Nicole Cummings

COVID-19 CHHS Webinar Series: Rural Populations and Infectious Disease Transmission: Implications for COVID-19

dhawkin — Wed, 24 Jun 2020 20:23:44 +0000

COVID-19 CHHS Webinar Series: Rural Populations and Infectious Disease Transmission: Implications for COVID-19 dhawkin Wed, 06/24/2020 - 16:23

Learn more about the COVID-19 Webinar Series and view recordings

Experts in Their Field Shed Light on the Disparities of Infectious Disease Transmission in Rural and Urban Areas with Application to Virginia

The College of Health and Human Services held its third COVID-19 Webinar Series, welcoming new panel members who shared their research and recent findings with the community. Moderated by Dean Germaine Louis, the panel heard from Dr. Cara L. Frankenfeld, associate professor of epidemiology, biostatistics and global and community health at George Mason; Dr. Caterina M. Scoglio, professor of electrical and computer engineering at Kansas State University, and Dr. Srini Venkatramanan, research scientist, network systems science and advanced computing from University of Virginia’s Biocomplexity Institute and Initiative.

Frankenfeld began by pointing out key distinctions between rural and urban populations, and how these communities are impacted differently by COVID-19. Geographic disparities are common in infectious diseases due to contrasting industries that drive the economy in rural and urban communities.

“In rural areas we see manufacturing, mining and farming. These industries are more susceptible to in-person contact, with higher risk of transmission,” explains Frankenfeld.

Other key disparities seen in rural areas are higher percentages of poverty, and low education rates.

Rural communities also have high numbers of elder populations and have less access to health care, including limited access to virus testing and health care facilities. In addition, more than half of rural counties have no hospital ICU beds. While we have yet to see a significant negative effect of this problem, it is a growing concern of health care professionals. Over 15% of Americans live in rural areas and are experiencing differential access to health care. It is vital to consider these communities going forward with COVID-19 relief and response systems.

Scoglio, who has studied counties in Kansas, presented insight with relevant application to Virginia. She found that a mostly urban county—Wyandotte county—where part of Kansas City is located, had approximately 1,400 cases. Some rural counties with special populations (e.g., penitentiaries and meat packing plants) had over 1,000 cases. One college county, where you might expect infection rates to be high, only had approximately 60 cases, and the majority of rural counties saw very low numbers, at 0 to 5 cases. This demonstrates the importance of considering the composition of different counties in expected infection rates. Virginia also has a dichotomy of communities, from heavily populated counties of Northern Virginia, to rural areas across the rest of the state, including several counties with universities.

“There are distinct strengths and vulnerabilities rural communities face when combatting infectious disease transmission,” states Scoglio.

Some advantages of rural communities that keep their infection rates low are how spread out households are, with fewer contact locations. However, many have close ties to other households. Scoglio conducted a study focusing on behavior and social awareness during COVID-19. According to a survey of 500 rural households, they found low compliance with stay at home orders. The study found that 49% of respondents would still visit a few households outside of their own home, even during a serious pandemic with recommended stay at home orders.

“It is difficult to get people to change their behaviors and routines,” concludes Scoglio.

From a more technical perspective, the panel heard from Venkatramanan, who works with the Biocomplexity Institute & Initiative which uses big data and simulations to interpret massively interactive systems. His current work aims to analyze COVID-19 transmission throughout rural and urban communities across the United States, and he has previously provided pandemic response for influenza, Ebola, Zika and now COVID-19 support for Virginia and the Department of Defense.

Venkatramanan provided visualizations on nationwide statistics of high demand resources, in order to better understand and visualize the disparities between rural and urban geographic areas that also apply to Virginia’s geography. “COVID is now reaching rural America, and we are starting to see more cases emerging, particularly in these special locations that include close contact industries,” states Venkatramanan.

In closing, rural and urban counties have distinguishing characteristics that set them up to experience COVID-19 in potentially different ways. The key characteristics discussed by the panelists were age, healthcare accessibility, and economic industries.

Learn more about the CHHS COVID-19 Webinar Series, view recordings of previous webinars, and register for future webinars.

COVID-19 CHHS Webinar Series: Weighing the Decision to Safely ‘Reopen’ Northern Virginia

dhawkin — Tue, 16 Jun 2020 18:20:49 +0000

COVID-19 CHHS Webinar Series: Weighing the Decision to Safely ‘Reopen’ Northern Virginia dhawkin Tue, 06/16/2020 - 14:20

Mason Faculty and Local Partner Discuss Working Together to “Reopen” Northern Virginia While Continuing to Flatten the Curve

On May 28, 2020, the day before Northern Virginia was set to begin Phase 1 of gradually “re-opening” aspects of the economy, the College of Health and Human Services held their second webinar in the College’s COVID-19 Webinar Series. The webinar featured a panel of experts to discuss COVID-19 from an economic and public health perspective. Each distinguished guest shared their unique expertise and insight on the decision to safely re-open Northern Virginia, and discussed George Mason's potential options for the fall semester.

Panel participants included Dr. Amira Roess, professor of global health and epidemiology; Dr. Emanuel (Chip) Petricoin, university professor and co-director at the Center for Applied Proteomics and Molecular Medicine; Sean O’Connor, professor of law at the Antonin Scalia Law School, and executive director at the Center for the Protection of Intellectual Property; Dr. Dan Houser, chair of the Department of Economics, and Victor Hoskins, president and CEO of Fairfax Economic Development. The webinar was moderated by Dean Germaine Louis.

Since May 20, states across the country have begun to expand the number of businesses and services that are open, moving away from stay-at-home-orders and into “Phase 1.”

Local commerce leaders (like Victor Hoskins), policymakers and government officials face complicated choices as they struggle to combat long-term economic repercussions, high unemployment and the possible unintended consequences of reopening prematurely.

The panel examined key indicators that decision-makers look to as signs we are ready to re-open. Roess recommended monitoring metrics such as the number of hospitalizations and fatality rates as a primary way to discern readiness, since the original objective of the stay-at-home order was to avoid overwhelming hospitals. In addition, making sure we have enough resources in place such as accessible testing, increased contact tracers, and an effective Virginia public health response system are all signs of readiness to move forward in the phases of reopening.

Furthermore, stabilizing the number of tests administered to 10,000 tests a day is critical in order to more accurately determine if there are any spikes in cases within the Northern Virginia area.

“We are missing a significant portion of [cases] through false test results. It’s not just about testing more, but testing more accurately and consistently,” emphasizes Petricoin.

During the stay-at-home-orders, many people have also been afraid to seek the help they need in order to avoid frequent doctor visits and travel. “Women with metastatic breast cancer may not be starting their trials of treatment, and patients with blood in their stools are not getting colonoscopies that may arise to stage four colon cancer the following year. We can’t be so scared of COVID that we put off the other big things that could harm us as well,” states Petricoin.

While reopening too soon could cause another wave of the virus, O’Connor expressed that extending the quarantine in the future could also cause issues in food supply and other essential industries people rely on every day to function.

“Regions need to become self-sufficient. There is no magical reopening date,” states O’Connor. Ramifications of COVID-19 affect each community and each industry differently. There is no one solution that will fit all, everyone will have to work together.

Hoskins and Houser discussed economic concern in the disproportionate impact on low income workers. People who work in retail and restaurant industries are directly affected by the pandemic and often already have lower incomes. Reopening these industries is important to do at this time, but it must be done cautiously since Phase 1 does not mean everything is back to normal. In order to succeed economically and socially, “as a community, we must accept the new social norms that will come out of this pandemic,” advises Houser.

“Any long-term solution must take into account people of all socioeconomic statuses. Long term planning is going to have to be much more inclusive if we want to reduce these massive disparities in infection and mortality rates. We need to work together to do this right the first time,” concludes Roess.

From the economical perspective, Hoskins believes now is the right time to re-open the economy. “While we should not face the world with fear, we need to defeat these new challenges with precaution. Re-opening should be done sector by sector. There may be different timing for different industries depending on what they provide,” explains Hoskins.

Some health officials fear people will re-enter too quickly into Phase 1 and may neglect safe practices in hope of returning to an immediate normal. If we are to successfully go through the motions of each phase, we will not see a full recovery of the past. Instead we must integrate new behavioral and social norms into our lives.

There are many questions that have yet to be answered regarding COVID-19, which is why many experts urge we err on the side of caution. While test accuracy is getting better, it is not quite there yet. Scientists are still unsure of how long immunity would last in a person who has been previously infected, and they are not confident immunity will last for over a year. Antibody tests (tests for past infections) may not be entirely reliable either.

“Going forward, testing accurately for asymptomatic transmission will be key,” says Roess, who is working closely with several organizations on their approach to reopening.

An audience question asked if the panel was making the decisions regarding the University’s plan for the fall 2020 semester. While the decision will ultimately be made by the Board of visitors, several of the panel members did participate in committees to inform the BOV decision. One such committee was dubbed the “tiger team.” A report presented by the “tiger team” can be viewed here.

In conclusion, even in a post-vaccine world, experts stressed that this disease will be a part of our lives, like other diseases in our lifetime such as the flu and the measles. Instead of fearing what the future holds we will adjust our behavior like we have done during any other difficult time in history.

Learn more about the CHHS COVID-19 Webinar Series, view recordings of previous webinars, and register for future webinars.