Comparative Analysis of COVID-19 Prevalence in Coastal Versus Inland Populations of North Carolina
DOI:
https://doi.org/10.47265/cjim.v1i1.546Keywords:
COVID-19, North Carolina, Environmental HealthAbstract
Statement of Significance
This study aimed to assess geographic trends in COVID-19 cases and deaths across North Carolina (NC). Our study found that population-adjusted COVID-19 cases and deaths were lower in the coastal region of NC during the study period, independent of demographic composition and population-density within the region. This represents an interesting finding regarding COVID-19 transmission that deserves further investigation. One possible explanation for this finding is differing environmental conditions between the inland and coastal region.
Background: Existing literature has explored the geographic and spatial variations in COVID-19 prevalence. Some studies suggest that the transmission and total prevalence of COVID-19 is diminished in areas with low levels of air pollution, high humidity, and more sunlight. The coastal regions of NC are more likely to have these environmental characteristics than the inland regions. Given these trends, we analyzed and compared population-adjusted COVID-19 case and death counts in the coastal and inland regions of NC.
Methods: Time series data displaying the prevalence of population adjusted COVID-19 case and death counts from 15 March 2020 to 15 August 2020 were plotted for a variety of North Carolina regional and population density classifications. A local regression analysis was computed to further assess the observed relationships. Basic demographic characteristics were also compared for the coastal versus inland region.
Results: There were fewer population-adjusted COVID-19 cases and deaths in the coastal region (889 cases/100,000; 12.5 deaths/100,000) than in the inland region (1426 cases/100,000; 23.5 deaths/100,000) at the endpoint of this study. This trend is observed even when controlling for population density, and in the absence of significant demographic differences between the two regions.
Conclusions: The prevalence of population-adjusted COVID-19 cases and deaths was lower in coastal versus inland NC during this study period. Given that the NC coastal region is associated with lower pollution, higher humidity, and more exposure to sunlight, our findings suggest that more research should be done to explore the correlation between environmental variables and the spread of COVID-19.
References
Ahmad FB, Cisewski JA, Miniño A, Anderson RN. Provisional Mortality Data — United States, 2020. Morb Mortal Wkly Rep. 2021;70(14):519-522. doi:10.15585/mmwr.mm7014e1
Fang Y, Nie Y, Penny M. Transmission dynamics of the COVID‐19 outbreak and effectiveness of government interventions: A data‐driven analysis. J Med Virol. 2020;92(6):645-659. doi:10.1002/jmv.25750
Gold JAW, Rossen LM, Ahmad FB, et al. Race, Ethnicity, and Age Trends in Persons Who Died from COVID-19 — United States, May–August 2020. Morb Mortal Wkly Rep. 2020;69(42):1517-1521. doi:10.15585/mmwr.mm6942e1
Garg S, Kim L, Whitaker M, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. Morb Mortal Wkly Rep. 2020;69(15):458-464. doi:10.15585/mmwr.mm6915e3
Gausman J, Langer A. Sex and Gender Disparities in the COVID-19 Pandemic. J Womens Health. 2020;29(4):465-466. doi:10.1089/jwh.2020.8472
Hoekman LM, Smits MMV, Koolman X. The Dutch COVID-19 approach: Regional differences in a small country. Health Policy Technol. 2020;9(4):613-622. doi:10.1016/j.hlpt.2020.08.008
Holmager TL, Lynge E, Kann CE, St-Martin G. Geography of COVID-19 in Denmark. Scand J Public Health. 2021;49(1):88-95. doi:10.1177/1403494820975607
Parcha V, Malla G, Suri SS, et al. Geographic Variation in Racial Disparities in Health and Coronavirus Disease-2019 (COVID-19) Mortality. Mayo Clin Proc Innov Qual Outcomes. 2020;4(6):703-716. doi:10.1016/j.mayocpiqo.2020.09.005
Sun F, Matthews SA, Yang T-C, Hu M-H. A spatial analysis of the COVID-19 period prevalence in U.S. counties through June 28, 2020: where geography matters? Ann Epidemiol. 2020;52:54-59.e1. doi:10.1016/j.annepidem.2020.07.014
Gatto M, Bertuzzo E, Mari L, et al. Spread and dynamics of the COVID-19 epidemic in Italy: Effects of emergency containment measures. Proc Natl Acad Sci. 2020;117(19):10484-10491. doi:10.1073/pnas.2004978117
Henning A, McLaughlin C, Armen S, Allen S. Socio-spatial influences on the prevalence of COVID-19 in central Pennsylvania. Spat Spatio-Temporal Epidemiol. 2021;37:100411. doi:10.1016/j.sste.2021.100411
Moriyama M, Hugentobler WJ, Iwasaki A. Seasonality of Respiratory Viral Infections. Annu Rev Virol. 2020;7(1). doi:10.1146/annurev-virology-012420-022445
Domingo JL, Rovira J. Effects of air pollutants on the transmission and severity of respiratory viral infections. Environ Res. 2020;187:109650. doi:10.1016/j.envres.2020.109650
Zoran MA, Savastru RS, Savastru DM, Tautan MN. Assessing the relationship between surface levels of PM2.5 and PM10 particulate matter impact on COVID-19 in Milan, Italy. Sci Total Environ. 2020;738:139825. doi:10.1016/j.scitotenv.2020.139825
Passerini G, Mancinelli E, Morichetti M, Virgili S, Rizza U. A Preliminary Investigation on the Statistical Correlations between SARS-CoV-2 Spread and Local Meteorology. Int J Environ Res Public Health. 2020;17(11):4051. doi:10.3390/ijerph17114051
Iqbal MM, Abid I, Hussain S, Shahzad N, Waqas MS, Iqbal MJ. The effects of regional climatic condition on the spread of COVID-19 at global scale. Sci Total Environ. 2020;739:140101. doi:10.1016/j.scitotenv.2020.140101
Martins LD, da Silva I, Batista WV, de Fátima Andrade M, de Freitas ED, Martins JA. How socio-economic and atmospheric variables impact COVID-19 and influenza outbreaks in tropical and subtropical regions of Brazil. Environ Res. 2020;191:110184. doi:10.1016/j.envres.2020.110184
Sagripanti J, Lytle CD. Estimated Inactivation of Coronaviruses by Solar Radiation With Special Reference to COVID‐19. Photochem Photobiol. Published online June 5, 2020:php.13293. doi:10.1111/php.13293
Ratnesar-Shumate S, Williams G, Green B, et al. Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces. J Infect Dis. Published online May 20, 2020:jiaa274. doi:10.1093/infdis/jiaa274
Cheng B, Wang-Li L, Meskhidze N, Classen J, Bloomfield P. Spatial and temporal variations of PM2.5 mass closure and inorganic PM2.5 in the Southeastern U.S. Environ Sci Pollut Res. 2019;26(32):33181-33191. doi:10.1007/s11356-019-06437-8
Robinson PJ. North Carolina Weather and Climate. University of North Carolina Press; 2005.
Boyles RP, Raman S. Analysis of climate trends in North Carolina (1949–1998). Environ Int. 2003;29(2-3):263-275. doi:10.1016/S0160-4120(02)00185-X
Patterson T. Geographic Pattern Analysis of North Carolina Climate Division Data: 1895–2013. Southeast Geogr. 2014;54(3):308-322. doi:10.1353/sgo.2014.0021
Rollston R, Galea S. COVID-19 and the Social Determinants of Health. Am J Health Promot. 2020;34(6):687-689. doi:10.1177/0890117120930536b
Coastal Area Management Act. NC Department of Environmental Quality. Accessed May 11, 2021. https://deq.nc.gov/about/divisions/coastal-management/coastal-management-rules/cama
The North Carolina Rural Center. NC Rural Center 2015 Impacts Report.; 2016. https://www.ncleg.gov/documentsites/committees/BCCI-6678//4-6-16/NCRC3%20Rural_Center_Impacts_Report.pdf4-6-16.pdf
SimplyAnalytics. Accessed August 5, 2020. https://simplyanalytics.com/
Azar KMJ, Shen Z, Romanelli RJ, et al. Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California. Health Aff (Millwood). 2020;39(7):1-8. doi:10.1377/hlthaff.2020.00598
Stein RA, Ometa O. When Public Health Crises Collide: Social Disparities and COVID‐19. Int J Clin Pract. Published online May 14, 2020. doi:10.1111/ijcp.13524
Coronavirus Live Map | US Coronavirus Cases by County. USAFacts. Accessed June 16, 2020. https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/
Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) in the U.S. Centers for Disease Control and Prevention. Published June 17, 2020. Accessed June 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
North Carolina Identifies First Case of COVID-19. North Carolina Department of Health and Human Services. Published March 3, 2020. Accessed June 11, 2021. https://www.ncdhhs.gov/news/press-releases/2020/03/03/north-carolina-identifies-first-case-covid-19
Airhihenbuwa CO, Webster JD. Culture and African contexts of HIV/AIDS prevention, care and support. J Soc Asp HIVAIDS. 2004;1(1):4-13. doi:10.1080/17290376.2004.9724822
McNeill WH. Plagues and Peoples. Anchor Books; 1976.
Iliffe J. The African AIDS Epidemic: A History. Boydell & Brewer; 2016.
Menachemi N, Yiannoutsos CT, Dixon BE, et al. Population Point Prevalence of SARS-CoV-2 Infection Based on a Statewide Random Sample — Indiana, April 25–29, 2020. Morb Mortal Wkly Rep. 2020;69(29):960-964. doi:10.15585/mmwr.mm6929e1
Centers for Disease Control and Prevention. CDC Diagnostic Test for COVID-19. Published February 11, 2020. Accessed June 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/lab/testing.html
World Health Organization. Laboratory testing strategy recommendations for COVID-19. Published online March 21, 2020. https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf
WSOCTV.com News Staff. Here’s a list of North Carolina beaches that will reopen with restrictions during Phase 1. WSOC-TV. Published May 8, 2020. Accessed May 13, 2021. https://www.wsoctv.com/news/local/heres-list-north-carolina-beaches-that-will-reopen-with-restrictions-during-phase-1/MODAS4ORDJACFEYGUS4LWLWU7Q/
Featherston E. State of Emergency: Beach towns respond to COVID-19. WETC News. Accessed May 13, 2021. https://www.wect.com/2020/03/23/state-emergency-beach-towns-respond-covid-/
New Hanover County declares State of Emergency, limits gatherings to 10, closes public beach access to prevent spread of COVID-19. New Hanover County Communications and Outreach. Published March 20, 2020. Accessed May 13, 2021. https://news.nhcgov.com/news-releases/2020/03/new-hanover-county-declares-state-of-emergency-limits-gatherings-to-10-closes-public-beach-access-to-prevent-spread-of-covid-19/
Guo C, Bo Y, Lin C, et al. Meteorological factors and COVID-19 incidence in 190 countries: An observational study. Sci Total Environ. 2021;757:143783. doi:10.1016/j.scitotenv.2020.143783
Liu J, Zhou J, Yao J, et al. Impact of meteorological factors on the COVID-19 transmission: A multi-city study in China. Sci Total Environ. 2020;726:138513. doi:10.1016/j.scitotenv.2020.138513
Wang J, Tang K, Feng K, et al. High Temperature and High Humidity Reduce the Transmission of COVID-19. ArXiv200305003 Q-Bio. Published online May 22, 2020. Accessed May 13, 2021. http://arxiv.org/abs/2003.05003
Cacho PM, Hernández JL, López-Hoyos M, Martínez-Taboada VM. Can climatic factors explain the differences in COVID-19 incidence and severity across the Spanish regions?: An ecological study. Environ Health. 2020;19(1):106. doi:10.1186/s12940-020-00660-4
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Austin J. Allen, Brice L. Bowrey, Aaron Gelinne, MD, Shawn Ahuja, Carolyn S. Quinsey, MD
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
