Epidemiology of the 2020 pandemic of COVID-19 in the state of Georgia: Inadequate critical care resources and impact after 7 weeks of community spread.

Objectives: Novel coronavirus (COVID-19) is a global pandemic currently spreading rapidly across the United States. We provide a comprehensive look at COVID-19 epidemiology across the state of Georgia, which includes vast rural communities that may be disproportionately impacted by the spread of this infectious disease. Methods: All 159 Georgia counties were included in this study. We examined the geographic variation of COVID-19 in Georgia from March 3 through April 24, 2020 by extracting data on incidence and mortality from various national and state datasets. We contrasted county-level mortality rates per 100,000 population (MRs) by county-level factors. Results: Metropolitan Atlanta had the overall highest number of confirmed cases; however, the southwestern rural parts of Georgia, surrounding the city of Albany, had the highest bi-weekly increases in incidence rate. Among counties with >10 cases, MRs were highest in the rural counties of Randolph (233.2), Terrell (182.5), Early (136.3), and Dougherty (114.2). Counties with the highest MRs (22.5-2332 per 100,000) had a higher proportion of: non-Hispanic Blacks residents, adults aged 60+, adults earning <$20,000 annually, and residents living in rural communities when compared with counties with lower MRs. These counties also had a lower proportion of the population with a college education, lower number of ICU beds per 100,000 population, and lower number of primary care physicians per 10,000 population. Conclusions: While urban centers in Georgia account for the bulk of COVID-19 cases, high mortality rates and low critical care capacity in rural Georgia are also of critical concern.

Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States.

In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97-5.26-91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99-27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.

Racial Disparities in the Epidemiology of COVID-19 in Georgia: Trends Since State-Wide Reopening.

Objective: To examine county-level factors associated with coronavirus disease 2019 (COVID-19) incidence and mortality in Georgia, focusing on changes after relaxation of "shelter-in-place" orders on April 24, 2020. Methods: County-level data on confirmed COVID-19 cases and deaths were obtained from the Johns Hopkins 2019 Novel Coronavirus Data Repository and linked with county-level data from the 2020 County Health Rankings. We examined associations of county-level factors with mortality and incidence rates (quantiles) using a logistic regression model. This research was conducted in June-July 2020 in Augusta, GA. Results: Counties in the highest quartile for mortality had higher proportions of non-Hispanic (NH)-Black residents (median: 37.4%; interquartile range [IQR]: 29.5-45.0; p<0.01) and residents with incomes less than $20,000 (median: 32.9%; IQR: 26.6-35.0; p<0.01). Counties in the highest quartile for NH-Black residents (38.7-78.0% NH-Black population) showed a 13-fold increase in odds (odds ratio=13.15, 95% confidence interval=1.40-123.80, p=0.05) for increased COVID-19 mortality controlling for income. Conclusions: Although highlighted by the pandemic, racial disparities predated COVID-19, exposing the urgency for diversion of resources to address the systematic residential segregation, educational gaps, and poverty levels experienced disproportionately by Black communities.

Epidemiology of the 2020 Pandemic of COVID-19 in the State of Texas: The First Month of Community Spread.

The pandemic of novel Coronavirus (SARS-CoV-2) is currently spreading rapidly across the United States. We provide a comprehensive overview of COVID-19 epidemiology across the state of Texas, which includes vast rural & vulnerable communities that may be disproportionately impacted by the spread of this new disease. All 254 Texas counties were included in this study. We examined the geographic variation of COVID-19 from March 1 through April 8, 2020 by extracting data on incidence and case fatality from various national and state datasets. We contrasted incidence and case fatality rates by county-level demographic and healthcare resource factors. Counties which are part of metropolitan regions, such as Harris and Dallas, experienced the highest total number of confirmed cases. However, the highest incidence rates per 100,000 population were in found in counties of Donley (353.5), Castro (136.4), Matagorda (114.4) and Galveston (93.4). Among counties with greater than 10 cases, the highest CFR were observed in counties of Comal (10.3%), Hockley (10%), Hood (10%), and Castro (9.1%). Counties with the highest CFR (> 10%) had a higher proportion of non-Hispanic Black residents, adults aged 65 and older, and adults smoking, but lower number of ICU beds per 100,000 population, and number of primary care physicians per 1000 population. Although the urban areas of Texas account for the majority of COVID-19 cases, the higher case-fatality rates and low health care capacity in rural areas need attention.