Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years. Methods Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region. Results The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between March and April 2020, particularly in hospitalizations for non-respiratory illnesses. From April onward there was a rise in the number of monthly hospitalizations per month. Hospitalizations per month, nationally and in each Census division, decreased for 20 of 25 MDCs between March and April 2020. There was also a decrease in hospitalizations per month for all age groups between March and April 2020 with the greatest decreases in hospitalizations observed for patients 50–64 and ≥65 years of age. Conclusions Rates of hospitalization declined substantially during the first months of the COVID-19 pandemic, suggesting delayed routine, elective, and emergency care in the United States. These lapses in care for illnesses not related to COVID-19 may lead to increases in morbidity and mortality for other conditions. Thus, in the current stage of the pandemic, clinicians and public-health officials should work, not only to prevent SARS-CoV-2 transmission, but also to ensure that care for non-COVID-19 conditions is not delayed.

Northward Expansion of Amblyomma americanum (Acari: Ixodidae) into Southern Michigan

Amblyomma americanum (Linnaeus) (Acari: Ixodidae) (lone star tick) is an aggressive, generalist parasite that vectors numerous important human and animal pathogens. In recent decades its geographic range has been expanding northwards from endemic regions in the southeastern and southcentral US. In 2019 five questing A. americanum comprising two life stages were detected at one site in Berrien County, in southwestern Michigan, satisfying one CDC criterium for an established population for the first time in the state. To better characterize the northern extent of emerging A. americanum, we conducted active surveillance (i.e., drag sampling) in summer 2020 throughout Michigans southern counties and detected one adult A. americanum from each of six widespread sites, including where they had been detected in 2019. A larger established population was identified at another site in Berrien County, which yielded 691 A. americanum comprising three life stages. Questing tick phenologies at this site were similar to that reported for other regions. Statewide surveillance in 2021 revealed no A. americanum outside of Berrien County, but establishment criteria were met again at the two sites where established populations were first detected respectively in 2019 and 2020. These observations may represent the initial successful invasion of A. americanum into Michigan. Data from passive (1999-2020) and active surveillance (2004-2021) efforts, including a domestic animal sentinel program (2015-2018), are reported to provide context for this nascent invasion. Continued active surveillance is needed to help inform the public, medical professionals, and public health officials of the health risks associated with this vector.

Observed Mass-Scale Call-Response Dynamics Between Public Health Officials and the American Public in the Surging COVID-19 Pandemic Summer 2020

By any objective measure, the United States has mishandled its response to the SARS-CoV-2 and COVID-19 outbreak, with 177,394 deaths and 5,745,721 cases. In the world, there have been some 796,330 deaths and 22,848,030 validated coronavirus cases (with 15,500,447 recovered). The real rates are thought to be 3x – 10x higher given the low access to tests. In this moment, there are multiple epidemics ongoing in the U.S., resulting in massive government and private industry expenditures, disrupted markets, and social roiling. In journalistic coverage and social image sets, the interactive call-response between public health officials and the general American public may be seen in the Summer of 2020 (in a time of phased shutdowns and re-openings and re-closings). This work offers an original content analysis of over 2,431 journalistic articles and 2,224 social images captured July 3, 2020 to understand where the call-response communications broke down and the message got lost at enormous social and personal cost. A sidebar offers an analysis of COVID-19 social memes.

Queering Environmental Justice: Unequal Environmental Health Burden on the LGBTQ+ Community

The LGBTQ+ (lesbian, gay, bisexual, transgender/-sexual, queer or questioning, intersex, asexual, and all subsects) population has been the target of federal and state discriminatory policies leading to high levels of institutional discrimination in the housing, employment, and health sectors. Social determinants of health such as housing conditions, economic opportunities, and access to health care may negatively and disproportionately affect the LGBTQ+ population and reduce their capacity to respond to environmental harm (e.g., obtaining necessary medical care). Social determinants of health have been shown to be associated with unequal harmful environmental exposure, primarily along lines of race/ethnicity and socioeconomic status. However, chronic diseases, such as respiratory diseases, cardiovascular disease, and cancer, associated with environmental exposure have been shown to occur in higher rates in the LGBTQ+ population than in the cisgender, heterosexual population. We explore how environmental exposures may disproportionately affect the LGBTQ+ population through examples of environmental exposures, health risks that have been linked to environmental exposures, and social institutions that could affect resilience to environmental stressors for this population. We provide recommendations for policymakers, public health officials, and researchers. (Am J Public Health. 2022;112(1):79–87. https://doi.org/10.2105/AJPH.2021.306406 )

The Effect of Risk Communication on Public Behavior to Non-Conventional Terrorism—Randomized Control Trial

Non-conventional terrorism (NCT) incorporates an extended dimension of uncertainty that can lead to fear among the public. Health officials have an unsubstantiated assumption that thousands will seek treatment in hospitals following NCT. This study aims to examine public behavioral intentions in the case of NCT and the effect of risk communication on intents. An online randomized controlled trial was conducted among 1802 adult participants in Israel. Threat perception and behavioral intent before and after exposure to hypothetical NCT scenarios were assessed stratified to the type of media, exposure to rumors, and risk communication. The majority (~64%) of participants are aware of the NCT threat. Almost half (45%) of participants indicated a “high” or “very high” chance of seeking medical attention following an NCT incident. Regression analysis suggests that the odds of participants exposed to risk communication to report an elevated intent of seeking medical attention were 0.470 (95% CI: 0.359, 0.615) times that of participants not exposed to risk communication, χ2 = 30.366, p < 0.001. The findings demonstrate the importance of effective risk communication in reducing undesired public behavior during NCT crises. Efforts must be invested to create a robust risk communication infrastructure to allow the proper management of possible NCT incidents.

Enabling Collaboration and Communication Across Law Enforcement Jurisdictions: Data Sharing in a Multiagency Partnership

Offenders do not always operate within jurisdictional boundaries and, as such, neighboring law enforcement agencies can benefit from sharing crime data and other investigation-related information with one another, with the shared goal of reducing crime throughout their region. In 2016, one such partnership was formed with seven law enforcement agencies, the District Attorney’s Office, and public health officials in King County, Washington. As part of a larger evaluation of this regional collaboration, the authors assessed the data and intelligence-sharing behaviors of key personnel from each participating agency over an 18-month period. This was done through a series of interviews with key personnel and the use of social network analysis. Results suggest that, although data-sharing networks increased in size and project personnel were able to identify benefits to sharing crime data with one another (e.g., seeing the “bigger picture” regarding crime in their region, using shared crime data to track and combat violent crime), they also identified a number of obstacles associated with cross-jurisdictional data sharing. Findings from this evaluation contribute to the collective understanding and implementation of a regional approach to crime control. If criminal justice agencies plan to work together to reduce crime, data and information sharing are essential. Therefore, it is imperative that agencies are aware of the positive outcomes associated with regional data sharing and the challenges that can arise throughout this collaborative effort.

Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake

Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families.

A Review on Contaminants of Emerging Concern in the Environment: A Focus on Active Chemicals in Sub-Saharan Africa

Active chemicals are among the contaminants of emerging concern that are rarely covered in regulatory documents in sub-Saharan Africa. These substances are neither in the list of routinely monitored substances nor in the guidelines for routine environmental monitoring activities. This has been of concern to public health officials, toxicologists, communities, and governments, hence the need for risk assessment and regulation of these substances. In this review article, the presence of active chemicals in the sub-Saharan African environment was investigated. The results indicate the availability of few studies in some countries, while in other countries no reports of active chemicals were found, hence the need for further research targeting such countries. It was further observed that mixtures of active chemicals from different therapeutic categories—such as antibiotics and analgesics—were reported. The natural environment is increasingly at risk due to the presence of these substances, their metabolites, and their transformation byproducts. These substances are characterized by persistence as a result of their non-biodegradable nature; hence, they circulate from one environmental compartment to another through the food chain, causing harm along the way. Most studies that evaluated the toxicity of these substances considered the effects of a single drug, but observations indicated the presence of drug mixtures, hence the need for further evaluation of the effects of drug–drug interactions—including synergistic and additive effects—for environmental sustainability. The presence of ACs in several environmental compartments at quantifiable quantities was discovered in this investigation, indicating the potential for ecosystem injury as a result of bioaccumulation, bioconcentration, and biomagnification through the food chain. This necessitates further research on the subject in order to ensure a healthier environment.

Dietary Recommendation for Survival During COVID-19

Corona viruses are a large family of viruses that exist in many different species of animals including camels, bovine animals, and bats. The new strain of corona virus identified as the cause of outbreaks of respiratory disease in people first detected in Wuhan, China, was COVID-19.WHO has published a new guide on how to eat healthily during the COVID-19 COVID pandemic and self-quarantine.The guideline contains valuable information about nutrition to help keep the immune system strong. It also has tips for a diet that supports good health while advised to stay at home and may have less opportunity to consume fresh foods and be physically active.The FDA continues important research to protect public health during the COVID-19 pandemic along with other federal, state , and local agencies and public health officials around the country [1,2,3].

Myths Surrounding Covid-19 Vaccine Candidates: A Guide to Fight Back

The Covid-19 pandemic has propelled public health officials into the socio-political sphere due to the need for constantly updated information on behalf of the public. However, many individuals choose to acquire health information/guidance from indirect sources, including social media, news organizations, and general word of mouth. As a result, myths and false narratives about various essential health topics, including vaccine characteristics and protective measures, can circulate un-verified between millions of individuals with little recourse. These can further widen the “gap” between public knowledge and current research, resulting in lower vaccine uptake (vaccine hesitancy) and protective measure adherence. Such actions have profound implications as nations attempt to achieve herd immunity and end the pandemic once and for all. Thus, it is vital that public health officials, health providers, researchers, and the general public be able to differentiate common Covid-19 myths from facts and be prepared to approach such interactions via sound reasoning and research-based evidence. This chapter will serve as a guide to accomplish just that.