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  1. Abstract

    Biodiversity in ecosystems plays an important role in supporting human welfare, including regulating the transmission of infectious diseases. Many of these services are not fully-appreciated due to complex environmental dynamics and lack of baseline data. Multicontinental amphibian decline due to the fungal pathogenBatrachochytrium dendrobatidis(Bd) provides a stark example. Even though amphibians are known to affect natural food webs—including mosquitoes that transmit human diseases—the human health impacts connected to their massive decline have received little attention. Here we leverage a unique ensemble of ecological surveys, satellite data, and newly digitized public health records to show an empirical link between a wave of Bd-driven collapse of amphibians in Costa Rica and Panama and increased human malaria incidence. Subsequent to the estimated date of Bd-driven amphibian decline in each ‘county’ (canton or distrito), we find that malaria cases are significantly elevated for several years. For the six year peak of the estimated effect, the annual expected county-level increase in malaria ranges from 0.76 to 1.1 additional cases per 1000 population. This is a substantial increase given that cases country-wide per 1000 population peaked during the timeframe of our study at approximately 1.5 for Costa Rica and 1.1 for Panama. This previously unidentified impact of biodiversity loss illustrates the often hidden human welfare costs of conservation failures. These findings also show the importance of mitigating international trade-driven spread of similar emergent pathogens likeBatrachochytrium salamandrivorans.

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    COVID-19 vaccines have been authorized in multiple countries, and more are under rapid development. Careful design of a vaccine prioritization strategy across sociodemographic groups is a crucial public policy challenge given that 1) vaccine supply will be constrained for the first several months of the vaccination campaign, 2) there are stark differences in transmission and severity of impacts from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across groups, and 3) SARS-CoV-2 differs markedly from previous pandemic viruses. We assess the optimal allocation of a limited vaccine supply in the United States across groups differentiated by age and essential worker status, which constrains opportunities for social distancing. We model transmission dynamics using a compartmental model parameterized to capture current understanding of the epidemiological characteristics of COVID-19, including key sources of group heterogeneity (susceptibility, severity, and contact rates). We investigate three alternative policy objectives (minimizing infections, years of life lost, or deaths) and model a dynamic strategy that evolves with the population epidemiological status. We find that this temporal flexibility contributes substantially to public health goals. Older essential workers are typically targeted first. However, depending on the objective, younger essential workers are prioritized to control spread or seniors to directly control mortality. When the objective is minimizing deaths, relative to an untargeted approach, prioritization averts deaths on a range between 20,000 (when nonpharmaceutical interventions are strong) and 300,000 (when these interventions are weak). We illustrate how optimal prioritization is sensitive to several factors, most notably, vaccine effectiveness and supply, rate of transmission, and the magnitude of initial infections. 
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