
Positive Trend ◽  
Respiratory Pathogens ◽  
Transmission Control ◽  
Cross Sectional ◽  
Social Distancing

Introduction: Cloth face coverings and surgical masks have become commonplace across the United States in response to the SARS-CoV-2 epidemic. While evidence suggests masks help curb the spread of respiratory pathogens, population level, empirical research remains limited. Face masks have quickly become a topic of public debate as government mandates have started requiring their use. Here we investigate the association between self-reported mask wearing, social distancing and community SARS-CoV-2 transmission in the United States, as well as the effect of statewide mandates on mask uptake. Methods: Serial cross-sectional surveys were administered June 3 through July 27, 2020 via a web platform. Surveys queried individuals' likelihood to wear a face mask to the grocery store or with family and friends. Responses (N = 378,207) were aggregated by week and state and combined with measures of the instantaneous reproductive number (Rt), social distancing proxies, respondent demographics and other potential sources of confounding. We fit multivariate logistic regression models to estimate the association between mask wearing and community transmission control (Rt <1) for each state and week. Multiple sensitivity analyses were considered to corroborate findings across mask wearing definitions, Rt estimators and data sources. Additionally, mask wearing in 12 states was evaluated two weeks before and after statewide mandates. Results: We find an increasing trend in mask usage across the U.S., although uptake varies by geography and demographic groups. A multivariate logistic model controlling for social distancing and other variables found a 10% increase in mask wearing was associated with a 3.53 (95% CI: 2.03, 6.43) odds of transmission control (Rt <1). We also find that communities with high mask wearing and social distancing have the highest predicted probability of a controlled epidemic. These positive associations were maintained across sensitivity analyses. Following state mandates, mask wearing did not show significant statistical changes in uptake, however the positive trend of increased mask wearing over time was preserved. Conclusion: Widespread utilization of face masks combined with social distancing increases the odds of SARS-CoV-2 transmission control. Mask wearing rose separately from government mask mandates, suggesting supplemental public health interventions are needed to maximize mask adoption and disrupt the spread of SARS-CoV-2, especially as social distancing measures are relaxed.

scholarly journals A Survey of COVID-19 Preparedness Among Hospitals in Idaho

2020 ◽  
Vol 41 (9) ◽  
pp. 1003-1010 ◽  
Author(s):  
Anubhav Kanwar ◽  
Susan Heppler ◽  
Kalpana Kanwar ◽  
Christopher K. Brown
Keyword(s):  
United States ◽  
The United States ◽  
Respiratory Pathogens ◽  
Critical Access Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nurse Administrators ◽  
Electronic Survey ◽  
Hospital Preparedness ◽  
Federal Guidelines

AbstractBackground:SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country.Objective:With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients.Design:Cross-sectional survey focused on various elements of respiratory disease preparedness.Setting:Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho.Methods:The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho.Results:Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents—specifically COVID-19—as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases.Conclusions:Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.

scholarly journals Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study

2020 ◽  
Author(s):  
Xiao Wu ◽  
Rachel C Nethery ◽  
M Benjamin Sabath ◽  
Danielle Braun ◽  
Francesca Dominici
Keyword(s):  
United States ◽  
Air Pollution ◽  
Death Rate ◽  
The United States ◽  
Sensitivity Analyses ◽  
List Type ◽  
County Level ◽  
Cross Sectional ◽  
Increased Risk

AbstractObjectivesUnited States government scientists estimate that COVID-19 may kill tens of thousands of Americans. Many of the pre-existing conditions that increase the risk of death in those with COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigated whether long-term average exposure to fine particulate matter (PM2.5) is associated with an increased risk of COVID-19 death in the United States.DesignA nationwide, cross-sectional study using county-level data.Data sourcesCOVID-19 death counts were collected for more than 3,000 counties in the United States (representing 98% of the population) up to April 22, 2020 from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center.Main outcome measuresWe fit negative binomial mixed models using county-level COVID-19 deaths as the outcome and county-level long-term average of PM2.5 as the exposure. In the main analysis, we adjusted by 20 potential confounding factors including population size, age distribution, population density, time since the beginning of the outbreak, time since state’s issuance of stay-at-home order, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables such as obesity and smoking. We included a random intercept by state to account for potential correlation in counties within the same state. We conducted more than 68 additional sensitivity analyses.ResultsWe found that an increase of only 1 μg/m3 in PM2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%). The results were statistically significant and robust to secondary and sensitivity analyses.ConclusionsA small increase in long-term exposure to PM2.5 leads to a large increase in the COVID-19 death rate. Despite the inherent limitations of the ecological study design, our results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and code are publicly available so our analyses can be updated routinely.Summary BoxWhat is already known on this topicLong-term exposure to PM2.5 is linked to many of the comorbidities that have been associated with poor prognosis and death in COVID-19 patients, including cardiovascular and lung disease.PM2.5 exposure is associated with increased risk of severe outcomes in patients with certain infectious respiratory diseases, including influenza, pneumonia, and SARS.Air pollution exposure is known to cause inflammation and cellular damage, and evidence suggests that it may suppress early immune response to infection.What this study addsThis is the first nationwide study of the relationship between historical exposure to air pollution exposure and COVID-19 death rate, relying on data from more than 3,000 counties in the United States. The results suggest that long-term exposure to PM2.5 is associated with higher COVID-19 mortality rates, after adjustment for a wide range of socioeconomic, demographic, weather, behavioral, epidemic stage, and healthcare-related confounders.This study relies entirely on publicly available data and fully reproducible, public code to facilitate continued investigation of these relationships by the broader scientific community as the COVID-19 outbreak evolves and more data become available.A small increase in long-term PM2.5 exposure was associated with a substantial increase in the county’s COVID-19 mortality rate up to April 22, 2020.

scholarly journals Statewide Interventions and Covid-19 Mortality in the United States: An Observational Study

2020 ◽  
Author(s):  
Nadir Yehya ◽  
Atheendar Venkataramani ◽  
Michael O Harhay
Keyword(s):  
United States ◽  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
The United States ◽  
School Closure ◽  
Sensitivity Analyses ◽  
Test Model ◽  
School Closures ◽  
Social Distancing

ABSTRACT Background Social distancing is encouraged to mitigate viral spreading during outbreaks. However, the association between distancing and patient-centered outcomes in Covid-19 has not been demonstrated. In the United States social distancing orders are implemented at the state level with variable timing of onset. Emergency declarations and school closures were two early statewide interventions. Methods To determine whether later distancing interventions were associated with higher mortality, we performed a state-level analysis in 55,146 Covid-19 non-survivors. We tested the association between timing of emergency declarations and school closures with 28-day mortality using multivariable negative binomial regression. Day 1 for each state was set to when they recorded ≥ 10 deaths. We performed sensitivity analyses to test model assumptions. Results At time of analysis, 37 of 50 states had ≥ 10 deaths and 28 follow-up days. Both later emergency declaration (adjusted mortality rate ratio [aMRR] 1.05 per day delay, 95% CI 1.00 to 1.09, p=0.040) and later school closure (aMRR 1.05, 95% CI 1.01 to 1.09, p=0.008) were associated with more deaths. When assessing all 50 states and setting day 1 to the day a state recorded its first death, delays in declaring an emergency (aMRR 1.05, 95% CI 1.01 to 1.09, p=0.020) or closing schools (aMRR 1.06, 95% CI 1.03 to 1.09, p&lt;0.001) were associated with more deaths. Results were unchanged when excluding New York and New Jersey. Conclusions Later statewide emergency declarations and school closure were associated with higher Covid-19 mortality. Each day of delay increased mortality risk 5 to 6%.

scholarly journals Exploring Predictors of Social Distancing Compliance in the United States during the COVID-19 Pandemic

2021 ◽  
pp. 1-22
Author(s):  
Alexa C. Hansen ◽  
Charlotte V. Farewell ◽  
Jennifer S. Jewell ◽  
Jenn A. Leiferman
Keyword(s):  
United States ◽  
Psychological Factors ◽  
Health Belief ◽  
The United States ◽  
Perceived Benefits ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Perceived Susceptibility ◽  
Social Distancing

Abstract Objective: Through the application of the Health Belief Model, this study sought to explore how relationships between perceived susceptibility, severity, and benefits of social distancing recommendations, as well as psychological factors, may impact compliance with COVID-19 social distancing recommendations in the United States. Methods: Between October and November 2020, a convenience sample of English-speaking adults in the United States completed an online, cross-sectional survey which included items assessing beliefs around threats (e.g., perceived susceptibility and severity), response efficacy, (e.g., perceived benefits), psychological factors (e.g., stress and COVID-specific anxiety), and compliance with social distancing measures (e.g., avoiding social gatherings). Results: Social distancing compliance was positively associated with perceived susceptibility of COVID-19 (b =.42, p < .05) and perceived benefits of social distancing recommendations (b = .81, p < .01). No significant associations were found between perceived severity of COVID-19 (p = .38), general stress (p = .28), COVID-19-related anxiety (p = .12) and compliance. Conclusions: Findings suggest that perceived susceptibility to COVID-19 and perceived benefits of social distancing measures significantly increased compliance with social distancing recommendations in this convenience sample of U.S. adults.

scholarly journals State-level impact of social distancing and testing on COVID-19 in the United States

2020 ◽  
Author(s):  
Weihsueh A. Chiu ◽  
Rebecca Fischer ◽  
Martial L. Ndeffo-Mbah
Keyword(s):  
United States ◽  
Large Scale ◽  
Disease Incidence ◽  
State Level ◽  
The United States ◽  
Contact Tracing ◽  
Reproductive Number ◽  
Social Distancing ◽  
Epidemic Curve ◽  
The Impact

Abstract Social distancing measures have been implemented in the United States (US) since March 2020, to mitigate the spread of SARS-CoV-2, the causative agent of COVID-19. However, by mid-May most states began relaxing these measures to support the resumption of economic activity, even as disease incidence continued to increase in many states. To evaluate the impact of relaxing social distancing restrictions on COVID-19 dynamics and control in the US, we developed a transmission dynamic model and calibrated it to US state-level COVID-19 cases and deaths from March to June 20th, 2020, using Bayesian methods. We used this model to evaluate the impact of reopening, social distancing, testing, contact tracing, and case isolation on the COVID-19 epidemic in each state. We found that using stay-at-home orders, most states were able to curtail their COVID-19 epidemic curve by reducing and achieving an effective reproductive number below 1. But by June 20th, 2020, only 19 states and the District of Columbia were on track to curtail their epidemic curve with a 75% confidence, at current levels of reopening. Of the remaining 31 states, 24 may have to double their current testing and/or contact tracing rate to curtail their epidemic curve, and seven need to further restrict social contact by 25% in addition to doubling their testing and contact tracing rates. When social distancing restrictions are being eased, greater state-level testing and contact tracing capacity remains paramount for mitigating the risk of large-scale increases in cases and deaths.

scholarly journals Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043863
Author(s):  
Jingyuan Wang ◽  
Ke Tang ◽  
Kai Feng ◽  
Xin Lin ◽  
Weifeng Lv ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Relative Humidity ◽  
Human Mobility ◽  
The United States ◽  
Reproductive Number ◽  
Cross Sectional ◽  
The Usa ◽  
Higher Temperature ◽  
Potential Impact ◽  
The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

scholarly journals A Cross-Sectional Study of 0.6 Million Children with Attention-Deficit/Hyperactivity Disorder in the United States

2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Family Income ◽  
Neurodevelopmental Disorder ◽  
Multiple Logistic Regression Analysis ◽  
The United States ◽  
Cross Sectional ◽  
Children With Adhd ◽  
Hyperactivity Disorder

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.

Sources of Information About Gestational Weight Gain, Diet, and Exercise Among Brazilian Immigrant Women Living in the United States: A Cross-Sectional Study

2021 ◽  
pp. 1-41
Author(s):  
Ana Cristina Lindsay ◽  
Qun Le ◽  
Denise Lima Nogueira ◽  
Márcia M. T. Machado ◽  
Mary L. Greaney
Keyword(s):  
United States ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
The United States ◽  
The Internet ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Gestational Weight ◽  
Diet And Exercise ◽  
First Time

Abstract Objectives: The objective of this study was to assess sources of information about gestational weight gain (GWG), diet, and exercise among first-time pregnant Brazilian women in the United States (US). Design: Cross-sectional survey. Setting: Massachusetts, United States. Participants: First-time pregnant Brazilian women. Results: Eighty-six women, the majority of whom were immigrants (96.5%) classified as having low-acculturation levels (68%), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72.1%), diet (79.1%), and exercise (74.4%) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7.55; 95% CI: 1.41, 40.26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67%), diet (71%), and exercise (52%) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0.32; 95% CI: 0.11, 0.93) and exercise (OR = 0.33; 95% CI: 0.11, 0.96) from family and friends than those who self-identified being normal weight pre-pregnancy. Conclusions: This is the first study to assess sources of information about GWG, diet, and exercise among pregnant Brazilian immigrants in the US. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioral change practices to this growing immigrant group.

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