The Effects of Race/Ethnicity, Age, and Area Deprivation Index (ADI) on COVID-19 Disease Early Dynamics: Washington, D.C. Case Study.

The COVID-19 pandemic and its associated mitigation strategies have significant psychosocial, behavioral, socioeconomic, and health impacts, particularly in vulnerable US populations. Different factors have been identified as influencers of the transmission rate; however, the effects of area deprivation index (as a measure of social determinants of health, SDoH) as a factor on COVID-19 disease early dynamics have not been established. We determined the effects of area deprivation index (ADI) and demographic factors on COVID-19 outcomes in Washington, D.C. This retrospective study used publicly available data on COVID-19 cases and mortality of Washington, D.C., during March 31st-July 4th, 2020. The main predictors included area deprivation index (ADI), age, and race/ethnicity. The ADI of each census block groups in D.C. (n=433) were obtained from Neighborhood Atlas map. Using a machine learning-based algorithm, the outcome variables were partitioned into time intervals: time duration (Pi, days), rate of change coefficient (Ei), and time segment load (Pi×Ei) for transmission rate and mortality. Correlation analysis and multiple linear regression models were used to determine associations between predictors and outcome variables. COVID-19 early transmission rate (E1) was highly correlated with ADI (SDoH; r= 0.88, p=0.0044) of the Washington, D.C. community. We also found positive association between ADI, age (0-17 years, r=0.91, p=0.0019), and race (African American/Black, r=0.86; p=0.0068) and COVID-19 outcomes. There was high variability in early transmission across the geographic regions (i.e., wards) of Washington, D.C., and this variability was driven by race/ethnic composition and ADI. Understanding the association of COVID-19 disease early transmission and mortality dynamics and key socio-demographic risk factors such as age, race, and ADI, as a measure of social determinants, will contribute to health equity/equality and distribution of economic resources/assistance and is essential for future predictive modeling of the COVID-19 pandemic to limit morbidity and mortality.

Monitoring COVID-19 pandemic through the lens of social media using natural language processing and machine learning.

PURPOSE: It has been over a year since the first known case of coronavirus disease (COVID-19) emerged, yet the pandemic is far from over. To date, the coronavirus pandemic has infected over eighty million people and has killed more than 1.78 million worldwide. This study aims to explore "how useful is Reddit social media platform to surveil COVID-19 pandemic?" and "how do people's concerns/behaviors change over the course of COVID-19 pandemic in North Carolina?". The purpose of this study was to compare people's thoughts, behavior changes, discussion topics, and the number of confirmed cases and deaths by applying natural language processing (NLP) to COVID-19 related data. METHODS: In this study, we collected COVID-19 related data from 18 subreddits of North Carolina from March to August 2020. Next, we applied methods from natural language processing and machine learning to analyze collected Reddit posts using feature engineering, topic modeling, custom named-entity recognition (NER), and BERT-based (Bidirectional Encoder Representations from Transformers) sentence clustering. Using these methods, we were able to glean people's responses and their concerns about COVID-19 pandemic in North Carolina. RESULTS: We observed a positive change in attitudes towards masks for residents in North Carolina. The high-frequency words in all subreddit corpora for each of the COVID-19 mitigation strategy categories are: Distancing (DIST)-"social distance/distancing", "lockdown", and "work from home"; Disinfection (DIT)-"(hand) sanitizer/soap", "hygiene", and "wipe"; Personal Protective Equipment (PPE)-"mask/facemask(s)/face shield", "n95(s)/kn95", and "cloth/gown"; Symptoms (SYM)-"death", "flu/influenza", and "cough/coughed"; Testing (TEST)-"cases", "(antibody) test", and "test results (positive/negative)". CONCLUSION: The findings in our study show that the use of Reddit data to monitor COVID-19 pandemic in North Carolina (NC) was effective. The study shows the utility of NLP methods (e.g. cosine similarity, Latent Dirichlet Allocation (LDA) topic modeling, custom NER and BERT-based sentence clustering) in discovering the change of the public's concerns/behaviors over the course of COVID-19 pandemic in NC using Reddit data. Moreover, the results show that social media data can be utilized to surveil the epidemic situation in a specific community.

Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study.

BACKGROUND: The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, emergency medical services (EMS) runs for opioid-related overdoses, and opioid overdose deaths have been reported. No study has examined changes in multiple naloxone administrations, an indicator of overdose severity, during the COVID-19 pandemic. OBJECTIVE: This study examines changes in the occurrence of naloxone administrations and multiple naloxone administrations during EMS runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina (NC). METHODS: Using a period-over-period approach, we compared the occurrence of opioid-related EMS runs, naloxone administrations, and multiple naloxone administrations during the 29-week period before (September 1, 2019, to March 9, 2020) and after NC's COVID-19 state of emergency declaration (ie, the COVID-19 period of March 10 to September 30, 2020). Furthermore, historical data were used to generate a quasi-control distribution of period-over-period changes to compare the occurrence of each outcome during the COVID-19 period to each 29-week period back to January 1, 2014. RESULTS: All outcomes increased during the COVID-19 period. Compared to the previous 29 weeks, the COVID-19 period experienced increases in the weekly mean number of opioid-related EMS runs (25.6, SD 5.6 vs 18.6, SD 6.6; P<.001), naloxone administrations (22.3, SD 6.2 vs 14.1, SD 6.0; P<.001), and multiple naloxone administrations (5.0, SD 1.9 vs 2.7, SD 1.9; P<.001), corresponding to proportional increases of 37.4%, 57.8%, and 84.8%, respectively. Additionally, the increases during the COVID-19 period were greater than 91% of all historical 29-week periods analyzed. CONCLUSIONS: The occurrence of EMS runs for opioid-related overdoses, naloxone administrations, and multiple naloxone administrations during EMS runs increased during the COVID-19 pandemic in Guilford County, NC. For a host of reasons that need to be explored, the COVID-19 pandemic appears to have exacerbated the opioid crisis.