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1. Associations between rurality and regional differences in sociodemographic factors and the 1918–20 influenza and 2020–21 COVID-19 pandemics in Missouri counties: An ecological study

   https://doi.org/10.1371/journal.pone.0290294  

   Sattenspiel, Lisa ; Orbann, Carolyn ; Bogan, Aaron ; Ramirez, Hailey ; Pirrone, Sean ; Dahal, Sushma ; McElroy, Jane A. ; Wikle, Christopher K. ( August 2023 , PLOS ONE)

   Acharya, Binod (Ed.)

   This study compares pandemic experiences of Missouri’s 115 counties based on rurality and sociodemographic characteristics during the 1918–20 influenza and 2020–21 COVID-19 pandemics. The state’s counties and overall population distribution have remained relatively stable over the last century, which enables identification of long-lasting pandemic attributes. Sociodemographic data available at the county level for both time periods were taken from U.S. census data and used to create clusters of similar counties. Counties were also grouped by rural status (RSU), including fully (100%) rural, semirural (1–49% living in urban areas), and urban (>50% of the population living in urban areas). Deaths from 1918 through 1920 were collated from the Missouri Digital Heritage database and COVID-19 cases and deaths were downloaded from the Missouri COVID-19 dashboard. Results from sociodemographic analyses indicate that, during both time periods, average farm value, proportion White, and literacy were the most important determinants of sociodemographic clusters. Furthermore, the Urban/Central and Southeastern regions experienced higher mortality during both pandemics than did the North and South. Analyses comparing county groups by rurality indicated that throughout the 1918–20 influenza pandemic, urban counties had the highest and rural had the lowest mortality rates. Early in the 2020–21 COVID-19 pandemic, urban counties saw the most extensive epidemic spread and highest mortality, but as the epidemic progressed, cumulative mortality became highest in semirural counties. Additional results highlight the greater effects both pandemics had on county groups with lower rates of education and a lower proportion of Whites in the population. This was especially true for the far southeastern counties of Missouri (“the Bootheel”) during the COVID-19 pandemic. These results indicate that rural-urban and socioeconomic differences in health outcomes are long-standing problems that continue to be of significant importance, even though the overall quality of health care is substantially better in the 21 st century. 

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2. Community Susceptibility and Resiliency to COVID-19 Across the Rural-Urban Continuum in the United States

   https://doi.org/https://doi.org/10.1111/jrh.12477  

   Peters, David J. ( July 2020 , The journal of rural health)

   Borders, Tyrone (Ed.)

   Purpose This study creates a COVID-19 susceptibility scale at the county level, describes its components, and then assesses the health and socioeconomic resiliency of susceptible places across the rural-urban continuum. Methods Factor analysis grouped 11 indicators into 7 distinct susceptibility factors for 3,079 counties in the conterminous United States. Unconditional mean differences are assessed using a multivariate general linear model. Data from 2018 are primarily taken from the US Census Bureau and CDC. Results About 33% of rural counties are highly susceptible to COVID-19, driven by older and health-compromised populations, and care facilities for the elderly. Major vulnerabilities in rural counties include fewer physicians, lack of mental health services, higher disability, and more uninsured. Poor Internet access limits telemedicine. Lack of social capital and social services may hinder local pandemic recovery. Meat processing facilities drive risk in micropolitan counties. Although metropolitan counties are less susceptible due to healthier and younger populations, about 6% are at risk due to community spread from dense populations. Metropolitan vulnerabilities include minorities at higher health and diabetes risk, language barriers, being a transportation hub that helps spread infection, and acute housing distress. Conclusions There is an immediate need to know specific types of susceptibilities and vulnerabilities ahead of time to allow local and state health officials to plan and allocate resources accordingly. In rural areas it is essential to shelter-in-place vulnerable populations, whereas in large metropolitan areas general closure orders are needed to stop community spread. Pandemic response plans should address vulnerabilities. 

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3. Investigating associations between COVID-19 mortality and population-level health and socioeconomic indicators in the United States: A modeling study

   https://doi.org/10.1371/journal.pmed.1003693  

   Kandula, Sasikiran ; Shaman, Jeffrey ( July 2021 , PLOS Medicine)

   Turner, Richard (Ed.)

   Background With the availability of multiple Coronavirus Disease 2019 (COVID-19) vaccines and the predicted shortages in supply for the near future, it is necessary to allocate vaccines in a manner that minimizes severe outcomes, particularly deaths. To date, vaccination strategies in the United States have focused on individual characteristics such as age and occupation. Here, we assess the utility of population-level health and socioeconomic indicators as additional criteria for geographical allocation of vaccines. Methods and findings County-level estimates of 14 indicators associated with COVID-19 mortality were extracted from public data sources. Effect estimates of the individual indicators were calculated with univariate models. Presence of spatial autocorrelation was established using Moran’s I statistic. Spatial simultaneous autoregressive (SAR) models that account for spatial autocorrelation in response and predictors were used to assess (i) the proportion of variance in county-level COVID-19 mortality that can explained by identified health/socioeconomic indicators (R 2 ); and (ii) effect estimates of each predictor. Adjusting for case rates, the selected indicators individually explain 24%–29% of the variability in mortality. Prevalence of chronic kidney disease and proportion of population residing in nursing homes have the highest R 2 . Mortality is estimated to increase by 43 per thousand residents (95% CI: 37–49; p < 0.001) with a 1% increase in the prevalence of chronic kidney disease and by 39 deaths per thousand (95% CI: 34–44; p < 0.001) with 1% increase in population living in nursing homes. SAR models using multiple health/socioeconomic indicators explain 43% of the variability in COVID-19 mortality in US counties, adjusting for case rates. R 2 was found to be not sensitive to the choice of SAR model form. Study limitations include the use of mortality rates that are not age standardized, a spatial adjacency matrix that does not capture human flows among counties, and insufficient accounting for interaction among predictors. Conclusions Significant spatial autocorrelation exists in COVID-19 mortality in the US, and population health/socioeconomic indicators account for a considerable variability in county-level mortality. In the context of vaccine rollout in the US and globally, national and subnational estimates of burden of disease could inform optimal geographical allocation of vaccines. 

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4. Spatiotemporal evolution of COVID-19 infection and detection within night light networks: comparative analysis of USA and China

   https://doi.org/10.1007/s41109-020-00345-4  

   Small, Christopher ; Sousa, Daniel ( February 2021 , Applied Network Science)

   The spatial distribution of population affects disease transmission, especially when shelter in place orders restrict mobility for a large fraction of the population. The spatial network structure of settlements therefore imposes a fundamental constraint on the spatial distribution of the population through which a communicable disease can spread. In this analysis we use the spatial network structure of lighted development as a proxy for the distribution of ambient population to compare the spatiotemporal evolution of COVID-19 confirmed cases in the USA and China. The Visible Infrared Imaging Radiometer Suite (VIIRS) Day/Night Band sensor on the NASA/NOAA Suomi satellite has been imaging night light at ~ 700 m resolution globally since 2012. Comparisons with sub-kilometer resolution census observations in different countries across different levels of development indicate that night light luminance scales with population density over ~ 3 orders of magnitude. However, VIIRS’ constant ~ 700 m resolution can provide a more detailed representation of population distribution in peri-urban and rural areas where aggregated census blocks lack comparable spatial detail. By varying the low luminance threshold of VIIRS-derived night light, we depict spatial networks of lighted development of varying degrees of connectivity within which populations are distributed. The resulting size distributions of spatial network components (connected clusters of nodes) vary with degree of connectivity, but maintain consistent scaling over a wide range (5 × to 10 × in area & number) of network sizes. At continental scales, spatial network rank-size distributions obtained from VIIRS night light brightness are well-described by power laws with exponents near −2 (slopes near −1) for a wide range of low luminance thresholds. The largest components (10⁴to 10⁵km²) represent spatially contiguous agglomerations of urban, suburban and periurban development, while the smallest components represent isolated rural settlements. Projecting county and city-level numbers of confirmed cases of COVID-19 for the USA and China (respectively) onto the corresponding spatial networks of lighted development allows the spatiotemporal evolution of the epidemic (infection and detection) to be quantified as propagation within networks of varying connectivity. Results for China show rapid nucleation and diffusion in January 2020 followed by rapid decreases in new cases in February. While most of the largest cities in China showed new confirmed cases approaching zero before the end of February, most of these cities also showed distinct second waves of cases in March or April. Whereas new cases in Wuhan did not approach zero until mid-March, as of December 2020 it has not yet experienced a second wave of cases. In contrast, the results for the USA show a wide range of trajectories, with an abrupt transition from slow increases in confirmed cases in a small number of network components in January and February, to rapid geographic dispersion to a larger number of components shortly before mobility reductions occurred in March. Results indicate that while most of the upper tail of the network had been exposed by the end of March, the lower tail of the component size distribution has only shown steep increases since mid-June.

    

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5. Modeling and tracking Covid-19 cases using Big Data analytics on HPCC system platform

   https://doi.org/10.1186/s40537-021-00423-z  

   Villanustre, Flavio ; Chala, Arjuna ; Dev, Roger ; Xu, Lili ; LexisNexis, Jesse Shaw ; Furht, Borko ; Khoshgoftaar, Taghi ( December 2021 , Journal of Big Data)

   Abstract This project is funded by the US National Science Foundation (NSF) through their NSF RAPID program under the title “Modeling Corona Spread Using Big Data Analytics.” The project is a joint effort between the Department of Computer & Electrical Engineering and Computer Science at FAU and a research group from LexisNexis Risk Solutions. The novel coronavirus Covid-19 originated in China in early December 2019 and has rapidly spread to many countries around the globe, with the number of confirmed cases increasing every day. Covid-19 is officially a pandemic. It is a novel infection with serious clinical manifestations, including death, and it has reached at least 124 countries and territories. Although the ultimate course and impact of Covid-19 are uncertain, it is not merely possible but likely that the disease will produce enough severe illness to overwhelm the worldwide health care infrastructure. Emerging viral pandemics can place extraordinary and sustained demands on public health and health systems and on providers of essential community services. Modeling the Covid-19 pandemic spread is challenging. But there are data that can be used to project resource demands. Estimates of the reproductive number (R) of SARS-CoV-2 show that at the beginning of the epidemic, each infected person spreads the virus to at least two others, on average (Emanuel et al. in N Engl J Med. 2020, Livingston and Bucher in JAMA 323(14):1335, 2020). A conservatively low estimate is that 5 % of the population could become infected within 3 months. Preliminary data from China and Italy regarding the distribution of case severity and fatality vary widely (Wu and McGoogan in JAMA 323(13):1239–42, 2020). A recent large-scale analysis from China suggests that 80 % of those infected either are asymptomatic or have mild symptoms; a finding that implies that demand for advanced medical services might apply to only 20 % of the total infected. Of patients infected with Covid-19, about 15 % have severe illness and 5 % have critical illness (Emanuel et al. in N Engl J Med. 2020). Overall, mortality ranges from 0.25 % to as high as 3.0 % (Emanuel et al. in N Engl J Med. 2020, Wilson et al. in Emerg Infect Dis 26(6):1339, 2020). Case fatality rates are much higher for vulnerable populations, such as persons over the age of 80 years (> 14 %) and those with coexisting conditions (10 % for those with cardiovascular disease and 7 % for those with diabetes) (Emanuel et al. in N Engl J Med. 2020). Overall, Covid-19 is substantially deadlier than seasonal influenza, which has a mortality of roughly 0.1 %. Public health efforts depend heavily on predicting how diseases such as those caused by Covid-19 spread across the globe. During the early days of a new outbreak, when reliable data are still scarce, researchers turn to mathematical models that can predict where people who could be infected are going and how likely they are to bring the disease with them. These computational methods use known statistical equations that calculate the probability of individuals transmitting the illness. Modern computational power allows these models to quickly incorporate multiple inputs, such as a given disease’s ability to pass from person to person and the movement patterns of potentially infected people traveling by air and land. This process sometimes involves making assumptions about unknown factors, such as an individual’s exact travel pattern. By plugging in different possible versions of each input, however, researchers can update the models as new information becomes available and compare their results to observed patterns for the illness. In this paper we describe the development a model of Corona spread by using innovative big data analytics techniques and tools. We leveraged our experience from research in modeling Ebola spread (Shaw et al. Modeling Ebola Spread and Using HPCC/KEL System. In: Big Data Technologies and Applications 2016 (pp. 347-385). Springer, Cham) to successfully model Corona spread, we will obtain new results, and help in reducing the number of Corona patients. We closely collaborated with LexisNexis, which is a leading US data analytics company and a member of our NSF I/UCRC for Advanced Knowledge Enablement. The lack of a comprehensive view and informative analysis of the status of the pandemic can also cause panic and instability within society. Our work proposes the HPCC Systems Covid-19 tracker, which provides a multi-level view of the pandemic with the informative virus spreading indicators in a timely manner. The system embeds a classical epidemiological model known as SIR and spreading indicators based on causal model. The data solution of the tracker is built on top of the Big Data processing platform HPCC Systems, from ingesting and tracking of various data sources to fast delivery of the data to the public. The HPCC Systems Covid-19 tracker presents the Covid-19 data on a daily, weekly, and cumulative basis up to global-level and down to the county-level. It also provides statistical analysis for each level such as new cases per 100,000 population. The primary analysis such as Contagion Risk and Infection State is based on causal model with a seven-day sliding window. Our work has been released as a publicly available website to the world and attracted a great volume of traffic. The project is open-sourced and available on GitHub. The system was developed on the LexisNexis HPCC Systems, which is briefly described in the paper. 

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