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Factors affecting COVID-19 infected and death rates inform lockdown-related policymaking.

ABSTRACT: BACKGROUND:After claiming nearly five hundred thousand lives globally, the COVID-19 pandemic is showing no signs of slowing down. While the UK, USA, Brazil and parts of Asia are bracing themselves for the second wave-or the extension of the first wave-it is imperative to identify the primary social, economic, environmental, demographic, ethnic, cultural and health factors contributing towards COVID-19 infection and mortality numbers to facilitate mitigation and control measures. METHODS:We process several open-access datasets on US states to create an integrated dataset of potential factors leading to the pandemic spread. We then apply several supervised machine learning approaches to reach a consensus as well as rank the key factors. We carry out regression analysis to pinpoint the key pre-lockdown factors that affect post-lockdown infection and mortality, informing future lockdown-related policy making. FINDINGS:Population density, testing numbers and airport traffic emerge as the most discriminatory factors, followed by higher age groups (above 40 and specifically 60+). Post-lockdown infected and death rates are highly influenced by their pre-lockdown counterparts, followed by population density and airport traffic. While healthcare index seems uncorrelated with mortality rate, principal component analysis on the key features show two groups: states (1) forming early epicenters and (2) experiencing strong second wave or peaking late in rate of infection and death. Finally, a small case study on New York City shows that days-to-peak for infection of neighboring boroughs correlate better with inter-zone mobility than the inter-zone distance. INTERPRETATION:States forming the early hotspots are regions with high airport or road traffic resulting in human interaction. US states with high population density and testing tend to exhibit consistently high infected and death numbers. Mortality rate seems to be driven by individual physiology, preexisting condition, age etc., rather than gender, healthcare facility or ethnic predisposition. Finally, policymaking on the timing of lockdowns should primarily consider the pre-lockdown infected numbers along with population density and airport traffic.

SUBMITTER: Roy S

PROVIDER: S-EPMC7584177 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Factors affecting COVID-19 infected and death rates inform lockdown-related policymaking.

Roy Satyaki S Ghosh Preetam P

PloS one 20201023 10

<h4>Background</h4>After claiming nearly five hundred thousand lives globally, the COVID-19 pandemic is showing no signs of slowing down. While the UK, USA, Brazil and parts of Asia are bracing themselves for the second wave-or the extension of the first wave-it is imperative to identify the primary social, economic, environmental, demographic, ethnic, cultural and health factors contributing towards COVID-19 infection and mortality numbers to facilitate mitigation and control measures.<h4>Metho ...[more]

PMID: 33095811

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Project description:Background: Confinement due to COVID-19 can have a short- and long-term impact on mental health (increased levels of stress and anxiety and emotional upheaval) and on people's quality of life. Knowing what factors are behind the stress can benefit the development of strategies and resources for future situations of a similar nature. The purpose of this study is to examine the incidence of a series of sociodemographic factors, confinement conditions, and work situation on the stress reported by confined citizens. Method: The sample is made up of 2008 citizens (19.9% men), the Perceived Stress Scale of 14 items (PSS-14) was used to assess the stress level of the population, as well as a sociodemographic questionnaire and different questions aimed at obtain information about the characteristics of the confinement and the employment situation. Data were collected using exponential snowball-type non-probability sampling. Results: The results suggest that sociodemographic factors such as age, gender, and income level could be good predictors of confinement stress. Post-confinement work expectancy along with pre-confinement working conditions can be key to protecting the well-being of confined populations. Limitations: This is a transversal study that forces us to be cautious with causal interpretations. The questionnaire was administered online, which means it excluded a good proportion of the population. Conclusion: The perception of stress being higher in women than men, with the lowest stress in older people and those with higher reported incomes. Stress levels increase as populations spend more weeks in confinement and the pre-confinement work situation seems key to protecting the well-being of the population. A lower stress is observed among stable couples without children confined in residential or suburban areas. Low income or economic instability is associated with a higher rate of stress and anxiety. The results can contribute to prioritizing actions and aid by contributing to the formation of teams and the design of tools for work in the current pandemic situation.

Project description:ImportanceDescriptive data have revealed significant racial/ethnic disparities in coronavirus disease 2019 (COVID-19) cases in the US, but underlying mechanisms of disparities remain unknown.ObjectiveTo examine the association between county-level sociodemographic risk factors and US COVID-19 incidence and mortality.Design, setting, and participantsThis cross-sectional study analyzed the association between US county-level sociodemographic risk factors and COVID-19 incidence using mixed-effects negative binomial regression, and COVID-19 mortality using zero-inflated negative binomial regression. Data on COVID-19 incidence and mortality were collected from January 20 to July 29, 2020. The association of social risk factors with weekly cumulative incidence and mortality was also examined by interacting time with the index measures, using a random intercept to account for repeated measures.Main outcomes and measuresSociodemographic data from publicly available data sets, including the US Centers for Disease Control and Prevention's Social Vulnerability Index (SVI), which includes subindices of socioeconomic status, household composition and disability, racial/ethnic minority and English language proficiency status, and housing and transportation.ResultsAs of July 29, 2020, there were a total of 4 289 283 COVID-19 cases and 147 074 COVID-19 deaths in the US. An increase of 0.1 point in SVI score was associated with a 14.3% increase in incidence rate (incidence rate ratio [IRR], 1.14; 95% CI, 1.13-1.16; P < .001) and 13.7% increase in mortality rate (IRR, 1.14; 95% CI, 1.12-1.16; P < .001), or an excess of 87 COVID-19 cases and 3 COVID-19 deaths per 100 000 population for a SVI score change from 0.5 to 0.6 in a midsize metropolitan county; subindices were also associated with both outcomes. A 0.1-point increase in the overall SVI was associated with a 0.9% increase in weekly cumulative increase in incidence rate (IRR, 1.01; 95% CI, 1.01-1.01; P < .001) and 0.5% increase in mortality rate (IRR, 1.01; 95% CI, 1.01-1.01; P < .001).Conclusions and relevanceIn this cross-sectional study, a wide range of sociodemographic risk factors, including socioeconomic status, racial/ethnic minority status, household composition, and environmental factors, were significantly associated with COVID-19 incidence and mortality. To address inequities in the burden of the COVID-19 pandemic, these social vulnerabilities and their root causes must be addressed.

Project description:The COVID-19 pandemic and government imposed social restrictions like lockdown exposed most individuals to an unprecedented stress, increasing mental health disorders worldwide. We explored subjective cognitive functioning and mental health changes and their possible interplay related to COVID-19-lockdown. We also investigated potential risk factors to identify more vulnerable groups. Across Italy, 1215 respondents completed our Qualtrics-based online-survey during the end of a seven to 10-week imposed lockdown and home confinement (from April 29 to May 17, 2020). We found subjective cognitive functioning and mental health severely changed in association with the lockdown. Under government regulations, cognitive complaints were mostly perceived in routine tasks involving attention, temporal orientation and executive functions-with no changes in language abilities. A paradoxical effect was observed for memory, with reduced forgetfulness compared to pre-lockdown. We found higher severity and prevalence of depression, anxiety disorders, abnormal sleep, appetite changes, reduced libido and health anxiety: with mild-to-severe depression and anxiety prevalence climbing to 32 and 36 percent, respectively, under restrictions. Being female, under 45 years, working from home or being underemployed were all identified as relevant risk factors for worsening cognition and mental health. Frequent consumers of COVID-19 mass media information or residents in highly infected communities reported higher depression and anxiety symptoms, particularly hypochondria in the latter. If similar restrictions are reimposed, governments must carefully consider these more vulnerable groups in their decisions, whilst developing effective global and long-term responses to the cognitive and mental health challenges of this type of pandemic; as well as implementing appropriate psychological interventions with specific guidelines: particularly regarding exposure to COVID-19 mass-media reports.

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Factors affecting COVID-19 infected and death rates inform lockdown-related policymaking.

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Factors affecting COVID-19 infected and death rates inform lockdown-related policymaking.

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