RESUMO
BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic warranted a myriad of government-ordered business closures across the USA in efforts to mitigate the spread of the virus. This study aims to discover the implications of government-enforced health policies of reopening public businesses amidst the pandemic and its effect on county-level infection rates. METHODS: Eighty-three US counties (n = 83) that reported at least 20 000 cases as of 4 November 2020 were selected for this study. The dates when businesses (restaurants, bars, retail, gyms, salons/barbers and public schools) partially and fully reopened, as well as infection rates on the 1st and 14th days following each businesses' reopening, were recorded. Regression analysis was conducted to deduce potential associations between the 14-day change in infection rate and mask usage frequency, median household income, population density and social distancing. RESULTS: On average, infection rates rose significantly as businesses reopened. The average 14-day change in infection rate was higher for fully reopened businesses (infection rate = +0.100) compared to partially reopened businesses (infection rate = +0.0454). The P-value of the two distributions was 0.001692, indicating statistical significance (P < 0.01). CONCLUSION: This research provides insight into the transmission of COVID-19 and promotes evidence-driven policymaking for disease prevention and community health.
Assuntos
COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Humanos , Pandemias/prevenção & controle , Saúde Pública , SARS-CoV-2RESUMO
Background: COVID-19 is constantly evolving, and highly populated communities consist of many different characteristics that may contribute to COVID-19 health outcomes. Therefore, we aimed to (1) quantify the relationships between county characteristics and severe and non-severe county-level health outcomes related to COVID-19. We also aimed to (2) compare these relationships across time periods where the Delta (B.1.617.2) and Omicron (B.1.1.529 and BA.1.1) variants were dominant in the U.S. Methods: We used multiple regression to measure the strength of relationships between healthcare outcomes and county characteristics in the 50 most populous U.S. counties. Results: We found many different significant predictors including the proportion of a population vaccinated, median household income, population density, and the proportion of residents aged 65+, but mainly found that socioeconomic factors and the proportion of a population vaccinated play a large role in the dynamics of the spread and severity of COVID-19 in communities with high populations. Discussion: The present study shines light on the associations between public health outcomes and county characteristics and how these relationships change throughout Delta and Omicron's dominance. It is important to understand factors underlying COVID-19 health outcomes to prepare for future health crises.
Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Renda , Densidade DemográficaRESUMO
Introduction: COVID-19 vaccine inequities have been widespread across California, the United States, and globally. As COVID-19 vaccine inequities have not been fully understood in the youth population, it is vital to determine possible factors that drive inequities to enable actionable change that promotes vaccine equity among vulnerable minor populations. Methods: The present study used the social vulnerability index (SVI) and daily vaccination numbers within the age groups of 12-17, 5-11, and under 5 years old across all 58 California counties to model the growth velocity and the anticipated maximum proportion of population vaccinated. Results: Overall, highly vulnerable counties, when compared to low and moderately vulnerable counties, experienced a lower vaccination rate in the 12-17 and 5-11 year-old age groups. For age groups 5-11 and under 5 years old, highly vulnerable counties are expected to achieve a lower overall total proportion of residents vaccinated. In highly vulnerable counties in terms of socioeconomic status and household composition and disability, the 12-17 and 5-11 year-old age groups experienced lower vaccination rates. Additionally, in the 12-17 age group, high vulnerability counties are expected to achieve a higher proportion of residents vaccinated compared to less vulnerable counterparts. Discussion: These findings elucidate shortcomings in vaccine uptake in certain pediatric populations across California and may help guide health policies and future allocation of vaccines, with special emphasis placed on vulnerable populations, especially with respect to socioeconomic status and household composition and disability.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Criança , Adolescente , Humanos , Pré-Escolar , Conservação dos Recursos Naturais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação , Demografia , California/epidemiologiaRESUMO
Coronavirus disease 2019 (COVID-19) disparities among vulnerable populations are of paramount concern that extend to vaccine administration. With recent uptick in infection rates, dominance of the delta variant, and authorization of a third booster shot, understanding the population-level vaccine coverage dynamics and underlying sociodemographic factors is critical for achieving equity in public health outcomes. This study aimed to characterize the scope of vaccine inequity in California counties through modeling the trends of vaccination using the Social Vulnerability Index (SVI). Overall SVI, its four themes, and 9228 data points of daily vaccination numbers from December 15, 2020, to May 23, 2021, across all 58 California counties were used to model the growth velocity and anticipated maximum proportion of population vaccinated, defined as having received at least one dose of vaccine. Based on the overall SVI, the vaccination coverage velocity was lower in counties in the high vulnerability category (v = 0.0346, 95% CI 0.0334, 0.0358) compared to moderate (v = 0.0396, 95% CI 0.0385, 0.0408) and low (v = 0.0414, 95% CI 0.0403, 0.0425) vulnerability categories. SVI Theme 3 (minority status and language) yielded the largest disparity in coverage velocity between low and high-vulnerable counties (v = 0.0423 versus v = 0.035, P < 0.001). Based on the current trajectory, while counties in low-vulnerability category of overall SVI are estimated to achieve a higher proportion of vaccinated individuals, our models yielded a higher asymptotic maximum for highly vulnerable counties of Theme 3 (K = 0.544, 95% CI 0.527, 0.561) compared to low-vulnerability counterparts (K = 0.441, 95% CI 0.432, 0.450). The largest disparity in asymptotic proportion vaccinated between the low and high-vulnerability categories was observed in Theme 2 describing the household composition and disability (K = 0.602, 95% CI 0.592, 0.612; versus K = 0.425, 95% CI 0.413, 0.436). Overall, the large initial disparities in vaccination rates by SVI status attenuated over time, particularly based on Theme 3 status which yielded a large decrease in cumulative vaccination rate ratio of low to high-vulnerability categories from 1.42 to 0.95 (P = 0.002). This study provides insight into the problem of COVID-19 vaccine disparity across California which can help promote equity during the current pandemic and guide the allocation of future vaccines such as COVID-19 booster shots.