Tag: pandemic

Opinion: Amid a Pandemic, a Health Care Algorithm Shows Promise and Peril

Mary Pat Campbell
Amid a Pandemic, a Health Care Algorithm Shows Promise and Peril

Excerpt:

In the midst of the uncertainty, Epic, a private electronic health record giant and a key purveyor of American health data, accelerated the deployment of a clinical prediction tool called the Deterioration Index. Built with a type of artificial intelligence called machine learning and in use at some hospitals prior to the pandemic, the index is designed to help physicians decide when to move a patient into or out of intensive care, and is influenced by factors like breathing rate and blood potassium level. Epic had been tinkering with the index for years but expanded its use during the pandemic. At hundreds of hospitals, including those in which we both work, a Deterioration Index score is prominently displayed on the chart of every patient admitted to the hospital.

The Deterioration Index is poised to upend a key cultural practice in medicine: triage. Loosely speaking, triage is an act of determining how sick a patient is at any given moment to prioritize treatment and limited resources. In the past, physicians have performed this task by rapidly interpreting a patient’s vital signs, physical exam findings, test results, and other data points, using heuristics learned through years of on-the-job medical training.

Ostensibly, the core assumption of the Deterioration Index is that traditional triage can be augmented, or perhaps replaced entirely, by machine learning and big data. Indeed, a study of 392 Covid-19 patients admitted to Michigan Medicine that the index was moderately successful at discriminating between low-risk patients and those who were at high-risk of being transferred to an ICU, getting placed on a ventilator, or dying while admitted to the hospital. But last year’s hurried rollout of the Deterioration Index also sets a worrisome precedent, and it illustrates the potential for such decision-support tools to propagate biases in medicine and change the ways in which doctors think about their patients.

Author(s): VISHAL KHETPAL, NISHANT SHAH

Publication Date: 27 May 2021

Publication Site: Undark Magazine

Unprecedented federal borrowing floods state budgets

Mary Pat Campbell

Link: https://thehill.com/opinion/finance/556660-unprecedented-federal-borrowing-floods-state-budgets

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Excerpt:

Once per calendar quarter, the state of Michigan conducts a Consensus Revenue Estimating Conference that provides updates on both the national and state economies and the state’s fiscal outlook. The May conference each year is especially significant because it sets the official revenue targets for the next fiscal year’s state budget. 

The May meeting packet contained a broad range of data points, but a few jumped out.

….

Another chart broke down the components of personal income. Over the previous four quarters, personal income was nearly $3,000 higher than pre-pandemic forecasts had expected. However, employee compensation actually declined by about half that amount. The entire increase is the result of the 53 percent increase in federal transfer payments that have floated U.S. households over the past year.

Author(s): DAVID GUENTHNER

Publication Date: 5 June 2021

Publication Site: The Hill

Quantifying impacts of the COVID-19 pandemic through life expectancy losses: a population-level study of 29 countries

Mary Pat Campbell

Link: https://www.medrxiv.org/content/10.1101/2021.03.02.21252772v4

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Abstract:

Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely-used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. Life tables by sex were calculated for 29 countries, including most European countries, Chile and the USA for 2015-2020. Life expectancy at birth and at age 60 for 2020 were contextualised against recent trends between 2015-19. Using decomposition techniques we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Bulgaria experienced the largest losses in life expectancy at birth during 2020 (2.1 and 1.6 years respectively), but reductions of more than an entire year were documented in eleven countries for males, and eight among females. Reductions were mostly attributable to increased mortality above age 60 and to official COVID-19 deaths. The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since WW-II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.

Author(s): José Manuel Aburto, Jonas Schöley, Ilya Kashnitsky, Luyin Zhang, Charles Rahal, Trifon I. Missov Melinda C. Mills, Jennifer B. Dowd, Ridhi Kashyap

Publication Date: 6 April 2021

Publication Site: medRxiv

What history tells you about post-pandemic booms

Mary Pat Campbell

Link: https://www.economist.com/finance-and-economics/2021/04/29/what-history-tells-you-about-post-pandemic-booms

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Excerpt:

The record suggests that, after periods of massive non-financial disruption such as wars and pandemics, GDP does bounce back. It offers three further lessons. First, while people are keen to go out and spend, uncertainty lingers. Second, crises encourage people and businesses to try new ways of doing things, upending the structure of the economy. Third, as “Les Miserables” shows, political upheaval often follows, with unpredictable economic consequences.

Publication Date: 1 May 2021

Publication Site: The Economist

‘The Premonition’ Review: A Pandemic of Experts

Mary Pat Campbell

Link: https://www.wsj.com/articles/the-premonition-review-a-pandemic-of-experts-11620078624

Excerpt:

The article, in any case, doesn’t claim that 180,000 people could have been saved by more robust public-health interventions in early 2020 but that those deaths are mostly the result of Americans’ poor health. That the U.S. death rate, even so, is lower than that of the U.K. and Italy and nearly equal to that of France — all G7 nations — rather complicates Mr. Lewis’s breezy thesis.

It is amazing to me that intelligent people in 2021 can survey the past year and conclude that some alternative set of non-pharmaceutical interventions would have made an appreciable difference in the spread of this magnificently resilient virus. But many such people do believe that, including the author of this book and its ostensible heroes. One of those heroes, an accomplished hospital administrator named Carter Mecher, drew up a national pandemic response plan for the George W. Bush administration. The key to stopping dangerous pathogens, he came to believe as he studied pandemic modeling, was closing schools.

….

Here is a point that Mr. Lewis’s heroes show no awareness of grasping: that the United States is a big unruly country in which people are accustomed to going where they please and don’t care for government authorities telling them what to do based on poorly understood “data.” One of the Wolverines, a public-health official in Santa Barbara County named Charity Dean, appears to believe that any sign of a dangerous contagion permits health authorities to assume dictatorial powers. She tells Mr. Lewis that in early 2020 California should have closed its borders “until it figured out exactly how much virus was circulating, and where” and that the U.S. should follow Thailand’s example and require “anyone entering the country to wear a GPS wristband” and so enable the authorities to know who’s disobeying quarantine rules.

Author(s): Barton Swaim

Publication Date: 3 May 2021

Publication Site: Wall Street Journal

Book Link: https://amzn.to/3xLQZzS

Nearly 1.5 Million Mothers Are Still Missing From the Workforce

Mary Pat Campbell

Link: https://www.wsj.com/articles/nearly-1-5-million-mothers-are-still-missing-from-the-workforce-11619472229

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Excerpt:

Black and Hispanic women disproportionately work in industries — such as leisure and hospitality — that were most negatively affected by the pandemic, said Valerie Wilson, director of the Economic Policy Institute’s Program on Race, Ethnicity and the Economy.

Since February of last year, participation rates for white women, including mothers, haven’t dropped more than 3.2 percentage points. Rates for women of color — especially Black and Hispanic mothers with children under 5 — have at times fallen more.

Large numbers of Black and Hispanic women work in essential sectors — most notably healthcare — that have seen increased demand in the past year. But in those industries, according to Dr. Wilson, they tend to hold jobs that offer comparatively low pay and flexibility.

The average number of hours men and women work per week has varied more widely since the start of the pandemic than in recent years. People have worked fewer hours overall, with men’s time dropping more significantly. That has narrowed — but not closed — the gap between hours worked by men and women.

Author(s): Katherine Riley, Stephanie Stamm |

Publication Date: 27 April 2021

Publication Site: Wall Street Journal

1918 Influenza: the Mother of All Pandemics

Mary Pat Campbell

Link: https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article

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Abstract:

The “Spanish” influenza pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.

Author(s): Jeffery K. Taubenberger, David M. Morens

Publication Date: January 2006

Publication Site: CDC

Covid Is Hitting Workers Differently Than the 2008 Financial Crisis

Mary Pat Campbell

Link: https://www.ineteconomics.org/perspectives/blog/covid-is-hitting-workers-differently-than-the-financial-crisis

Excerpt:

In a new INET working paper, we examine inequality in employment outcomes across social groups during recessions. We take a comparative perspective, studying results from two recent and severe US recessions: the “Great Recession” linked with the global financial crisis beginning in late 2007 and the “lockdown” recession caused by the COVID-19 pandemic. Comparing these two events presents an interesting case study to explore inequality in recessions.

The severity of a recession depends both on how much employment declines and the persistence of those declines. The primary job-months lost statistic in our analysis is designed to capture both of these dimensions. This measure simply adds up the difference between actual employment and pre-recession employment over the recession months. For example, if the pre-recession employment trend for a demographic group was flat and a person in that group lost a job in April but went back to work in July, that person’s experience would add three job-months lost to the total in their demographic group.

Author(s): Steven Fazzari, Ella Needler

Publication Date: 19 April 2021

Publication Site: Institute for New Economic Thinking

India’s giant second wave is a disaster for it and the world

Mary Pat Campbell

Link: https://www.economist.com/leaders/2021/04/24/indias-giant-second-wave-is-a-disaster-for-it-and-the-world

Excerpt:

April 14th was a big day in India. Hindus and Sikhs gathered to mark the new year. Many Muslims celebrated the first day of Ramadan at late-night feasts with friends and family. In Haridwar, a temple town that this year hosts the Kumbh Mela, an intermittent Hindu festival that is the world’s biggest religious gathering, between 1m and 3m people shoved and jostled to take a ritual dip in the Ganges. And across the country, the number of people testing positive for covid-19 for the first time surpassed 200,000 in a single day. It has continued to surge since, reaching 315,000 just one week later—the highest daily figure in any country at any point during the pandemic. Deaths, too, are beginning to soar, and suspicions abound that the grisly official toll is itself a massive underestimate. Makeshift pyres are being constructed on pavements outside crematoriums to deal with the influx of bodies.

Publication Date: 24 April 2021

Publication Site: The Economist

Pandemic Accelerates Social Risks to Investment Portfolios

Mary Pat Campbell

Link: https://www.ai-cio.com/news/pandemic-accelerates-social-risks-investment-portfolios/

Excerpt:

According to State Street Global Advisors (SSGA)’s annual stewardship report, the COVID-19 pandemic has accelerated the trend of the increasing significance of social risks within environmental, social, and governance (ESG) risk management.

“Insufficient data remains a challenge, but the ‘S’ is undeniably more important than ever to investors and other stakeholders,” according to the report. “As a result, companies are more focused on social issues, which will likely lead to a proliferation in data over the coming years.”

The firm said it is working with the Sustainability Accounting Standards Board (SASB) and others to develop relevant key performance indicators and is refining its approach to social issues such as human capital management.

Author(s): Michael Katz

Publication Date: 29 March 2021

Publication Site: ai-CIO

5 Worst States for New COVID-19 Cases

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2021/03/30/5-worst-states-for-new-covid-19-cases/

Excerpt:

The fourth U.S. wave of COVID-19 cases has started.

It’s not yet clear whether the wave will be a big one, or a little swell tamped down by masks, vaccines and successful social distancing efforts. But the total number of new cases in the United States increased to 422,980 in the seven-day period ending March 27, up 11% from the total for the week ending March 20.

The number of cases per 100,000 residents increased to 127. That was up from 115 per 100,000 U.S. residents a week earlier, and up from a recent low of 113 per 100,000 U.S. residents two weeks earlier.

Author(s): Allison Bell

Publication Date: 30 March 2021

Publication Site: Think Advisor

How elimination versus suppression became Covid’s cold war

Mary Pat Campbell

Link: https://www.theguardian.com/commentisfree/2021/mar/03/covid-19-elimination-versus-suppression?mc_cid=919aa668d9&mc_eid=983bcf5922

Excerpt:

The rest of the world is pursuing a mitigation and suppression strategy, according to which we will have to live with Covid-19 and therefore we must learn to manage it – aiming for herd immunity by the most painless route possible. The poster child for this approach is Sweden’s chief epidemiologist, Anders Tegnell, who told me last week that elimination was a pipe dream for most of the world because even if a country were able to achieve it once, it would be impossible to prevent reintroductions without maintaining a costly and potentially restrictive surveillance apparatus. If the strategy failed, the country would have to revert to suppression anyway, but the population would have paid a much higher price. He too is in it for the long haul, he says; “sustainability” is his watchword. This is how he justifies the gradual tightening of restrictions in his country, from a very relaxed start.

And so the world is cleaved in two, with each bloc operating according to a different set of assumptions, in a kind of public health rerun of the cold war. One bloc assumes that Covid-19 can be eliminated, the other that it can’t. The latter thinks the former is chasing an impossible utopia. The former thinks the utopia could be achieved if only everyone pulled together.

Author(s): Laura Spinney

Publication Date: 3 March 2021

Publication Site: The Guardian