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1.
Artigo em Inglês | MEDLINE | ID: mdl-38791857

RESUMO

Human travel plays a crucial role in the spread of infectious disease between regions. Travel of infected individuals from one region to another can transport a virus to places that were previously unaffected or may accelerate the spread of disease in places where the disease is not yet well established. We develop and apply models and metrics to analyze the role of inter-regional travel relative to the spread of disease, drawing from data on COVID-19 in the United States. To better understand how transportation affects disease transmission, we established a multi-regional time-varying compartmental disease model with spatial interaction. The compartmental model was integrated with statistical estimates of travel between regions. From the integrated model, we derived a transmission import index to assess the risk of COVID-19 transmission between states. Based on the index, we determined states with high risk for disease spreading to other states at the scale of months, and we analyzed how the index changed over time during 2020. Our model provides a tool for policymakers to evaluate the influence of travel between regions on disease transmission in support of strategies for epidemic control.


Assuntos
COVID-19 , Viagem , Humanos , COVID-19/transmissão , COVID-19/epidemiologia , Viagem/estatística & dados numéricos , Estados Unidos/epidemiologia , SARS-CoV-2 , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/epidemiologia , Análise Espacial
2.
Artigo em Inglês | MEDLINE | ID: mdl-38673402

RESUMO

In the early phases of the COVID-19 pandemic, vaccine accessibility was limited, impacting large metropolitan areas such as Los Angeles County, which has over 10 million residents but only nine initial vaccination sites, which resulted in people experiencing long travel times to get vaccinated. We developed a mixed-integer linear model to optimize site selection, considering equitable access for vulnerable populations. Analyzing 277 zip codes between December 2020 and May 2021, our model incorporated factors such as car ownership, ethnic group disease vulnerability, and the Healthy Places Index, alongside travel times by car and public transit. Our optimized model significantly outperformed actual site allocations for all ethnic groups. We observed that White populations faced longer travel times, likely due to their residences being in more remote, less densely populated areas. Conversely, areas with higher Latino and Black populations, often closer to the city center, benefited from shorter travel times in our model. However, those without cars experienced greater disadvantages. While having many vaccination sites might improve access for those dependent on public transit, that advantage is diminished if people must search among many sites to find a location with available vaccines.


Assuntos
COVID-19 , Vacinação em Massa , Humanos , COVID-19/prevenção & controle , Los Angeles , Vacinação em Massa/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , SARS-CoV-2
3.
Health Care Manag Sci ; 26(1): 79-92, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36282367

RESUMO

We analyze the progression of COVID-19 in the United States over a nearly one-year period beginning March 1, 2020 with a novel metric motivated by queueing models, tracking partial-average day-of-event and cumulative probability distributions for events, where events are points in time when new cases and new deaths are reported. The partial average represents the average day of all events preceding a point of time, and is an indicator as to whether the pandemic is accelerating or decelerating in the context of the entire history of the pandemic. The measure supplements traditional metrics, and also enables direct comparisons of case and death histories on a common scale. We also compare methods for estimating actual infections and deaths to assess the timing and dynamics of the pandemic by location. Three example states are graphically compared as functions of date, as well as Hong Kong as an example that experienced a pronounced recent wave of the pandemic. In addition, statistics are compared for all 50 states. Over the period studied, average case day and average death day varied by two to five months among the 50 states, depending on data source, with the earliest averages in New York and surrounding states, as well as Louisiana.


Assuntos
COVID-19 , Humanos , Estados Unidos/epidemiologia , Pandemias , Benchmarking , Hong Kong
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