A comprehensive analysis of COVID-19 transmission and mortality rates at the county level in the United States considering socio-demographics, health indicators, mobility trends and health care infrastructure attributes.

Tanmoy Bhowmik,Naveen Chandra Iraganaboina,Sudipta Dey Tirtha,Naveen Eluru,George Liu

doi:10.1371/journal.pone.0249133

Tanmoy Bhowmik, Naveen Chandra Iraganaboina + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0249133

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Journal: PloS one	Publication Date: Apr 1, 2021
Citations: 32	License type: CC BY 4.0

Affiliation: University of Central Florida

Abstract

BackgroundSeveral research efforts have evaluated the impact of various factors including a) socio-demographics, (b) health indicators, (c) mobility trends, and (d) health care infrastructure attributes on COVID-19 transmission and mortality rate. However, earlier research focused only on a subset of variable groups (predominantly one or two) that can contribute to the COVID-19 transmission/mortality rate. The current study effort is designed to remedy this by analyzing COVID-19 transmission/mortality rates considering a comprehensive set of factors in a unified framework.Methods and findingsWe study two per capita dependent variables: (1) daily COVID-19 transmission rates and (2) total COVID-19 mortality rates. The first variable is modeled using a linear mixed model while the later dimension is analyzed using a linear regression approach. The model results are augmented with a sensitivity analysis to predict the impact of mobility restrictions at a county level. Several county level factors including proportion of African-Americans, income inequality, health indicators associated with Asthma, Cancer, HIV and heart disease, percentage of stay at home individuals, testing infrastructure and Intensive Care Unit capacity impact transmission and/or mortality rates. From the policy analysis, we find that enforcing a stay at home order that can ensure a 50% stay at home rate can result in a potential reduction of about 33% in daily cases.ConclusionsThe model framework developed can be employed by government agencies to evaluate the influence of reduced mobility on transmission rates at a county level while accommodating for various county specific factors. Based on our policy analysis, the study findings support a county level stay at home order for regions currently experiencing a surge in transmission. The model framework can also be employed to identify vulnerable counties that need to be prioritized based on health indicators for current support and/or preferential vaccination plans (when available).

Highlights

Coronavirus disease 2019 (COVID-19) pandemic, as of August 20th, has spread to 188 countries with a reported 23.1 million cases and 802 thousand fatalities [1]
Several research efforts have evaluated the impact of various factors including a) sociodemographics, (b) health indicators, (c) mobility trends, and (d) health care infrastructure attributes on COVID-19 transmission and mortality rate
The model framework developed can be employed by government agencies to evaluate the influence of reduced mobility on transmission rates at a county level while accommodating

Summary

Introduction

Coronavirus disease 2019 (COVID-19) pandemic, as of August 20th, has spread to 188 countries with a reported 23.1 million cases and 802 thousand fatalities [1]. Among the various countries affected, United States has reported the highest number of confirmed cases (5.5 million) and deaths (173 thousand) in the world [4] In this context, it is important that we clearly understand the factors affecting COVID-19 transmission and mortality rate to prescribe policy actions grounded in empirical evidence to slow the spread of the transmission and/or prepare action plans for potential vaccination programs in the near future. It is important that we clearly understand the factors affecting COVID-19 transmission and mortality rate to prescribe policy actions grounded in empirical evidence to slow the spread of the transmission and/or prepare action plans for potential vaccination programs in the near future Towards contributing to these objectives, the current study develops a comprehensive framework for examining COVID-19 transmission and mortality rates in the United States using COVID-19 data at a county level encompassing about 93% of the US population. The current study effort is designed to remedy this by analyzing COVID-19 transmission/mortality rates considering a comprehensive set of factors in a unified framework

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