ABSTRACT
Background: Without pharmacologic interventions, the preferred strategy to combat COVID-19 is to slow the virus' spread via social distancing measures. The components of social distancing include: school closure, restrictions on gatherings, non-essential business closure, stay at home orders and limitations on travel. Most countries have implemented many of these restrictions. Conversely, Sweden has not initiated these restrictions and instead has recommended that citizens avoid mass gatherings, which presents an opportunity to examine the effects of the components of social distancing on mortality in Nordic countries. Purpose: Investigate the impact of social distancing measures on fatalities associated with COVID-19. Method: COVID-19 fatalities, as reported by the World Health Organisation, were recorded for each of the Nordic countries from 6th February 2020 to 30th April 2020. The fatalities were compared using a Cox proportional hazard regression analysis. Results: The normalised fatalities ranged significantly (1.87 to 129 deaths/population/km2) in the Nordic countries. Sweden was found to have a significantly higher risk of COVID-19 related mortality at the α=0.05 level as compared to Finland (HR=0.15;p<0.001) and Norway and Denmark (HR=0.23;p=0.002). Conclusion: The population-density normalised mortality in Sweden was significantly greater than other Nordic countries, possibly due to differences in the implementation of social distancing policies.
ABSTRACT
Background: In the setting of COVID-19, hypertension, diabetes, and obesity are postulated to contribute to adverse outcomes. Among different ethnic groups in the United States of America, African Americans have a higher incidence of the above conditions. It is hypothesised that the African American population in the United States may bear a disproportionate burden of COVID-19-related mortality. Purpose(s): Evaluate the correlation between African American ethnicity and incidence of COVID-19-related mortality. Method(s): COVID-19-related fatalities reported for Oregon, Missouri, and Georgia between the 6th February and 30th April 2020 were obtained from state health departments. These states were selected due to similarities in the social distancing measures implemented but differences in their African American population (32.4% Georgia, 11.8% Missouri, 2.2% Oregon). Fatalities in each state were analysed using the Cox proportional hazard regression analysis. Result(s): Of the reported fatalities in Georgia, Missouri, and Oregon, 51.0%, 38.0%, and 4.0% were in African Americans, respectively. This corresponds to a 2.1 to 2.8-fold increase in the risk of COVID-19-related mortality in African Americans as compared to all other ethnicities. The incidence of African American fatalities for the total population of each state ranged from 0.12 to 3.22 deaths/population/mile2. As compared to Oregon, the risk of COVID-19-related mortality was significantly higher in Georgia (hazard ratio (HR)=4.4;p<0.001) and Missouri (HR=2.2;p=0.001) at the alpha=0.05 level, proportional to the increased population of African Americans. Conclusion(s): Initial results show that African American ethnicity may significantly contribute to an overall incidence of COVID-19-related mortality.
ABSTRACT
INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic has precipitated a myriad of challenges to the United States (US) healthcare system. Predictive models have sought to forecast the extend of healthcare resource deficient in order to prepare the US healthcare system, based on the assumption that fatalities are linked to intensive care (ICU) and hospital utilization. This study aims to construct a predictive model for ICU utilization, based on COVID-19 positivity rates and COVID-19 related fatalities. METHODS: Data was obtained from each state's public health department dashboard and validated via the Institute for Health Metrics and Evaluation, the Center for Disease Control and Prevention, and the COVID Tracking Project databases. Data from the five states (California (CA), Florida (FL), New Jersey (NJ), New York (NY), and Texas (TX)) with the highest incidence of COVID-19 related fatalities, ICU utilization, and inpatient deaths were collected from April 1, 2020 to July 14, 2020. The rates of positive COVID-19 tests and death were utilized to construct a linear model predicting ICU utilization referenced to July 14, 2020. The actual incidence of COVID-19-related ICU utilization for each state was compared to the model using the root-mean-square-error (RMSE). RESULTS: Linear models were created for all assessed states, except TX. For the TX model, the fit of the data was non-significant. In all cases, there was a positive linear correlation observed between daily ICU utilization and mortality and COVID-positivity rates (CA R2=0.66, FL R2=0.88, NJ R2=0.68, NY R2=0.32). The RMSE was 1.81 for CA, 0.21 for FL, 0.30 for NJ, and 0.77 for NY. As expected, incidence of ICU and hospital utilization was higher than the US average for all states assessed, except for FL. The incidence of ICU and hospital utilization in Florida remained significantly lower than the US average (ICU OR 0.64, 95% CI 0.51 - 0.77;hospital OR 0.02, 95% CI 0.017 - 0.021). CONCLUSIONS: Increased ICU utilization was associated with both COVID-19-related mortality and COVID-19 positivity. Overall, for CA, FL, NJ, NY the there was a correlation between observed ICU utilization and these values.
ABSTRACT
Introduction: In response to the COVID-19 pandemic, many educational institutions have been forced to transition to remote learning. While the impact of remote learning on students has been well studied, few studies have examined the impact of the switch to distance learning on the workload and stress management of pharmacy educators and researchers. Research Question or Hypothesis: The rapid transition to remote learning necessitated by the COVID-19 pandemic adversely impacted pharmacy educators. Study Design: Cross-sectional qualitative survey. Methods: To assess the perceived levels of stress and workload of educators and researchers, a 28-question survey was developed. The survey was sent to the Academic Section of the International Pharmaceutical Federation (FIP) and the pharmacy faculty of St. Louis College of Pharmacy. Data was anonymously collected via SurveyMonkey. Demographic data (area of practice, time to transition to remote learning, time spent in the academic practice setting, and baseline use of remote classrooms) was collected and utilized to create cohorts (transition time < 7 days versus >7 days) that assessed the impact of time for remote learning transition on burnout and practice setting burden. One-tailed t-tests were conducted and results were interpreted at the α = 0.05 level. Results: The data demonstrated that the transition time to remote learning and practice discipline had a significant impact on aspects of stress and workload for pharmacy educators. Educators in the <7-day transition cohort displayed significant perceived increases in workload (P < 0.001) and emotional burden (P = 0.03). Further, pharmacy practice educators displayed significant perceptions in decrease in community connection (P = 0.003), unequal expectations (P < 0.001), and increased stress from clinical positions (P = 0.002). Conclusion: Faculty workload and perceived stress was adversely impacted by the transition to remote learning, with significant findings observed in educators with the shortest amount of transition time and concurrent positions as pharmacy practice educators or researchers.