scholarly journals Returning to a Normal Life via COVID-19 Vaccines in the United States: A Large-scale Agent-Based Simulation Study

10.2196/27419 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e27419
Author(s):  
Junjiang Li ◽  
Philippe Giabbanelli
Keyword(s):  
United States ◽  
Large Scale ◽  
Vaccination Campaign ◽  
Vaccination Strategy ◽  
The United States ◽  
Current Evidence ◽  
Logistic Growth ◽  
Agent Based ◽  
Current Availability ◽  
Nonpharmaceutical Interventions

Background In 2020, COVID-19 has claimed more than 300,000 deaths in the United States alone. Although nonpharmaceutical interventions were implemented by federal and state governments in the United States, these efforts have failed to contain the virus. Following the Food and Drug Administration's approval of two COVID-19 vaccines, however, the hope for the return to normalcy has been renewed. This hope rests on an unprecedented nationwide vaccine campaign, which faces many logistical challenges and is also contingent on several factors whose values are currently unknown. Objective We study the effectiveness of a nationwide vaccine campaign in response to different vaccine efficacies, the willingness of the population to be vaccinated, and the daily vaccine capacity under two different federal plans. To characterize the possible outcomes most accurately, we also account for the interactions between nonpharmaceutical interventions and vaccines through 6 scenarios that capture a range of possible impacts from nonpharmaceutical interventions. Methods We used large-scale, cloud-based, agent-based simulations by implementing the vaccination campaign using COVASIM, an open-source agent-based model for COVID-19 that has been used in several peer-reviewed studies and accounts for individual heterogeneity and a multiplicity of contact networks. Several modifications to the parameters and simulation logic were made to better align the model with current evidence. We chose 6 nonpharmaceutical intervention scenarios and applied the vaccination intervention following both the plan proposed by Operation Warp Speed (former Trump administration) and the plan of one million vaccines per day, proposed by the Biden administration. We accounted for unknowns in vaccine efficacies and levels of population compliance by varying both parameters. For each experiment, the cumulative infection growth was fitted to a logistic growth model, and the carrying capacities and the growth rates were recorded. Results For both vaccination plans and all nonpharmaceutical intervention scenarios, the presence of the vaccine intervention considerably lowers the total number of infections when life returns to normal, even when the population compliance to vaccines is as low as 20%. We noted an unintended consequence; given the vaccine availability estimates under both federal plans and the focus on vaccinating individuals by age categories, a significant reduction in nonpharmaceutical interventions results in a counterintuitive situation in which higher vaccine compliance then leads to more total infections. Conclusions Although potent, vaccines alone cannot effectively end the pandemic given the current availability estimates and the adopted vaccination strategy. Nonpharmaceutical interventions need to continue and be enforced to ensure high compliance so that the rate of immunity established by vaccination outpaces that induced by infections.

scholarly journals Returning to a normal life via COVID-19 vaccines in the USA: a large-scale agent-based simulation study (Preprint)

2021 ◽  
Author(s):  
Junjiang Li ◽  
Philippe Giabbanelli
Keyword(s):  
Large Scale ◽  
Vaccination Campaign ◽  
Vaccination Strategy ◽  
Current Evidence ◽  
Logistic Growth ◽  
Agent Based ◽  
Pharmaceutical Intervention ◽  
Current Availability ◽  
The Usa ◽  
Pharmaceutical Interventions

BACKGROUND In 2020, COVID-19 has claimed more than 300,000 deaths in the US alone. While non-pharmaceutical interventions were implemented by federal and state governments in the USA, these efforts have failed to contain the virus. Following the FDA approval of two COVID-19 vaccines, however, the hope for the return to normalcy is renewed. This hope rests on an unprecedented nation-wide vaccine campaign, which faces many logistical challenges and is also contingent on several factors whose values are currently unknown. OBJECTIVE We study the effectiveness of a nation-wide vaccine campaign in response to different vaccine efficacies, the willingness of the population to be vaccinated, and the daily vaccine capacity under two different federal plans. To characterize the possible outcomes most accurately, we also account for the interactions between non-pharmaceutical interventions and vaccines, through six scenarios that capture a range of possible impact from non-pharmaceutical interventions. METHODS We use large-scale cloud-based agent-based simulations by implementing the vaccination campaign using Covasim, an open-source ABM for COVID-19 that has been used in several peer-reviewed studies and accounts for individual heterogeneity as well as a multiplicity of contact networks. Several modifications to the parameters and simulation logic were made to better align the model with current evidence. We chose six non-pharmaceutical intervention scenarios and applied the vaccination intervention following both the plan proposed by Operation Warp Speed (former Trump administration) and the plan of one million vaccines per day, proposed by the Biden administration. We accounted for unknowns in vaccine efficacies and levels of population compliance by varying both parameters. For each experiment, the cumulative infection growth is fitted to a logistic growth model, and the carrying capacities and the growth rates are recorded. RESULTS For both vaccination plans and all non-pharmaceutical intervention scenarios, the presence of the vaccine intervention considerably lowers the total number of infections when life returns to normal, even when the population compliance to vaccines is as low at 20%. We noted an unintended consequence: given the vaccine availability estimates under both federal plans and the focus on vaccinating individuals by age categories, a significant reduction in non-pharmaceutical interventions results in a counterintuitive situation in which higher vaccine compliance then leads to more total infections. CONCLUSIONS Although potent, vaccines alone cannot effectively end the pandemic given the current availability estimates and the adopted vaccination strategy. Non-pharmaceutical interventions need to continue and be enforced to ensure high compliance, so that the rate of immunity established by vaccination outpaces that induced by infections.

scholarly journals Returning to a normal life via COVID-19 vaccines in the USA: a large-scale agent-based simulation study

2021 ◽  
Author(s):  
Junjiang Li ◽  
Philippe J. Giabbanelli
Keyword(s):  
Large Scale ◽  
Vaccination Campaign ◽  
Vaccination Strategy ◽  
Current Evidence ◽  
Logistic Growth ◽  
Agent Based ◽  
Pharmaceutical Intervention ◽  
Current Availability ◽  
The Usa ◽  
Pharmaceutical Interventions

AbstractBackgroundIn 2020, COVID-19 has claimed more than 300,000 deaths in the US alone. While non-pharmaceutical interventions were implemented by federal and state governments in the USA, these efforts have failed to contain the virus. Following the FDA approval of two COVID-19 vaccines, however, the hope for the return to normalcy is renewed. This hope rests on an unprecedented nation-wide vaccine campaign, which faces many logistical challenges and is also contingent on several factors whose values are currently unknown.ObjectiveWe study the effectiveness of a nation-wide vaccine campaign in response to different vaccine efficacies, the willingness of the population to be vaccinated, and the daily vaccine capacity under two different federal plans. To characterize the possible outcomes most accurately, we also account for the interactions between non-pharmaceutical interventions and vaccines, through six scenarios that capture a range of possible impact from non-pharmaceutical interventions.MethodsWe use large-scale cloud-based agent-based simulations by implementing the vaccination campaign using Covasim, an open-source ABM for COVID-19 that has been used in several peer-reviewed studies and accounts for individual heterogeneity as well as a multiplicity of contact networks. Several modifications to the parameters and simulation logic were made to better align the model with current evidence. We chose six non-pharmaceutical intervention scenarios and applied the vaccination intervention following both the plan proposed by Operation Warp Speed (former Trump administration) and the plan of one million vaccines per day, proposed by the Biden administration. We accounted for unknowns in vaccine efficacies and levels of population compliance by varying both parameters. For each experiment, the cumulative infection growth is fitted to a logistic growth model, and the carrying capacities and the growth rates are recorded.ResultsFor both vaccination plans and all non-pharmaceutical intervention scenarios, the presence of the vaccine intervention considerably lowers the total number of infections when life returns to normal, even when the population compliance to vaccines is as low at 20%. We noted an unintended consequence: given the vaccine availability estimates under both federal plans and the focus on vaccinating individuals by age categories, a significant reduction in non-pharmaceutical interventions results in a counterintuitive situation in which higher vaccine compliance then leads to more total infections.ConclusionsAlthough potent, vaccines alone cannot effectively end the pandemic given the current availability estimates and the adopted vaccination strategy. Non-pharmaceutical interventions need to continue and be enforced to ensure high compliance, so that the rate of immunity established by vaccination outpaces that induced by infections.

Quality Control of Data in a Large-Scale Cancer Register Program

1966 ◽  
Vol 05 (02) ◽  
pp. 67-74 ◽  
Author(s):  
W. I. Lourie ◽  
W. Haenszeland
Keyword(s):  
United States ◽  
Quality Control ◽  
Cancer Patients ◽  
Large Scale ◽  
The United States ◽  
Newly Diagnosed ◽  
Related Data ◽  
Cancer Register ◽  
Independent Review ◽  
End Results

Quality control of data collected in the United States by the Cancer End Results Program utilizing punchcards prepared by participating registries in accordance with a Uniform Punchcard Code is discussed. Existing arrangements decentralize responsibility for editing and related data processing to the local registries with centralization of tabulating and statistical services in the End Results Section, National Cancer Institute. The most recent deck of punchcards represented over 600,000 cancer patients; approximately 50,000 newly diagnosed cases are added annually.Mechanical editing and inspection of punchcards and field audits are the principal tools for quality control. Mechanical editing of the punchcards includes testing for blank entries and detection of in-admissable or inconsistent codes. Highly improbable codes are subjected to special scrutiny. Field audits include the drawing of a 1-10 percent random sample of punchcards submitted by a registry; the charts are .then reabstracted and recoded by a NCI staff member and differences between the punchcard and the results of independent review are noted.

Utopias of One

2019 ◽  
Author(s):  
Joshua Kotin
Keyword(s):  
United States ◽  
Soviet Union ◽  
World War I ◽  
Large Scale ◽  
Jim Crow ◽  
Personal Autonomy ◽  
The United States ◽  
Soviet Period ◽  
Original Research ◽  
The Soviet Union

This book is a new account of utopian writing. It examines how eight writers—Henry David Thoreau, W. E. B. Du Bois, Osip and Nadezhda Mandel'shtam, Anna Akhmatova, Wallace Stevens, Ezra Pound, and J. H. Prynne—construct utopias of one within and against modernity's two large-scale attempts to harmonize individual and collective interests: liberalism and communism. The book begins in the United States between the buildup to the Civil War and the end of Jim Crow; continues in the Soviet Union between Stalinism and the late Soviet period; and concludes in England and the United States between World War I and the end of the Cold War. In this way it captures how writers from disparate geopolitical contexts resist state and normative power to construct perfect worlds—for themselves alone. The book contributes to debates about literature and politics, presenting innovative arguments about aesthetic difficulty, personal autonomy, and complicity and dissent. It models a new approach to transnational and comparative scholarship, combining original research in English and Russian to illuminate more than a century and a half of literary and political history.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

Ban Ki-moon, 2007–2016

2018 ◽  
Author(s):  
Richard Gowan
Keyword(s):  
United States ◽  
Decision Making ◽  
Security Council ◽  
Large Scale ◽  
Central African Republic ◽  
The United States ◽  
Cautious Approach ◽  
Peacekeeping Operations ◽  
Council Decision ◽  
The Face

During Ban Ki-moon’s tenure, the Security Council was shaken by P5 divisions over Kosovo, Georgia, Libya, Syria, and Ukraine. Yet it also continued to mandate and sustain large-scale peacekeeping operations in Africa, placing major burdens on the UN Secretariat. The chapter will argue that Ban initially took a cautious approach to controversies with the Council, and earned a reputation for excessive passivity in the face of crisis and deference to the United States. The second half of the chapter suggests that Ban shifted to a more activist pressure as his tenure went on, pressing the Council to act in cases including Côte d’Ivoire, Libya, and Syria. The chapter will argue that Ban had only a marginal impact on Council decision-making, even though he made a creditable effort to speak truth to power over cases such as the Central African Republic (CAR), challenging Council members to live up to their responsibilities.

scholarly journals Discursive Strategies and Sequenced Institutional Change: The Case of Marriage Equality in the United States

2021 ◽  
pp. 003232172110205
Author(s):  
Giulia Mariani ◽  
Tània Verge
Keyword(s):  
United States ◽  
Institutional Change ◽  
The United States ◽  
Marriage Equality ◽  
Agent Based ◽  
Discursive Strategies ◽  
Policy Debates ◽  
The Status ◽  
Private Actors

Building on historical and discursive institutionalism, this article examines the agent-based dynamics of gradual institutional change. Specifically, using marriage equality in the United States as a case study, we examine how actors’ ideational work enabled them to make use of the political and discursive opportunities afforded by multiple venues to legitimize the process of institutional change to take off sequentially through layering, displacement, and conversion. We also pay special attention to how the discursive strategies deployed by LGBT advocates, religious-conservative organizations and other private actors created new opportunities to influence policy debates and tip the scales to their preferred policy outcome. The sequential perspective adopted in this study allows problematizing traditional conceptualizations of which actors support or contest the status quo, as enduring oppositional dynamics lead them to perform both roles in subsequent phases of the institutional change process.

scholarly journals Systematic Review of Arts-Based Interventions to Address Suicide Prevention and Survivorship in Australia, Canada, the United Kingdom, and the United States of America

2021 ◽  
Vol 22 (1_suppl) ◽  
pp. 53S-63S
Author(s):  
Jill Sonke ◽  
Kelley Sams ◽  
Jane Morgan-Daniel ◽  
Andres Pumariega ◽  
Faryal Mallick ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
United Kingdom ◽  
Suicide Prevention ◽  
United States Of America ◽  
The United States ◽  
Current Evidence ◽  
Study Objective ◽  
The United Kingdom ◽  
The Arts

Study Objective. Suicide is a serious health problem that is shaped by a variety of social and mental health factors. A growing body of research connects the arts to positive health outcomes; however, no previous systematic reviews have examined the use of the arts in suicide prevention and survivorship. This review examined how the arts have been used to address suicide prevention and survivorship in nonclinical settings in Australia, Canada, the United Kingdom, and the United States of America. Design and Setting. Ten bibliographic databases, five research repositories, and reference sections of articles were searched to identify published studies. Articles presenting outcomes of interventions conducted between 2014 and 2019 and written in English, were included. Primary Results. Nine studies met inclusion criteria, including qualitative, quantitative randomized controlled trials, quantitative nonrandomized, quantitative descriptive, and mixed-methods studies. The programs studied used film and television (n = 3), mixed-arts (n = 3), theatre (n = 2), and quilting (n = 1). All nine interventions used the arts to elicit emotional involvement, while seven also used the arts to encourage engagement with themes of health. Study outcomes included increased self-efficacy, awareness of mental health issues, and likelihood for taking action to prevent suicide, as well as decreases in suicidal risk and self-harming behaviors. Conclusions. Factors that influence suicide risk and survivorship may be effectively addressed through arts-based interventions. While the current evidence is promising with regard to the potential for arts programs to positively affect suicide prevention and survivorship, this evidence needs to be supplemented to inform recommendations for evidence-based arts interventions.

scholarly journals 1068. Large-Scale Migration and the Changing Viral Hepatitis Prevalences in North America: A modeling approach

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S563-S563
Author(s):  
Kenneth A Valles ◽  
Lewis R Roberts
Keyword(s):  
United States ◽  
Viral Hepatitis ◽  
Large Scale ◽  
Country Of Origin ◽  
Human Movement ◽  
High Volume ◽  
The United States ◽  
The Philippines ◽  
Outcome Data ◽  
Treatment Programs

Abstract Background Infection by hepatitis B and C viruses causes inflammation of the liver and can lead to cirrhosis, liver failure, and hepatocellular carcinoma. The WHO’s ambition to eliminate viral hepatitis by 2030 requires strategies specific to the dynamic disease profiles each nation faces. Large-scale human movement from high-prevalence nations to the United States and Canada have altered the disease landscape, likely warranting adjustments to present elimination approaches. However, the nature and magnitude of the new disease burden remains unknown. This study aims to generate a modeled estimate of recent HBV and HCV prevalence changes to the United States and Canada due to migration. Methods Total migrant populations from 2010-2019 were obtained from United Nations Migrant Stock database. Country-of-origin HBV and HCV prevalences were obtained for the select 40 country-of-origin nations from the Polaris Observatory and systematic reviews. A standard pivot table was used to evaluate the disease contribution from and to each nation. Disease progression estimates were generated using the American Association for the Study of the Liver guidelines and outcome data. Results Between 2010 and 2019, 7,676,937 documented migrants arrived in US and Canada from the selected high-volume nations. Primary migrant source regions were East Asia and Latin America. Combined, an estimated 878,995 migrants were HBV positive, and 226,428 HCV positive. The majority of both migrants (6,477,506) and new viral hepatitis cases (HBV=840,315 and HCV=215,359) were found in the United States. The largest source of HBV cases stemmed from the Philippines, and HCV cases from El Salvador. Conclusion Massive human movement has significantly changed HBV and HCV disease burdens in both the US and Canada over the past decade and the long-term outcomes of cirrhosis and HCC are also expected to increase. These increases are likely to disproportionally impact individuals of the migrant and refugee communities and screening and treatment programs must be strategically adjusted in order to reduce morbidity, mortality, and healthcare expenses. Disclosures All Authors: No reported disclosures

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