COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability.

Yoo Min Park,Bennett Wall,Katherine Jones,Gregory D Kearney,Robert J Howard,Ray H Hylock

doi:10.3390/ijerph18178987

Abstract

The geographic areas most impacted by COVID-19 may not remain static because public health measures/behaviors change dynamically, and the impacts of pandemic vulnerability also may vary geographically and temporally. The nature of the pandemic makes spatiotemporal methods essential to understanding the distribution of COVID-19 deaths and developing interventions. This study examines the spatiotemporal trends in COVID-19 death rates in the United States from March 2020 to May 2021 by performing an emerging hot spot analysis (EHSA). It then investigates the effects of the COVID-19 time-dependent and basic social vulnerability factors on COVID-19 death rates using geographically and temporally weighted regression (GTWR). The EHSA results demonstrate that over the three phases of the pandemic (first wave, second wave, and post-vaccine deployment), hot spots have shifted from densely populated cities and the states with a high percentage of socially vulnerable individuals to the states with relatively relaxed social distancing requirements, and then to the states with low vaccination rates. The GTWR results suggest that local infection and testing rates, social distancing interventions, and other social, environmental, and health risk factors show significant associations with COVID-19 death rates, but these associations vary over time and space. These findings can inform public health planning.

Highlights

The emergence of the coronavirus disease 2019 (COVID-19) has caused unprecedented challenges to global public health and healthcare systems since its onset in late 2019
The high death rates in these regions may be due to the high percentage of socially vulnerable populations, such as uninsured residents, people living in poverty, individuals with jobs that require working in close contact, and elderly people, as well as the lack of binational public health strategies between the United States and Mexico and limited public testing
This study investigates the spatiotemporal trends and geographic disparities in COVID-19 mortality from 1 March 2020 to 31 May 2021 by identifying emerging hot and cold spots of death rates over the three phases of the pandemic

Summary

Introduction

The emergence of the coronavirus disease 2019 (COVID-19) has caused unprecedented challenges to global public health and healthcare systems since its onset in late 2019. Several studies have reported that the pandemic has disproportionately impacted socially vulnerable populations, including the elderly, racial/ethnic minorities, low-income communities, people with low educational attainment, the uninsured population, people with chronic comorbidities and underlying health conditions, and other underserved communities [1–4]. Protecting these groups is paramount due to their increased risk of COVID-19 mortality [5,6].

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Conclusion