Dataset Information

COVID-19 healthcare demand projections: Arizona.

ABSTRACT: Beginning in March 2020, the United States emerged as the global epicenter for COVID-19 cases with little to guide policy response in the absence of extensive data available for reliable epidemiological modeling in the early phases of the pandemic. In the ensuing weeks, American jurisdictions attempted to manage disease spread on a regional basis using non-pharmaceutical interventions (i.e., social distancing), as uneven disease burden across the expansive geography of the United States exerted different implications for policy management in different regions. While Arizona policymakers relied initially on state-by-state national modeling projections from different groups outside of the state, we sought to create a state-specific model using a mathematical framework that ties disease surveillance with the future burden on Arizona's healthcare system. Our framework uses a compartmental system dynamics model using a SEIRD framework that accounts for multiple types of disease manifestations for the COVID-19 infection, as well as the observed time delay in epidemiological findings following public policy enactments. We use a compartment initialization logic coupled with a fitting technique to construct projections for key metrics to guide public health policy, including exposures, infections, hospitalizations, and deaths under a variety of social reopening scenarios. Our approach makes use of X-factor fitting and backcasting methods to construct meaningful and reliable models with minimal available data in order to provide timely policy guidance in the early phases of a pandemic.

SUBMITTER: Gel ES

PROVIDER: S-EPMC7710107 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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COVID-19 healthcare demand projections: Arizona.

Gel Esma S ES Jehn Megan M Lant Timothy T Muldoon Anna R AR Nelson Trisalyn T Ross Heather M HM

PloS one 20201202 12

Beginning in March 2020, the United States emerged as the global epicenter for COVID-19 cases with little to guide policy response in the absence of extensive data available for reliable epidemiological modeling in the early phases of the pandemic. In the ensuing weeks, American jurisdictions attempted to manage disease spread on a regional basis using non-pharmaceutical interventions (i.e., social distancing), as uneven disease burden across the expansive geography of the United States exerted ...[more]

PMID: 33264308

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Project description:COVID-19 burdens are disproportionally high in underserved and vulnerable communities in Arizona. As the pandemic progressed, it is unclear if the initial associated health disparities have changed. This study aims to elicit the dynamic landscape of COVID-19 disparities at the community level and identify newly emerging vulnerable subpopulations. Findings from this study can inform interventions to increase health equity among minoritized communities in the Southwest, other regions of the US, and globally. We compiled biweekly COVID-19 case counts of 274 zip code tabulation areas (ZCTAs) in Arizona from October 21, 2020, to November 25, 2021, a time spanning multiple waves of COVID-19 case growth. Within each biweekly period, we tested the associations between the growth rate of COVID-19 cases and the population composition in a ZCTA including race/ethnicity, income, employment, and age using multiple regression analysis. We then compared the associations across time periods to discover temporal patterns of health disparities. The association between the percentage of Latinx population and the COVID-19 growth rate was positive before April 2021 but gradually converted to negative afterwards. The percentage of Black population was not associated with the COVID-19 growth rate at the beginning of the study but became positive after January 2021 which persisted till the end of the study period. Young median age and high unemployment rate emerged as new risk factors around mid-August 2021. Based on these findings, we identified 37 ZCTAs that were highly vulnerable to future fast escalation of COVID-19 cases. As the pandemic progresses, vulnerabilities associated with Latinx ethnicity improved gradually, possibly bolstered by culturally responsive programs in Arizona to support Latinx. Still communities with disadvantaged social determinants of health continued to struggle. Our findings inform the need to adjust current resource allocations to support the design and implementation of new interventions addressing the emerging vulnerabilities at the community level.

Project description:BackgroundWhile the COVID-19 outbreak in China now appears suppressed, Europe and the USA have become the epicentres, both reporting many more deaths than China. Responding to the pandemic, Sweden has taken a different approach aiming to mitigate, not suppress, community transmission, by using physical distancing without lockdowns. Here we contrast the consequences of different responses to COVID-19 within Sweden, the resulting demand for care, intensive care, the death tolls and the associated direct healthcare related costs.MethodsWe used an age-stratified health-care demand extended SEIR (susceptible, exposed, infectious, recovered) compartmental model for all municipalities in Sweden, and a radiation model for describing inter-municipality mobility. The model was calibrated against data from municipalities in the Stockholm healthcare region.ResultsOur scenario with moderate to strong physical distancing describes well the observed health demand and deaths in Sweden up to the end of May 2020. In this scenario, the intensive care unit (ICU) demand reaches the pre-pandemic maximum capacity just above 500 beds. In the counterfactual scenario, the ICU demand is estimated to reach ∼20 times higher than the pre-pandemic ICU capacity. The different scenarios show quite different death tolls up to 1 September, ranging from 5000 to 41 000, excluding deaths potentially caused by ICU shortage. Additionally, our statistical analysis of all causes excess mortality indicates that the number of deaths attributable to COVID-19 could be increased by 40% (95% confidence interval: 0.24, 0.57).ConclusionThe results of this study highlight the impact of different combinations of non-pharmaceutical interventions, especially moderate physical distancing in combination with more effective isolation of infectious individuals, on reducing deaths, health demands and lowering healthcare costs. In less effective mitigation scenarios, the demand on ICU beds would rapidly exceed capacity, showing the tight interconnection between the healthcare demand and physical distancing in the society. These findings have relevance for Swedish policy and response to the COVID-19 pandemic and illustrate the importance of maintaining the level of physical distancing for a longer period beyond the study period to suppress or mitigate the impacts from the pandemic.

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COVID-19 healthcare demand projections: Arizona.

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COVID-19 healthcare demand projections: Arizona.

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