ABSTRACT
We examine the potential for exploiting retailer location choice in targeting health interventions. Using geospatial data, we quantify proximity to vaccines created by a U.S. federal program distributing COVID-19 vaccines to commercial retail pharmacies. We assess the distributional impacts of a proposal to provide vaccines at Dollar General, a low-priced general merchandise retailer. Adding Dollar General to the federal program would substantially decrease the distance to vaccine sites for low-income, rural, and minority U.S. households, groups for which COVID-19 vaccine take-up has been disproportionately slow.
ABSTRACT
Nursing homes and other long-term care facilities account for a disproportionate share of COVID-19 cases and fatalities worldwide. Outbreaks in U.S. nursing homes have persisted despite nationwide visitor restrictions beginning in mid-March. An early report issued by the Centers for Disease Control and Prevention identi?ed sta? members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, Washington to other skilled nursing facilities. The full extent of sta? connections between nursing homes—and the role these connections serve in spreading a highly contagious respiratory infection—is currently unknown given the lack of centralized data on cross-facility employment. We perform the ?rst large-scale analysis of nursing home connections via shared sta? and contractors using device-level geolocation data from 50 million smartphones, and ?nd that 5.1 percent of smartphone users who visit a nursing home for at least one hour also visit another facility during our 11-week study period—even after visitor restrictions were imposed. We construct network measures of connectedness and estimate that nursing homes, on average, share connections with 7 other facilities. Controlling for demographic and other factors, a home’s sta?-network connections and its centrality within the greater network strongly predict COVID-19 cases. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Multivariate regressions comparing demographically and geographically similar nursing homes suggest that 49 percent of COVID cases among nursing home residents are attributable to sta? movement between facilities.
ABSTRACT
As countries transition from facing COVID-19 vaccine supply shortfalls to requiring novel strategies to facilitate vaccination, modern retail chains—often designed and located to target particular demographic groups—are a potential vaccine delivery vehicle. Using geospatial data, we quantify the proximity to vaccines created by a U.S. federal program that distributes vaccines to commercial retail pharmacies. We then quantify the impact of a proposal to provide vaccines at Dollar General, a low-priced general merchandise retailer. We show that adding Dollar General to the federal program would substantially decrease the distance to vaccine sites for low-income and minority U.S. households.
ABSTRACT
Nursing homes and other long-term care facilities account for a disproportionate share of COVID-19 cases and fatalities worldwide. Outbreaks in US nursing homes have persisted despite nationwide visitor restrictions beginning in mid-March. An early report issued by the Centers for Disease Control and Prevention identified staff members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, WA, to other skilled nursing facilities. The full extent of staff connections between nursing homes-and the role these connections serve in spreading a highly contagious respiratory infection-is currently unknown given the lack of centralized data on cross-facility employment. We perform a large-scale analysis of nursing home connections via shared staff and contractors using device-level geolocation data from 50 million smartphones, and find that 5.1% of smartphone users who visited a nursing home for at least 1 h also visited another facility during our 11-wk study period-even after visitor restrictions were imposed. We construct network measures of connectedness and estimate that nursing homes, on average, share connections with 7.1 other facilities. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Controlling for demographic and other factors, a home's staff network connections and its centrality within the greater network strongly predict COVID-19 cases.