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During the start of the COVID-19 pandemic in 2020, lockdowns and movement restrictions were thought to negatively impact population mental health, since depression and anxiety symptoms were frequently reported. This study investigates the effect of COVID-19 mitigation measures on mental health across the United States, at county and state levels using difference-in-differences analysis. It examines the effect on mental health facility usage and the prevalence of mental illnesses, drawing on large-scale medical claims data for mental health patients joined with publicly available state- and county-specific COVID-19 cases and lockdown information. For consistency, the main focus is on two types of social distancing policies, stay-at-home and school closure orders. Results show that lockdown has significantly and causally increased the usage of mental health facilities in regions with lockdowns in comparison to regions without such lockdowns. Particularly, resource usage increased by 18% in regions with a lockdown compared to 1% decline in regions without a lockdown. Also, female populations have been exposed to a larger lockdown effect on their mental health. Diagnosis of panic disorders and reaction to severe stress significantly increased by the lockdown. Mental health was more sensitive to lockdowns than to the presence of the pandemic itself. The effects of the lockdown increased over an extended time to the end of December 2020., (© 2024. The Author(s).)

Predicting epidemic evolution is essential for making informed decisions and guiding the implementation of necessary countermeasures. Computational models are vital tools that provide insights into illness progression and enable early detection, proactive intervention, and targeted preventive measures. This paper introduces Sybil, a framework that integrates machine learning and variant-aware compartmental models, leveraging a fusion of data-centric and analytic methodologies. To validate and evaluate Sybil's forecasts, we employed COVID-19 data from several European and U.S. states. The dataset included the number of new and recovered cases, fatalities, and variant presence over time. We evaluate the forecasting precision of Sybil in periods in which there is a change in the trend of the pandemic evolution or a new variant appears. Results demonstrate that Sybil outperforms conventional data-centric approaches, being able to forecast accurately the changes in the trend, the magnitude of these changes, and the future prevalence of new variants., (© 2024. The Author(s).)

Though COVID-19 is no longer a pandemic but rather an endemic, the epidemiological situation related to the SARS-CoV-2 virus is developing at an alarming rate, impacting every corner of the world. The rapid escalation of the coronavirus has led to the scientific community engagement, continually seeking solutions to ensure the comfort and safety of society. Understanding the joint impact of medical and non-medical interventions on COVID-19 spread is essential for making public health decisions that control the pandemic. This paper introduces two novel hybrid machine-learning ensembles that combine supervised and unsupervised learning for COVID-19 data classification and regression. The study utilizes publicly available COVID-19 outbreak and potential predictive features in the USA dataset, which provides information related to the outbreak of COVID-19 disease in the US, including data from each of 3142 US counties from the beginning of the epidemic (January 2020) until June 2021. The developed hybrid hierarchical classifiers outperform single classification algorithms. The best-achieved performance metrics for the classification task were Accuracy = 0.912, ROC-AUC = 0.916, and F1-score = 0.916. The proposed hybrid hierarchical ensemble combining both supervised and unsupervised learning allows us to increase the accuracy of the regression task by 11% in terms of MSE, 29% in terms of the area under the ROC, and 43% in terms of the MPP metric. Thus, using the proposed approach, it is possible to predict the number of COVID-19 cases and deaths based on demographic, geographic, climatic, traffic, public health, social-distancing-policy adherence, and political characteristics with sufficiently high accuracy. The study reveals that virus pressure is the most important feature in COVID-19 spread for classification and regression analysis. Five other significant features were identified to have the most influence on COVID-19 spread. The combined ensembling approach introduced in this study can help policymakers design prevention and control measures to avoid or minimize public health threats in the future., (© 2024. The Author(s).)

COVID-19 has dramatically changed people's mobility geste patterns and affected the operations of different functional spots. In the environment of the successful reopening of countries around the world since 2022, it's pivotal to understand whether the reopening of different types of locales poses a threat of wide epidemic transmission. In this paper, by establishing an epidemiological model based on mobile network data, combining the data handed by the Safegraph website, and taking into account the crowd inflow characteristics and the changes of susceptible and latent populations, the trends of the number of crowd visits and the number of epidemic infections at different functional points of interest after the perpetration of continuing strategies were simulated. The model was also validated with daily new cases in ten metropolitan areas in the United States from March to May 2020, and the results showed that the model fitted the evolutionary trend of realistic data more accurately. Further, the points of interest were classified into risk levels, and the corresponding reopening minimum standard prevention and control measures were proposed to be implemented according to different risk levels. The results showed that restaurants and gyms became high-risk points of interest after the perpetration of the continuing strategy, especially the general dine-in restaurants were at higher risk levels. Religious exertion centers were the points of interest with the loftiest average infection rates after the perpetration of the continuing strategy. Points of interest such as convenience stores, large shopping malls, and pharmacies were at a lower risk for outbreak impact after the continuing strategy was enforced. Based on this, continuing forestallment and control strategies for different functional points of interest are proposed to provide decision support for the development of precise forestallment and control measures for different spots. [ABSTRACT FROM AUTHOR]

Throughout the pandemic era, COVID-19 was one of the remarkable unexpected situations over the past few years, but with the decentralization and globalization of efforts and knowledge, a successful vaccine-based control strategy was efficiently designed and applied worldwide. On the other hand, excused confusion and hesitation have widely impacted public health. This paper aims to reduce COVID-19 vaccine hesitancy taking into consideration the patient's medical history. The dataset used in this study is the Vaccine Adverse Event Reporting System (VAERS) dataset which was created as a corporation between the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) to gather reported side effects that may be caused by PFIEZER, JANSSEN, and MODERNA vaccines. In this paper, a Deep Learning (DL) model has been developed to identify the relationship between a certain type of COVID-19 vaccine (i.e. PFIEZER, JANSSEN, and MODERNA) and the adverse reactions that may occur in vaccinated patients. The adverse reactions under study are the recovery condition, possibility to be hospitalized, and death status. In the first phase of the proposed model, the dataset has been pre-proceesed, while in the second phase, the Pigeon swarm optimization algorithm is used to optimally select the most promising features that affect the performance of the proposed model. The patient's status after vaccination dataset is grouped into three target classes (Death, Hospitalized, and Recovered). In the third phase, Recurrent Neural Network (RNN) is implemented for both each vaccine type and each target class. The results show that the proposed model gives the highest accuracy scores which are 96.031% for the Death target class in the case of PFIEZER vaccination. While in JANSSEN vaccination, the Hospitalized target class has shown the highest performance with an accuracy of 94.7%. Finally, the model has the best performance for the Recovered target class in MODERNA vaccination with an accuracy of 97.794%. Based on the accuracy and the Wilcoxon Signed Rank test, we can conclude that the proposed model is promising for identifying the relationship between the side effects of COVID-19 vaccines and the patient's status after vaccination. The study displayed that certain side effects were increased in patients according to the type of COVID-19 vaccines. Side effects related to CNS and hemopoietic systems demonstrated high values in all studied COVID-19 vaccines. In the frame of precision medicine, these findings can support the medical staff to select the best COVID-19 vaccine based on the medical history of the patient., (© 2023. The Author(s).)

The prolonged COVID-19 pandemic has tied up significant medical resources, and its management poses a challenge for the public health care decision making. Accurate predictions of the hospitalizations are crucial for the decision makers to make informed decision for the medical resource allocation. This paper proposes a method named County Augmented Transformer (CAT). To generate accurate predictions of four-week-ahead COVID-19 related hospitalizations for every states in the United States. Inspired by the modern deep learning techniques, our method is based on a self-attention model (known as the transformer model) that is actively used in Natural Language Processing. Our transformer based model can capture both short-term and long-term dependencies within the time series while enjoying computational efficiency. Our model is a data based approach that utilizes the publicly available information including the COVID-19 related number of confirmed cases, deaths, hospitalizations data, and the household median income data. Our numerical experiments demonstrate the strength and the usability of our model as a potential tool for assisting the medical resources allocation. [ABSTRACT FROM AUTHOR]

COVID-19 vaccines have reduced infections and hospitalizations across the globe, yet resistance to vaccination remains strong. This paper investigates the role of cable television news in vaccine hesitancy and associated local vaccination rates in the United States. We find that, in the earlier stages of the vaccine roll-out (starting May 2021), higher local viewership of Fox News Channel has been associated with lower local vaccination rates. We can verify that this association is causal using exogenous geographical variation in the channel lineup. The effect is driven by younger individuals (under 65 years of age), for whom COVID-19 has a low mortality risk. Consistent with changes in beliefs about the effectiveness of the vaccine as a mechanism, we find that Fox News increased reported vaccine hesitancy in local survey responses. We can rule out that the effect is due to differences in partisanship, to local health policies, or to local COVID-19 infections or death rates. The other two major television networks, CNN and MSNBC, have no effect. That, in turn, indicates that more differentiated characteristics, like the networks' messaging or tendency for controversy, matter and that the effect of Fox News on COVID-19 vaccine uptake is not due to the general consumption of cable news. We also show that there is no historical effect of Fox News on flu vaccination rates, suggesting that the effect is COVID-19-specific and not driven by general skepticism toward vaccines., (© 2022. The Author(s).)

The COVID-19 pandemic is a global health concern that has spread around the globe. Machine Learning is promising in the fight against the COVID-19 pandemic. Machine learning and artificial intelligence have been employed by various healthcare providers, scientists, and clinicians in medical industries in the fight against COVID-19 disease. In this paper, we discuss the impact of the Covid-19 pandemic on alcohol consumption habit changes among healthcare workers in the United States during the first wave of the Covid-19 pandemic. We utilize multiple supervised and unsupervised machine learning methods and models such as decision trees, logistic regression, support vector machines, multilayer perceptron, XGBoost, CatBoost, LightGBM, AdaBoost, Chi-Squared Test, mutual information, KModes clustering and the synthetic minority oversampling technique on a mental health survey data obtained from the University of Michigan Inter-University Consortium for Political and Social Research to investigate the links between COVID-19-related deleterious effects and changes in alcohol consumption habits among healthcare workers. Through the interpretation of the supervised and unsupervised methods, we have concluded that healthcare workers whose children stayed home during the first wave in the US consumed more alcohol. We also found that the work schedule changes due to the Covid-19 pandemic led to a change in alcohol use habits. Changes in food consumption, age, gender, geographical characteristics, changes in sleep habits, the amount of news consumption, and screen time are also important predictors of an increase in alcohol use among healthcare workers in the United States. [ABSTRACT FROM AUTHOR]

As the COVID-19 spread over the globe and new variants of COVID-19 keep occurring, reliable real-time forecasts of COVID-19 hospitalizations are critical for public health decisions on medical resources allocations. This paper aims to forecast future 2 weeks national and state-level COVID-19 new hospital admissions in the United States. Our method is inspired by the strong association between public search behavior and hospitalization admissions and is extended from a previously-proposed influenza tracking model, AutoRegression with GOogle search data (ARGO). Our LASSO-penalized linear regression method efficiently combines Google search information and COVID-19 related time series information with dynamic training and rolling window prediction. Compared to other publicly available models collected from COVID-19 forecast hub, our method achieves substantial error reduction in a retrospective out-of-sample evaluation from Jan 4, 2021, to Dec 27, 2021. Overall, we showed that our method is flexible, self-correcting, robust, accurate, and interpretable, making it a potentially powerful tool to assist healthcare officials and decision making for the current and future infectious disease outbreaks., (© 2022. The Author(s).)

Since early 2020, non-pharmaceutical interventions (NPIs)-implemented at varying levels of severity and based on widely-divergent perspectives of risk tolerance-have been the primary means to control SARS-CoV-2 transmission. This paper aims to identify how risk tolerance and vaccination rates impact the rate at which a population can return to pre-pandemic contact behavior. To this end, we developed a novel mathematical model and we used techniques from feedback control to inform data-driven decision-making. We use this model to identify optimal levels of NPIs across geographical regions in order to guarantee that hospitalizations will not exceed given risk tolerance thresholds. Results are shown for the state of Colorado, United States, and they suggest that: coordination in decision-making across regions is essential to maintain the daily number of hospitalizations below the desired limits; increasing risk tolerance can decrease the number of days required to discontinue NPIs, at the cost of an increased number of deaths; and if vaccination uptake is less than 70%, at most levels of risk tolerance, return to pre-pandemic contact behaviors before the early months of 2022 may newly jeopardize the healthcare system. The sooner we can acquire population-level vaccination of greater than 70%, the sooner we can safely return to pre-pandemic behaviors., (© 2022. The Author(s).)

In addition to concern about physical health consequences of COVID-19, many researchers also note the concerning impact on behavioral health and quality of life due to disruption. The purpose of this paper is to explore pathways of COVID-19 behavioral health and quality of life. We found increased anxiety, depression, and alcohol misuse and that the pandemic exacerbated prior problems. Further community indicators also lead to poorer behavioral health and overall decreased quality of life. The nature of COVID-19 and vast reach of the virus suggests that behavioral health concerns should take a primary role in pandemic recovery., (© 2022. The Author(s).)

Containing the COVID-19 pandemic while balancing the economy has proven to be quite a challenge for the world. We still have limited understanding of which combination of policies have been most effective in flattening the curve; given the challenges of the dynamic and evolving nature of the pandemic, lack of quality data etc. This paper introduces a novel data mining-based approach to understand the effects of different non-pharmaceutical interventions in containing the COVID-19 infection rate. We used the association rule mining approach to perform descriptive data mining on publicly available data for 50 states in the United States to understand the similarity and differences among various policies and underlying conditions that led to transitions between different infection growth curve phases. We used a multi-peak logistic growth model to label the different phases of infection growth curve. The common trends in the data were analyzed with respect to lockdowns, face mask mandates, mobility, and infection growth. We observed that face mask mandates combined with mobility reduction through moderate stay-at-home orders were most effective in reducing the number of COVID-19 cases across various states., (© 2021. The Author(s).)

The COVID-19 global pandemic has significantly impacted every aspect of life all over the world. The United States is reported to have suffered more than 20% of the global casualties from this pandemic. It is imperative to investigate the growth dynamics of the disease in the US based on varying geographical and governmental factors that best manifest itself in each State of the Country. This paper utilizes a hybrid machine learning and continuum deformation-based approach for analyzing the stability and growth rate of the pandemic. To this end, principal stress values of the pandemic continuum body are obtained using Mohr's Circle method and overlapping, moving windows of data are analysed successively. This helps in finding the correlations between the growth rate and Governments' action/Public's reaction. Government actions include "state of emergency", "shelter at place", and "phase declarations". We also consider the vaccination rate milestones, which shows us the coordinated Governments' action/Public's reaction. Finally, a number of recommendations are made to the Governments and people for better management of future pandemics., (© 2021. The Author(s).)

The global spread of COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has casted a significant threat to mankind. As the COVID-19 situation continues to evolve, predicting localized disease severity is crucial for advanced resource allocation. This paper proposes a method named COURAGE (COUnty aggRegation mixup AuGmEntation) to generate a short-term prediction of 2-week-ahead COVID-19 related deaths for each county in the United States, leveraging modern deep learning techniques. Specifically, our method adopts a self-attention model from Natural Language Processing, known as the transformer model, to capture both short-term and long-term dependencies within the time series while enjoying computational efficiency. Our model solely utilizes publicly available information for COVID-19 related confirmed cases, deaths, community mobility trends and demographic information, and can produce state-level predictions as an aggregation of the corresponding county-level predictions. Our numerical experiments demonstrate that our model achieves the state-of-the-art performance among the publicly available benchmark models., (© 2021. The Author(s).)

In this paper, we proposed a multi-method modeling approach to community-level spreading of COVID-19 disease. Our methodology was composed of interconnected age-stratified system dynamics models in an agent-based modeling framework that allowed for a granular examination of the scale and severity of disease spread, including metrics such as infection cases, deaths, hospitalizations, and ICU usage. Model parameters were calibrated using an optimization technique with an objective function to minimize error associated with the cumulative cases of COVID-19 during a training period between March 15 and October 31, 2020. We outlined several case studies to demonstrate the model's state- and local-level projection capabilities. We further demonstrated how model outcomes could be used to evaluate perceived levels of COVID-19 risk across different localities using a multi-criteria decision analysis framework. The model's two, three, and four week out-of-sample projection errors varied on a state-by-state basis, and generally increased as the out-of-sample projection period was extended. Additionally, the prediction error in the state-level projections was generally due to an underestimation of cases and an overestimation of deaths. The proposed modeling approach can be used as a virtual laboratory to investigate a wide range of what-if scenarios and easily adapted to future high-consequence public health threats.

During the unprecedented situation that all countries around the globe are facing due to the Coronavirus disease 2019 (COVID-19) pandemic, which has also had severe socioeconomic consequences, it is imperative to explore novel approaches to monitoring and forecasting regional outbreaks as they happen or even before they do so. To that end, in this paper, the role of Google query data in the predictability of COVID-19 in the United States at both national and state level is presented. As a preliminary investigation, Pearson and Kendall rank correlations are examined to explore the relationship between Google Trends data and COVID-19 data on cases and deaths. Next, a COVID-19 predictability analysis is performed, with the employed model being a quantile regression that is bias corrected via bootstrap simulation, i.e., a robust regression analysis that is the appropriate statistical approach to taking against the presence of outliers in the sample while also mitigating small sample estimation bias. The results indicate that there are statistically significant correlations between Google Trends and COVID-19 data, while the estimated models exhibit strong COVID-19 predictability. In line with previous work that has suggested that online real-time data are valuable in the monitoring and forecasting of epidemics and outbreaks, it is evident that such infodemiology approaches can assist public health policy makers in addressing the most crucial issues: flattening the curve, allocating health resources, and increasing the effectiveness and preparedness of their respective health care systems.

Hodgkin lymphoma (HL) is a rare malignancy affecting the lymphatic system. Our study examined the incidence rates of adult HL based on sex, race/ethnicity, age, and histological subgroups in the United States (US) from 2000 to 2020. Data for this study were extracted from the Surveillance, Epidemiology, and End Results 22 database. HL patients were identified utilizing the International Classification of Diseases for Oncology version 3 and categorized as classical HL, lymphocyte-rich/mixed cell/lymphocyte depleted, nodular sclerosis, classical HL, not otherwise specified, and nodular lymphocyte-predominant HL. The study reported average annual percent change (AAPC). All estimates were presented as counts and age-standardized incidence rates (ASIRs) per 100,000 individuals. Between 2000 and 2019, a total of 70,924 cases of HL were reported in the US. Classical HL was the predominant subtype (94.27%), and most incident cases were among non-Hispanic Whites (66.92%) and those aged 20–29 years (24.86%). The ASIR per 100,000 population was 3.83 for men and 2.92 for women. Both sexes showed declines in the AAPCs between 2000 and 2019 (− 0.64% [− 0.99, − 0.28] and − 0.40% [− 0.77, − 0.03] for men and women, respectively). There was a significant decrease in ASIRs after COVID-19 among both sexes (percent change: − 7.49% [− 11.58, − 3.40]). Throughout all age groups, men had a higher incidence rate compared to women, except for those aged 20–29 years. Although the overall HL incidence rate was lowered in the study period from 2000 to 2019, a dramatic decrease in ASIRs of HL patients following COVID-19 pandemic was observed. [ABSTRACT FROM AUTHOR]

We study the problem of synthesizing lockdown policies—schedules of maximum capacities for different types of activity sites—to minimize the number of deceased individuals due to a pandemic within a given metropolitan statistical area (MSA) while controlling the severity of the imposed lockdown. To synthesize and evaluate lockdown policies, we develop a multiscale susceptible, infected, recovered, and deceased model that partitions a given MSA into geographic subregions, and that incorporates data on the behaviors of the populations of these subregions. This modeling approach allows for the analysis of heterogeneous lockdown policies that vary across the different types of activity sites within each subregion of the MSA. We formulate the synthesis of optimal lockdown policies as a nonconvex optimization problem and we develop an iterative algorithm that addresses this nonconvexity through sequential convex programming. We empirically demonstrate the effectiveness of the developed approach by applying it to six of the largest MSAs in the United States. The developed heterogeneous lockdown policies not only reduce the number of deceased individuals by up to 45 percent over a 100 day period in comparison with three baseline lockdown policies that are less heterogeneous, but they also impose lockdowns that are less severe. [ABSTRACT FROM AUTHOR]

The associations between clinical phenotypes of coronavirus disease 2019 (COVID-19) and the host inflammatory response during the transition from peak illness to convalescence are not yet well understood. Blood plasma samples were collected from 129 adult SARS-CoV-2 positive inpatient and outpatient participants between April 2020 and January 2021, in a multi-center prospective cohort study at 8 military hospitals across the United States. Plasma inflammatory protein biomarkers were measured in samples from 15 to 28 days post symptom onset. Topological Data Analysis (TDA) was used to identify patterns of inflammation, and associations with peak severity (outpatient, hospitalized, ICU admission or death), Charlson Comorbidity Index (CCI), and body mass index (BMI) were evaluated using logistic regression. The study population (n = 129, 33.3% female, median 41.3 years of age) included 77 outpatient, 31 inpatient, 16 ICU-level, and 5 fatal cases. Three distinct inflammatory biomarker clusters were identified and were associated with significant differences in peak disease severity (p < 0.001), age (p < 0.001), BMI (p < 0.001), and CCI (p = 0.001). Host-biomarker profiles stratified a heterogeneous population of COVID-19 patients during the transition from peak illness to convalescence, and these distinct inflammatory patterns were associated with comorbid disease and severe illness due to COVID-19. [ABSTRACT FROM AUTHOR]

A life-saving treatment, solid organ transplantation (SOT) has transformed the survival and quality of life of patients with end-organ dysfunction. The coronavirus disease (COVID-19) pandemic has impacted the practice of deceased and living donations worldwide by various resource shifting, including healthcare personnel and equipment such as ventilators and bed space. Our work explores the COVID-19 pandemic and global transplant data to create a statistical model for deducing the impact of COVID-19 on living donor and deceased donor transplants in the United States of America (USA). In severely impacted regions, transplant centers need to carefully balance the risks and benefits of performing a transplant during the COVID-19 pandemic. In our statistical model, the COVID cases are used as an explanatory variable (input) to living or deceased donor transplants (output). The model is shown to be statistically accurate for both estimation of the correlation structure, and prediction of future donors. The provided predictions are to be taken as probabilistic assertions, so that for each instant where the prediction is calculated, a statistical measure of accuracy (confidence interval) is provided. The method is tested on both low and high frequency data, that notoriously exhibit a different behavior. [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 virus has led to a pandemic with staggering morbidity and mortality. There is evidence showing that pre-existing conditions and environmental factors are associated with worse COVID-19 outcomes. Among these conditions, altitude is of particular interest. Altitude has been shown to influence the morbidity and mortality of multiple chronic pathologies such as cardiovascular disease, chronic obstructive pulmonary disease and lung cancer. COVID-19 fatality rate has been associated with as altitude as well, but findings are disputed. Therefore, we revisit this assessment with a comprehensive analysis of the relationship between COVID-19 fatality rates and altitude for the Mountain region of the United States while considering the effect of additional comorbidities and sociodemographic factors. A Generalized Additive Model (GAM) approach using one year of county data adjusted by population density was performed to evaluate associations within states and for the whole region. Our analysis revealed a consistent effect where COVID-19 case-fatality rate is decreased with higher altitude, even when controlling for pre-existing conditions and certain demographic variables. In summary, the work presented provides evidence that suggests that the protective effects of high altitude are likely to be influenced by physiologic factors but demographic trends that are associated with life at high altitude must also be considered. [ABSTRACT FROM AUTHOR]

The sudden spread of COVID-19 infections in a region can catch its healthcare system by surprise. Can one anticipate such a spread and allow healthcare administrators to prepare for a surge a priori? We posit that the answer lies in distinguishing between two types of waves in epidemic dynamics. The first kind resembles a spatio-temporal diffusion pattern. Its gradual spread allows administrators to marshal resources to combat the epidemic. The second kind is caused by super-spreader events, which provide shocks to the disease propagation dynamics. Such shocks simultaneously affect a large geographical region and leave little time for the healthcare system to respond. We use time-series analysis and epidemiological model estimation to detect and react to such simultaneous waves using COVID-19 data from the time when the B.1.617.2 (Delta) variant of the SARS-CoV-2 virus dominated the spread. We first analyze India's second wave from April to May 2021 that overwhelmed the Indian healthcare system. Then, we analyze data of COVID-19 infections in the United States (US) and countries with a high and low Indian diaspora. We identify the Kumbh Mela festival as the likely super-spreader event, the exogenous shock, behind India's second wave. We show that a multi-area compartmental epidemiological model does not fit such shock-induced disease dynamics well, in contrast to its performance with diffusion-type spread. The insufficient fit to infection data can be detected in the early stages of a shock-wave propagation and can be used as an early warning sign, providing valuable time for a planned healthcare response. Our analysis of COVID-19 infections in the US reveals that simultaneous waves due to super-spreader events in one country (India) can lead to simultaneous waves in other places. The US wave in the summer of 2021 does not fit a diffusion pattern either. We postulate that international travels from India may have caused this wave. To support that hypothesis, we demonstrate that countries with a high Indian diaspora exhibit infection growth soon after India's second wave, compared to countries with a low Indian diaspora. Based on our data analysis, we provide concrete policy recommendations at various stages of a simultaneous wave, including how to avoid it, how to detect it quickly after a potential super-spreader event occurs, and how to proactively contain its spread. [ABSTRACT FROM AUTHOR]

The widespread COVID-19 pandemic fundamentally changed many people's ways of life. With the necessity of social distancing and lock downs across the United States, evidence shows more people engage in outdoor activities. With the utilization of location-based service (LBS) data, we seek to explore how visitation patterns to national parks changed among communities of color during the COVID-19 pandemic. Our results show that visitation rates to national parks located closer than 347 km to individuals have increased amidst the pandemic, but the converse was demonstrated amongst parks located further than 347 km from individuals. More importantly, COVID-19 has adversely impacted visitation figures amongst non-white and Native American communities, with visitation volumes declining if these communities are situated further from national parks. Our results show disproportionately low-representations amongst national park visitors from these communities of color. African American communities display a particularly concerning trend whereby their visitation to national parks is substantially lower amongst communities closer to national parks. [ABSTRACT FROM AUTHOR]

Travel patterns and mobility affect the spread of infectious diseases like COVID-19. However, we do not know to what extent local vs. visitor mobility affects the growth in the number of cases. This study evaluates the impact of state-level local vs. visitor mobility in understanding the growth with respect to the number of cases for COVID spread in the United States between March 1, 2020, and December 31, 2020. Two metrics, namely local and visitor transmission risk, were extracted from mobility data to capture the transmission potential of COVID-19 through mobility. A combination of the three factors: the current number of cases, local transmission risk, and the visitor transmission risk, are used to model the future number of cases using various machine learning models. The factors that contribute to better forecast performance are the ones that impact the number of cases. The statistical significance of the forecasts is also evaluated using the Diebold–Mariano test. Finally, the performance of models is compared for three waves across all 50 states. The results show that visitor mobility significantly impacts the case growth by improving the prediction accuracy by 33.78%. We also observe that the impact of visitor mobility is more pronounced during the first peak, i.e., March–June 2020. [ABSTRACT FROM AUTHOR]

As the COVID-19 ravaging through the globe, accurate forecasts of the disease spread are crucial for situational awareness, resource allocation, and public health decision-making. Alternative to the traditional disease surveillance data collected by the United States (US) Centers for Disease Control and Prevention (CDC), big data from Internet such as online search volumes also contain valuable information for tracking infectious disease dynamics such as influenza epidemic. In this study, we develop a statistical model using Internet search volume of relevant queries to track and predict COVID-19 pandemic in the United States. Inspired by the strong association between COVID-19 death trend and symptom-related search queries such as "loss of taste", we combine search volume information with COVID-19 time series information for US national level forecasts, while leveraging the cross-state cross-resolution spatial temporal framework, pooling information from search volume and COVID-19 reports across regions for state level predictions. Lastly, we aggregate the state-level frameworks in an ensemble fashion to produce the final state-level 4-week forecasts. Our method outperforms the baseline time-series model, while performing reasonably against other publicly available benchmark models for both national and state level forecast. [ABSTRACT FROM AUTHOR]

We expanded a published mathematical model of SARS-CoV-2 transmission with complex, age-structured transmission and with laboratory-derived source and wearer protection efficacy estimates for a variety of face masks to estimate their impact on COVID-19 incidence and related mortality in the United States. The model was also improved to allow realistic age-structured transmission with a pre-specified R0 of transmission, and to include more compartments and parameters, e.g. for groups such as detected and undetected asymptomatic infectious cases who mask up at different rates. When masks are used at typically-observed population rates of 80% for those ≥ 65 years and 60% for those < 65 years, face masks are associated with 69% (cloth) to 78% (medical procedure mask) reductions in cumulative COVID-19 infections and 82% (cloth) to 87% (medical procedure mask) reductions in related deaths over a 6-month timeline in the model, assuming a basic reproductive number of 2.5. If cloth or medical procedure masks' source control and wearer protection efficacies are boosted about 30% each to 84% and 60% by cloth over medical procedure masking, fitters, or braces, the COVID-19 basic reproductive number of 2.5 could be reduced to an effective reproductive number ≤ 1.0, and from 6.0 to 2.3 for a variant of concern similar to delta (B.1.617.2). For variants of concern similar to omicron (B.1.1.529) or the sub-lineage BA.2, modeled reductions in effective reproduction number due to similar high quality, high prevalence mask wearing is more modest (to 3.9 and 5.0 from an R0 = 10.0 and 13.0, respectively). None-the-less, the ratio of incident risk for masked vs. non-masked populations still shows a benefit of wearing masks even with the higher R0 variants. [ABSTRACT FROM AUTHOR]

Misinformation about the COVID-19 pandemic proliferated widely on social media platforms during the course of the health crisis. Experts have speculated that consuming misinformation online can potentially worsen the mental health of individuals, by causing heightened anxiety, stress, and even suicidal ideation. The present study aims to quantify the causal relationship between sharing misinformation, a strong indicator of consuming misinformation, and experiencing exacerbated anxiety. We conduct a large-scale observational study spanning over 80 million Twitter posts made by 76,985 Twitter users during an 18.5 month period. The results from this study demonstrate that users who shared COVID-19 misinformation experienced approximately two times additional increase in anxiety when compared to similar users who did not share misinformation. Socio-demographic analysis reveals that women, racial minorities, and individuals with lower levels of education in the United States experienced a disproportionately higher increase in anxiety when compared to the other users. These findings shed light on the mental health costs of consuming online misinformation. The work bears practical implications for social media platforms in curbing the adverse psychological impacts of misinformation, while also upholding the ethos of an online public sphere. [ABSTRACT FROM AUTHOR]

Risk stratification for hospitalized adults with COVID-19 is essential to inform decisions about individual patients and allocation of resources. So far, risk models for severe COVID outcomes have included age but have not been optimized to best serve the needs of either older or younger adults. Models also need to be updated to reflect improvements in COVID-19 treatments. This retrospective study analyzed data from 6906 hospitalized adults with COVID-19 from a community health system across five states in the western United States. Risk models were developed to predict mechanical ventilation illness or death across one to 56 days of hospitalization, using clinical data available within the first hour after either admission with COVID-19 or a first positive SARS-CoV-2 test. For the seven-day interval, models for age ≥ 18 and < 50 years reached AUROC 0.81 (95% CI 0.71–0.91) and models for age ≥ 50 years reached AUROC 0.82 (95% CI 0.77–0.86). Models revealed differences in the statistical significance and relative predictive value of risk factors between older and younger patients including age, BMI, vital signs, and laboratory results. In addition, for hospitalized patients, sex and chronic comorbidities had lower predictive value than vital signs and laboratory results. [ABSTRACT FROM AUTHOR]

The ongoing SARS-CoV-2 pandemic has been holding the world hostage for several years now. Mobility is key to viral spreading and its restriction is the main non-pharmaceutical interventions to fight the virus expansion. Previous works have shown a connection between the structural organization of cities and the movement patterns of their residents. This puts urban centers in the focus of epidemic surveillance and interventions. Here we show that the organization of urban flows has a tremendous impact on disease spreading and on the amenability of different mitigation strategies. By studying anonymous and aggregated intra-urban flows in a variety of cities in the United States and other countries, and a combination of empirical analysis and analytical methods, we demonstrate that the response of cities to epidemic spreading can be roughly classified in two major types according to the overall organization of those flows. Hierarchical cities, where flows are concentrated primarily between mobility hotspots, are particularly vulnerable to the rapid spread of epidemics. Nevertheless, mobility restrictions in such types of cities are very effective in mitigating the spread of a virus. Conversely, in sprawled cities which present many centers of activity, the spread of an epidemic is much slower, but the response to mobility restrictions is much weaker and less effective. Investing resources on early monitoring and prompt ad-hoc interventions in more vulnerable cities may prove helpful in containing and reducing the impact of future pandemics. [ABSTRACT FROM AUTHOR]

In previous work, Giuntella et al. (Proc Natl Acad Sci 118:e2016632118, 2021), we documented large disruptions to physical activity, sleep, time use and mental health among young adults at the onset of the COVID-19 pandemic in Spring 2020. This study explores the trends 1 year into COVID-19, as vaccines began to roll out, COVID-19 deaths declined, and social distancing measures eased in the United States. We combine biometric and survey data from multiple cohorts of college students spanning Spring 2019 through Spring 2021 (N = 1179). Our results show persistent impacts of the pandemic on physical activity and mental health. One year into the pandemic, daily steps averaged about 6300 per day compared to about 9800 per day prior to the pandemic, a 35% decline. Almost half of participants were at risk of clinical depression compared to a little over one-third prior to the pandemic, a 36% increase. The impacts on screen time, social interactions and sleep duration at the onset of COVID-19 largely dissipated over the course of the pandemic, though screen time remained significantly higher than pre-pandemic levels. In contrast to the sharp changes in lifestyle and mental health documented as the pandemic emerged in March 2020, we do not find evidence of behavioral changes or improvements in mental well-being over the course of Spring 2021 as the pandemic eased. [ABSTRACT FROM AUTHOR]

We investigate the connection between the choice of transportation mode used by commuters and the probability of COVID-19 transmission. This interplay might influence the choice of transportation means for years to come. We present data on commuting, socioeconomic factors, and COVID-19 disease incidence for several US metropolitan areas. The data highlights important connections between population density and mobility, public transportation use, race, and increased likelihood of transmission. We use a transportation model to highlight the effect of uncertainty about transmission on the commuters' choice of transportation means. Using multiple estimation techniques, we found strong evidence that public transit ridership in several US metro areas has been considerably impacted by COVID-19 and by the policy responses to the pandemic. Concerns about disease transmission had a negative effect on ridership, which is over and above the adverse effect from the observed reduction in employment. The COVID-19 effect is likely to reduce the demand for public transport in favor of lower density alternatives. This change relative to the status quo will have implications for fuel use, congestion, accident frequency, and air quality. More vulnerable communities might be disproportionally affected as a result. We point to the need for additional studies to further quantify these effects and to assist policy in planning for the post-COVID-19 transportation future. [ABSTRACT FROM AUTHOR]

Despite the widespread use of face masks to combat COVID-19, little is known about their social and behavioral consequences. To understand the impact of face masks on interpersonal trust, we designed a novel experiment to assess the causal impact of face mask use on whether individuals follow economically relevant advice from a stranger. From a survey of more than 2000 US citizens, conducted during July and August 2020, we find that almost 5% fewer individuals trust advice when it is given by someone wearing a mask than when it is given by someone not wearing a mask. While, surprisingly, health-related risks do not seem to alter the way masks affect trust, the effects of masks are particularly large among individuals whose households face economic risks due to COVID-19 and those with below-average normative beliefs about mask wearing. Our results highlight the non-health-related meaning that face masks have developed during COVID-19 and suggest that mask use undermines trust in others among a substantial share of the US population. [ABSTRACT FROM AUTHOR]

Contact tracing can play a key role in controlling human-to-human transmission of a highly contagious disease such as COVID-19. We investigate the benefits and costs of contact tracing in the COVID-19 transmission. We estimate two unknown epidemic model parameters (basic reproductive number R 0 and confirmed rate δ 2 ) by using confirmed case data. We model contact tracing in a two-layer network model. The two-layer network is composed by the contact network in the first layer and the tracing network in the second layer. In terms of benefits, simulation results show that increasing the fraction of traced contacts decreases the size of the epidemic. For example, tracing 25 % of the contacts is enough for any reopening scenario to reduce the number of confirmed cases by half. Considering the act of quarantining susceptible households as the contact tracing cost, we have observed an interesting phenomenon. The number of quarantined susceptible people increases with the increase of tracing because each individual confirmed case is mentioning more contacts. However, after reaching a maximum point, the number of quarantined susceptible people starts to decrease with the increase of tracing because the increment of the mentioned contacts is balanced by a reduced number of confirmed cases. The goal of this research is to assess the effectiveness of contact tracing for the containment of COVID-19 spreading in the different movement levels of a rural college town in the USA. Our research model is designed to be flexible and therefore, can be used to other geographic locations. [ABSTRACT FROM AUTHOR]