Current perspective on pandemic of COVID-19 in the United States.
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ABSTRACT:
SUBMITTER: Sahu KK
PROVIDER: S-EPMC7346962 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
Current perspective on pandemic of COVID-19 in the United States.
Sahu Kamal Kant KK Kumar Raman R
Journal of family medicine and primary care 20200430 4
Currently, the world is facing its 3<sup>rd</sup> coronavirus outbreak of the 21<sup>st</sup> century, which has turned to a pandemic recently. Starting on December 2019, coronavirus disease (COVID-19) was first detected in Wuhan City, Hubei province, China. As of 31<sup>st</sup> March, 2020, more than 900,000 COVID-19 cases have been reported across the globe involving more than 200 countries. The first case of the United States (US) was confirmed on 20<sup>th</sup> January, 2020 in a 35-year-o ...[more]
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Project description:Objectives:The paper highlights US health policy and technology responses to the COVID-19 pandemic from January 1, 2020 - August 9, 2020. Methods:A review of primary data sources in the US was conducted. The data were summarized to describe national and state-level trends in the spread of COVID-19 and in policy and technology solutions. Results:COVID-19 cases and deaths initially peaked in late March and April, but after a brief reduction in June cases and deaths began rising again July and continued to climb into early August. The US policy response is best characterized by its federalist, decentralized nature. The national government has led in terms of economic and fiscal response, increasing funding for scientific research into testing, treatment, and vaccines, and in creating more favorable regulations for the use of telemedicine. State governments have been responsible for many of the containment, testing, and treatment responses, often with little federal government support. Policies that favor economic re-opening are often followed by increases in state-level case numbers, which are then followed by stricter containment measures, such as mask wearing or pausing re-opening plans. Conclusions:While all US states have begun to "re-open" economic activities, this trend appears to be largely driven by social tensions and economic motivations than an ability to effectively test and surveil populations.
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Project description:BackgroundNationwide data of the COVID-19 pandemic's impact on Heart Failure (HF) hospitalizations is lacking. We conducted this study to elucidate the impact of the COVID-19 pandemic on HF hospitalizations. Additionally, we assessed the differences in hospitalization characteristics during the pandemic and the impact that a concurrent diagnosis of COVID-19 has on various outcomes and predictors of inpatient mortality among patients admitted for HF.MethodsThe National Inpatient Sample (NIS) database was queried for all hospitalizations with a primary diagnosis of HF between 2017 - 2020. Monthly HF hospitalizations were trended longitudinally over this period. Beginning April 1, 2020, concurrent COVID-19 infections were identified. Subsequently, we stratified HF hospitalizations between April 2020 and December 2020 (HF-2020) based on if concomitant COVID-19 was diagnosed, forming the HF-COVID+ve and HF-COVID-ve groups respectively. HF-2020 was also compared with pre-pandemic HF hospitalizations between April 2019 and December 2019 (HF-2019). Baseline characteristics were compared, and adjusted outcomes were obtained.ResultsDuring the initial COVID-19 surge in April 2020, HF admissions were reduced by 47% compared to January 2020. Following this decline, HF hospitalizations increased but did not reach pre-pandemic levels. HF-2020 admissions had an increased complication burden compared to HF-2019, including acute myocardial infarction (8.9% vs. 6.6%, p<0.005) and pulmonary embolism (4.1% vs. 3.4%, p<0.005) indicating a sicker cohort of patients. HF-COVID+ve hospitalizations had 2.9 times higher odds of inpatient mortality compared to HF-COVID-ve and an increased adjusted length of stay by 2.16 days (p<0.005).ConclusionA pandemic of the same magnitude as COVID-19 can overwhelm even the most advanced health systems. Early resource mobilization and preparedness is essential to provide care to a sick cohort of patients like acute heart failure, who are directly and indirectly effected by the consequences of the pandemic which has worsened hospitalization outcomes.
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Project description:Despite calls for political consensus, there is growing evidence that the public response to the COVID-19 pandemic has been politicized in the US. We examined the extent to which this polarization exists among the US public across two national studies. In a representative US sample (N = 699, March 2020) we find that liberals (compared to conservatives) perceive higher risk, place less trust in politicians to handle the pandemic, are more trusting of medical experts such as the WHO, and are more critical of the government response. We replicate these results in a second, pre-registered study (N = 1000; April 2020), and find that results are similar when considering partisanship, rather than political ideology. In both studies we also find evidence that political polarization extends beyond attitudes, with liberals consistently reporting engaging in a significantly greater number of health protective behaviors (e.g., wearing face masks) than conservatives. We discuss the possible drivers of polarization on COVID-19 attitudes and behaviors, and reiterate the need for fostering bipartisan consensus to effectively address and manage the COVID-19 pandemic.
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Project description:Surveys indicate US residents spent more time outdoors in 2020 than in 2019, but fewer tick bite-related emergency department visits and Lyme disease laboratory tests were reported. Despite ongoing exposure, Lyme disease case reporting for 2020 might be artificially reduced due to coronavirus disease-associated changes in healthcare-seeking behavior.
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Project description:IntroductionThe purpose of this study was to assess colorectal surgery outcomes, discharge destination, and readmission in the United States during the COVID-19 pandemic.MethodsAdult colorectal surgery patients in the American College of Surgeons National Surgical Quality Improvement Program database (2019-2020) and its colectomy and proctectomy procedure-targeted files were included. The prepandemic time period was defined from April 1, 2019 to December 31, 2019. The pandemic time period was defined from April 1, 2020 to December 31, 2020 in quarterly intervals (Q2 April-June; Q3 July-September; Q4 October-December). Factors associated with morbidity and in-hospital mortality were assessed using multivariable logistic regression.ResultsAmong 62,393 patients, 34,810 patients (55.8%) underwent colorectal surgery prepandemic and 27,583 (44.2%) during the pandemic. Patients who had surgery during the pandemic had higher American Society of Anesthesiologists class and presented more frequently with dependent functional status. The proportion of emergent surgeries increased (12.7% prepandemic versus 15.2% pandemic, P < 0.001), with less laparoscopic cases (54.0% versus 51.0%, P < 0.001). Higher rates of morbidity with a greater proportion of discharges to home and lesser proportion of discharges to skilled care facilities were observed with no considerable differences in length of stay or worsening readmission rates. Multivariable analysis demonstrated increased odds of overall and serious morbidity and in-hospital mortality, during Q3 and/or Q4 of the 2020 pandemic.ConclusionsDifferences in hospital presentation, inpatient care, and discharge disposition of colorectal surgery patients were observed during the COVID-19 pandemic. Pandemic responses should emphasize balancing resource allocation, educating patients and providers on timely medical workup and management, and optimizing discharge coordination pathways.
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