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1.
South Med J ; 114(10): 649-656, 2021 10.
Article in English | MEDLINE | ID: covidwho-1608690

ABSTRACT

OBJECTIVES: Although disparities in coronavirus disease 2019 (COVID-19) prevalence are known, knowledge of the recent surge of COVID-19 in Texas and factors affecting fatality rates is limited. Understanding the health disparities associated with COVID-19 can help healthcare professionals determine the populations that are most in need of COVID-19 preventive care and treatment. The aim of this study was to assess COVID-19-related case and mortality rates. METHODS: Our cross-sectional analysis used Texas Department of State Health Services COVID-19 case surveillance counts. Case, hospitalization, and mortality counts were obtained from March to July 2020. RESULTS: From March to July 2020, there were 420,397 COVID-19-related cases and 6954 deaths in Texas. There were 3277 new cases and 104 deaths in March, and 261,876 new cases and 3660 deaths in July. The number of new COVID-19 cases was the highest from March to April (relative risk 1.77, 95% confidence interval [CI] 1.76-1.78). Although the death rate in June was a 30% increase over the rate in May, death rates nearly tripled by the end of July, for a total of 3660 deaths. Of the 3958 deaths, demographic data were available for 753 deaths. Of these, 440 were male, 16 Asian, 95 Black, 221 Hispanic, 325 White, and 96 were "Other" or "Unknown." Males were associated with a slightly higher chance of acquiring COVID-19 than females (odds ratio [OR] 1.11, 95% CI 1.09-1.14) and nearly a 29% higher chance of dying of COVID-19 compared with females (OR 1.29, 95% CI 1.11-1.49). Bivariate analysis revealed that the probability of acquiring COVID-19 was 12% higher in older adults compared with individuals younger than 65 years old (OR 1.12, 95% CI 1.08-1.16), and older adults had an 18.8 times higher risk of death when compared with the rate of younger individuals (OR 18.79, 95% CI 15.93-22.15). Hispanics and Blacks were 70% and 48%, respectively, more likely to contract COVID-19 than Whites. All races had lower significant chance of death when compared with Whites. At the end of July, there was a total of 430,485 Texas COVID-19 cases and 6387 fatalities (8.8% of all cases and 4% of all deaths in the United States.). Case fatality ratios were the highest in older adults. As we continued to observe data, in contrast to previous study time points, we found that Asians and Hispanics had no significant difference in COVID mortality rates and were comparable in terms of mortality odds and death case ratios when compared with Whites. CONCLUSIONS: This time period represents the highest COVID-19 surge time in Texas. Although our data consist of a short time period of population-level data in an ongoing pandemic and are limited by information reported to the Texas Department of State Health Services, older age, male sex, Hispanics, and Blacks are currently associated with higher infection rates, whereas older age, male sex, and Whites are associated with higher mortality rates. Clinicians and decision makers should be aware of the COVID-19 health disparities and risk factors for mortality to better promote targeted interventions and allocate resources accordingly.


Subject(s)
COVID-19/economics , Health Status Disparities , /statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/ethnology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Odds Ratio , Prevalence , Risk Factors , State Government , Texas/epidemiology
2.
PLoS One ; 16(12): e0260613, 2021.
Article in English | MEDLINE | ID: covidwho-1581780

ABSTRACT

There is widespread recognition that stressors related to Coronavirus Disease 2019 (COVID-19) jeopardize the development of emerging adults, more particularly those living in disadvantaged communities. What is less well understood is what might support emerging adult resilience to COVID-19-related stressors. In response, this article reports a 5-week qualitative study with 24 emerging adults (average age: 20) living in a South African township. Using digital diaries and repeated individual interviews, young people shared their lived experiences of later (i.e., month 4 and 7) lockdown-related challenges (i.e., contagion fears; livelihood threats; lives-on-hold) and how they managed these challenges. An inductive thematic analysis showed that personal and collective compliance, generous ways-of-being, and tolerance-facilitators enabled emerging adult resilience to said challenges. Importantly, these resilience-enablers drew on resources associated with multiple systems and reflected the situational and cultural context of the township in question. In short, supporting emerging adult resilience to COVID-19-related stressors will require contextually aligned, multisystemic responses.


Subject(s)
COVID-19/psychology , Resilience, Psychological , Adolescent , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Male , Medicine, African Traditional , South Africa/epidemiology , Vulnerable Populations/psychology , Young Adult
3.
PLoS One ; 16(12): e0261381, 2021.
Article in English | MEDLINE | ID: covidwho-1581746

ABSTRACT

The Covid-19 pandemic has brought forth a major landscape shock in the mobility sector. Due to its recentness, researchers have just started studying and understanding the implications of this crisis on mobility. We contribute by combining mobility data from various sources to bring a novel angle to understanding mobility patterns during Covid-19. The goal is to expose relations between mobility and Covid-19 variables and understand them by using our data. This is crucial information for governments to understand and address the underlying root causes of the impact.


Subject(s)
COVID-19/economics , COVID-19/prevention & control , Marketing/statistics & numerical data , Pandemics/economics , Pandemics/prevention & control , Patient Isolation/methods , SARS-CoV-2 , Travel/statistics & numerical data , COVID-19/epidemiology , COVID-19/mortality , Humans , Netherlands/epidemiology
4.
Nutrients ; 14(1)2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1580546

ABSTRACT

COVID-19 has negatively impacted many households' financial well-being, food security, and mental health status. This paper investigates the role financial resources play in understanding the relationship between food security and mental health among U.S. households using data from a survey in June 2020. Results show job loss and savings draw down to pay for household bills had a significant relationship with both lower food security and greater numbers of poor mental health days during the pandemic.


Subject(s)
COVID-19/economics , COVID-19/psychology , Food Security/statistics & numerical data , Income/statistics & numerical data , Mental Health/statistics & numerical data , Adult , Female , Food Security/economics , Humans , Male , Mental Health/economics , Middle Aged , Pandemics , SARS-CoV-2 , United States
5.
J Med Internet Res ; 23(2): e25429, 2021 02 09.
Article in English | MEDLINE | ID: covidwho-1575482

ABSTRACT

BACKGROUND: As the number of COVID-19 cases increased precipitously in the United States, policy makers and health officials marshalled their pandemic responses. As the economic impacts multiplied, anecdotal reports noted the increased use of web-based crowdfunding to defray these costs. OBJECTIVE: We examined the web-based crowdfunding response in the early stage of the COVID-19 pandemic in the United States to understand the incidence of initiation of COVID-19-related campaigns and compare them to non-COVID-19-related campaigns. METHODS: On May 16, 2020, we extracted all available data available on US campaigns that contained narratives and were created between January 1 and May 10, 2020, on GoFundMe. We identified the subset of COVID-19-related campaigns using keywords relevant to the COVID-19 pandemic. We explored the incidence of COVID-19-related campaigns by geography, by category, and over time, and we compared the characteristics of the campaigns to those of non-COVID-19-related campaigns after March 11, when the pandemic was declared. We then used a natural language processing algorithm to cluster campaigns by narrative content using overlapping keywords. RESULTS: We found that there was a substantial increase in overall GoFundMe web-based crowdfunding campaigns in March, largely attributable to COVID-19-related campaigns. However, as the COVID-19 pandemic persisted and progressed, the number of campaigns per COVID-19 case declined more than tenfold across all states. The states with the earliest disease burden had the fewest campaigns per case, indicating a lack of a case-dependent response. COVID-19-related campaigns raised more money, had a longer narrative description, and were more likely to be shared on Facebook than other campaigns in the study period. CONCLUSIONS: Web-based crowdfunding appears to be a stopgap for only a minority of campaigners. The novelty of an emergency likely impacts both campaign initiation and crowdfunding success, as it reflects the affective response of a community. Crowdfunding activity likely serves as an early signal for emerging needs and societal sentiment for communities in acute distress that could be used by governments and aid organizations to guide disaster relief and policy.


Subject(s)
COVID-19/epidemiology , Crowdsourcing/statistics & numerical data , Financial Support , COVID-19/economics , Cost of Illness , Cross-Sectional Studies , Crowdsourcing/economics , Government , Humans , Narration , Natural Language Processing , Pandemics , SARS-CoV-2 , United States/epidemiology
6.
Nutrients ; 13(2)2021 Jan 25.
Article in English | MEDLINE | ID: covidwho-1575182

ABSTRACT

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.


Subject(s)
COVID-19/epidemiology , Nutritional Status , Pandemics , Psychological Distress , Stress, Psychological/epidemiology , Aged , COVID-19/economics , COVID-19/psychology , Cross-Sectional Studies , Female , Food Insecurity/economics , Humans , Independent Living/economics , Independent Living/psychology , Independent Living/statistics & numerical data , Malaysia/epidemiology , Male , Middle Aged , Patient Health Questionnaire/statistics & numerical data , Stress, Psychological/diagnosis , Stress, Psychological/economics , Stress, Psychological/psychology
7.
Value Health ; 24(11): 1551-1569, 2021 11.
Article in English | MEDLINE | ID: covidwho-1557697

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has had a major impact on our society, with drastic policy restrictions being implemented to contain the spread of the severe acute respiratory syndrome coronavirus 2. This study aimed to provide an overview of the available evidence on the cost-effectiveness of various coronavirus disease 2019 policy measures. METHODS: A systematic literature search was conducted in PubMed, Embase, and Web of Science. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the Consensus Health Economic Criteria checklist. Next, the quality of the epidemiological models was evaluated. RESULTS: A total of 3688 articles were identified (March 2021), of which 23 were included. The studies were heterogeneous with regard to methodological quality, contextual factors, strategies' content, adopted perspective, applied models, and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation, and hygienic measures were found to be cost-effective. Furthermore, the most optimal choice and combination of strategies depended on the reproduction number and context. With a rising reproduction number, extending the testing strategy and early implementation of combined multiple restriction measures are most efficient. CONCLUSIONS: The quality assessment highlighted numerous flaws and limitations in the study approaches; hence, their results should be interpreted with caution because the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key because this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.


Subject(s)
COVID-19/economics , Cost-Benefit Analysis/standards , Health Policy/economics , COVID-19/epidemiology , COVID-19/prevention & control , Cost-Benefit Analysis/trends , Health Policy/trends , Humans
8.
Nutrients ; 13(12)2021 Dec 08.
Article in English | MEDLINE | ID: covidwho-1554890

ABSTRACT

The COVID-19 pandemic has increased food insecurity worldwide, yet there has been limited assessment of shifts in the cost and affordability of healthy, equitable and sustainable diets. This study explores the impact of the COVID-19 pandemic and income supplements provided by the Australian government on diet cost and affordability for low-income households in an Australian urban area. The Healthy Diets ASAP method protocol was applied to assess the cost and cost differential of current and recommended diets before (in 2019) and during the COVID-19 pandemic (late 2020) for households with a minimum-wage and welfare-only disposable household income, by area of socioeconomic disadvantage, in Greater Brisbane, Queensland, Australia. Data were collected between August and October, 2020, from 78 food outlets and compared with data collected in the same locations between May and October, 2019, in an earlier study. The price of most healthy food groups increased significantly during the pandemic-with the exception of vegetables and legumes, which decreased. Conversely, the price of discretionary foods and drinks did not increase during the pandemic. The cost of the current and recommended diets significantly increased throughout this period, but the latter continued to be less expensive than the former. Due to income supplements provided between May and September 2020, the affordability of the recommended diet improved greatly, by 27% and 42%, for households with minimum-wage and welfare-only disposable household income, respectively. This improvement in the affordability of the recommended diet highlights the need to permanently increase welfare support for low-income families to ensure food security.


Subject(s)
COVID-19 , Diet, Healthy/economics , Food Insecurity/economics , Income , Pandemics , SARS-CoV-2 , Adult , COVID-19/economics , COVID-19/epidemiology , Female , Humans , Male , Queensland/epidemiology
11.
Lancet ; 397(10279): 1127-1138, 2021 03 20.
Article in English | MEDLINE | ID: covidwho-1525996

ABSTRACT

In 2010, the US health insurance system underwent one of its most substantial transformations with the passage of the Affordable Care Act, which increased coverage for millions of people in the USA, including those with and at risk of HIV. Even so, the system of HIV care and prevention services in the USA is a complex patchwork of payers, providers, and financing mechanisms. People with HIV are primarily covered by Medicaid, Medicare, private insurance, or a combination of these; many get care through other programmes, particularly the Ryan White HIV/AIDS Program, which serves as the nation's safety net for people with HIV who remain uninsured or underinsured but offers modest to no support for prevention services. While uninsurance has drastically declined over the past decade, the USA trails other high-income countries in key HIV-specific metrics, including rates of viral suppression. In this paper in the Series, we provide an overview of the coverage and financing landscape for HIV treatment and prevention in the USA, discuss how the Affordable Care Act has changed the domestic health-care system, examine the major programmes that provide coverage and services, and identify remaining challenges.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/economics , HIV Infections/drug therapy , HIV Infections/prevention & control , Insurance Coverage/legislation & jurisprudence , Insurance, Health/legislation & jurisprudence , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Aged , Anti-Retroviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Gender Identity , HIV Infections/economics , HIV Infections/epidemiology , Humans , Incidence , Male , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act , Risk Assessment , SARS-CoV-2/genetics , United States/epidemiology
13.
PLoS One ; 16(11): e0260015, 2021.
Article in English | MEDLINE | ID: covidwho-1523446

ABSTRACT

State governments in the U.S. have been facing difficult decisions involving tradeoffs between economic and health-related outcomes during the COVID-19 pandemic. Despite evidence of the effectiveness of government-mandated restrictions mitigating the spread of contagion, these orders are stigmatized due to undesirable economic consequences. This tradeoff resulted in state governments employing mandates at widely different ways. We compare the different policies states implemented during periods of restriction ("lockdown") and reopening with indicators of COVID-19 spread and consumer card spending at each state during the first "wave" of the pandemic in the U.S. between March and August 2020. We find that while some states enacted reopening decisions when the incidence rate of COVID-19 was minimal or sustained in its relative decline, other states relaxed socioeconomic restrictions near their highest incidence and prevalence rates experienced so far. Nevertheless, all states experienced similar trends in consumer card spending recovery, which was strongly correlated with reopening policies following the lockdowns and relatively independent from COVID-19 incidence rates at the time. Our findings suggest that consumer card spending patterns can be attributed to government mandates rather than COVID-19 incidence in the states. We estimate the recovery in states that reopened in late April was more than the recovery in states that did not reopen in the same period- 15% for consumer card spending and 18% for spending by high income households. This result highlights the important role of state policies in minimizing health impacts while promoting economic recovery and helps planning effective interventions in subsequent waves and immunization efforts.


Subject(s)
COVID-19/economics , Pandemics/economics , Policy , COVID-19/epidemiology , Humans , United States/epidemiology
16.
Proc Natl Acad Sci U S A ; 118(46)2021 11 16.
Article in English | MEDLINE | ID: covidwho-1506908

ABSTRACT

COVID-19 has had worse health, education, and labor market effects on groups with low socioeconomic status (SES) than on those with high SES. Little is known, however, about whether COVID-19 has also had differential effects on noncognitive skills that are important for life outcomes. Using panel data from before and during the pandemic, we show that COVID-19 affects one key noncognitive skill, that is, prosociality. While prosociality is already lower for low-SES students prior to the pandemic, we show that COVID-19 infections within families amplify the prosociality gap between French high school students of high and low SES by almost tripling its size in comparison to pre-COVID-19 levels.


Subject(s)
COVID-19/economics , COVID-19/transmission , Family , SARS-CoV-2 , Social Behavior , Social Class , Adolescent , Humans
18.
BMC Pregnancy Childbirth ; 21(1): 755, 2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1506167

ABSTRACT

BACKGROUND: The COVID-19 pandemic has exacerbated the financial insecurity of women and their families globally. Some studies have explored the impact of financial strain among pregnant women, in particular, during the pandemic. However, less is known about the factors associated with pregnant women's experiences of material hardship. METHODS: This cross-sectional study used a non-probability sample to examine the factors associated with pregnant women's experiences of material hardship during the COVID-19 pandemic. In January 2021, 183 pregnant women living in the United States participated in an online Qualtrics panel survey. In addition to socio-demographic characteristics, individuals were asked about their finances and predictors of financial well-being, mental health symptoms, and intimate partner violence (IPV) experiences. Chi-square analysis and one-way ANOVA were used to examine whether women's experiences with material hardship and associated factors differed by income level (i.e., less than $20,000; $20,000 to $60,000; more than $60,000). Ordinary least squares regression was used to calculate unadjusted and adjusted estimates. RESULTS: Study findings showed that the majority of women in the sample experienced at least one form of material hardship in the past year. Individuals with an annual household income less than $20,000 reported the highest average number of material hardships experienced (M = 3.7, SD = 2.8). Compared to women with household incomes less than $20,000, women with incomes of more than $60,000 reported significantly fewer material hardships, less financial strain, and higher levels of financial support, economic self-efficacy, and economic-self-sufficiency. Women with incomes of $60,000 or more also reported significantly lower levels of psychological abuse, and a smaller percentage met the cut-off for anxiety. Economic self-sufficiency, financial strain, posttraumatic stress disorder, and economic abuse were all significantly associated with material hardship. CONCLUSIONS: A contribution of this study is that it highlights the significant, positive association between economic abuse, a unique form of IPV, and material hardship among pregnant women during the pandemic. These findings suggest the need for policy and practice interventions that help to ameliorate the financial insecurity experienced by some pregnant women, as well as respond to associated bidirectional vulnerabilities (e.g., mental health symptoms, experiences of IPV).


Subject(s)
COVID-19/economics , Economic Status , Income/classification , Pregnant Women/psychology , Adult , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Income/statistics & numerical data , Intimate Partner Violence/psychology , Intimate Partner Violence/statistics & numerical data , Pandemics , Pregnancy , SARS-CoV-2 , Stress Disorders, Post-Traumatic , Surveys and Questionnaires , United States/epidemiology
19.
PLoS One ; 16(11): e0258700, 2021.
Article in English | MEDLINE | ID: covidwho-1504697

ABSTRACT

Protecting healthcare professionals is crucial in maintaining a functioning healthcare system. The risk of infection and optimal preventive strategies for healthcare workers during the COVID-19 pandemic remain poorly understood. Here we report the results of a cohort study that included pre- and asymptomatic healthcare workers. A weekly testing regime has been performed in this cohort since the beginning of the COVID-19 pandemic to identify infected healthcare workers. Based on these observations we have developed a mathematical model of SARS-CoV-2 transmission that integrates the sources of infection from inside and outside the hospital. The data were used to study how regular testing and a desynchronisation protocol are effective in preventing transmission of COVID-19 infection at work, and compared both strategies in terms of workforce availability and cost-effectiveness. We showed that case incidence among healthcare workers is higher than would be explained solely by community infection. Furthermore, while testing and desynchronisation protocols are both effective in preventing nosocomial transmission, regular testing maintains work productivity with implementation costs.


Subject(s)
Asymptomatic Infections , COVID-19 Testing/methods , COVID-19/diagnosis , COVID-19/economics , Health Personnel , SARS-CoV-2 , Algorithms , Cost-Benefit Analysis , Cross Infection , Data Collection , Delivery of Health Care , Hospitals , Humans , Mass Screening/methods , Models, Theoretical , Occupational Exposure , Pandemics , Risk , Stochastic Processes , Switzerland/epidemiology
20.
PLoS One ; 16(11): e0259451, 2021.
Article in English | MEDLINE | ID: covidwho-1504036

ABSTRACT

INTRODUCTION: Our aim was to examine attitudes of the general population towards reasonableness of these costs, as well as the degree to which these costs are shared across society (solidarity financing) and to determine the factors associated with them. METHOD: Repeated cross-sectional data from a nationally representative online-survey. More precisely, data from wave 8 (21-22 April 2020) and wave 16 (7-8 July 2020) were used (in wave 8: analytical sample with n = 976, average age was 47.0 years (SD: 15.3 years), ranging from 18 to 74 years, 51.8% female; in wave 16: analytical sample with n = 978, average age was 46.1 years (SD: 15.9 years), ranging from 18 to 74 years, 50.9% female). After a short introduction emphasizing considerable economic costs associated with the measures against the spread of the coronavirus, individuals were asked to rate the following statements (outcome measures), in each case from 1 = strongly disagree to 7 = strongly agree: "These economic costs are currently reasonable in relation to the objective pursued" (reasonableness of costs), "These economic costs should be borne jointly by all citizens and depending on income" (solidarity financing). RESULTS: In wave 8 (wave 16 in parentheses), the average rating for the attitude towards reasonableness of costs was 4.3, SD: 1.8 (wave 16, average: 4.2, SD: 1.8) and the average rating for the attitude towards solidarity financing was 3.7, SD: 1.9 (wave 16, average: 3.3, SD: 2.0). In wave 8, more positive attitudes towards the reasonableness of costs and solidarity financing were associated with being male, higher education, not being in a partnership/being unmarried, higher affect regarding COVID-19 and higher presumed severity with respect to COVID-19. Furthermore, more positive attitudes towards the reasonableness of costs were associated with having a migration background. More positive attitudes towards solidarity financing was associated with higher age groups. Mainly similar findings were observed in wave 16. DISCUSSION: Agreement with reasonableness of costs of preventative measures as well as solidarity financing was moderately high. Knowledge of these attitudes is important to ensure social cohesion during the fight against COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Adolescent , Adult , Aged , Attitude to Health , COVID-19/economics , Cross-Sectional Studies , Female , Germany/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Models, Economic , Perception , Regression Analysis , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
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