scholarly journals COVID-19 Mortality Following Mass Gatherings

2020 ◽  
Author(s):  
Oren Miron ◽  
Kun-Hsing Yu ◽  
Rachel Wilf-Miron ◽  
Nadav Davidovitch
Keyword(s):  
United States ◽  
Fold Increase ◽  
The United States ◽  
Mass Gathering ◽  
Mass Gatherings

AbstractWe examined Coronavirus Disease-2019 (COVID-19) mortality following 5 mass gatherings at outdoor rallies in the United States, during August 2020. We found that COVID-19 mortality started increasing 19-24 days after the mass gathering. In a 50-mile radius there was a 2.1-fold increase in COVID-19 mortality, and in a 51-100 miles radius there was a 1.4-fold increase. Our results suggest that precautions should be taken in mass gatherings and in at least a 50-mile radius, in order to limit COVID-19 mortality.

scholarly journals COVID-19 infections following outdoor mass gatherings in low incidence areas: retrospective cohort study

2020 ◽  
Author(s):  
Oren Miron ◽  
Kun-Hsing Yu ◽  
Rachel Wilf-Miron ◽  
Nadav Davidovitch
Keyword(s):  
United States ◽  
Retrospective Cohort ◽  
Outcome Measure ◽  
Moving Average ◽  
The United States ◽  
Mass Gathering ◽  
Main Outcome Measure ◽  
Mass Gatherings ◽  
Low Incidence ◽  
Incidence Increase

AbstractObjectiveIndoor mass gatherings in counties with high COVID-19 incidence have been linked to infections. We examined if outdoor mass gatherings in counties with low COVID-19 incidence are also followed by infections.MethodsWe retrospectively examined COVID-19 incidence in 20 counties that held mass gathering rallies (19 outdoor and 1 indoor) in the United States in August-September 2020. They were compared to the rest of the United States counties. We utilized a 7-day moving average and compared the change on the gathering date and 15 days later, based on the 95% confidence interval. For control counties we used the median of the gathering dates.SettingThe United StatesPopulation8.4 million in the counties holding mass gatherings, and 324 Million in the rest of the counties in the United States.Main Outcome MeasureChange in COVID-19 incidence rate per 100,000 capita during the two weeks following mass gatherings.ResultsIn the two weeks following the gatherings, the COVID-19 incidence increased significantly in 14 of 20 counties. The county with the highest incidence increase (3.8-fold) had the 2nd lowest incidence before the gathering. The county with the highest decrease (0.4-fold) had the 3rd highest incidence before the gathering. At the gathering date, the average incidence of counties with gatherings was lower than the rest of the United States, and after the gathering, it increased 1.5-fold, while the rest of the United States increased 1.02-fold.ConclusionThese results suggest that even outdoor gatherings in areas with low COVID-19 incidence are followed by increased infections, and that further precautions should be taken at such gatherings.What is already known on the topicMass gatherings have been linked to COVID-19 infections, but it is less clear how much it happens outdoors, and in areas with low incidence.What this study addsCOVID-19 infections increased significantly in 14 of 20 counties that held mass gathering rallies in the United States, 19 of which were outdoors. The county with the highest incidence increase (3.8-fold) was outdoors and had a low incidence before the gathering. The average incidence of all 20 counties with gatherings was lower at the gathering day compared with the rest of the United State, and it increased 1.5-fold following the gatherings. Our findings suggest a need for precautions in mass gatherings, even when outdoors and in areas with a low incidence of COVID-19.

scholarly journals Heat Vulnerability and Heat Island Mitigation in the United States

Atmosphere ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 558 ◽  
Author(s):  
Jungmin Lim ◽  
Mark Skidmore
Keyword(s):  
United States ◽  
Local Governments ◽  
Heat Waves ◽  
Fold Increase ◽  
The United States ◽  
Extreme Heat ◽  
Mitigation Measures ◽  
Heat Island ◽  
Weather Extremes ◽  
Heat Vulnerability

Heat waves are the deadliest type of natural hazard among all weather extremes in the United States. Given the observed and anticipated increase in heat risks associated with ongoing climate change, this study examines community vulnerability to extreme heat and the degree to which heat island mitigation (HIM) actions by state/local governments reduce heat-induced fatalities. The analysis uses all heat events that occurred over the 1996–2011 period for all United States counties to model heat vulnerability. Results show that: (1) Higher income reduces extreme heat vulnerability, while poverty intensifies it; (2) living in mobile homes or rental homes heightens susceptibility to extreme heat; (3) increased heat vulnerability due to the growth of the elderly population is predicted to result in a two-fold increase in heat-related fatalities by 2030; and (4) community heat island mitigation measures reduce heat intensities and thus heat-related fatalities. Findings also show that an additional locally implemented measure reduces the annual death rate by 15%. A falsification test rules out the possibility of spurious inference on the life-saving role of heat island mitigation measures. Overall, these findings inform efforts to protect the most vulnerable population subgroups and guide future policies to counteract the growing risk of deadly heat waves.

Physician Integration into Mass Gathering Medical Care: The United States Air Show

1993 ◽  
Vol 8 (2) ◽  
pp. 165-168 ◽  
Author(s):  
Michael F. Boyle ◽  
Robert A. De Lorenzo ◽  
Richard Garrison
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
Vital Role ◽  
Mass Gathering ◽  
Limited Information ◽  
Physician Staffing ◽  
Small Patient Population ◽  
Minor Injuries ◽  
Physician Integration

AbstractIntroduction:Limited information exists concerning physician staffing at mass gathering events.Methods:A retrospective review of the preparation, planning, and provision of medical care for the United States Air Show was performed. Patient encounters from the air show for the years 1981–1991 also were evaluated.Results:The frequency rate of overall encounters was 8.45 patients/10,000 spectators and hospital transport rate was 0.6/10,000 spectators. The majority of complaints were related to heat or minor injuries. During this period, emergency physicians played a vital role in both medical planning and on-site staffing. Emergency medicine residents also participated. A small patient population received direct benefit from on-site physician intervention.Conclusion:The on-site emergency physician is of benefit in event preplanning and reducing the burden on the EMS system during mass gathering events.

scholarly journals LB11. Rapid Rise in Decreased Susceptibility to Azithromycin among Shigella Isolates in the United States: A Look at National Surveillance Data, 2011–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S763-S763 ◽  
Author(s):  
Cindy Friedman ◽  
Ian Plumb ◽  
Jared Reynolds ◽  
Jessica Chen ◽  
Kaitlin Tagg ◽  
...  
Keyword(s):  
United States ◽  
Resistance Mechanism ◽  
Fold Increase ◽  
The United States ◽  
Adult Males ◽  
Rapid Rise ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Sex With Men

Abstract Background Shigella spp. cause ~500,000 illnesses in the United States annually. Antibiotics are recommended for immunocompromised patients and shorten the duration of illness, thus limiting spread. First-line treatments include ciprofloxacin (CIP) and azithromycin (AZM). CIP resistance is a growing problem in the United States; decreased susceptibility to AZM (DSA) has been reported globally, particularly among men who have sex with men (MSM). We reviewed National Antimicrobial Resistance Monitoring System (NARMS) data to determine DSA trends among Shigella isolates in the United States. Methods Health departments nationwide forward every 20th Shigella isolate to CDC NARMS for antimicrobial susceptibility testing using broth microdilution. We defined CIP resistance using CLSI clinical breakpoints and DSA using epidemiological cutoff values where available. We performed whole genome sequencing on isolates from 2016 and screened the sequences for resistance determinants using ResFinder 3.0. Results To date, we have tested 3,044 Shigella isolates collected during 2011–2017. Overall, 264 isolates (9%) had DSA, increasing from 3% in 2011 to 23% in 2017; 41 (16%) were also CIP resistant. The odds of DSA increased by 1.5 (95% confidence interval [CI] 1.4–1.6) annually. DSA was more common among adult males (OR 21.2, CI 14.9–30.3), in isolates from the West census region (OR 2.4, CI 1.8–3.2), and in S. flexneri (OR 8.2, CI 6.3–10.7). Of 543 sequenced isolates, 52 (10%) had DSA; of these, 31 (60%) contained both mph(A) and erm(B) genes, 17 (33%) contained mph(A) only, and 4 (8%) had no identified macrolide-resistance mechanism. Conclusions In 2017, nearly 1 in 4 Shigella isolates tested had DSA, a 7-fold increase since 2011. This rapid rise in DSA parallels that seen in other countries, where resistance to other clinically relevant drugs is high and macrolides are no longer useful as empiric treatment. The increased risk of DSA in adult males is consistent with previous reports of DSA Shigella in MSM. The resistance genes observed are typically plasmid-mediated and can be transferred to other bacteria. Public health strategies to mitigate the spread of resistant Shigella should include antibiotic stewardship and novel approaches for sexually transmitted infection prevention in MSM. Disclosures All authors: No reported disclosures.

Autism, Through a Social Lens

Contexts ◽  
2009 ◽  
Vol 8 (2) ◽  
pp. 40-45 ◽  
Author(s):  
Stephen Poulson
Keyword(s):  
United States ◽  
Disease Control ◽  
Fold Increase ◽  
The United States ◽  
Centers For Disease Control

Since the early 1990s the United States has seen a 10-fold increase in autism diagnoses. In 2007, 1 in 150 children were diagnosed with it, according to the Centers for Disease Control.

Atrial Fibrillation: Epidemiologic Considerations and Rationale for Conversion and Maintenance of Sinus Rhythm

2003 ◽  
Vol 8 (1_suppl) ◽  
pp. S13-S26 ◽  
Author(s):  
Bramah N. Singh
Keyword(s):  
United States ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Sinus Rhythm ◽  
Surgical Techniques ◽  
Hypertensive Heart Disease ◽  
Fold Increase ◽  
The United States ◽  
Lone Atrial Fibrillation

Atrial fibrillation is now the most common cardiac arrhythmia for which a patient is hospitalized. Clinically, it presents in a form that is paroxysmal, persistent, or permanent and may be symptomatic or asymptomatic, occurring in the setting of either no cardiac disease (“lone atrial fibrillation”) or, most often, in association with an underlying disease. Atrial fibrillation is associated with a 2-fold increase in mortality and, in the United States alone, causes over 75,000 cases of stroke per year. The annual prevalence of stroke is 5% to 7%, but the use of adequate anticoagulation can reduce this to less than 1%. Atrial fibrillation is a disorder of the elderly, with almost equal prevalence in men and women. In the United States, 80% of atrial fibrillation occurs in patients over the age of 65 years, and its prevalence tracks that of heart failure, which may be the cause, as well as the result, of the arrhythmia. Both conditions are increasing in epidemic proportions in the aging population. The most common causes of atrial fibrillation are hypertensive heart disease, coronary artery disease, and heart failure with a miscellany of lesser conditions, with about 10% lacking structural heart disease. Unlike other supraventricular arrhythmias, cure by the use of catheter ablation and surgical techniques has not been a reality except in a relatively small number of cases. However, restoration and maintenance of sinus rhythm remain the initial goal of therapy for most patients. Pharmacologic approaches remain the mainstay of therapy for rate control and anticoagulation as well as for maintenance of sinus rhythm following pharmacological or electrical conversion. The changing epidemiology of atrial fibrillation is highlighted, with the focus on its conversion by the use of newer and novel antifibrillatory agents relative to the mechanisms of the arrhythmia, to restore the stability of sinus rhythm.

Bibliometric Analysis of Palliative Care-Related Publication Trends During 2001 to 2016

2018 ◽  
Vol 35 (10) ◽  
pp. 1280-1286 ◽  
Author(s):  
Chia-Jen Liu ◽  
Te-Chun Yeh ◽  
Su-Hsuan Hsu ◽  
Chao-Mei Chu ◽  
Chih-Kuang Liu ◽  
...  
Keyword(s):  
United States ◽  
Palliative Care ◽  
Socioeconomic Factors ◽  
Research Output ◽  
Scientific Information ◽  
Fold Increase ◽  
The United States ◽  
Related Literature ◽  
Leading Position ◽  
Number Of Publications

Background: The scientific contributions (publications) and international influence (citations) from authors providing the palliative care (PC)-related literature has a limited number of bibliometric reports. We aimed to analyze PC-related literature using the Institute for Scientific Information Web of Science (WoS) database. Methods: WoS database was used to retrieve publications with the following key words with title: “palliative care” OR “End of Life care” OR “terminal care.”. The statistical analysis of the documents published during 2001 to 2016 was performed. The quantity and quality of research were assessed by the number of total publications and citation analysis. In addition, we also analyzed whether there were possible correlations between publication and socioeconomic factors. Results: The total research output was 6273 articles for PC. There was a 3-fold increase in the number of publications during the period and strong correlation between the year and number of PC-related publications ( R2 = .96). The United States took a leading position in PC research (2448, 39.0%). The highest average citations was reported for the Norway (21.8). Australia had gained the highest productive ability in PC research (24.9 of articles per million populations). The annual impact factor rose progressively with time and increased 1.13 to 2.24 from 2003 to 2016. The number of publications correlated with gross domestic product ( r = .74; P < .001). Conclusion: The United States and United Kingdom contributed most of the publications, but some East Asian countries also had a great performance. According to the socioeconomic factors, the publication capacity of top 20 countries is correlated with their economic scale.

Modeling Tamarisk (Tamarix spp.) Habitat and Climate Change Effects in the Northwestern United States

2009 ◽  
Vol 2 (3) ◽  
pp. 200-215 ◽  
Author(s):  
Becky K. Kerns ◽  
Bridgett J. Naylor ◽  
Michelle Buonopane ◽  
Catherine G. Parks ◽  
Brendan Rogers
Keyword(s):  
Climate Change ◽  
United States ◽  
Habitat Suitability ◽  
Fold Increase ◽  
The United States ◽  
Future Climate Change ◽  
Distribution Data ◽  
Climate Data ◽  
Considerable Uncertainty ◽  
Projected Changes

AbstractTamarisk species are shrubs or small trees considered by some to be among the most aggressively invasive and potentially detrimental exotic plants in the United States. Although extensively studied in the southern and interior west, northwestern (Oregon, Washington, and Idaho) distribution and habitat information for tamarisk is either limited or lacking. We obtained distribution data for the northwest, developed a habitat suitability map, and projected changes in habitat due to climate change in a smaller case study area using downscaled climate data. Results show extensive populations of tamarisk east of the Cascade Mountains. Despite the perceived novelty of tamarisk in the region, naturalized populations were present by the 1920s. Major population centers are limited to the warmest and driest environments in the central Snake River Plain, Columbia Plateau, and Northern Basin and Range. Habitat suitability model results indicate that 21% of the region supports suitable tamarisk habitat. Less than 1% of these areas are occupied by tamarisk; the remainder is highly vulnerable to invasion. Although considerable uncertainty exists regarding future climate change, we project a 2- to 10-fold increase in highly suitable tamarisk habitat by the end of the century. Our habitat suitability maps can be used in “what if” exercises as part of planning, detection, restoration, management, and eradication purposes.

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