ASM Microbe

ASM Microbe

Issue: July 2021
Source:

Millar JA, et al. Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave. Presented at World Microbe Forum; June 20-24, 2021 (virtual meeting).

Disclosures: The authors report no relevant financial disclosures.
June 22, 2021
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Researchers identify variables associated with COVID-19 fatalities during first wave

Issue: July 2021
Source:

Millar JA, et al. Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave. Presented at World Microbe Forum; June 20-24, 2021 (virtual meeting).

Disclosures: The authors report no relevant financial disclosures.
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Long-term infrastructure and short-term interventions had the biggest impact on reducing COVID-19 deaths in the United States during the first wave of cases, according to new research.

The research, which was presented at the World Microbe Forum virtual meeting, explored COVID-19 case counts and deaths in the U.S. between March 28, 2020, and June 12, 2020.

Jess Millar pullquote

“Public health approaches seek to reduce the burden of COVID-19 within populations, saving patients from ever becoming ill and preserving clinical resources to the greatest extent possible,” Maia S. Majumder, PhD, a computational epidemiologist at Harvard Medical School and Boston Children’s Hospital, and Jess A. Millar, MS, a PhD candidate in the University of Michigan’s department of ecology and evolutionary biology, told Healio. “As public health resources are also limited, policymakers need to understand which populations are at the greatest risk of severe disease.”

The researchers identified variables associated with decreased or increased case fatality rates (CFRs) using public datasets. The study’s overarching goal was to “help officials target public health interventions and health care resources” to areas at increased risk for COVID-19-associated death.

In total, the researchers examined 22 potential variables affecting the CFR.

According to their findings, variables that were inversely associated with a lag-adjusted CFR (laCFR) — which accounted for the lag between cases and deaths, which can lead to an underestimated CFR — a were number of hospitals per 10,000 people (–39% laCFR per additional hospital per 10,000), the banning of religious gatherings (–13% laCFR), percentage of housing units that were mobile homes (–0.79% laCFR per 1% increase in the proportion of mobile homes) and the population percentage without health insurance (–1.5% laCFR per 1% increase in percentage uninsured).

Variables directly associated with laCFR included the percentage of the population aged 65 years and older (+4.4% laCFR per 1% increase in population aged 65 and older), the percentage of African American or Black people (+0.97% laCFR per 1% increase in Black or African American population), the percentage of people with asthma (+9.1% laCFR per 1% increase in asthma prevalence) and the number of hospitals (+3.1% laCFR per one additional hospital), according to the researchers.

Majumder and Millar said the study’s limitations included the potential underreporting of cases, that the type and timing of tests may have affected the laCFR, and that the study period ended in mid-June.

“The exact day of June 12, 2020, was chosen because enough cases had occurred in the U.S. to obtain reliable estimates of laCFR by county and it preceded CDC reopening guidance and a shift in reporting to the HHS Protect system, which is less readily available to the public than the prior CDC reporting system,” Majumder and Millar said. “The decision by the government to switch to the HHS Protect system hinders the ability of academic scientists to aid in the response to the ongoing pandemic. Making these data more readily available to the public would permit inclusion of additional data for future research.”

In addition to being presented at the meeting, the findings were published on the preprint server medRxiv earlier this year.

References:

Millar JA, et al. medRxiv. 2021;doi:10.1101/2021.02.24.21252135.

Millar JA, et al. Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave. Presented at World Microbe Forum; June 20-24, 2021 (virtual meeting).