scholarly journals It’s complicated: characterizing the time-varying relationship between cell phone mobility and COVID-19 spread in the US

2021 ◽  
Author(s):  
Sean Jewell ◽  
Joseph Futoma ◽  
Lauren Hannah ◽  
Andrew C. Miller ◽  
Nicholas J. Foti ◽  
...  
Keyword(s):  
Cell Phone ◽  
The United States ◽  
Spatiotemporal Variation ◽  
Policy Implications ◽  
Infection Rates ◽  
Local Effects ◽  
Level Data ◽  
The Us ◽  
Model Flexibility ◽  
One Year

AbstractRestricting in-person interactions is an important technique for limiting the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although early research found strong associations between cell phone mobility and infection spread during the initial outbreaks in the United States, it is unclear whether this relationship persists across locations and time. We propose an interpretable statistical model to identify spatiotemporal variation in the association between mobility and infection rates. Using one year of US county-level data, we found that sharp drops in mobility often coincided with declining infection rates in the most populous counties in spring 2020. However, the association varied considerably in other locations and across time. Our findings are sensitive to model flexibility, as more restrictive models average over local effects and mask much of the spatiotemporal variation. We conclude that mobility does not appear to be a reliable leading indicator of infection rates, which may have important policy implications.

scholarly journals It’s complicated: characterizing the time-varying relationship between cell phone mobility and COVID-19 spread in the US

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Sean Jewell ◽  
Joseph Futoma ◽  
Lauren Hannah ◽  
Andrew C. Miller ◽  
Nicholas J. Foti ◽  
...  
Keyword(s):  
Cell Phone ◽  
The United States ◽  
Spatiotemporal Variation ◽  
Policy Implications ◽  
Time Varying ◽  
Infection Rates ◽  
Local Effects ◽  
Level Data ◽  
The Us ◽  
Model Flexibility

AbstractRestricting in-person interactions is an important technique for limiting the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although early research found strong associations between cell phone mobility and infection spread during the initial outbreaks in the United States, it is unclear whether this relationship persists across locations and time. We propose an interpretable statistical model to identify spatiotemporal variation in the association between mobility and infection rates. Using 1 year of US county-level data, we found that sharp drops in mobility often coincided with declining infection rates in the most populous counties in spring 2020. However, the association varied considerably in other locations and across time. Our findings are sensitive to model flexibility, as more restrictive models average over local effects and mask much of the spatiotemporal variation. We conclude that mobility does not appear to be a reliable leading indicator of infection rates, which may have important policy implications.

scholarly journals Estimating Unreported COVID-19 Cases with a Time-Varying SIR Regression Model

2021 ◽  
Vol 18 (3) ◽  
pp. 1090
Author(s):  
Zhenghong Peng ◽  
Siya Ao ◽  
Lingbo Liu ◽  
Shuming Bao ◽  
Tao Hu ◽  
...  
Keyword(s):  
United States ◽  
Transmission Rate ◽  
Fixed Time ◽  
The United States ◽  
Ordinary Least Squares ◽  
Time Varying ◽  
County Level ◽  
Infection Rates ◽  
Level Data ◽  
The Us

Background: Potential unreported infection might impair and mislead policymaking for COVID-19, and the contemporary spread of COVID-19 varies in different counties of the United States. It is necessary to estimate the cases that might be underestimated based on county-level data, to take better countermeasures against COVID-19. We suggested taking time-varying Susceptible-Infected-Recovered (SIR) models with unreported infection rates (UIR) to estimate factual COVID-19 cases in the United States. Methods: Both the SIR model integrated with unreported infection rates (SIRu) of fixed-time effect and SIRu with time-varying parameters (tvSIRu) were applied to estimate and compare the values of transmission rate (TR), UIR, and infection fatality rate (IFR) based on US county-level COVID-19 data. Results: Based on the US county-level COVID-19 data from 22 January (T1) to 20 August (T212) in 2020, SIRu was first tested and verified by Ordinary Least Squares (OLS) regression. Further regression of SIRu at the county-level showed that the average values of TR, UIR, and IFR were 0.034%, 19.5%, and 0.51% respectively. The ranges of TR, UIR, and IFR for all states ranged from 0.007–0.157 (mean = 0.048), 7.31–185.6 (mean = 38.89), and 0.04–2.22% (mean = 0.22%). Among the time-varying TR equations, the power function showed better fitness, which indicated a decline in TR decreasing from 227.58 (T1) to 0.022 (T212). The general equation of tvSIRu showed that both the UIR and IFR were gradually increasing, wherein, the estimated value of UIR was 9.1 (95%CI 5.7–14.0) and IFR was 0.70% (95%CI 0.52–0.95%) at T212. Interpretation: Despite the declining trend in TR and IFR, the UIR of COVID-19 in the United States is still on the rise, which, it was assumed would decrease with sufficient tests or improved countersues. The US medical system might be largely affected by severe cases amidst a rapid spread of COVID-19.

scholarly journals Alternate care sites during the COVID-19 pandemic: Policy Implications for pandemic surge planning

2021 ◽  
pp. 1-8
Author(s):  
Sue Anne Bell ◽  
Lydia Krienke ◽  
Kathryn Quanstrom
Keyword(s):  
United States ◽  
Capacity Planning ◽  
The United States ◽  
Policy Implications ◽  
Multiple Response ◽  
Current Policy ◽  
Surge Capacity ◽  
Effective Care ◽  
The Us ◽  
Staffing Needs

Abstract Alternate care sites across the US were widely underutilized during the COVID-19 outbreak, while the volume and severity of COVID-19 cases overwhelmed health systems across the United States. The challenges presented by the pandemic have shown the need to design surge capacity principles with consideration for demand that strains multiple response capabilities. We reviewed current policy and previous literature from past ACS as well as highlight challenges from the COVID-19 pandemic, to make recommendations that can inform future surge capacity planning. Our recommendations include: 1) Preparedness actions need to be continuous and flexible; 2) Staffing needs must be met as they arise with solutions that are specific to the pandemic; 3) Health equity must be a focus of ACS establishment and planning; and 4) ACS should be designed to function without compromising safe and effective care. A critical opportunity exists to identify improvements for future use of ACS in pandemics.

scholarly journals Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey

2021 ◽  
Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman
Keyword(s):  
Multinomial Logistic Regression ◽  
Public Attitudes ◽  
The United States ◽  
Public Affairs ◽  
Policy Implications ◽  
Reproductive Age ◽  
Factors Associated ◽  
The Us ◽  
The Law ◽  
Nationally Representative

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.

scholarly journals Land Use and Family Formation in the Settlement of the US Great Plains

2012 ◽  
Vol 36 (3) ◽  
pp. 279-310 ◽  
Author(s):  
Myron P. Gutmann ◽  
Sara M. Pullum-Piñón ◽  
Kristine Witkowski ◽  
Glenn D. Deane ◽  
Emily Merchant
Keyword(s):  
Land Use ◽  
Great Plains ◽  
Agricultural Land ◽  
Family Formation ◽  
Descriptive Analysis ◽  
The United States ◽  
Level Data ◽  
The Us ◽  
Intensive Cropping ◽  
Western Great Plains

In agricultural settings, environment shapes patterns of settlement and land use. Using the Great Plains of the United States during the period of its initial Euro-American settlement (1880–1940) as an analytic lens, this article explores whether the same environmental factors that determine settlement timing and land use—those that indicate suitability for crop-based agriculture—also shape initial family formation, resulting in fewer and smaller families in areas that are more conducive to livestock raising than to cropping. The connection between family size and agricultural land availability is now well known, but the role of the environment has not previously been explicitly tested. Descriptive analysis offers initial support for a distinctive pattern of family formation in the western Great Plains, where precipitation is too low to support intensive cropping. However, multivariate analysis using county-level data at 10-year intervals offers only partial support to the hypothesis that environmental characteristics produce these differences. Rather, this analysis has found that the region was also subject to the same long-term social and demographic changes sweeping the rest of the country during this period.

Abstract 12789: Clinical Factors Associated With Mortality Among Patients Hospitalized for Heart Failure in Egypt

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed Hassanin ◽  
Mahmoud M Hassanein ◽  
Madiha F Abdel-maksoud
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
The United States ◽  
Clinical Factors ◽  
Clinical Variables ◽  
Factors Associated ◽  
The Us ◽  
One Year

Introduction: Heart failure (HF) is a growing public health burden in many low and middle-income countries (LMIC). However, most HF registries were conducted in high income countries, which often have different ethnic and cultural backgrounds from that of LMIC. Hypothesis: Independent clinical variables associated with mortality in patients hospitalized for HF in Egypt are different from those established in the United States (US). Methods: Between 2011 and 2014, 1,660 patients hospitalized for HF were enrolled from 20 centers across Egypt as part of the European Society of Cardiology HF long-term Registry. Deceased patients were compared to survivors, to identify demographic, clinical and biochemical variables associated with in-hospital and one-year mortality. Variables associated with mortality on univariate analysis, and independent variables identified in the Acute Decompensated Heart Failure National Registry (ADHERE) and in the Seattle Heart Failure Model, both based in the US, were entered into the multivariate logistic regression model. Results: In-hospital mortality was 5%. Only two independent clinical factors associated with in-hospital mortality were identified: elevated serum creatinine (sCr), OR=1.47 [95% CI: 1.23, 1.74] for every point increases above one mg/dl; and low admission systolic blood pressure (SBP), OR=1.54; [95% CI: 1.43, 1.65] for every 10 points decrease in SBP below 140 mmHg. At one-year follow up, mortality was 27%. Independent predictors of one-year mortality were: age, OR=1.47; [95% CI: 1.23,1.75] for every 10-year increase above 40; low discharge SBP, OR=1.30 [95% CI: 1.08, 1.52] for every 10 points decrease below 140 mmHg; low ejection fraction, OR=1.51 [95% CI: 0.59,0.73] for every 5 points decrease from 65%; chronic liver disease, OR=3.0 [95% CI: 1.51,5.88]; history of stroke, OR=3.2 [95% CI: 1.52,6.65]. These variables overlapped with those identified in US registries. Conclusions: Independent clinical variables associated with mortality after HF hospitalization in Egypt are similar to those reported in HF registries in the US.

scholarly journals Public Reporting: Illumination or Shadows?

2006 ◽  
Vol 17 (2) ◽  
pp. 97-98
Author(s):  
LE Nicolle
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Health Care Organizations ◽  
State Legislatures ◽  
The United States ◽  
Public Reporting ◽  
Mandatory Reporting ◽  
Infection Rates ◽  
The Us ◽  
Conceptual Shift

The infection control communities in Britain and the United States (US) are experiencing an extraordinary conceptual shift with legislated mandatory reporting of hospital infections. In Britain, this shift began in 2001 with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia episodes (1), which are reported to the National Health Service and are publically available on a Health Protection Agency Web site. In the US, the impetus for public reporting of infection rates has come from consumer groups (2). These organizations have bypassed health care organizations and public health and other practitioners, and have addressed their demands to state legislatures. At least eight states have now passed and several more are considering legislation to mandate reporting. The process has been rancorous and, at least initially, vigorously opposed by health care organizations and infection control practitioners.

scholarly journals Weight Mobility and Obesity in a Representative Sample of the US Adult Population

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Deanna J. M. Isaman ◽  
Amy E. Rothberg
Keyword(s):  
Representative Sample ◽  
Medical Expenditure Panel Survey ◽  
Adult Population ◽  
The United States ◽  
Incidence Rates ◽  
Medical Expenditure ◽  
The Us ◽  
Prevalence Of Obesity ◽  
One Year ◽  
Overweight Or Obesity

Background. Despite the attention given to the prevalence of obesity, surprisingly little is known about the incidence or reduction of obesity. We report the 1-year incidence and remission of obesity in a representative sample of the US population. Methods. Individuals from the Medical Expenditure Panel Survey (MEPS) panel 17 were classified into standard obesity categories at enrollment and one year later. Incidence rates were calculated by age. Results. Although the overall prevalence of obesity remained nearly constant, remission rates from obesity (stratified by age) ranged from 11 to 27% while incidence rates ranged from 6 to 16%. For almost all age levels, the proportion of individuals leaving an obese or overweight state was greater than or equal to the proportion who progressed to a more severe level of overweight or obesity. Overall, 36% of adults lost at least 2.5 kg/m2 in the one-year period; only 8% gained 2.5 kg/m2 or more. Individuals less than 25 years of age had higher rates of leaving overweight (23% versus <16%) and obesity (27% versus 24%) classifications than people of other ages. Conclusions. Prevalence rates of obesity are well documented in the United States, but incidence is understudied. Public health efforts that target young people with overweight or obesity may yield the greatest benefit.

scholarly journals The Extent of Al-Qaeda’s Presence in Africa: Security Threats and Policy Implications to the U.S.

2021 ◽  
Vol 11 (2) ◽  
pp. 26-41
Author(s):  
Daniel Chigudu
Keyword(s):  
United States ◽  
Qualitative Methodology ◽  
The United States ◽  
Policy Implications ◽  
Al Qaeda ◽  
Security Threats ◽  
Policy Recommendations ◽  
Security Threat ◽  
Nuclear Terrorism ◽  
The Us

Following a period close to fifteen years of fighting the extremist terrorist group Al Qaeda in Pakistan and Afghanistan, the United States (US) is faced with diverse security threats from affiliates of Al Qaeda in Africa. This study explores the extent of Al Qaeda’s presence in Africa, security threat and policy implications to the US. A qualitative methodology through document analysis and informed by the interpretivist research paradigm was employed. With Al Qaeda’s continued growth, there could be nuclear terrorism, arms and drug trafficking among other threats. Policy recommendations are given for the United States of America.

Changes in the use of commercial and lab-developed IVD assays in the clinical setting for PD-L1 expression testing in NSCLC in the United States.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 154-154
Author(s):  
Ayse Levent ◽  
Pieter De Richter ◽  
William H Angel ◽  
Ciny Edathanal ◽  
Christophe Homer
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Stage Iv ◽  
The United States ◽  
Subsequent Treatment ◽  
Trial Data ◽  
Clinical Practices ◽  
The Us ◽  
One Year

154 Background: In 2016 we observed a lack of standardization in the use of cut-off points to define positivity when testing for PD-L1 expression in NSCLC, despite these being specified by assay manufacturers or recommended based on trial data. One year on we look at how clinical practice has changed in light of new approvals for PD-(L)1 inhibitors, availability of new IVD assays and changes in clinical practice guidelines recommending the use of immunotherapy for stage IV NSCLC. Here we explore how the variety of test brands and cut-off points used in the US has changed since 2016 by examining real-world clinical usage data. Methods: Between June and August 2016 and June and August 2017, a panel of pathologists in the US (n = 21 in 2016 and n = 28 in 2017) was asked to report on their practices relating to PD-L1 expression testing in NSCLC, through the submission of online de-identified record forms (n = 167 and n = 224 PD-L1-tested samples in 2016 and 2017 respectively). Results: Of the 224 samples gathered in 2017, 187 (84%) were tested with the Dako 22C3 pharmDx assay (vs 67% in 2016), 16 (7%) with the Dako 28-8 pharmDx assay (vs 22% in 2016) and 11 (5%) with a lab-developed test (LDT). An increase in the use of 1% staining as the cut-off was observed for both 22C3 and 28-8 pharmDx. The full distribution of cut-offs used is shown in the table below. Conclusions: Following initial fragmentation of clinical practices in 2016, PD-L1 expression testing has seen consolidation towards greater use of the Dako 22C3 assay and higher conformity in testing at the recommended cut-off points. While greater standardization simplifies testing, the choice of assay has potential implications on subsequent treatment: current PD-L1 assays allow physicians to confirm whether a specific PD-(L)1 inhibitor is appropriate for a patient, but there is no single PD-L1 expression test that supports oncologists in making treatment decisions for the PD-(L)1 inhibitor class as a whole.[Table: see text]

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