CDC (Cindy and David's Conversations) Game: Advising President to Survive Pandemic.

Ongoing debates on anti-COVID19 policies have been focused on coexistence-with vs. zero-out (virus) strategies, which can be simplified as "always open (AO)" vs. "always closed (AC)." We postulate that a middle ground, dubbed LOHC (low-risk-open and high-risk-closed), is likely favorable, precluding obviously irrational HOLC (high-risk-open and low-risk-closed). From a meta-strategy perspective, these four policies cover the full spectrum of anti-pandemic policies. By emulating the reality of anti-pandemic policies today, the study aims to identify possible cognitive gaps and traps by harnessing the power of evolutionary game-theoretic analysis and simulations, which suggest that (i) AO and AC seems to be "high-probability" events (0.412-0.533); (ii) counter-intuitively, the middle ground-LOHC-seems to be small-probability event (0.053), possibly mirroring its wide adoptions but broad failures. Besides devising specific policies, an equally important challenge seems to deal with often hardly avoidable policy transitions along the process from emergence, epidemic, through pandemic, to endemic state.

The Mashpee Wampanoag Tribe COVID-19 Pandemic Response: A Case Study.

During the COVID-19 pandemic, the Mashpee Wampanoag Tribe of southeastern Massachusetts requested US federal government assistance. The tribe collaborated successfully with many partners in response to the COVID-19 pandemic. In this case study, the authors describe the tribe's collaboration with a team from the Centers for Disease Control and Prevention who assisted with epidemiology, case investigation and contact tracing, infection prevention and control, community prevention measures, and vaccination. Collaborative efforts resulted in over 200 public service announcements and videos produced, 55 tribal staff trained, 222 people followed up for contact tracing, 80% of tribal members vaccinated, and 5 COVID-19 response plans written. Deployment response teams learned elements essential to partnering with a Native American tribe. This successful partnership during a rapidly evolving pandemic suggests the US federal government and tribal nations can work together effectively to build response capacity for future infectious disease threats.

Co-infection of respiratory pathogens in SARS-CoV-2 positive patients at North West India, Rajasthan.

PURPOSE: Infection due to SARS-CoV-2 shows wide spectrum of disease from asymptomatic to severe disease and death. Coinfection of SARS-CoV-2 with other respiratory pathogens may affect the severity of disease and its outcome. Identification of other respiratory pathogens may help to initiate proper management and avoid unnecessary complications. MATERIALS AND METHODS: Total 250 SARS-COV-2 positive patients admitted in S.M.S hospitalwere included in study. Throat and nasopharyngeal swabs samples were collected in Viral Transport Medium (VTM) and nucleic acid extraction was done by automated EasyMag extractor and tested for 20 respiratory viruses and two bacteria by real time PCR. RESULTS: Out of 250 SARS CoV2 positive samples, 176 (70%) were positive for other respiratory pathogens also. The highest co-infection was due to HCoVOC43 (32.8%) virus followed by bacterial co-infection with S. pneumoniae (14.8%). Six (2.4%) patients with co-infection were on ventilator with age >65yr and three (1.2%) died during treatment. All three cases were found to have other co-morbid diseases like; asthma, Parkinson's and hypertension. CONCLUSION: High number of patients were found to have coinfection with other viruses and bacteria, timely identification and providing specific treatment to these patients can help improve outcome.

The Public Health Response of the US Federal Government to the Coronavirus Crisis and the Narrative of Donald J. Trump

Since first coming to the attention of the global public in January 2020, few countries in the world have been as severely impacted by the novel coronavirus as the United States. Though it holds just four per cent of the world's total population, as of mid-2020 the US leads the world with a quarter of confirmed COVID-19 cases and deaths. Despite this dire situation, the Administration of President Donald J. Trump has frequently downplayed the severity of the virus, and Trump himself has often relayed misinformation to the American public about both the virus itself and his Administration's response to it. Accordingly, independent analysis has ranked the US last in "fact-based communications” about the coronavirus when compared to other nations with advanced economies. This chapter provides a chronological overview of how the coronavirus pandemic has unfolded in the US through September 2020, with a particular focus on the various comments made by President Trump. By drawing on Trump's many public statements, the chapter pieces together the narrative that Trump has constructed about the coronavirus crisis and examines that narrative in light of the broader public health response of the US federal government to the pandemic. In concluding, it finds that Trump's narrative has been erratic, divisive, and misleading and that this, combined with a chaotic federal response to the crisis, has undermined public health in the United States. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021.

Myocarditis following vaccination with Pfizer-BioNTech BNT162b2 against coronavirus infection (COVID-19)

Postvaccination myocarditis was reported as early as 1957 in association with smallpox vaccination. Following Emergency Use Authorization of the Pfizer-BioNTech BNT162b2 vaccine by the FDA on December 11, 2020, approval was granted in Israel on December 20, 2020. A national vaccination campaign for novel coronavirus infection (COVID-19) using the Pfizer vaccine ensued in Israel. The vaccination campaign was based on a 2-dose regimen administered with a 21-day interval, and later a third (booster) vaccine was added. A unique nationwide active surveillance program with hospital reports of diagnoses of myocarditis and verification of vaccinations. Based on comparisons with historical (pre-COVID-19) incidence of myocarditis, observed-to-expected ratios were calculated. The results clearly demonstrated an association between vaccination and myocarditis, mainly in young males and mainly in the first week after the second vaccine. These studies are the only nationwide active surveillance studies performed to date and provide the most accurate estimates of myocarditis occurrence after the Pfizer-BioNTech BNT162b2 mRNA-based vaccination. © 2023 Elsevier Inc. All rights reserved.

Elementary statistics projects using covid data

This article describes five elementary statistics projects involving the Covid-19 data made available to the public in csv files by the Centers for Disease Control and Prevention. The first project examined data available at the beginning of the covid surge in New York City in spring, 2020, and used the correlation coefficient to estimate the total number of deaths that could be expected as the spike ran its course. The second project is an easy one on the concept of excess deaths and on the mechanics of extracting parts of a data file that answer relevant questions. The data is from a spike in deaths in the particularly bad flu surge in the winter of 2017-2018. The third and fourth projects ask the student to fit a logistic growth curve to observed cumulative numbers of deaths in a spike, like the Covid spikes in New York City and Wisconsin and the nationwide 2017-2018 flu spike. The method is a simple linear regression with transformed variables. The fifth project involves hypothesis testing and judging when a Poisson model might be useful. The paper also documents difficulties and adaptations of the sort familiar to all teachers who have taught during the Covid-19 pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Tracking COVID-19 in the United States With Surveillance of Aggregate Cases and Deaths.

Early during the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) leveraged an existing surveillance system infrastructure to monitor COVID-19 cases and deaths in the United States. Given the time needed to report individual-level (also called line-level) COVID-19 case and death data containing detailed information from individual case reports, CDC designed and implemented a new aggregate case surveillance system to inform emergency response decisions more efficiently, with timelier indicators of emerging areas of concern. We describe the processes implemented by CDC to operationalize this novel, multifaceted aggregate surveillance system for collecting COVID-19 case and death data to track the spread and impact of the SARS-CoV-2 virus at national, state, and county levels. We also review the processes established to acquire, process, and validate the aggregate number of cases and deaths due to COVID-19 in the United States at the county and jurisdiction levels during the pandemic. These processes include time-saving tools and strategies implemented to collect and validate authoritative COVID-19 case and death data from jurisdictions, such as web scraping to automate data collection and algorithms to identify and correct data anomalies. This topical review highlights the need to prepare for future emergencies, such as novel disease outbreaks, by having an event-agnostic aggregate surveillance system infrastructure in place to supplement line-level case reporting for near-real-time situational awareness and timely data.

Modeling Behavior and Vaccine Hesitancy Using Twitter-Derived US Population Sentiment during the COVID-19 Pandemic to Predict Daily Vaccination Inoculations.

The sentiment analysis of social media for predicting behavior during a pandemic is seminal in nature. As an applied contribution, we present sentiment-based regression models for predicting the United States COVID-19 first dose, second dose, and booster daily inoculations from 1 June 2021 to 31 March 2022. The models merge independent variables representing fear of the virus and vaccine hesitancy. Large correlations exceeding 77% and 84% for the first-dose and booster-dose models inspire confidence in the merger of the independent variables. Death count as a traditional measure of fear is a lagging indicator of inoculations, while Twitter-positive and -negative tweets are strong predictors of inoculations. Thus, the use of sentiment analysis for predicting inoculations is strongly supported with administrative events being catalysts for tweets. Non-inclusion in the second-dose regression model of data occurring before the 1 June 2021 timeframe appear to limit the second-dose model results-only achieving a moderate correlation exceeding 53%. Limiting tweet collection to geolocated tweets does not encompass the entire US Twitter population. Nonetheless, results from Kaiser Family Foundation (KFF) surveys appear to generally support the regression factors common to the first-dose and booster-dose regression models and their results.

Exploration and verification of COVID-19-related hub genes in liver physiological and pathological regeneration.

Objectives An acute injury is often accompanied by tissue regeneration. In this process, epithelial cells show a tendency of cell proliferation under the induction of injury stress, inflammatory factors, and other factors, accompanied by a temporary decline of cellular function. Regulating this regenerative process and avoiding chronic injury is a concern of regenerative medicine. The severe coronavirus disease 2019 (COVID-19) has posed a significant threat to people's health caused by the coronavirus. Acute liver failure (ALF) is a clinical syndrome resulting from rapid liver dysfunction with a fatal outcome. We hope to analyze the two diseases together to find a way for acute failure treatment. Methods COVID-19 dataset (GSE180226) and ALF dataset (GSE38941) were downloaded from the Gene Expression Omnibus (GEO) database, and the "Deseq2" package and "limma" package were used to identify differentially expressed genes (DEGs). Common DEGs were used for hub genes exploration, Protein-Protein Interaction (PPI) network construction, Gene Ontology (GO) functional enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) was used to verify the role of hub genes in liver regeneration during in vitro expansion of liver cells and a CCl4-induced ALF mice model. Results: The common gene analysis of the COVID-19 and ALF databases revealed 15 hub genes from 418 common DEGs. These hub genes, including CDC20, were related to cell proliferation and mitosis regulation, reflecting the consistent tissue regeneration change after the injury. Furthermore, hub genes were verified in vitro expansion of liver cells and in vivo ALF model. On this basis, the potential therapeutic small molecule of ALF was found by targeting the hub gene CDC20. Conclusion We have identified hub genes for epithelial cell regeneration under acute injury conditions and explored a new small molecule Apcin for liver function maintenance and ALF treatment. These findings may provide new approaches and ideas for treating COVID-19 patients with ALF.

Precision recruitment for high-risk participants in a COVID-19 cohort study.

Background: Studies for developing diagnostics and treatments for infectious diseases usually require observing the onset of infection during the study period. However, when the infection base rate incidence is low, the cohort size required to measure an effect becomes large, and recruitment becomes costly and prolonged. We developed a model for reducing recruiting time and resources in a COVID-19 detection study by targeting recruitment to high-risk individuals. Methods: We conducted an observational longitudinal cohort study at individual sites throughout the U.S., enrolling adults who were members of an online health and research platform. Through direct and longitudinal connection with research participants, we applied machine learning techniques to compute individual risk scores from individually permissioned data about socioeconomic and behavioral data, in combination with predicted local prevalence data. The modeled risk scores were then used to target candidates for enrollment in a hypothetical COVID-19 detection study. The main outcome measure was the incidence rate of COVID-19 according to the risk model compared with incidence rates in actual vaccine trials. Results: When we used risk scores from 66,040 participants to recruit a balanced cohort of participants for a COVID-19 detection study, we obtained a 4- to 7-fold greater COVID-19 infection incidence rate compared with similar real-world study cohorts. Conclusion: This risk model offers the possibility of reducing costs, increasing the power of analyses, and shortening study periods by targeting for recruitment participants at higher risk.

How health organizations communicate about COVID-19 on social media: a comparative content analysis.

BACKGROUND: This study examined how different health organizations (i.e., the Chinese CDC, the Korean CDC, the United States CDC, and WHO) communicated about the COVID-19 pandemic on social media, thus providing implications for organizations touse social media effectively in global health crises in the future. METHODS: Three bilingual researchers conducted a content analysis ofsocial media posts (N = 1,343) of these health organizations on Twitter and Sina Weibo to explore the frames of the COVID-19 pandemic, the purposes, and the strategies to communicate about it. RESULTS: Prevention was the dominant frame of the social media content of these four health organizations. Information update was the major communication purpose for WHO, the United States CDC, and the Korean CDC; however, guidance was the primary communication purpose for the Chinese CDC. The United States CDC, the Chinese CDC, and the Korean CDC heavily relied on multiple social media strategies (i.e., visual, hyperlink, and authority quotation) in their communication to the public about the COVID-19 pandemic, whereas WHO primarily employed quoting authorities. Significantdifferences were revealed across these health organizations in frames, communication purposes, and strategies. Theoretical and practical implications and limitations were discussed. CONCLUSIONS: This study examined how different global health organizations communicate about the COVID-19 pandemic on social media. We discussed how and why these global health organizations communicate the COVID-19 pandemic, which would help health-related organizations design messages strategically on global public health issues in the future.

Epidemiology and Disease Burden of Alcohol Associated Liver Disease.

Consumption of alcohol in excess leads to substantial medical, economic, and societal burdens. Approximately 5.3% of all global deaths may be attributed to alcohol consumption. Moreover, the burden of alcohol associated liver disease (ALD) accounts for 5.1% of all disease and injury worldwide. Alcohol use disorder (AUD) affects men more than women globally with significant years of life loss to disability in low, middle and well-developed countries. Precise data on global estimates of alcohol related steatosis, alcohol related hepatitis, and alcohol related cirrhosis have been challenging to obtain. In the United States (US), alcohol related steatosis has been estimated at 4.3% based on NHANES data which has remained stable over 14 years. However, alcohol-related fibrotic liver disease has increased over the same period. In those with AUD, the prevalence of alcohol related hepatitis has been estimated at 10-35%. Globally, the prevalence of alcohol-associated cirrhosis has been estimated at 23.6 million individuals for compensated cirrhosis and 2.46 million for those with decompensated cirrhosis. The contribution of ALD to global mortality and disease burden of liver related deaths is substantial. In 2016 liver disease related to AUD contributed to 50% of the estimated liver disease deaths for age groups 15 years and above. Data from the US report high cost burdens associated with those admitted with alcohol-related liver complications. Finally, the recent COVID-19 pandemic has been associated with marked increase in alcohol consumption worldwide and will likely increase the burden of ALD.

Vaccine confidence among those living with allergy during the COVID pandemic (ACCORD): A scoping review.

Background: Reports of allergic reactions to coronavirus disease 2019 (COVID-19) vaccines, coupled with an "infodemic" of misinformation, carry the potential to undermine confidence in the COVID-19 vaccines. However, no attempts have been made to comprehensively synthesize the literature on how allergic disease and fear of allergic reactions to the vaccines contribute to hesitancy. Objectives: Our aim was to review the academic and gray literature on COVID-19 vaccine hesitancy and allergic reactions. Methods: We searched 4 databases (CINAHL, PsycINFO, MEDLINE, and Embase) using a search strategy developed by content and methodologic experts. No restrictions were applied regarding COVID-19 vaccine type, country of study, or patient age. Eligible articles were restricted to 10 languages. Results: Of the 1385 unique records retrieved from our search, 60 articles (4.3%) were included. Allergic reactions to the COVID-19 vaccine were rare but slightly more common in individuals with a history of allergic disease. A fifth of the studies (13 of 60 [22%]) discussed vaccine hesitancy due to possibility of an allergic reaction. Additionally, the present review identified research on details of vaccine-related anaphylaxis (eg, a mean and median [excluding clinical trial data] of 12.4 and 5 cases per million doses, respectively) and allergic reactions (eg, a mean and median [excluding clinical trial data] of 489 and 528 cases per million doses, respectively). Conclusion: COVID-19 vaccine acceptance among individuals living with allergy and among those with no history of allergic disease may be affected by fear of an allergic reaction. Despite the low incidence of allergic reactions to the COVID-19 vaccine, fear of such reactions is one of the most commonly cited concerns reported in the literature.

COVID-19 pandemic lesson learned- critical parameters and research needs for UVC inactivation of viral aerosols.

The COVID-19 pandemic highlighted public awareness of airborne disease transmission in indoor settings and emphasized the need for reliable air disinfection technologies. This increased awareness will carry in the post-pandemic era along with the ever-emerging SARS-CoV variants, necessitating effective and well-defined protocols, methods, and devices for air disinfection. Ultraviolet (UV)-based air disinfection demonstrated promising results in inactivating viral bioaerosols. However, the reported data diversity on the required UVC doses has hindered determining the best UVC practices and led to confusion among the public and regulators. This article reviews available information on critical parameters influencing the efficacy of a UVC air disinfection system and, consequently, the required dose including the system's components as well as operational and environmental factors. There is a consensus in the literature that the interrelation of humidity and air temperature has a significant impact on the UVC susceptibility, which translate to changing the UVC efficacy of commercialized devices in indoor settings under varying conditions. Sampling and aerosolization techniques reported to have major influence on the result interpretation and it is recommended to use several sampling methods simultaneously to generate comparable and conclusive data. We also considered the safety concerns and the potential safe alternative of UVC, far-UVC. Finally, the gaps in each critical parameter and the future research needs of the field are represented. This paper is the first step to consolidating literature towards developing a standard validation protocol for UVC air disinfection devices which is determined as the one of the research needs.

Measuring the Evolution of Risk Communication Strategy for Health Authorities During the COVID-19 Pandemic: An Empirical Comparison Between China and the United States.

Objectives: Investigate how the speech context of news conferences reveals the risk communication strategies for health authorities during COVID-19 and measure the evolution of those risk communication strategies. Methods: We collected news conference transcripts concerning COVID-19 for the first quarter from the official websites of the Centers for Disease Control and Prevention (CDC) and the National Health Commission of the People's Republic of China (NHC) in 2020. Quantitative analyses were conducted on the topics and emotions of transcripts to measure the evolution of risk communication strategy. A total of three types of analysis were carried out in our study: topic, sentiment, and risk communication evolution analyses. Results: The trending topics and the number of these in the two institutions evolved with the infection status. The CDC and NHC maintained primarily neutral sentiment, while the non-neutral sentiment of the CDC swung more dramatically. Furthermore, the changing pattern of risk communication evolution for the CDC and NHC varied, where the latter had a more stable change routine. Conclusion: Our study finds that the strategies could be measured by topic variation, emotional expressions, and confirmed cases. The CDC and NHC tend to adopt different risk communication strategies and have specific change routines facing the pandemic. In addition, our findings contribute to addressing the WHO research agenda for managing risk communication during the COVID-19 pandemic, which helps health authorities formulate and measure risk communication strategies.

Adapting Longstanding Public Health Collaborations between Government of Kenya and CDC Kenya in Response to the COVID-19 Pandemic, 2020-2021.

Kenya's Ministry of Health (MOH) and the US Centers for Disease Control and Prevention in Kenya (CDC Kenya) have maintained a 40-year partnership during which measures were implemented to prevent, detect, and respond to disease threats. During the COVID-19 pandemic, the MOH and CDC Kenya rapidly responded to mitigate disease impact on Kenya's 52 million residents. We describe activities undertaken jointly by the MOH and CDC Kenya that lessened the effects of COVID-19 during 5 epidemic waves from March through December 2021. Activities included establishing national and county-level emergency operations centers and implementing workforce development and deployment, infection prevention and control training, laboratory diagnostic advancement, enhanced surveillance, and information management. The COVID-19 pandemic provided fresh impetus for the government of Kenya to establish a national public health institute, launched in January 2022, to consolidate its public health activities and counter COVID-19 and future infectious, vaccine-preventable, and emerging zoonotic diseases.

COVID-19 vaccine provocation test outcome in high-risk allergic patients: A retrospective study from a tertiary hospital in Indonesia.

Background: High COVID-19 vaccine coverage is essential. Patients who are considered high risk for hypersensitivity reactions and have had an allergic reaction to the COVID-19 vaccine are usually referred to an allergist for assessment of vaccination. Administration of a vaccine graded challenge (also known as a provocation test) is an option that can be considered in this population. This primary objective of this study is to describe the outcome of the COVID-19 vaccine provocation test and to understand the predicting factors associated with hypersensitivity reaction after the provocation test as the secondary objective. Methods: Adult patients with a history of hypersensitivity reaction to the first COVID-19 vaccine and high-allergic patients who underwent COVID-19 vaccine provocation test up until May 2022 were included. A protocol using skin prick test (SPT), intradermal test (IDT), followed by graded challenge was developed for the determined vaccine used. Results: A total of 232 patients were included in the analysis. Twenty-eight had hypersensitivity to their first COVID-19 vaccine dose and 204 were high risk for allergic reaction. Hypersensitivity reactions occurred in 20 patients (8.6%, 95% CI: 5-12.2%), consisting of 4 reactions after SPT, 9 after IDT, 7 during or after titrated challenge. Half of the reactions were mild; however, 3 patients developed severe reactions. Patients with history of anaphylaxis were more likely to experience hypersensitivity reaction after provocation test (aRR = 2.79, 95% CI: 1.05-7.42). Conclusion: Provocation test in COVID-19 vaccination has a high success rate in patients with a history of hypersensitivity to the first COVID-19 vaccine and in high allergic patients. History of anaphylaxis is associated with hypersensitivity reaction after a COVID-19 vaccine provocation test.

COVID-19 infection differences among people with disabilities.

Purpose: People with disabilities may be at higher risk for COVID-19 infection and death as a result of their impairments and/or medical conditions, and systemic inequities and disadvantages. People with disabilities are also a very heterogenous group, with many people with disabilities being multiply marginalized. The aim of this study was to examine differences in COVID-19 diagnosis and vaccination between people with and without disabilities, and to explore sociodemographic differences in COVID-19 diagnosis and vaccination among the disability community itself. Methods: To do so, we analyzed secondary United States Census Bureau data from 444,422 people (52,890 adults with disabilities and 391,532 adults without disabilities) about COVID-19 diagnosis, vaccination, and sociodemographics. Frequency person-weights were applied. Results: In this study, 19.3% of adults with disabilities were diagnosed with COVID-19 during the pandemic compared to 16.7% of adults without disabilities. People with disabilities were 1.20 times more likely to be diagnosed with COVID-19 than adults without disabilities. Among people with disabilities, the following groups were more likely to be diagnosed with COVID-19: people with cognitive disabilities; cisgender women; Black people; Hispanic people; people with some college or associate's degrees; people with employer and/or private insurance; and people who lived in larger households. There was not a significant difference in vaccination between people with and without disabilities; however, there were vaccination disparities among the disability community. Conclusions: Many of the people with disabilities who were more likely to face health care disparities prior to the pandemic were also more likely to be diagnosed with COVID-19 during the pandemic.