Category Archives: pandemic

where have we already seen second waves of COVID-19?

I’m definitely not an epidemiologist, so take this post with thousands of grains of salt. But I am trying to think about whether we should expect a major second wave of COVID-19.

Andrew Atkeson, Karen Kopecky, Tao Zha look at the 23 countries and 25 states with the highest death tolls and find a consistent pattern for all of them. One clear peak has been followed by “relatively slow growth or even shrinkage of daily deaths from the disease.” These are illustrations of the classic pattern:

There is enormous variation in the death rate at the peak. For instance, at their respective peaks, 24 people per million died each day in Belgium, versus 0.27 per million in New Zealand. Yet most states and countries–and all the ones included by Atkeson, Kopecky, and Zha–look similar 20-30 days after the peak. Belgium, for example, has had less than one daily death per million since June 12.

However, some countries and states do not exhibit this pattern. I have found pretty clear evidence of second peaks in Croatia, Iran, Israel, Japan, and Turkey, plus Idaho, Louisiana, and Mississippi.

I included the USA in the graph because it also shows two humps (the second smaller than the first). However, disaggregating US data to the state level suggests that there were simply two batches of states that had one peak each. At the state level, the only true second peaks that I see are in Idaho, Louisiana, and Mississippi. There are also some cases, like Australia, in which you can see a second peak if you squint–but the death rate has never been high. And there are countries, like Ukraine, that seem to wobble upward slowly without peaking,

Reading Atkeson, Kopecky, and Zha, one might guess that most badly-afflicted countries have accomplished impressive declines by implementing interventions. That is not such good news, since these policies are costly and hard to sustain. But it would be surprising if all the jurisdictions in their sample accomplished the same outcome in 20-30 days despite applying divergent policies. There is some chatter that these places have reached herd immunity, but I am convinced by Howard Forman and others that’s not what’s happening. Still there could be a strong tendency for COVID-19 to taper off for other reasons, which might offer good news.

It could also be the case that we simply haven’t seen many second waves yet. When you play Russian Roulette, things often go fine for a while, but the game always ends the same. Possibly places like Turkey and Croatia and Idaho and Louisiana demonstrate that we’re all at risk of a resurgence at a random moment.

Some European countries have recently reported increases in cases, although not deaths. Perhaps this is only because of increased testing rates–but then again, why is testing becoming more common unless rising numbers of people are experiencing symptoms? Deaths may follow.

In any event, I am searching and waiting for more information about the actual second waves. Why have they happened and what can we learn from their experiences?

explore the dimensions of equity and inequity in the USA

How did I spend my summer vacation? Mainly, working with colleagues to build this new website.

You can use it to explore how various categories of Americans–racial groups and genders, people from different walks of life, voters supporting Trump or Biden, and more–fare on a whole range of social outcomes, from having diabetes, to being confused for someone of the same race, to being laid off because of COVID. A very simple interface yields results like this:

The site also presents “research briefs” based on the underlying survey data that go well beyond the queries that you can run yourself using on the homepage. So far, they are about COVID and policing; more are coming.

This is an effort to inject some additional facts into the public debate, to experiment with data-visualization, and to bring faculty together from across a research university to combine their disciplinary perspectives on one multifaceted issue.

See also: debating equity; defining equity and equality; sorting out human welfare, equity and mobility; college and mobility; and 14 kinds of research we need for #reducinginequality.

College graduates, high income earners most likely to feel helped by government during pandemic

Latinos, those with only high school education, and under-30s hit harder by layoffs than other groups, according to new Tufts University national survey

This is the latest from the Tufts Priority Research Area on Equity, which I co-lead.

MEDFORD/SOMERVILLE, Mass. (July 30, 2020)—College graduates and high earners with incomes between $85,000 and $150,000 are most likely to feel that the government has helped them during the pandemic or that other individuals have assisted them, according to a national survey from Tufts University.

At the same time, the national survey found that Latinos, people under the age of 30, and those with only a high school diploma were more likely to have been laid off than other groups.

“The survey results provide insight into Americans’ differing perceptions of who is helping them through these unprecedented times, and who is bearing the brunt of the pandemic’s economic impacts,” said Wenhui Feng, assistant professor of Public Health and Community Medicine at Tufts University School of Medicine, who contributed to the study. “Layoffs have affected all population subgroups, but the economic toll of COVID-19 has hit particularly hard a segment of the population that was struggling even before the pandemic.”

The survey was designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement. The research group previously released data showing that only 57 percent of Americans would get vaccinated for COVID-19 if a vaccine were available. It also has released additional research about who has been more likely to self-isolate and to be tested for the virus during the pandemic.

Government, nonprofits provide assistance

About one third (33%) of survey respondents say that the government has helped them deal with COVID-19 or its effects. The survey did not ask specifically how people were helped, but the federal government has provided financial assistance to some individuals and companies, and various federal, state and local governmental entities have provided testing, information and healthcare.

Individuals with higher education levels are more likely to feel that they have received assistance. About a quarter of people (24.5%) without a high school degree, 29% of high school graduates, 32% of people with some college, and 39% of people with at least a bachelor’s degree say they feel they have been helped. People from households with incomes between $85,000 and $150,000 are most likely to report that the government has assisted them. 

By contrast, the study reveals that nonprofits have been a critical source of assistance for underserved segments of the population. Overall, 6% of Americans say a nonprofit has helped them with the virus or its impact, but that rate is triple (18%) among those with an income below $20,000/year. Latinos are most likely to report receiving assistance from nonprofits (13%), compared with 8% of non-Latino Black individuals, 4% of non-Latino white individuals, and 8% of those with less than a high school degree.

Employment also impacted

About one in seven (14%) of those surveyed say they were laid off due to COVID-19. Layoffs are more than twice as common for people with only a high school degree than for those with a bachelor’s degree or higher (17% versus 9%). Layoffs have been more common for Latinos (20%) than for African Americans (13.5%) or whites (12%). They have been most common for people under 30 (23%) and least common for those 60 and older (8.5%).

Other research conducted by the Center for Information & Research on Civic Learning and Engagement, part of Tufts University’s Tisch College of Civic Life, has also documented the adverse economic impacts of COVID-19 on youth—particularly on youth of color.

About the study

The survey was designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement. It was fielded online by Ipsos between May 29 and June 10, 2020, using its KnowledgePanel. The sample was nationally representative, and the number of complete responses was 1,267 non-institutionalized adult residents of the United States.

More technical information about the survey is at https://equityresearch.tufts.edu/the-survey/.

Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement was established in 2019 as part of a strategic effort to use resources and expertise across the university to address major global issues. It brings together researchers from across the university to discuss and investigate aspects of equity and inequity in the United States and the world. The research has been funded by Tufts University’s Office of the Vice Provost for Research as one of several such initiatives.

The group’s principal investigators are Jennifer Allen, professor of Community Health in Tufts’ School of Arts and Sciences; Peter Levine, associate dean for academic affairs and Lincoln Filene Professor of Citizenship & Public Affairs at Tisch College of Civic Life at Tufts; and Tom Stopka, an epidemiologist and associate professor at Tufts School of Medicine. Other members of the group can be found here.

By September 2020, the Research Group will launch a website at https://equityresearch.tufts.edu that will allow anyone to explore numerous dimensions of equity and inequity with an interactive data-visualization tool. Tufts’ Jonathan M. Tisch College of Civic Life is funding the data-visualization tool.

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For more information o, contact: Robin Smyton robin.smyton@tufts.edu 617.627.5392 or Jen McAndrew jennifer.mcandrew@tufts.edu 617.627.2029.

About Tufts University

Tufts University, located on campuses in Boston, Medford/Somerville and Grafton, Massachusetts, and in Talloires, France, is recognized among the premier research universities in the United States. Tufts enjoys a global reputation for academic excellence and for the preparation of students as leaders in a wide range of professions. A growing number of innovative teaching and research initiatives span all Tufts campuses, and collaboration among the faculty and students in the undergraduate, graduate and professional programs across the university’s schools is widely encouraged.

Differences in COVID-19 response

Women, college graduates, Democrats more likely to self-isolate to reduce coronavirus risks

Survey also finds differences in prevalence of COVID-19 testing based on geographic, personal and socio-economic factors

MEDFORD/SOMERVILLE, Mass (July 20, 2020)—Women, older Americans, Democrats and people with more education are more likely to try to isolate themselves from contact with other people to reduce COVID-19 transmission risks, according to a new Tufts University national survey.

The survey also identified notable differences in whether people have received testing for COVID-19 based on geographic regions, age group, educational level, political affiliation, income, race/ethnicity and gender. Those who have been tested for COVID-19 most commonly live in the Northeast, are affiliated with the Democratic party, and are African American, according to the research.

“The results of our survey indicate that there are significant demographic and geographic differences in how people respond to COVID-19 pandemic risks, and that these disparities in protective responses need to be taken into account by public health and public policy officials,” said Tom Stopka, an epidemiologist at Tufts School of Medicine, and a co-lead on the study.

“As public health officials continue to increase access to testing  across the U.S. in light of persistent surges in COVID-19 infections in many states, they need to consider how to increase testing in geographic hotspots and the highest-risk groups to better understand infection patterns and inform data-driven public health and clinical responses,” Stopka added.

The survey was designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement. The research group previously released data showing that only 57 percent of Americans plan to get vaccinated for COVID-19. The group will soon release additional research about the economic impacts of the pandemic.

Self-isolation rates differ

Overall, 71% of adult Americans say they have tried to separate themselves from others to avoid COVID-19.

Women are about nine percentage points more likely to self-isolate (75% versus 66% for men). People with a bachelor’s degree are almost 20 percentage points more likely to self-isolate than those with a high school diploma (79% versus 59.3%, respectively). Democrats (77.5%) and Independents (73%) are about 10 points more likely to self-isolate than Republicans (66%). Almost eight out of ten Americans who are 60 or older report trying to self-isolate, while two-thirds of respondents in all other age categories report similar attempts.                        

The disparities among those who are more likely to self-isolate may reflect opportunities and perceived risks, according to the researchers. For instance, retired people and people who work at computers can isolate more easily than people who provide in-person services. Also, people in older age groups may be paying close attention to the elevated risks that they face based on national and international epidemiological data and news.

“Below age 60, all age groups are self-isolating at the same rate. That may counter speculation that the young are flouting restrictions,” said Peter Levine, an associate dean of academic affairs at Tufts’ Tisch College.

Testing rates vary by geographic region

Overall, 7% of those polled say that they have personally been tested for COVID-19, and 17% report that someone in their family has been tested.

These testing rates vary by region. In the Northeast, 10% have been tested, and 21% have a family member who has been tested, compared to 5% and 14% in the Midwest, respectively, with the other regions in between. Democrats are significantly more likely to have been tested (9%) or to have a tested family member (22%) than Republicans (6% and 13.5%, respectively). African Americans are the most likely to be tested (10%) or to have had a test in the family (26%), compared to 5% and 14% for Whites, respectively. Increased testing may reflect the higher rate of infection among African Americans that has been widely reported.

About the survey

The survey was fielded online by Ipsos between May 29 and June 10, 2020, using its KnowledgePanel. The sample was nationally representative, and the number of complete responses was 1,267 non-institutionalized adult residents of the United States. More technical information about the survey is at https://equityresearch.tufts.edu/the-survey/.

Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement was established in 2019 as part of a strategic effort to use resources and expertise across the university to address major global issues. It brings together researchers from across Tufts campuses and schools to discuss and investigate aspects of equity and inequity in the United States and the world. The research has been funded by Tufts University’s Office of the Vice Provost for Research as one of several such initiatives.

The group’s principal investigators are Jennifer Allen, professor of Community Health in the Tufts School of Arts and Sciences; Levine; and Stopka. Other members of the group can be found here.

By September 2020, the Research Group will launch a website at https://equityresearch.tufts.edu that will allow anyone to explore numerous dimensions of equity and inequity with an interactive data-visualization tool. Tufts’ Jonathan M. Tisch College of Civic Life is funding the data-visualization tool.

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About Tufts University

Tufts University, located on campuses in Boston, Medford/Somerville and Grafton, Massachusetts, and in Talloires, France, is recognized among the premier research universities in the United States. Tufts enjoys a global reputation for academic excellence and for the preparation of students as leaders in a wide range of professions. A growing number of innovative teaching and research initiatives span all Tufts campuses, and collaboration among the faculty and students in the undergraduate, graduate and professional programs across the university’s schools is widely encouraged.

only 57 percent of Americans say they would get COVID-19 vaccine

Vaccine interest higher among Whites and Hispanics, wealthier households, and Democrats

This is the latest product from the Tufts Research Group on Equity in Health, Wealth, and Civic Engagement, which I co-lead; and I did some of this analysis.

MEDFORD/SOMERVILLE, Mass. (July 9, 2020)—Despite widespread agreement among experts that having a prophylactic COVID-19 vaccine will be critical to the nation’s ability to safely return to some form of normalcy, only 57% of Americans say they would get a COVID-19 vaccine if it were available today, according to a national survey designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement.

The nationally representative survey also uncovered significant variations in vaccination acceptance by race/ethnicity, household income, educational background and party affiliation. Whites and Hispanics, Democrats, those with more formal education, and those with higher incomes reported being more likely to get vaccinated than Blacks, Republicans, those with less education, and those with lower incomes. Fully one-quarter of respondents said they didn’t know if they would get the vaccine, possibly indicating the need for more public health education and information.

 “It’s really concerning that only 57% of our respondents said they would get vaccinated. It’s evident that we need to begin working on a national vaccine strategy and education campaign right now– even before we have the vaccine in hand,” said Jennifer Allen, professor of community health in Tufts University’s School of Arts and Sciences and co-leader of the study. “There is still some uncertainty, but some studies show that we need between 60 and 70% of the population to be vaccinated in order to confer herd immunity.”

There has been growing resistance to all vaccines in the U.S. over the past decade, which has led to reduced compliance with vaccine recommendations and the re-emergence of diseases like measles and mumps, which were previously well-controlled. Growing anti-vaccination sentiment has been fueled by misinformation about vaccines, including the widely de-bunked theory that vaccines could cause autism.

Whites and Hispanics more likely to vaccinate

The study also revealed marked differences of opinion toward vaccination across racial groups, with 58% of non-Hispanic whites and Hispanics reporting they would get the vaccine as compared with 48% of non-Hispanic Blacks.

“The pandemic has disproportionately affected Black individuals,” said Allen. “The lower level of vaccine acceptance within this population is worrisome, as it suggests the vaccine could further exacerbate COVID-19 racial/ethnic disparities. Given the legacy of medical experimentation on African Americans, there is understandable mistrust in medical science and in government.

“The accelerated time-frame for vaccine development and testing could further raise concerns about the safety and efficacy of an eventual vaccine,” Allen continued. “Targeted efforts will be needed to make sure that a vaccine doesn’t further widen the gap in health outcomes.”

Income and education plays factor

Surprisingly, those with higher levels of income and education were more likely to report that they would get the COVID-19 vaccine. “Historically, those most likely to refuse vaccines have been those with higher levels of income and education,” said Allen.

Among those with incomes less than $20,000, only 41% said they would get the vaccine, compared with 72% among those with incomes of $150,000 or more. Less than half of those with a high school education or below said they would get the vaccine, compared with 74% among those who had a college education.

Differences across political parties

Sharp polarization by political party affiliation also emerged in the responses. Willingness to be vaccinated was highest among Democrats (71%) compared with Independents (61%) and Republicans (47%).

“Differences between political parties are striking. As with many aspects of the pandemic, vaccination is a highly partisan issue,” said Peter Levine, an associate dean at Tufts’ Tisch College of Civic Life. “The partisan gap may pose an obstacle to widespread vaccination.”

While public health officials, clinicians and pharmaceutical companies race to develop a COVID-19 vaccine, it is evident that, should a successful vaccine become available, distribution and administration will need to be accompanied by health communication, promotion and education campaigns,” said Tom Stopka, an infectious disease epidemiologist and associate professor with the Tufts University School of Medicine, and a co-leader of the study. “Such campaigns can help to increase understanding of how the vaccine will work, decrease doubts and mistrust of local, state, and federal officials, and potentially demonstrate that the benefits of the vaccine far outweigh the risks.

“The U.S. population has been overwhelmed with COVID-19 information and stress, as well as massive changes to their day-to-day lives,” added Stopka. “When and if a vaccine becomes available, and has been thoroughly tested in human populations, it will be necessary to also develop a massive public health communication campaign to provide community members with the information they need to make an informed decision to protect themselves, and to protect their families and local communities.”

The survey was fielded online by Ipsos using its KnowledgePanel. The sample was nationally representative, and the number of complete responses was 1,267. More technical information about the survey is at https://equityresearch.tufts.edu/the-survey/.

Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement was established in 2019 as part of a strategic effort to use resources and expertise of Tufts campuses and schools to address major global issues. It brings together researchers from across the university to discuss and investigate aspects of equity and inequity in the United States and the world. The research has been funded by Tufts University’s Office of the Vice Provost for Research as one of several such initiatives

The group’s principal investigators are Allen, Levine and Stopka. Other members of the group can be found here

By September 2020, the Research Group will launch a website at https://equityresearch.tufts.edu that will allow anyone to explore numerous dimensions of equity and inequity with an interactive data-visualization tool. Tufts’ Jonathan M. Tisch College of Civic Life is funding the data-visualization tool.

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About Tufts University

Tufts University, located on campuses in Boston, Medford/Somerville and Grafton, Massachusetts, and in Talloires, France, is recognized among the premier research universities in the United States. Tufts enjoys a global reputation for academic excellence and for the preparation of students as leaders in a wide range of professions. A growing number of innovative teaching and research initiatives span all Tufts campuses, and collaboration among the faculty and students in the undergraduate, graduate and professional programs across the university’s schools is widely encouraged.