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2.
Public Health Rep ; 136(6): 782-790, 2021.
Article in English | MEDLINE | ID: covidwho-1374029

ABSTRACT

OBJECTIVE: COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. METHODS: We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. RESULTS: The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. CONCLUSIONS: Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/mortality , Cause of Death , Child , Child, Preschool , Comorbidity , Female , Florida/epidemiology , Health Status , Humans , Infant , Male , Middle Aged , Ohio/epidemiology , Pandemics , SARS-CoV-2 , Sex Factors , Socioeconomic Factors , United States/epidemiology , Young Adult
4.
J Surg Oncol ; 124(7): 983-988, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1320076

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic led to disruptions in operative and hospital capabilities as the country triaged resources and canceled elective procedures. This study details the operative experience of a safety-net hospital for cancer-related operations during a 3-month period at the height of the pandemic. METHODS: Patients operated on for or diagnosed with malignancies of the abdomen, breast, skin, or soft-tissue (September 3, 2020-September 6, 2020) were identified from operative/clinic schedules. Sociodemographics, tumor and treatment characteristics, and COVID-19 information was identified through retrospective chart review of a prospectively maintained database. Descriptive statistics were calculated. RESULTS: Fifty patients evaluated within this window underwent oncologic surgery. Median age was 61 (interquartile range: 53-68), 56% were female, 86% were White, and 66% were Hispanic. The majority (28%) were for colon cancer. Only two patients tested positive for COVID-19 preoperatively or within 30 days of their operation. There were no mortalities during the 1-year study period. CONCLUSION: During the COVID-19 pandemic, many hospitals and operative centers limited interventions to preserve resources, but oncologic procedures continued at many large-volume academic cancer centers. This study underscores the importance of continuing to offer surgery during the pandemic for surgical oncology cases at safety-net hospitals to minimize delays in time-sensitive oncologic treatment.


Subject(s)
COVID-19/complications , Elective Surgical Procedures/methods , Hospitals, High-Volume/statistics & numerical data , Neoplasms/surgery , SARS-CoV-2/isolation & purification , Safety-net Providers/statistics & numerical data , Aged , COVID-19/transmission , COVID-19/virology , Female , Florida/epidemiology , Humans , Male , Middle Aged , Neoplasms/epidemiology , Neoplasms/virology , Retrospective Studies , Surgical Oncology
5.
Am J Manag Care ; 27(6): 234-240, 2021 06.
Article in English | MEDLINE | ID: covidwho-1289744

ABSTRACT

OBJECTIVES: To determine (1) factors linked to hospitalizations among managed care patients (MCPs), (2) outcome improvement with use of outpatient off-label treatment, and (3) outcome comparison between MCPs and a mirror group. STUDY DESIGN: Retrospective cohort study comparing MCPs with an age- and gender-matched mirror group in Florida from April 1, 2020, to May 31, 2020. METHODS: A total of 38,193 MCPs in a Florida primary care group were monitored for COVID-19 incidence, hospitalization, and mortality. The highest-risk patients were managed by the medical group's COVID-19 Task Force. As part of a population health program, the COVID-19 Task Force contacted patients, conducted medical encounters, and tracked data including comorbidities and medical outcomes. The MCPs enrolled in the medical group were compared with a mirror group from the state of Florida. RESULTS: The mean (SD) age among the MCPs was 67.9 (15.2) years, and 60% were female. Older age and hypertension were the most important factors in predicting COVID-19. Obesity, chronic kidney disease (CKD), and congestive heart failure (CHF) were linked to higher rates of hospitalizations. Patients prescribed off-label outpatient medications had 73% lower likelihood of hospitalization (P < .05). Compared with the mirror group, MCPs had 60% lower COVID-19 mortality (P < .05). CONCLUSIONS: MCPs have risk factors similar to the general population for COVID-19 incidence and progression, including older age, hypertension, obesity, CHF, and CKD. Outpatient treatment with off-label medicines decreased hospitalizations. A comprehensive population health program decreased COVID-19 mortality.


Subject(s)
COVID-19/therapy , Managed Care Programs/organization & administration , Pneumonia, Viral/therapy , Aged , COVID-19/mortality , Comorbidity , Female , Florida/epidemiology , Hospitalization/statistics & numerical data , Humans , Incidence , Male , Off-Label Use , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Retrospective Studies , Risk Factors , SARS-CoV-2
7.
J Health Care Poor Underserved ; 32(2): 598-606, 2021.
Article in English | MEDLINE | ID: covidwho-1268210

ABSTRACT

In response to the COVID-19 pandemic, the Herbert Wertheim College of Medicine's Neighborhood Health Education Learning Program (NeighborhoodHELP) initiated a longitudinal assessment and mitigation of social and health care challenges for a population of approximately 850 underserved households. Here, we describe the needs assessment, ensuing interventions, and lessons learned during this pandemic.


Subject(s)
COVID-19/epidemiology , Needs Assessment , Vulnerable Populations , Adolescent , Adult , Aged , Child , Community Health Services , Consumer Health Information , Female , Florida/epidemiology , Food Assistance , Health Services Needs and Demand , Humans , Male , Medically Underserved Area , Middle Aged , Pandemics , Social Determinants of Health , Young Adult
8.
Child Abuse Negl ; 118: 105136, 2021 08.
Article in English | MEDLINE | ID: covidwho-1252567

ABSTRACT

BACKGROUND: COVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases. OBJECTIVES: To estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020. METHODS: Secondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs. RESULTS: Prior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S. CONCLUSIONS: The COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Child Abuse/psychology , Child Abuse/trends , Child Welfare/psychology , Child Welfare/trends , Child , Family/psychology , Florida/epidemiology , Humans , Male , New Jersey/epidemiology , New York City/epidemiology , Pandemics/prevention & control , Public Health/trends , SARS-CoV-2 , United States/epidemiology , Wisconsin/epidemiology
9.
Am J Epidemiol ; 190(6): 1075-1080, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1249276

ABSTRACT

Increasing hospitalizations for COVID-19 in the United States and elsewhere have ignited debate over whether to reinstate shelter-in-place policies adopted early in the pandemic to slow the spread of infection. The debate includes claims that sheltering in place influences deaths unrelated to infection or other natural causes. Testing this claim should improve the benefit/cost accounting that informs choice on reimposing sheltering in place. We used time-series methods to compare weekly nonnatural deaths in California with those in Florida. California was the first state to begin, and among the last to end, sheltering in place, while sheltering began later and ended earlier in Florida. During weeks when California had shelter-in-place orders in effect, but Florida did not, the odds that a nonnatural death occurred in California rather than Florida were 14.4% below expected levels. Sheltering-in-place policies likely reduce mortality from mechanisms unrelated to infection or other natural causes of death.


Subject(s)
COVID-19/prevention & control , Cause of Death/trends , Quarantine/statistics & numerical data , COVID-19/mortality , California/epidemiology , Florida/epidemiology , Humans , Likelihood Functions , SARS-CoV-2 , United States
12.
Nutrition ; 84: 111106, 2021 04.
Article in English | MEDLINE | ID: covidwho-1182641

ABSTRACT

OBJECTIVE: The 2019 coronavirus disease (COVID-19) pandemic has disproportionally affected a variety of patients with underlying risk factors such as respiratory and cardiovascular diseases, diabetes, obesity, and black race. Vitamin D deficiency, which can result in a compromised immune response, has been also linked to increased risk and increased morbidities associated with COVID-19. In the absence of large-scale longitudinal studies to determine the strength of association between vitamin deficiency and COVID-19, cross-sectional studies of large patient cohorts can be used. METHODS: We used the i2b2 patient's registry platform at the University of Florida Health Center to generate a count of patients using the international classification of diseases (ICD)-10 diagnosis codes for the period of October 1, 2015, through June 30, 2020. Logistic regression of the aggregates was used for the analysis. RESULTS: Patients with vitamin D deficiency were 4.6 times more likely to be positive for COVID-19 (indicated by the ICD-10 diagnostic code COVID19) than patients with no deficiency (P < 0.001). The association decreased slightly after adjusting for sex (odds ratio [OR] = 4.58; P < 0.001) and malabsorption (OR = 4.46; P < 0.001), respectively. The association decreased significantly but remained robust (P < 0.001) after adjusting for race (OR = 3.76; P < 0.001), periodontal disease status (OR = 3.64; P < 0.001), diabetes (OR = 3.28; P < 0.001), and obesity (OR = 2.27; P < 0.001), respectively. In addition, patients with vitamin D deficiency were 5 times more likely to be infected with COVID-19 than patients with no deficiency after adjusting for age groups (OR = 5.155; P < 0.001). CONCLUSIONS: Vitamin D deficiency is significantly associated with increased risk for COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/etiology , SARS-CoV-2 , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/virology , Adolescent , Adult , Aged , COVID-19/virology , Cross-Sectional Studies , Female , Florida/epidemiology , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Registries , Risk Factors , Vitamin D/blood , Vitamin D Deficiency/blood , Young Adult
13.
BMC Public Health ; 21(1): 687, 2021 04 08.
Article in English | MEDLINE | ID: covidwho-1175315

ABSTRACT

BACKGROUND: The stay-at-home orders imposed in early April 2020 due to the COVID-19 pandemic in various states complicated mosquito control activities across the United States (US), and Florida was no exception. Mosquito control programs are the first line of defense against mosquito-borne pathogens. The purpose of this study was to examine the capabilities of Florida mosquito programs to implement key mosquito measures during the COVID-19 pandemic lockdown. METHODS: Using a self-administered online survey, we examined the capabilities of all Florida mosquito control programs (both state-approved mosquito districts, N = 63; and open programs, N = 27) at a time when the state of Florida was still under heightened awareness of, stay-at-home orders and planning a phase 1 reopening over the COVID-19 pandemic (June to July 2020). The final sample included mosquito control programs structured as the Board of County Commissioners (BOCC) (n = 42), independent tax district (n = 16), municipal (n = 10), and health or emergency department (n = 5). We used descriptive statistics to summarize information about the characteristics of responding programs, their implemented mosquito control and surveillance activities.  wWe used bivariate analysis to compare the characteristics of responding programs and the self-reported mosquito measures. RESULTS: Of the recruited mosquito control programs, 73 completed the survey (81.1% response rate; 73/90). Of these, 57.5% (n = 42) were Board of County Commissioners (BOCC) mosquito control programs, 21.9% (n = 16) were independent tax district programs, 13.7% (n = 10) were municipal mosquito control programs, and only 6.8% (n = 5) were either health or emergency department mosquito control programs. Except for arbovirus surveillance, most programs either fully or partially performed larval (61.8%) and adult (78.9%) surveillance; most programs conducted species-specific control for Aedes aegypti (85.2%, n = 54), Aedes albopictus (87.3%, n = 55), Culex quinquefasciatus (92.1%, n = 58), and Culex nigripalpus (91.9%, n = 57). CONCLUSIONS: Findings underscore the importance of ongoing mosquito control activities, and suggest that Florida mosquito control programs are vigilant and have significant capability to handle potential mosquito-borne disease threats, but arbovirus surveillance systems (laboratory testing of mosquito pools and testing of human and nonhuman specimens for arboviruses) are needed during pandemics as well.


Subject(s)
COVID-19 , Insect Bites and Stings , Mosquito Control , Florida/epidemiology , Humans , Insect Bites and Stings/prevention & control , Mosquito Control/organization & administration , Program Evaluation
15.
BMC Public Health ; 21(1): 603, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1158200

ABSTRACT

BACKGROUND: Given the emerging literature regarding the impacts of lockdown measures on mental health, this study aims to describe the psychosocial health of school-aged children and adolescents during the COVID-19 Safer-at-Home School mandates. METHODS: A cross-sectional study was conducted in April 2020 (n = 280) among K-12 students at a research school in North Central Florida. Bivariate analysis and logistic and multinomial logistic regression models were used to examine socio-demographic and knowledge, attitude, and practice (KAP) predictors of indicators of anxiety-related, depressive, and obsessive-compulsive disorder(OCD)-related symptoms. Outcomes (anxiety, OCD, and depressive related symptoms) were measured by indices generated based on reported symptoms associated with each psychosocial outcome. RESULTS: Loss of household income was associated with increased risk for all three index-based outcomes: depressive symptoms [aOR = 3.130, 95% CI = (1.41-6.97)], anxiety-related symptoms [aOR = 2.531, 95%CI = (1.154-5.551)], and OCD-related symptoms [aOR = 2.90, 95%CI = (1.32-6.36)]. Being female was associated with being at higher risk for depressive symptoms [aOR = 1.72, 95% CI = (1.02-2.93)], anxiety-related symptoms [aOR = 1.75, 95% CI = (1.04-2.97)], and OCD-related symptoms [aOR = 1.764, 95%CI = (1.027-3.028)]. Parental practices protective against COVID-19 were associated with children being at higher risk of depressive symptoms [aOR = 1.55, 95% CI = (1.04-2.31)]. Lower school level was associated with children being at higher risk of anxiety-related and OCD-related symptoms. CONCLUSIONS: As the COVID-19 pandemic continues, schools should prioritize mental health interventions that target younger, female students, and children of families with income loss. Limiting the spread of COVID-19 through school closure may exacerbate negative psychosocial health outcomes in children, thus school administrators should move quickly to target those at greatest risk.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Mental Health/statistics & numerical data , Pandemics , Adolescent , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Female , Florida/epidemiology , Humans , Male , SARS-CoV-2 , Schools , Vulnerable Populations
16.
MMWR Morb Mortal Wkly Rep ; 70(12): 437-441, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1151033

ABSTRACT

After detection of cases of COVID-19 in Florida in March 2020, the governor declared a state of emergency on March 9,* and all school districts in the state suspended in-person instruction by March 20. Most kindergarten through grade 12 (K-12) public and private schools in Florida reopened for in-person learning during August 2020, with varying options for remote learning offered by school districts. During August 10-December 21, 2020, a total of 63,654 COVID-19 cases were reported in school-aged children; an estimated 60% of these cases were not school-related. Fewer than 1% of registered students were identified as having school-related COVID-19 and <11% of K-12 schools reported outbreaks. District incidences among students correlated with the background disease incidence in the county; resumption of in-person education was not associated with a proportionate increase in COVID-19 among school-aged children. Higher rates among students were observed in smaller districts, districts without mandatory mask-use policies, and districts with a lower proportion of students participating in remote learning. These findings highlight the importance of implementing both community-level and school-based strategies to reduce the spread of COVID-19 and suggest that school reopening can be achieved without resulting in widespread illness among students in K-12 school settings.


Subject(s)
COVID-19/epidemiology , Schools/organization & administration , Schools/statistics & numerical data , Students/statistics & numerical data , Adolescent , COVID-19/prevention & control , Child , Child, Preschool , Florida/epidemiology , Humans , Incidence , Time Factors
17.
J Public Health Manag Pract ; 27(3): 295-298, 2021.
Article in English | MEDLINE | ID: covidwho-1150047

ABSTRACT

OBJECTIVE: To assess whether county age distribution is associated with age-specific COVID-19 infection, emergency department, hospitalization, and mortality rates. DESIGN: Florida's 2020 COVID-19 cases are summarized into age-specific county rates and supplemented with socioeconomic and demographic characteristics and 2020 presidential voting results to assess the association of population age structure and political choices with age-specific COVID-19 infection, emergency, hospitalization, and mortality rates. RESULTS: Younger counties experienced higher under-25 infection rates, as well as higher over-64 infection, emergency, and hospitalization rates. Older counties experienced reduced infection rates for all ages and decreased over-64 emergency and hospitalization rates. Trump's vote share was associated with higher infection rates for all and higher over-64 emergency, hospitalization, and mortality rates. CONCLUSIONS: Younger counties experience higher COVID-19 infection rates for all residents, with elevated morbidity risks among seniors. Older counties had lower COVID-19 infection, emergency, and hospitalization rates. Age-specific messaging may help slow pandemic spread.


Subject(s)
COVID-19/mortality , COVID-19/psychology , Cause of Death , Hospitalization/statistics & numerical data , Pandemics/statistics & numerical data , Politics , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Florida/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Socioeconomic Factors , Young Adult
18.
JAMA Netw Open ; 4(3): e214149, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1141277

ABSTRACT

Importance: Significant concern has been raised that crisis standards of care policies aimed at guiding resource allocation may be biased against people based on race/ethnicity. Objective: To evaluate whether unanticipated disparities by race or ethnicity arise from a single institution's resource allocation policy. Design, Setting, and Participants: This cohort study included adults (aged ≥18 years) who were cared for on a coronavirus disease 2019 (COVID-19) ward or in a monitored unit requiring invasive or noninvasive ventilation or high-flow nasal cannula between May 26 and July 14, 2020, at 2 academic hospitals in Miami, Florida. Exposures: Race (ie, White, Black, Asian, multiracial) and ethnicity (ie, non-Hispanic, Hispanic). Main Outcomes and Measures: The primary outcome was based on a resource allocation priority score (range, 1-8, with 1 indicating highest and 8 indicating lowest priority) that was assigned daily based on both estimated short-term (using Sequential Organ Failure Assessment score) and longer-term (using comorbidities) mortality. There were 2 coprimary outcomes: maximum and minimum score for each patient over all eligible patient-days. Standard summary statistics were used to describe the cohort, and multivariable Poisson regression was used to identify associations of race and ethnicity with each outcome. Results: The cohort consisted of 5613 patient-days of data from 1127 patients (median [interquartile range {IQR}] age, 62.7 [51.7-73.7]; 607 [53.9%] men). Of these, 711 (63.1%) were White patients, 323 (28.7%) were Black patients, 8 (0.7%) were Asian patients, and 31 (2.8%) were multiracial patients; 480 (42.6%) were non-Hispanic patients, and 611 (54.2%) were Hispanic patients. The median (IQR) maximum priority score for the cohort was 3 (1-4); the median (IQR) minimum score was 2 (1-3). After adjustment, there was no association of race with maximum priority score using White patients as the reference group (Black patients: incidence rate ratio [IRR], 1.00; 95% CI, 0.89-1.12; Asian patients: IRR, 0.95; 95% CI. 0.62-1.45; multiracial patients: IRR, 0.93; 95% CI, 0.72-1.19) or of ethnicity using non-Hispanic patients as the reference group (Hispanic patients: IRR, 0.98; 95% CI, 0.88-1.10); similarly, no association was found with minimum score for race, again with White patients as the reference group (Black patients: IRR, 1.01; 95% CI, 0.90-1.14; Asian patients: IRR, 0.96; 95% CI, 0.62-1.49; multiracial patients: IRR, 0.81; 95% CI, 0.61-1.07) or ethnicity, again with non-Hispanic patients as the reference group (Hispanic patients: IRR, 1.00; 95% CI, 0.89-1.13). Conclusions and Relevance: In this cohort study of adult patients admitted to a COVID-19 unit at 2 US hospitals, there was no association of race or ethnicity with the priority score underpinning the resource allocation policy. Despite this finding, any policy to guide altered standards of care during a crisis should be monitored to ensure equitable distribution of resources.


Subject(s)
COVID-19 , Health Care Rationing , Healthcare Disparities/ethnology , Hospitalization/statistics & numerical data , Resource Allocation , Standard of Care/statistics & numerical data , COVID-19/ethnology , COVID-19/therapy , Cohort Studies , Female , Florida/epidemiology , Health Care Rationing/methods , Health Care Rationing/organization & administration , Health Services Needs and Demand , Humans , Male , Middle Aged , Mortality/ethnology , Resource Allocation/methods , Resource Allocation/organization & administration
19.
J Public Health Manag Pract ; 27(3): 310-317, 2021.
Article in English | MEDLINE | ID: covidwho-1138028

ABSTRACT

INTRODUCTION: COVID-19 represents an unprecedented challenge to policy makers as well as those entrusted with capturing, monitoring, and analyzing COVID-19 data. Effective public policy is data-informed policy. This requires a liaison between public health scientists and public officials. OBJECTIVE: This article details the experience, challenges, and lessons learned advising public officials in a large metropolitan area from March to October 2020. METHODS: To effectively do this, an R Markdown report was created to iteratively monitor the number of COVID-19 tests performed, positive tests obtained, COVID-19 hospitalization census, intensive care unit census, the number of patients with COVID-19 on ventilators, and the number of deaths due to COVID-19. RESULTS: These reports were presented and discussed at meetings with policy makers to further comprehension. DISCUSSION: To facilitate the fullest understanding by both the general public and policy makers alike, we advocate for greater centralization of public health surveillance data, objective operational definitions of metrics, and greater interagency communication to best guide and inform policy makers. Through consistent data reporting methods, parsimonious and consistent analytic methods, a clear line of communication with policy makers, transparency, and the ability to navigate unforeseen externalities such as "data dumps" and reporting delays, scientists can use information to best support policy makers in times of crises.


Subject(s)
Administrative Personnel/psychology , COVID-19/prevention & control , Health Policy , Information Dissemination/methods , Pandemics/prevention & control , Public Health Surveillance/methods , Public Health/methods , Adult , COVID-19/epidemiology , Communication , Female , Florida/epidemiology , Humans , Intersectoral Collaboration , Male , Middle Aged , SARS-CoV-2
20.
Am J Epidemiol ; 190(6): 1075-1080, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1132424

ABSTRACT

Increasing hospitalizations for COVID-19 in the United States and elsewhere have ignited debate over whether to reinstate shelter-in-place policies adopted early in the pandemic to slow the spread of infection. The debate includes claims that sheltering in place influences deaths unrelated to infection or other natural causes. Testing this claim should improve the benefit/cost accounting that informs choice on reimposing sheltering in place. We used time-series methods to compare weekly nonnatural deaths in California with those in Florida. California was the first state to begin, and among the last to end, sheltering in place, while sheltering began later and ended earlier in Florida. During weeks when California had shelter-in-place orders in effect, but Florida did not, the odds that a nonnatural death occurred in California rather than Florida were 14.4% below expected levels. Sheltering-in-place policies likely reduce mortality from mechanisms unrelated to infection or other natural causes of death.


Subject(s)
COVID-19/prevention & control , Cause of Death/trends , Quarantine/statistics & numerical data , COVID-19/mortality , California/epidemiology , Florida/epidemiology , Humans , Likelihood Functions , SARS-CoV-2 , United States
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