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UTHSC team’s COVID data system highlighted as model for public health preparedness, population health surveillance

When COVID-19 hit the Mid-South in 2020, researchers at the University of Tennessee Health Science Center quickly saw how Memphis was struggling to keep…

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When COVID-19 hit the Mid-South in 2020, researchers at the University of Tennessee Health Science Center quickly saw how Memphis was struggling to keep pace with the rapid advance of the pandemic. So, they got to work.

Credit: UTHSC

When COVID-19 hit the Mid-South in 2020, researchers at the University of Tennessee Health Science Center quickly saw how Memphis was struggling to keep pace with the rapid advance of the pandemic. So, they got to work.

In a report recently published in Disaster Medicine and Public Health Preparedness, senior authors David Schwartz, MD, FACR, professor and chair of the Department of Radiation Oncology in the UTHSC College of Medicine, and Arash Shaban-Nejad, PhD, MPH, associate professor and director of Population and Precision Health in the UTHSC-ORNL Center for Biomedical Informatics, outline how they helped to lead a multi-disciplinary team at UTHSC and the University of Memphis to create a unique, community-focused COVID-19 data registry intended to serve as a model to guide public health policies and interventions or community campaigns nationwide.

The registry, called the Memphis Pandemic Health Informatics System (MEMPHI-SYS), is a direct offshoot from the drive-through COVID-19 testing site at Tiger Lane at the Mid-South Fairgrounds, an initiative led by Dr. Schwartz in collaboration with the Shelby County Health Department and the City of Memphis to make COVID testing available to the public for free.

“Dr. Shaban-Nejad and I had worked together in the past to look at data science’s role in cancer treatment,” Dr. Schwartz said. “Since we were collecting clinical data, such as symptoms and patient employment status, from the Tiger Lane testing site, we decided to leverage clinical and data science expertise here at UTHSC in Memphis to start answering questions as to the epidemiology and patterns of the spread and presentation of COVID in the early days of the pandemic.”

As the report, titled The Memphis Pandemic Health Informatics System (MEMPHI-SYS) — Creating a Metropolitan COVID-19 Data Registry Linked Directly to Community Testing to Enhance Population Health Surveillance, explains, the testing sites required patients to schedule an appointment over the phone or using an online chatbot. Each patient provided their demographic information, geographic locations, medical history highlights, COVID exposure history, and risk factors for COVID complications. MEMPHI-SYS provided a platform for that patient information to be collected, analyzed, and compiled on a HIPAA-compliant dashboard where healthcare providers, community partners, public officials, and other stakeholders can access it.

According to the authors, a system like MEMPHI-SYS was desperately needed in Memphis. Dr. Schwartz said, when COVID hit, the region was lacking in resources to respond to large public health events.

“We had to do a crash course in metropolitan-level infectious disease response in the middle of the first large-scale public health emergency in our generation’s lifetime,” Dr. Schwartz said. “There’s no way to be able to respond with appropriately resourced and localized testing and intervention without data. We didn’t have that in 2020, so we were pretty much just making our best guesses as to where to put these resources and how to properly size and scope these resources.”

While it was created in response to COVID, MEMPHI-SYS was designed prospectively. Because of the registry, Dr. Shaban-Nejad said leaders will be able to make better informed decisions in the future. “The platform is data agnostic, so it is readily available to be changed to any other public health disaster,” he said. “We can use this system to guide public leaders and inform policy-making and decision-making regarding resource allocation.”

“I am so very proud of the incredible work of Dr. Schwartz and Dr. Shaban-Nejad,” said Scott Strome, MD, executive dean of the College of Medicine. “Not only were they leaders of our initial strategy to combat COVID-19, but their work also resulted in a robust tool to combat infectious threats in the future.”

According to the report, the registry will also serve as a data warehouse to help improve population health surveillance and reduce health disparities and social risks in disadvantaged neighborhoods. The UTHSC College of Medicine’s Office of Community Health Engagement plans to continue using the geographical and demographic data in MEMPHI-SYS to prioritize outreach and direct distribution of medical, behavioral, and social resources toward neighborhoods most in need.

The data can also be used to anticipate, detect, and monitor health issues that may arise in certain local areas. “If you collect historical data for a patient, you can potentially predict a patient’s future health status. Now, we can do pretty much the same thing for the entire Memphis population,” Dr. Shaban-Nejad said.

MEMPHI-SYS isn’t contributing to only the field of public health. According to Dr. Shaban-Nejad, it also helps in the advancement of artificial intelligence (AI) and data science technologies. Dr. Schwartz touted his counterpart’s work in pushing the boundaries of cutting-edge AI technologies.

“A big problem with AI is that human users cannot easily see how a particular algorithm is functioning inside of its black box,” Dr. Schwartz said. “The trailblazing aspect of Dr. Shaban-Nejad’s work is that we’re able to look under the hood. His platform can display a ‘dashboard’ that’s understandable to the human mind, showing how our AI got to its answer in the first place. What we are aiming to do is to digest a huge amount of social, economic, and epidemiologic data in a transparent, explainable way that providers, patients, and policy leaders can quickly understand and act upon, even in the thick of a public health emergency. That’s the level of preparation Memphis needs and should expect. We will lead the country in this.”

According to the paper, MEMPHI-SYS was made possible by a collaboration of clinicians, data scientists, biostatisticians, geospatial mapping experts, community outreach experts, and behavioral health specialists. Five additional senior team members are on the UTHSC faculty: Robert Davis, MD, MPH, founding director of the UTHSC-ORNL Center for Biomedical Informatics, provided biomedical informatics expertise; Fridtjof Thomas, PhD, professor in the College of Medicine’s Department of Preventive Medicine, served as the team’s data science lead; Karen C. Johnson, MD, MPH, chair of the Department of Preventive Medicine, provided mentorship and population health science experience; and Altha Stewart, MD, senior associate dean for Community Health Engagement, and Laura Harris, PhD, associate professor of psychiatry in the College of Medicine, looked at ways to implement the data after it was placed in the registry. Esra Ozdenerol, PhD, professor of geographic information systems at the University of Memphis, provided geospatial informatics expertise.


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Government

Federal Food Stamps Program Hits Record Costs In 2022

Federal Food Stamps Program Hits Record Costs In 2022

In early January, The Wall Street Journal Editorial Board warned that one peril of a…

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Federal Food Stamps Program Hits Record Costs In 2022

In early January, The Wall Street Journal Editorial Board warned that one peril of a large administrative state is the mischief agencies can get up to when no one is watching.

Specifically, they highlight the overreach of the Agriculture Department, which expanded food-stamp benefits by evading the process for determining benefits and end-running Congressional review.

Exhibit A in the over-reach is the fact that the cost of the federal food stamps program known as the Supplemental Nutrition Assistance Program (SNAP) increased to a record $119.5 billion in 2022, according to data released by the U.S. Department of Agriculture...

Food Stamp costs have literally exploded from $60.3 billion in 2019, the last year before the pandemic, to the record-setting $119.5 billion in 2022.

In 2019, the average monthly per person benefit was $129.83 in 2019, according to the U.S. Department of Agriculture. That increased by 78 percent to $230.88 in 2022.

Even more intriguing is the fact that the number of participants had increased from 35.7 million in 2019 to 41.2 million in 2022...

All of which is a little odd - the number of people on food stamps remains at record highs while the post-COVID-lockdown employment picture has improved dramatically...

Source: Bloomberg

If any of this surprises you, it really shouldn't given that 'you, the people' voted for the welfare state. However, as WSJ chided: "abuse of process doesn’t get much clearer than that."

In its first review of USDA, the GAO skewered Agriculture’s process for having violated the Congressional Review Act, noting that the “2021 [Thrifty Food Plan] meets the definition of a rule under the [Congressional Review Act] and no CRA exception applies. Therefore, the 2021 TFP is subject to the requirement that it be submitted to Congress.” GAO’s second report says “officials made this update without key project management and quality assurance practices in place.”

Abuse of process doesn’t get much clearer than that. The GAO review won’t unwind the increase, which requires action by the USDA. But the GAO report should resonate with taxpayers who don’t like to see the politicization of a process meant to provide nutrition to those in need, not act as a vehicle for partisan agency staffers to impose their agenda without Congressional approval.

All of this undermines transparency and accountability for a program that provided food stamps to some 41 million people in 2021. The Biden Administration is using the cover of the pandemic to expand the entitlement state beyond what Congress authorized.

The question now is, will House Republicans draw attention to this lawlessness and use their power of the purse to stop it to the extent possible with a Democratic Senate.

And don't forget, the US economy is "strong as hell."

Tyler Durden Sat, 01/28/2023 - 09:55

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Spread & Containment

A Royal Caribbean Cruise Line Adult Favorite Has Not Come Back

The cruise line has almost fully returned to normal after the covid pandemic, but one very popular activity hasn’t been brought back.

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The cruise line has almost fully returned to normal after the covid pandemic, but one very popular activity hasn't been brought back.

In the early days of Royal Caribbean Group's (RCL) - Get Free Report return from its 15-month covid pandemic shutdown, cruising looked a lot different. Ships sailed with limited capacities, masks were required in most indoor areas, and social distancing was a thing.

Keeping people six feet apart made certain aspects of taking a cruise impossible. Some were made easier by the lower passenger counts. For example, all Royal Caribbean Windjammer buffets required reservations to keep the crowds down, but in practice that system was generally not needed because capacities were never reached.

Dance parties and nightclub-style events had to be held on the pool decks or in larger spaces, and shows in the big theaters left open seats between parties traveling together. In most cases, accommodations were made and events more or less happened in a sort of normal fashion.

A few very popular events were not possible, however, in an environment where keeping six feet between passengers was a goal. Two of those events -- the first night balloon drop and the adult "Crazy Quest" game show -- simply did not work with social-distancing requirements.

One of those popular events has now made its comeback while the second appears to still be missing (aside from a few one-off appearances).

TheStreet

The Quest Is Still Mostly Missing

In late November, Royal Caribbean's adult scavenger hunt, "The Quest," (sometimes known as "Crazy Quest") began appearing on select sailings. And at the time it appeared like it was coming back across the fleet: A number of people posted about the return of the interactive adult game show in an unofficial Royal Caribbean Facebook group.

It first appeared during a Wonder of the Seas transatlantic sailing.

Since, then its appearances continue to be spotty and it has not returned on a fleetwide basis. This might not be due to any covid-related issues directly, but covid may play a role.

On some ships, Studio B, which hosts "The Quest," has been used for show rehearsals. That has been more of an issue with the trouble Royal Caribbean has had in getting new crew members onboard. And while that staffing issue has been improving, some shows may not have had full complements of performers, so using the space for rehearsal has been a continuing need.

In addition, while covid rules have gone away, covid has not, and ill cast members may force the need for more rehearsals.

Royal Caribbean has not publicly commented on when (or whether) "The Quest" will make a full comeback

Royal Caribbean Balloon Drops Are Back   

Before the pandemic, Royal Caribbean kicked off many of its cruises with a balloon drop on the Royal Promenade. That went away because it forced people to cluster as music was performed and, at midnight, balloons fell from the ceiling.

Now, the cruise line has brought back the balloon drop, albeit with a twist. The drop itself is appearing on activity schedules for upcoming Royal Caribbean cruises. Immediately after it, however, the cruise line has added something new: "The Big Recycle Balloon Pickup."

Most of the dropped balloons get popped during the drop. Previously, crewmembers picked up the used balloons. Now, the cruise line has made it a "fun" passenger activity.

"Get environmentally friendly as you help us gather our 100% biodegradable balloons in recycle baskets," the cruise line shared in its app. 

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Spread & Containment

What’s Still Missing on Royal Caribbean Cruises Post Covid

The cruise line has almost fully returned to normal after the covid pandemic, but one very popular activity hasn’t been brought back.

Published

on

The cruise line has almost fully returned to normal after the covid pandemic, but one very popular activity hasn't been brought back.

In the early days of Royal Caribbean Group's (RCL) - Get Free Report return from its 15-month covid pandemic shutdown, cruising looked a lot different. Ships sailed with limited capacities, masks were required in most indoor areas, and social distancing was a thing.

Keeping people six feet apart made certain aspects of taking a cruise impossible. Some were made easier by the lower passenger counts. For example, all Royal Caribbean Windjammer buffets required reservations to keep the crowds down, but in practice that system was generally not needed because capacities were never reached.

Dance parties and nightclub-style events had to be held on the pool decks or in larger spaces, and shows in the big theaters left open seats between parties traveling together. In most cases, accommodations were made and events more or less happened in a sort of normal fashion.

A few very popular events were not possible, however, in an environment where keeping six feet between passengers was a goal. Two of those events -- the first night balloon drop and the adult "Crazy Quest" game show -- simply did not work with social-distancing requirements.

One of those popular events has now made its comeback while the second appears to still be missing (aside from a few one-off appearances).

TheStreet

The Quest Is Still Mostly Missing

In late November, Royal Caribbean's adult scavenger hunt, "The Quest," (sometimes known as "Crazy Quest") began appearing on select sailings. And at the time it appeared like it was coming back across the fleet: A number of people posted about the return of the interactive adult game show in an unofficial Royal Caribbean Facebook group.

It first appeared during a Wonder of the Seas transatlantic sailing.

Since, then its appearances continue to be spotty and it has not returned on a fleetwide basis. This might not be due to any covid-related issues directly, but covid may play a role.

On some ships, Studio B, which hosts "The Quest," has been used for show rehearsals. That has been more of an issue with the trouble Royal Caribbean has had in getting new crew members onboard. And while that staffing issue has been improving, some shows may not have had full complements of performers, so using the space for rehearsal has been a continuing need.

In addition, while covid rules have gone away, covid has not, and ill cast members may force the need for more rehearsals.

Royal Caribbean has not publicly commented on when (or whether) "The Quest" will make a full comeback

Royal Caribbean Balloon Drops Are Back   

Before the pandemic, Royal Caribbean kicked off many of its cruises with a balloon drop on the Royal Promenade. That went away because it forced people to cluster as music was performed and, at midnight, balloons fell from the ceiling.

Now, the cruise line has brought back the balloon drop, albeit with a twist. The drop itself is appearing on activity schedules for upcoming Royal Caribbean cruises. Immediately after it, however, the cruise line has added something new: "The Big Recycle Balloon Pickup."

Most of the dropped balloons get popped during the drop. Previously, crewmembers picked up the used balloons. Now, the cruise line has made it a "fun" passenger activity.

"Get environmentally friendly as you help us gather our 100% biodegradable balloons in recycle baskets," the cruise line shared in its app. 

Read More

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