Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality

2022 ◽  
Vol 112 (1) ◽  
pp. 154-164
Author(s):  
Lauren C. Zalla ◽  
Grace E. Mulholland ◽  
Lindsey M. Filiatreau ◽  
Jessie K. Edwards
Keyword(s):  
Public Health ◽  
Native Americans ◽  
Indirect Effects ◽  
Excess Mortality ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Public Health Response ◽  
Health Response ◽  
Race Ethnicity ◽  
Expected Mortality

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

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 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 Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Mona Marin ◽  
Tricia L Kitzmann ◽  
Lisa James ◽  
Patricia Quinlisk ◽  
Wade K Aldous ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
The United States ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
University Of Iowa ◽  
Outbreak Control ◽  
Response Planning ◽  
Health Response ◽  
The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was >$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

scholarly journals Modeling and Controlling Epidemic Outbreaks: The Role of Population Size, Model Heterogeneity and Fast Response in the Case of Measles

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1892
Author(s):  
Kezban Yagci Sokat ◽  
Benjamin Armbruster
Keyword(s):  
Public Health ◽  
Simulation Models ◽  
Fast Response ◽  
The United States ◽  
Public Health Response ◽  
Health Response ◽  
Detailed Simulation ◽  
Stochastic Simulation Model ◽  
Outbreak Size

Modelers typically use detailed simulation models and vary the fraction vaccinated to study outbreak control. However, there is currently no guidance for modelers on how much detail (i.e., heterogeneity) is necessary and how large a population to simulate. We provide theoretical and numerical guidance for those decisions and also analyze the benefit of a faster public health response through a stochastic simulation model in the case of measles in the United States. Theoretically, we prove that the outbreak size converges as the simulation population increases and that the outbreaks are slightly larger with a heterogeneous community structure. We find that the simulated outbreak size is not sensitive to the size of the simulated population beyond a certain size. We also observe that in case of an outbreak, a faster public health response provides benefits similar to increased vaccination. Insights from this study can inform the control and elimination measures of the ongoing coronavirus disease (COVID-19) as measles has shown to have a similar structure to COVID-19.

scholarly journals A Collaborative Multi-Model Ensemble for Real-Time Influenza Season Forecasting in the U.S

2019 ◽  
Author(s):  
Nicholas G Reich ◽  
Craig J McGowan ◽  
Teresa K Yamana ◽  
Abhinav Tushar ◽  
Evan L Ray ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Seasonal Influenza ◽  
Influenza Season ◽  
Forecast Accuracy ◽  
The United States ◽  
Model Ensemble ◽  
Public Health Response ◽  
Health Response ◽  
Component Models

AbstractSeasonal influenza results in substantial annual morbidity and mortality in the United States and worldwide. Accurate forecasts of key features of influenza epidemics, such as the timing and severity of the peak incidence in a given season, can inform public health response to outbreaks. As part of ongoing efforts to incorporate data and advanced analytical methods into public health decision-making, the United States Centers for Disease Control and Prevention (CDC) has organized seasonal influenza forecasting challenges since the 2013/2014 season. In the 2017/2018 season, 22 teams participated. A subset of four teams created a research consortium called the FluSight Network in early 2017. During the 2017/2018 season they worked together to produce a collaborative multi-model ensemble that combined 21 separate component models into a single model using a machine learning technique called stacking. This approach creates a weighted average of predictive densities where the weight for each component is based on that component’s forecast accuracy in past seasons. In the 2017/2018 influenza season, one of the largest seasonal outbreaks in the last 15 years, this multi-model ensemble performed better on average than all individual component models and placed second overall in the CDC challenge. It also outperformed the baseline multi-model ensemble created by the CDC that took a simple average of all models submitted to the forecasting challenge. This project shows that collaborative efforts between research teams to develop ensemble forecasting approaches can bring measurable improvements in forecast accuracy and important reductions in the variability of performance from year to year. Efforts such as this, that emphasize real-time testing and evaluation of forecasting models and facilitate the close collaboration between public health officials and modeling researchers, are essential to improving our understanding of how best to use forecasts to improve public health response to seasonal and emerging epidemic threats.

scholarly journals Quantifying Public Interest in Police Reforms by Mining Internet Search Data Following George Floyd’s Death (Preprint)

2020 ◽  
Author(s):  
John W Ayers ◽  
Benjamin M Althouse ◽  
Adam Poliak ◽  
Eric C Leas ◽  
Alicia L Nobles ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Police Training ◽  
The United States ◽  
Policy Reforms ◽  
Police Reform ◽  
Public Health Response ◽  
Health Response ◽  
2016 Election ◽  
Search Data

BACKGROUND The death of George Floyd while in police custody has resurfaced serious questions about police conduct that result in the deaths of unarmed persons. OBJECTIVE Data-driven strategies that identify and prioritize the public’s needs may engender a public health response to improve policing. We assessed how internet searches indicative of interest in police reform changed after Mr Floyd’s death. METHODS We monitored daily Google searches (per 10 million total searches) that included the terms “police” and “reform(s)” (eg, “reform the police,” “best police reforms,” etc) originating from the United States between January 1, 2010, through July 5, 2020. We also monitored searches containing the term “police” with “training,” “union(s),” “militarization,” or “immunity” as markers of interest in the corresponding reform topics. RESULTS The 41 days following Mr Floyd’s death corresponded with the greatest number of police “reform(s)” searches ever recorded, with 1,350,000 total searches nationally. Searches increased significantly in all 50 states and Washington DC. By reform topic, nationally there were 1,220,000 total searches for “police” and “union(s)”; 820,000 for “training”; 360,000 for “immunity”; and 72,000 for “militarization.” In terms of searches for all policy topics by state, 33 states searched the most for “training,” 16 for “union(s),” and 2 for “immunity.” States typically in the southeast had fewer queries related to any police reform topic than other states. States that had a greater percentage of votes for President Donald Trump during the 2016 election searched more often for police “union(s)” while states favoring Secretary Hillary Clinton searched more for police “training.” CONCLUSIONS The United States is at a historical juncture, with record interest in topics related to police reform with variability in search terms across states. Policy makers can respond to searches by considering the policies their constituencies are searching for online, notably police training and unions. Public health leaders can respond by engaging in the subject of policing and advocating for evidence-based policy reforms.

scholarly journals Quantifying Public Interest in Police Reforms by Mining Internet Search Data Following George Floyd’s Death

10.2196/22574 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22574
Author(s):  
John W Ayers ◽  
Benjamin M Althouse ◽  
Adam Poliak ◽  
Eric C Leas ◽  
Alicia L Nobles ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Police Training ◽  
The United States ◽  
Policy Reforms ◽  
Police Reform ◽  
Public Health Response ◽  
Health Response ◽  
2016 Election ◽  
Search Data

Background The death of George Floyd while in police custody has resurfaced serious questions about police conduct that result in the deaths of unarmed persons. Objective Data-driven strategies that identify and prioritize the public’s needs may engender a public health response to improve policing. We assessed how internet searches indicative of interest in police reform changed after Mr Floyd’s death. Methods We monitored daily Google searches (per 10 million total searches) that included the terms “police” and “reform(s)” (eg, “reform the police,” “best police reforms,” etc) originating from the United States between January 1, 2010, through July 5, 2020. We also monitored searches containing the term “police” with “training,” “union(s),” “militarization,” or “immunity” as markers of interest in the corresponding reform topics. Results The 41 days following Mr Floyd’s death corresponded with the greatest number of police “reform(s)” searches ever recorded, with 1,350,000 total searches nationally. Searches increased significantly in all 50 states and Washington DC. By reform topic, nationally there were 1,220,000 total searches for “police” and “union(s)”; 820,000 for “training”; 360,000 for “immunity”; and 72,000 for “militarization.” In terms of searches for all policy topics by state, 33 states searched the most for “training,” 16 for “union(s),” and 2 for “immunity.” States typically in the southeast had fewer queries related to any police reform topic than other states. States that had a greater percentage of votes for President Donald Trump during the 2016 election searched more often for police “union(s)” while states favoring Secretary Hillary Clinton searched more for police “training.” Conclusions The United States is at a historical juncture, with record interest in topics related to police reform with variability in search terms across states. Policy makers can respond to searches by considering the policies their constituencies are searching for online, notably police training and unions. Public health leaders can respond by engaging in the subject of policing and advocating for evidence-based policy reforms.

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