scholarly journals Oscillations in U.S. COVID-19 Incidence and Mortality Data Reflect Diagnostic and Reporting Factors

mSystems ◽  
2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Aviv Bergman ◽  
Yehonatan Sella ◽  
Peter Agre ◽  
Arturo Casadevall
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health System ◽  
Epidemiological Data ◽  
The United States ◽  
Mortality Data ◽  
Data Sets ◽  
Periodic Oscillations ◽  
The Public ◽  
Incidence And Mortality

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic currently in process differs from other infectious disease calamities that have previously plagued humanity in the vast amount of information that is produced each day, which includes daily estimates of the disease incidence and mortality data. Apart from providing actionable information to public health authorities on the trend of the pandemic, the daily incidence reflects the process of disease in a susceptible population and thus reflects the pathogenesis of COVID-19, the public health response, and diagnosis and reporting. Both new daily cases and daily mortality data in the United States exhibit periodic oscillatory patterns. By analyzing New York City (NYC) and Los Angeles (LA) testing data, we demonstrate that this oscillation in the number of cases can be strongly explained by the daily variation in testing. This seems to rule out alternative hypotheses, such as increased infections on certain days of the week, as driving this oscillation. Similarly, we show that the apparent oscillation in mortality in the U.S. data are mostly an artifact of reporting, which disappears in data sets that record death by episode date, such as the NYC and LA data sets. Periodic oscillations in COVID-19 incidence and mortality data reflect testing and reporting practices and contingencies. Thus, these contingencies should be considered first prior to suggesting biological mechanisms. IMPORTANCE The incidence and mortality data for the COVID-19 data in the United States show periodic oscillations, giving the curve a distinctive serrated pattern. In this study, we show that these periodic highs and lows in incidence and mortality data are due to daily differences in testing for the virus and death reporting, respectively. These findings are important because they provide an explanation based on public health practices and shortcomings rather than biological explanations, such as infection dynamics. In other words, when oscillations occur in epidemiological data, a search for causes should begin with how the public health system produces and reports the information before considering other causes, such as infection cycles and higher incidences of events on certain days. Our results suggest that when oscillations occur in epidemiological data, this may be a signal that there are shortcomings in the public health system generating that information.

scholarly journals Aging, Diabetes, and the Public Health System in the United States

2012 ◽  
Vol 102 (8) ◽  
pp. 1482-1497 ◽  
Author(s):  
Carl J. Caspersen ◽  
G. Darlene Thomas ◽  
Letia A. Boseman ◽  
Gloria L. A. Beckles ◽  
Ann L. Albright
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Public Health System ◽  
The United States ◽  
The Public

The US Public Health System and Ethics

2019 ◽  
pp. 62-76
Author(s):  
Debra DeBruin ◽  
Jonathon P. Leider
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Disease Control ◽  
Public Health System ◽  
The United States ◽  
Health Improvement ◽  
Local Health ◽  
The Public ◽  
Health Accounts

The public health enterprise is responsible for the protection and promotion of population health across the United States. Approximately 2,800 local health departments join state and territorial health agencies, federal agencies, and other government organizations in constituting the core of the governmental public health system in the United States. Spending on governmental public health accounts for less than 3 percent of the nation’s multi-trillion-dollar health budget. Yet it is responsible for health improvement, infectious disease control, pandemic planning, chronic disease control, environmental health, maternal and child health, and more. This chapter reviews the genesis and structure of the public health system. It examines the implications of that organizational structure for the many and varied ethical considerations that arise in the practice of public health.

scholarly journals Effectiveness of Face Coverings in Mitigating the COVID-19 Pandemic in the United States

2021 ◽  
Vol 18 (7) ◽  
pp. 3666
Author(s):  
Olukayode James Ayodeji ◽  
Seshadri Ramkumar
Keyword(s):  
Public Health ◽  
United States ◽  
District Of Columbia ◽  
Preventive Measure ◽  
The United States ◽  
Protective Measure ◽  
Sharp Change ◽  
The Public ◽  
Public Health Challenges ◽  
Effective Preventive Measure

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.

Will Routine Annual Influenza Prevention and Control Systems Serve the United States Well in a Pandemic?

2009 ◽  
Vol 3 (S2) ◽  
pp. S160-S165 ◽  
Author(s):  
Jeanne S. Ringel ◽  
Melinda Moore ◽  
John Zambrano ◽  
Nicole Lurie
Keyword(s):  
Public Health ◽  
United States ◽  
Prevention And Control ◽  
The United States ◽  
Qualitative Assessment ◽  
Full Potential ◽  
Pandemic Preparedness ◽  
The Public ◽  
Influenza Prevention ◽  
And Control

ABSTRACTObjective: To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic.Methods: The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents.Results: Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available.Conclusions: Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system’s response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths). (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S160–S165)

Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

2020 ◽  
pp. e1-e8
Author(s):  
Jonathon P. Leider ◽  
Jessica Kronstadt ◽  
Valerie A. Yeager ◽  
Kellie Hall ◽  
Chelsey K. Saari ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Latent Class ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Profile Data ◽  
The Public ◽  
Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

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