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Collins-Smith A, Prasannan L, Shan W, Dori E, Katzow M, Blitz MJ. Effect of Lockdown Period of COVID-19 Pandemic on Maternal Weight Gain, Gestational Diabetes, and Newborn Birth Weight. Am J Perinatol 2024; 41:e584-e593. [PMID: 35973792 PMCID: PMC10243366 DOI: 10.1055/a-1925-1347] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to determine whether the lockdown period of the initial novel coronavirus disease 2019 (COVID-19) surge in New York affected gestational weight gain (GWG), newborn birth weight (BW), and the frequency of gestational diabetes mellitus (GDM). Maternal and newborn outcomes during the first wave of the pandemic were compared with those during the same timeframe in the previous 2 years. STUDY DESIGN Retrospective cross-sectional study of all live singleton term deliveries from April 1 to July 31 between 2018 and 2020 at seven hospitals within a large academic health system in New York. Patients were excluded for missing data on: BW, GWG, prepregnancy body mass index, and gestational age at delivery. We compared GWG, GDM, and BW during the pandemic period (April-July 2020) with the same months in 2018 and 2019 (prepandemic) to account for seasonality. Linear regression was used to model the continuous outcomes of GWG and BW. Logistic regression was used to model the binary outcome of GDM. RESULTS A total of 20,548 patients were included in the study: 6,672 delivered during the pandemic period and 13,876 delivered during the prepandemic period. On regression analysis, after adjustment for study epoch and patient characteristics, the pandemic period was associated with lower GWG (β = -0.46, 95% confidence interval [CI]: -0.87 to -0.05), more GDM (adjusted odds ratio [aOR] = 1.24, 95% CI: 1.10-1.39), and no change in newborn BW (β = 0.03, 95% CI: -11.7 to 11.8) compared with the referent period. The largest increases in GDM between the two study epochs were noted in patients who identified as Hispanic (8.6 vs. 6.0%; p < 0.005) and multiracial/other (11.8 vs. 7.0%; p < 0.001). CONCLUSION The lockdown period of the pandemic was associated with a decrease in GWG and increase in GDM. Not all groups were affected equally. Hispanic and multiracial patients experienced a larger percentage change in GDM compared with non-Hispanic white patients. KEY POINTS · The COVID-19 lockdown was associated with decreased GWG and increased GDM.. · No change in newborn BW was seen during the lockdown.. · Overall, the lockdown did not have a large clinical effect on these pregnancy outcomes..
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Affiliation(s)
- Ana Collins-Smith
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Lakha Prasannan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Weiwei Shan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Ezra Dori
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Michelle Katzow
- Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
- Department of Research, Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Matthew J. Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
- Department of Research, Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
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Ponce SA, Green A, Strassle PD, Nápoles AM. Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data. BMC Public Health 2024; 24:22. [PMID: 38166883 PMCID: PMC10762906 DOI: 10.1186/s12889-023-17491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces. METHODS The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes. RESULTS Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03). DISCUSSION Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.
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Affiliation(s)
- Stephanie A Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Alexis Green
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Paula D Strassle
- Division of Intramural Research , National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, 2 White Flint North, Room C13, Rockville, MD, 20818, USA.
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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Murphy C, Lim WW, Mills C, Wong JY, Chen D, Xie Y, Li M, Gould S, Xin H, Cheung JK, Bhatt S, Cowling BJ, Donnelly CA. Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230132. [PMID: 37611629 PMCID: PMC10446910 DOI: 10.1098/rsta.2023.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Caitriona Murphy
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Wey Wen Lim
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathal Mills
- Department of Statistics, University of Oxford, Oxford, UK
| | - Jessica Y. Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Yanmy Xie
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Mingwei Li
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hualei Xin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Justin K. Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin J. Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Christl A. Donnelly
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Huang Q. Age-based spatial disparities of COVID-19 incidence rates in the United States counties. PLoS One 2023; 18:e0286881. [PMID: 37289782 PMCID: PMC10249835 DOI: 10.1371/journal.pone.0286881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
COVID-19 incidence disparities have been documented in the literature, but the different driving factors among age groups have yet to be explicitly explained. This study proposes a community-based COVID-19 spatial disparity model, considering different levels of geographic units (individual and community), various contextual variables, multiple COVID-19 outcomes, and different geographic contextual elements. The model assumes the existence of age nonstationarity effects on health determinants, suggesting that health effects of contextual variables vary among place and age groups. Based on this conceptual model and theory, the study selected 62 county-level variables for 1,748 U.S. counties during the pandemic, and created an Adjustable COVID-19 Potential Exposure Index (ACOVIDPEI) using principal component analysis (PCA). The validation was done with 71,521,009 COVID-19 patients in the U.S. from January 2020 through June 2022, with high incidence rates shifting from the Midwest, South Carolina, North Carolina, Arizona, and Tennessee to the West and East coasts. This study corroborates the age nonstationarity effect of health determinants on COVID-19 exposures. These results empirically identify the geographic disparities of COVID-19 incidence rates among age groups and provide the evidentiary guide for targeting pandemic recovery, mitigation, and preparedness in communities.
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Affiliation(s)
- Qian Huang
- Center for Rural Health Research, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
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Mehranbod CA, Gobaud AN, Branas CC, Chen Q, Giovenco DP, Humphreys DK, Rundle AG, Bushover BR, Morrison CN. Trends in alcohol-impaired crashes in California, 2016 to 2021: A time series analysis for alcohol involvement and crash distribution among demographic subgroups. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1119-1131. [PMID: 37095075 PMCID: PMC10858975 DOI: 10.1111/acer.15091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND In 2020, the COVID-19 pandemic and control measures changed alcohol consumption in the United States (US) and globally. Before the pandemic, alcohol-impaired crashes contributed to approximately one-third of all road traffic crash injuries and fatalities nationally. We examined the impact of the COVID-19 pandemic on crashes and examined differences in alcohol-involved crashes across various subgroups. METHODS The University of California Berkeley Transportation Injury Mapping Systems provided information on all crashes reported to the California Highway Patrol from January 1, 2016 through December 31, 2021. Using autoregressive integrated moving average (ARIMA) models applied to weekly time series data, we estimated the effect of California's first mandatory statewide shelter-in-place order (March 19, 2020) on crashes per 100,000 population. We also examined crash subgroups according to crash severity, sex, race/ethnicity, age, and alcohol involvement. RESULTS In California, the mean crash rate per week before the pandemic (January 1, 2016-March 18, 2020) was 9.5 crashes per 100,000 population, and 10.3% of those were alcohol-involved. After the initiation of the COVID-19 stay-at-home order, the percentage of crashes that were alcohol-involved rose to 12.7%. Overall, the crash rate across California decreased significantly (-4.6 crashes per 100,000; 95% CI: -5.3, -3.9), including across all examined subgroups, with the greatest decrease among the least severe crashes. However, there was a 2.3% absolute increase in the proportion of crashes that were alcohol-involved (0.02 crashes per 100,000; 95% CI: 0.02, 0.03). CONCLUSIONS The initiation of a COVID-19 stay-at-home ordinance in California was associated with a substantial decrease in overall crash rates. While crashes have returned to pre-pandemic levels, alcohol-involved crashes remain elevated. The initiation of the stay-at-home order significantly increased alcohol-impaired driving, which has remained elevated.
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Affiliation(s)
- Christina A. Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ariana N. Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Charles C. Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Daniel P. Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - David K. Humphreys
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Brady R. Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Parmet WE, Erwin PC. The Challenges to Public Health Law in the Aftermath of COVID-19. Am J Public Health 2023; 113:267-268. [PMID: 36791356 PMCID: PMC9932389 DOI: 10.2105/ajph.2022.307208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 02/17/2023]
Affiliation(s)
- Wendy E Parmet
- Wendy E. Parmet is with the Center for Health Policy & Law, Northeastern University, Boston, MA. Paul C. Erwin is with the School of Public Health, University of Alabama at Birmingham. Both authors are associate editors of AJPH
| | - Paul C Erwin
- Wendy E. Parmet is with the Center for Health Policy & Law, Northeastern University, Boston, MA. Paul C. Erwin is with the School of Public Health, University of Alabama at Birmingham. Both authors are associate editors of AJPH
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Choi AJ, Hean AC, Lee JK, Tran ND, Lin TK, Apollonio DE. A Retrospective Global Assessment of Factors Associated With COVID-19 Policies and Health Outcomes. Front Public Health 2022; 10:843445. [PMID: 35615034 PMCID: PMC9125067 DOI: 10.3389/fpubh.2022.843445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/29/2022] [Indexed: 12/15/2022] Open
Abstract
Background The 2019 Global Health Security (GHS) Index measured the capacities of countries to prepare for and respond to epidemics and pandemics. However, the COVID-19 pandemic revealed that GHS Index scores were poorly correlated with ability to respond to infectious disease threats. It is critical to understand how public health policies may reduce the negative impacts of pandemics. Objective To identify non-pharmaceutical interventions (NPIs) that can minimize morbidity and mortality during the COVID-19 and future pandemics, this study examined associations between country characteristics, NPI public health policies, and COVID-19 outcomes during the first year of the pandemic, prior to the introduction of the COVID-19 vaccine. This global analysis describes worldwide trends in policy implementation and generates a stronger understanding of how NPIs contributed to improved health outcomes. Design This cross-sectional, retrospective study relied on information drawn from publicly available datasets through December 31, 2020. Primary and Secondary Outcome Measures We conducted multivariate regressions to examine associations between country characteristics and policies, and policies and health outcomes. Results Countries with higher health service coverage prior to the pandemic implemented more policies and types of policies. Countries with more bordering countries implemented more border control policies (0.78**), and countries with denser populations implemented more masking policies (0.24*). Across all countries, fewer COVID-19 cases and deaths per million were associated with masking (-496.10*, -7.57), testing and tracing (-108.50**, -2.47**), and restriction of movement (-102.30*, -2.10*) policies, with stronger associations when these policies were mandatory rather than voluntary. Conclusions Country characteristics, including health service coverage, number of bordering countries, and population density, may predict the frequency and nature of public health interventions. Countries with higher health service coverage may have the infrastructure to react more efficiently to a pandemic, leading them to implement a greater number of policies. Mandatory masking, testing and tracing, and restriction of movement policies were associated with more favorable COVID-19 population health outcomes. While these results are consistent with existing COVID-19 mathematical models, policy effectiveness depends on how well they are implemented. Our results suggest that social distancing policies were less effective in reducing infectious disease risk, which may reflect difficulties with enforcement and monitoring.
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Affiliation(s)
- Angela Jeong Choi
- School of Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew C. Hean
- School of Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Julia K. Lee
- School of Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Nguyen D. Tran
- School of Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Tracy Kuo Lin
- Department of Social and Behavioral Sciences, Institute for Health & Aging, University of California, San Francisco, San Francisco, CA, United States
| | - Dorie E. Apollonio
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, United States
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Abstract
PURPOSE The COVID-19 pandemic resulted in increased penetrating trauma and decreased length of stay (LOS) amongst the adult trauma population, findings important for resource allocation. Studies regarding the pediatric trauma population are sparse and mostly single-center. This multicenter study examined pediatric trauma patients, hypothesizing increased penetrating trauma and decreased LOS after the 3/19/2020 stay-at-home (SAH) orders. METHODS A multicenter retrospective analysis of trauma patients ≤ 17 years old presenting to 11 centers in California was performed. Demographic data, injury characteristics, and outcomes were collected. Patients were divided into three groups based on injury date: 3/19/2019-6/30/2019 (CONTROL), 1/1/2020-3/18/2020 (PRE), 3/19/2020-6/30/2020 (POST). POST was compared to PRE and CONTROL in separate analyses. RESULTS 1677 patients were identified across all time periods (CONTROL: 631, PRE: 479, POST: 567). POST penetrating trauma rates were not significantly different compared to both PRE (11.3 vs. 9.0%, p = 0.219) and CONTROL (11.3 vs. 8.2%, p = 0.075), respectively. POST had a shorter mean LOS compared to PRE (2.4 vs. 3.3 days, p = 0.002) and CONTROL (2.4 vs. 3.4 days, p = 0.002). POST was also not significantly different than either group regarding intensive care unit (ICU) LOS, ventilator days, and mortality (all p > 0.05). CONCLUSIONS This multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS.
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Gimbrone C, Rutherford C, Kandula S, Martínez-Alés G, Shaman J, Olfson M, Gould MS, Pei S, Galanti M, Keyes KM. Associations between COVID-19 mobility restrictions and economic, mental health, and suicide-related concerns in the US using cellular phone GPS and Google search volume data. PLoS One 2021; 16:e0260931. [PMID: 34936666 PMCID: PMC8694413 DOI: 10.1371/journal.pone.0260931] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022] Open
Abstract
During the COVID-19 pandemic, US populations have experienced elevated rates of financial and psychological distress that could lead to increases in suicide rates. Rapid ongoing mental health monitoring is critical for early intervention, especially in regions most affected by the pandemic, yet traditional surveillance data are available only after long lags. Novel information on real-time population isolation and concerns stemming from the pandemic's social and economic impacts, via cellular mobility tracking and online search data, are potentially important interim surveillance resources. Using these measures, we employed transfer function model time-series analyses to estimate associations between daily mobility indicators (proportion of cellular devices completely at home and time spent at home) and Google Health Trends search volumes for terms pertaining to economic stress, mental health, and suicide during 2020 and 2021 both nationally and in New York City. During the first pandemic wave in early-spring 2020, over 50% of devices remained completely at home and searches for economic stressors exceeded 60,000 per 10 million. We found large concurrent associations across analyses between declining mobility and increasing searches for economic stressor terms (national proportion of devices at home: cross-correlation coefficient (CC) = 0.6 (p-value <0.001)). Nationally, we also found strong associations between declining mobility and increasing mental health and suicide-related searches (time at home: mood/anxiety CC = 0.53 (<0.001), social stressor CC = 0.51 (<0.001), suicide seeking CC = 0.37 (0.006)). Our findings suggest that pandemic-related isolation coincided with acute economic distress and may be a risk factor for poor mental health and suicidal behavior. These emergent relationships warrant ongoing attention and causal assessment given the potential for long-term psychological impact and suicide death. As US populations continue to face stress, Google search data can be used to identify possible warning signs from real-time changes in distributions of population thought patterns.
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Affiliation(s)
- Catherine Gimbrone
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Caroline Rutherford
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, United States of America
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Madelyn S. Gould
- Department of Epidemiology, Columbia University, New York, NY, United States of America
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Sen Pei
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Marta Galanti
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University, New York, NY, United States of America
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Reinhart E, Chen DL. Association of Jail Decarceration and Anticontagion Policies With COVID-19 Case Growth Rates in US Counties. JAMA Netw Open 2021; 4:e2123405. [PMID: 34473257 PMCID: PMC8414192 DOI: 10.1001/jamanetworkopen.2021.23405] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety. OBJECTIVE To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This cohort study used county-level data from January to November 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population. EXPOSURES Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. MAIN OUTCOMES AND MEASURES Daily COVID-19 case growth rates. RESULTS In the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%- 7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). CONCLUSIONS AND RELEVANCE Although many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial detention policies are likely to be important for improving US public health, biosecurity, and pandemic preparedness.
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Affiliation(s)
- Eric Reinhart
- Data and Evidence for Justice Reform, The World Bank, Washington, DC
- Department of Anthropology, Harvard University, Cambridge, Massachusetts
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois
| | - Daniel L. Chen
- Data and Evidence for Justice Reform, The World Bank, Washington, DC
- Centre National de la Recherche Scientifique, Paris, France
- Toulouse School of Economics, Toulouse, France
- Institute for Advanced Study in Toulouse, Toulouse, France
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Trivedi MM, Das A. Did the Timing of State Mandated Lockdown Affect the Spread of COVID-19 Infection? A County-level Ecological Study in the United States. J Prev Med Public Health 2021; 54:238-244. [PMID: 34370936 PMCID: PMC8357543 DOI: 10.3961/jpmph.21.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/01/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: Previous pandemics have demonstrated that several demographic, geographic, and socioeconomic factors may play a role in increased infection risk. During this current coronavirus disease 2019 (COVID-19) pandemic, our aim was to examine the association of timing of lockdown at the county level and aforementioned risk factors with daily case rate (DCR) in the United States. Methods: A cross-sectional study using publicly available data was performed including Americans with COVID-19 infection as of May 24, 2020. The United States counties with >100 000 population and >50 cases per 100 000 people were included. The independent variable was the days required from the declaration of lockdown to reach the target case rate (50/100 000 cases) while the dependent (outcome) variable was the DCR per 100 000 on the day of statistical calculation (May 24, 2020) after adjusting for multiple confounding socio-demographic, geographic, and health-related factors. Each independent factor was correlated with outcome variables and assessed for collinearity with each other. Subsequently, all factors with significant association to the outcome variable were included in multiple linear regression models using stepwise method. Models with best R2 value from the multiple regression were chosen. Results: The timing of mandated lockdown order had the most significant association on the DCR per 100 000 after adjusting for multiple socio-demographic, geographic and health-related factors. Additional factors with significant association with increased DCR include rate of uninsured and unemployment. Conclusions: The timing of lockdown order was significantly associated with the spread of COVID-19 at the county level in the United States.
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Affiliation(s)
- Megh M Trivedi
- Pediatric Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Anirudha Das
- Pediatric Institute, Cleveland Clinic, Cleveland, OH, USA
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