Focusing on Vulnerable Populations During COVID-19

Kuy, SreyRam; Tsai, Raymond; Bhatt, Jay; Chu, Quyen D.; Gandhi, Pritesh; Gupta, Rohit; Gupta, Reshma; Hole, Michael K.; Hsu, Benson; Hughes, Lauren S.; Jarvis, Lenore; Jha, Sachin Sunny; Annamalai, Alagappan; Kotwal, Mansi; Sakran, Joseph V.; Vohra, Sameer; Henry, Tracey L.; Correa, Ricardo

doi:10.1097/acm.0000000000003571

Cited by 50 publications

(52 citation statements)

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“…Examining the impact of COVID-19 on vulnerable communities in the US is of growing importance [ 15 , 50 ]. Mounting evidence suggests that social determinants of health and community contextual factors contribute to disparities in both COVID-19 incident cases and deaths [ 2 , 3 , 6 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

Neelon

Mutiso

Mueller

et al. 2020

Preprint

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Background: Emerging evidence suggests that socially vulnerable communities are at higher risk for coronavirus disease 2019 (COVID-19) outbreaks in the United States. However, no prior studies have examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. The purpose of this study was to examine temporal trends among counties with high and low social vulnerability and to quantify disparities in these trends over time. We hypothesized that highly vulnerable counties would have higher incidence and death rates compared to less vulnerable counties and that this disparity would widen as the pandemic progressed. Methods: We conducted a retrospective longitudinal analysis examining COVID-19 incidence and death rates from March 1 to August 31, 2020 for each county in the US. We obtained daily COVID-19 incident case and death data from USAFacts and the Johns Hopkins Center for Systems Science and Engineering. We classified counties using the Social Vulnerability Index (SVI), a percentile-based measure from the Centers for Disease Control and Prevention in which higher scores represent more vulnerability. Using a Bayesian hierarchical negative binomial model, we estimated daily risk ratios (RRs) comparing counties in the first (lower) and fourth (upper) SVI quartiles. We adjusted for percentage of the county designated as rural, percentage in poor or fair health, percentage of adult smokers, county average daily fine particulate matter (PM2.5), percentage of primary care physicians per 100,000 residents, and the proportion tested for COVID-19 in the state. Results: In unadjusted analyses, we found that for most of March 2020, counties in the upper SVI quartile had significantly fewer cases per 100,000 than lower SVI quartile counties. However, on March 30, we observed a crossover effect in which the RR became significantly greater than 1.00 (RR = 1.10, 95% PI: 1.03, 1.18), indicating that the most vulnerable counties had, on average, higher COVID-19 incidence rates compared to least vulnerable counties. Upper SVI quartile counties had higher death rates on average starting on March 30 (RR = 1.17, 95% PI: 1.01,1.36). The death rate RR achieved a maximum value on July 29 (RR = 3.22, 95% PI: 2.91, 3.58), indicating that most vulnerable counties had, on average, 3.22 times more deaths per million than the least vulnerable counties. However, by late August, the lower quartile started to catch up to the upper quartile. In adjusted models, the RRs were attenuated for both incidence cases and deaths, indicating that the adjustment variables partially explained the associations. We also found positive associations between COVID-19 cases and deaths and percentage of the county designated as rural, percentage of resident in fair or poor health, and average daily PM2.5. Conclusions: Results indicate that the impact of COVID-19 is not static but can migrate from less vulnerable counties to more vulnerable counties over time. This highlights the importance of protecting vulnerable populations as the pandemic unfolds.

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Section: Discussionmentioning

confidence: 99%

“…Protecting vulnerable populations is critically important during the COVID-19 pandemic, as these groups are generally at higher risk for adverse health outcomes [14, 15]. Hurst et al define vulnerability as an identifiably elevated risk of incurring greater wrong or harm [16].…”

Section: Introductionmentioning

confidence: 99%

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

Neelon

Mutiso

Mueller

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…A comprehensive review by Alcendor provided in-depth information on the factors associated with morbidity and mortality among minority populations [ 21 ]. African Americans (AAs) and Hispanics/Latinos were disproportionately impacted by COVID-19 infection when compared with non-Hispanic Whites ( Figure 1 B) [ 21 , 22 , 23 ]. U.S. counties such as Hancock and Randolph County, Georgia, with majority AA population are experiencing a three-fold higher infection rate and six-fold higher death rate than White counties.…”

Section: Epidemiological/viral Origin Datamentioning

confidence: 99%

“…COVID-19 infection induces oxidative stress, triggers unregulated cytokine production (cytokine storm) and inflammation [ 89 , 90 , 91 ]. These events enhance the risk of morbidity and mortality rate in most vulnerable populations [ 21 , 23 ].…”

Section: Figurementioning

confidence: 99%

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges

Coke

Davison

Fields

et al. 2021

JCM

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The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.

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“…Since the World Health Organization declared the novel coronavirus a Public Health Emergency of International Concern in March 2020, the crisis has deeply affected the health and wellbeing of refugees and displaced persons. 5 , 6 Entrenched inequalities in host countries not only increase the exposure of refugees to health risks in a pandemic, but also magnify the challenges to accessing adequate healthcare services as compared to national populations. Many refugees live in overcrowded housing and are disproportionately represented in workplaces that place them at risk of exposure to Covid-19 such as factories, production plants, and frontline healthcare work.…”

Section: Introductionmentioning

confidence: 99%

Refugee Health During the Covid-19 Pandemic: A Review of Global Policy Responses

Lupieri¹

2021

RMHP

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Refugees and displaced persons have been severely affected by the Covid-19 pandemic. Yet findings from this narrative review reveal that the health needs of refugees have been largely neglected within global healthcare responses. Such gaps include: (1) responding to the needs of refugees in camps and detention centers; (2) providing adequate public health information; (3) providing access to healthcare and mental health services; (4) and including refugees as decision-makers within health responses. More research is urgently needed to investigate why these gaps exists and to provide recommendations for improving the inclusiveness of healthcare policies during a pandemic.

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Focusing on Vulnerable Populations During COVID-19

Cited by 50 publications

References 1 publication

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges

Refugee Health During the Covid-19 Pandemic: A Review of Global Policy Responses

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