As part of its effort to create opportunities to share important public health information with the community, the Public Health Data and Training Center at the Institute for Public Health shares the following articles and books during this period of COVID-19 virus and sheltering at home. Here’s what we’re reading. We hope you find these writings not only helpful, but also interesting!
Urban Density Is Not an Enemy in the Coronavirus Fight: Evidence from China
This article concerns the relationship between population density and COVID-19 infections using data from China and provides insights about risk that researchers and policy makers should consider. The authors found that infection was not positively associated with the population density, and wealthier cities tended to have lower rates. This might be due to financial and infrastructure supports from the local government as well as more robust services, like affordable door-to-door delivery and high-speed internet. Another important contributor to the infection rate was financial and geographical distance to Wuhan, Hebei, where the virus was first detected. I consider this important information for policy makers to stress the importance of tracking not only the local data but also data from neighboring areas before making decisions. I push back on the article as it didn’t mention the importance of the stay-at-home order. But given the background of social distancing, it may actually be the migration of the population and supports from the government that might make a difference. –Tracy Liang, Data Analyst
The Ghost Map
My husband thought I had officially lost my mind when he caught me reading a book by Steven Johnson about an epidemic in the midst of a pandemic. But this book is difficult to put down. It tells the story of the cholera outbreak in London in 1854, and at times reads like a detective novel. Not only do we get to follow along with the scientific theories of the time, we see the inquiries unfold in the minds and lives of an unlikely duo – a physician and a member of the clergy. Their collaboration reminds me a lot of the multidisciplinary research teams of the present day who are racing to stop the spread of COVID-19. –Randi Foraker, Center Director
Health departments are concerned about spikes in STIs while attention is on COVID-19
Testing for sexually transmitted infections has fallen dramatically across the county, and in St. Louis, during the Covid-19 pandemic. This article describes the NACCHO survey of health departments that reflects what we have heard in our national conversations. Clinics have had to adjust their services, some have closed, some have moved to telemedicine and some have stopped walk-in availability. These changes will have effects on STDs, including syphilis, HIV, and PrEP care.
The CDC’s Division of STD Prevention (of which I’m a clinical team member) issued emergency guidance for sexual health care as a stop-gap measure for areas affected by COVID19. I am still seeing many people with syphilis and gonorrhea at the St. Louis County Sexual Health Clinic, so many of us are looking to the future and planning what sexual health care will need to look like alongside COVID19’s changes to healthcare. Emergency rooms, which perform a substantial number of STD tests, have seen reduced visits as people are staying away. Our contract tracers for syphilis and HIV have been moved to COVID efforts. We are collecting as much data from clinics and providers as we can to inform planning as we move forward. –Hilary Reno, Institute for Public Health Faculty Scholar
How Pandemics Change History
I read this interview with Yale history professor Frank Snowden in the New Yorker. I read it back in early March but keep returning to two ideas. The first is that the essential element of public health is information. While obvious it seemed like an important reminder. The second is that epidemics have the power to reshape us. This can happen through political or social unrest, but also through our collective grappling with moral and philosophical questions about our very humanity.
Speaking of information, here is a local piece published in Medium by Karishma Furtado of Forward Through Ferguson and Alexandra Morshed of the Prevention Training Center on the disproportionate impact of covid-19 on Black St. Louisans. They provide a well-documented narrative of testing in Missouri, and outline specific actions for the region to take to address racial equity. One of those actions is “Municipal, city, public health, and hospital leaders should provide updated downloadable data on testing numbers, cases, hospitalizations, and deaths by race.” —Anne Trolard, Center Manager