Digital Commons Network^™

Covid-19 And Investors' Trading Behavior: Evidence From The New Zealand Equity Market, Finn West Wilkinson, Marinela Adriana Finta, Olena Onishchenko

Research Collection Lee Kong Chian School Of Business

This paper examines the trading behavior of retail and institutional investors during the COVID-19 pandemic in New Zealand. Using transaction-level data, it compares how retail and institutional investors trade over the government announcements, lockdown, and reopening periods. Retail and institutional investors' trading intensifies around government announcements, which facilitates attenuating illiquidity during the lockdown. Nevertheless, while retail trading is substantially more prominent during the lockdown than over the control and reopening periods, institutional investors do not trade significantly more per se or on announcements during the lockdown but trade less during the reopening. Their trading also relates to contemporaneous returns, and …

Art In Public: Potential Public Pedagogy Post-Pandemic, Lyndall Adams, Nicola Kaye, Emma Jayakumar, Clive Barstow, Harrison See

Research outputs 2022 to 2026

This article speculates how art in public space might evolve in a COVID-19 world. We examine the complexity embedded within the realm of public space using two public art projects as case studies: an artwork produced as part of an artist residency inside the Parliament of Western Australia and a public artwork commission for a highway interchange at Wanneroo, Western Australia. Both projects are used as examples to speculate on how we might navigate the complexity and possibilities for art in public as a consequence of a refiguration of such public spaces resulting from COVID-19 prevention measures. This article postulates …

Vaccination As A Protective Factor Against Hospitalization For Sars-Cov-2 Infections: An Observational Study Using Surveillance Data, Chandrayani Simanjorang, Kristin Mutiara Tarigan, Diva Anita Churiana Sudrajat, Rana Zahra Raniyah Wangsawinangun, Asy Syifa Anwari Zahra

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Death due to SARS-CoV-2 generally occurs in patients requiring hospital care (hospitalization). However, it is still unclear whether vaccination acts as a protective factor against hospitalization in SARS-CoV-2 patients in Indonesia. This study examines the association between vaccination and hospitalization among SARS-CoV-2 patients. It employs a quantitative, cross-sectional design using secondary data from SARS-CoV-2 surveillance records at the Jakarta Health Agency (January–August 2021). Findings show that patients who received the 1st vaccine dose had a 0.34 times lower risk of hospitalization compared to unvaccinated individuals (aPOR=0.34; 95% CI=0.31–0.38). Those who received the 2nd dose had an even lower risk (aPOR=0.16; …

Behavioral Changes Of Tourists Caused By The Covid-19 And Management Response :During The Goto Travel Campaign In 2020, Yoshiki Murase

Japanese Society and Culture

This research set out to clarify how consumers perceive and change their tourism consumption as the government works on demand-stimulating measures such as the GoTo Travel campaign set up as a response to the worldwide spread of the COVID-19. The main purpose of this study is to give some suggestions about how the tourism industry can operate in such difficult circumstances and consider the implications for its management. Firstly, we referred to previous research and the latest data concerning travel agencies, the airline industry, and the accommodation and restaurant industry. These are the cornerstones of the tourism industry, and they …

Dock2 Deficiency And Gata2 Haploinsufficiency Can Underlie Critical Coronavirus Disease 2019 (Covid-19) Pneumonia, Sajjad Biglari, Leila Youssefian, Mohammad Amin Tabatabaiefar, Amir Hossein Saeidian, Bahareh Abtahi-Naeini, Erfan Khorram, Roya Sherkat, Atefeh Sohanforooshan Moghaddam, Fatemeh Mohaghegh, Maziyar Rahimi, Hamid Rahimi, Sharareh Babaei, Mohammad Shahrooei, Nikoo Mozafari, Shirin Zaresharifi, Fatemeh Vahidnezhad, Vida Homayouni, Lam C Tsoi, Johann E Gudjonsson, Hakon Hakonarson, Jean-Laurent Casanova, Emmanuelle Jouanguy, Vivien Béziat, Qian Zhang, Aurélie Cobat, Hassan Vahidnezhad

Faculty, Staff and Students Publications

The life-threatening coronavirus disease 2019 (COVID-19) affects about 1 in 1,000 healthy people under 50 without underlying conditions. Among patients with critical COVID-19 pneumonia, rare germline variants at genes controlling type I IFN immunity have been reported in up to 5% of patients. Causal etiologies in 80-85% of cases are still unknown. We analyzed two families with hypoxemic COVID-19 pneumonia for known single-gene inborn errors of immunity. In Family 1, two siblings with critical COVID-19 were homozygous for a DOCK2 variant, c.3624+5G>A. DOCK2 deficiency is a known T-cell disorder underlying severe viral diseases. The variant resulted in skipping exon …

The Influence Of Improved Access To Alcohol-Based Hand Rub And Hand Hygiene Training In Healthcare Facilities On Hand Hygiene Adherence In Belize During Covid-19: June 2021-August 2022., Kelsey Mcdavid, Anh N Ly, Nicholas Bivens, Francis Morey, Gerhaldine Morazan, Russell Manzanero, Melissa Musa-Diaz, Alexandra Medley, Kristy O Murray, Matthew J Lozier

Faculty, Staff and Students Publications

Access to hand hygiene (HH) resources in clinical settings is important to prevent healthcare-associated infections, including COVID-19. However, many countries, including Belize, have limited national data on the availability of HH resources and healthcare worker (HCW) hand hygiene adherence (HHA) in healthcare facilities (HCFs). We conducted a study in the 11 largest public HCFs across Belize to evaluate access to HH resources and HHA before and after an intervention (provision of alcohol-based hand rub (ABHR) wall mounts and HH training). Descriptive statistics and multilevel logistic regressions were used to assess changes in HH resources and HHA from baseline to follow-up …

Dynamic Gene Attention Focus (Dygaf): Enhancing Biomarker Identification Through Dual-Model Attention Networks, Md Khairul Islam, Himanshu Wagh, Hairong Wei

Michigan Tech Publications

The DyGAF model, which stands for Dynamic Gene Attention Focus, is specifically designed and tailored to address the challenges in biomarker detection, progression reporting of pathogen infection, and disease diagnostics. The DyGAF model introduced a novel dual-model attention-based mechanism within neural networks, combined with machine learning algorithms to enhance the process of biomarker identification. The model transcended traditional diagnostic approaches by meticulously analyzing gene expression data. DyGAF not only identified but also ranked genes based on their significance, revealing a comprehensive list of the top genes essential for disease detection and prognosis. In addition, KEGG pathways, Wiki Pathways, and Gene …

Cabin Crew Leadership Styles During Covid-19: A Case Of Thailand, Phobphison Phob-Udom, Thanavutd Chutiphongdech, Teepakorn Kampitak

Asia-Pacific Social Science Review

The COVID-19 pandemic significantly impacted the airline industry, causing a sharp decline in international air travel. To survive, airlines quickly adopted cost-cutting strategies, including human resource retrenchments. These job losses created widespread job insecurity, leading to negative consequences such as depression, lower motivation, job dissatisfaction, and a decline in overall productivity among cabin crews. During a crisis, leadership becomes a strategic tool for maintaining employee performance, as leadership styles play a key role in reducing job stress and anxiety among subordinates. Although studies on crisis leadership in tourism and hospitality are somewhat prevalent, little attention has been paid to the …

Faculty Views About Their Covid-19 Layoffs From A Public University In The Us Midwest, Susan E. Ramlo

Journal of Collective Bargaining in the Academy

In July 2020, a public university in the US Midwest announced it would lay off 96 bargaining unit faculty based on a force majeure clause in the union contract. Most of the faculty held tenure and some were distinguished professors. The layoffs occurred with no faculty input and immediately following a major university reorganization. This study uses Q methodology [Q] to examine the Perceived Organizational Support [POS] of these laid off unionized faculty within an agency theory framework. Q allows us to reveal and describe the divergent views of the laid off faculty based upon analyses of their sorts of …

Critical Appraisal Of Multidrug Therapy In The Ambulatory Management Of Patients With Covid-19 And Hypoxemia Part I. Evidence Supporting The Strength Of Association, Eleftherios Gkioulekas, Peter A. Mccullough, Colleen Aldous

School of Mathematical & Statistical Sciences Faculty Publications

This critical appraisal is focused on three published case series of 119 COVID-19 patients with hypoxemia who were successfully treated in the United States, Zimbabwe, and Nigeria with similar off-label ivermectin-based multidrug treatments that may include ivermectin, nebulized nanosilver, doxycycline, zinc, Vitamins C, and Vitamin D, resulting in rapid recovery of oxygen levels. We used a simplified self-controlled case series method to investigate the association between treatment and the existence of hospitalization rate reduction. External controls of hospitalized patients were compared against the subgroup of patients with baseline room air SpO2 ≤ 90% to investigate the association between treatment and …

Critical Appraisal Of Multidrug Therapy In The Ambulatory Management Of Patients With Covid-19 And Hypoxemia. Part Ii: Causal Inference Using The Bradford Hill Criteria, Eleftherios Gkioulekas, Peter A. Mccullough, Colleen Aldous

School of Mathematical & Statistical Sciences Faculty Publications

We continue the critical appraisal of three published case series of 119 COVID-19 patients with hypoxemia, treated in the United States, Zimbabwe, and Nigeria with similar ivermectin-based multidrug treatments, to assess the available evidence supporting a causal relationship between treatment and reduction in hospitalizations and mortality. A narrative review was conducted to assess the Bradford Hill criteria for a causal association. We used a previously proposed refinement of the Bradford Hill criteria that reorganized them into three categories of direct, mechanistic, and parallel evidence. The efficacy of the two most aggressive ivermectin-based multidrug protocols is supported by the Bradford Hill …

What Happens In Vegas, Stays In Vegas. Or Does It?: A Dormant Commerce Clause Analysis Of Nevada’S Online Sports Gambling In-Person Registration Requirement, Lena E. Richardson

San Diego Law Review

Is the in-person registration requirement Nevada’s last-ditch effort to keep what happens in Vegas, in Vegas? This Comment argues that Nevada violates the Dormant Commerce Clause by requiring in-person registration for online sports betting. Part II introduces Nevada’s sports gaming regulations, history, regulatory scheme, and the potentially impacted industries. Part III discusses the relevant law on the Dormant Commerce Clause under a discrimination test. Part IV analyzes Nevada’s in-person registration requirement under the Dormant Commerce Clause and discusses legitimate local purposes for the regulation and reasonable alternatives, concluding that the regulation violates the Dormant Commerce Clause. Part V proposes that …

The Impact Of Covid-19 On The United States Higher Education System, Phoenix Daniel Van Wormer

University Honors Theses

In the spring of 2020, colleges across the United States rapidly transitioned to online/remote learning during the COVID-19 global pandemic. Since then, online and remote learning have evolved into an integral component of higher education. This thesis examines the extent to which COVID-19-mandated remote and online learning impacted students pursuing higher education in the United States. By utilizing research that compares academic structures before and after the pandemic, I demonstrate how the shift to online and remote learning has changed teaching and learning methods. I also evaluate the impact of these changes on student performance and engagement, with particular focus …

Covid-19 Conspiracies: A Bodyguard Of Lies, Chris Hables Gray

Secrecy and Society

No abstract provided.

A Narrative Review Of The Covid-19 Infodemic And Censorship In Healthcare, Mitchell Liester, Sohaib Ashraf, Patricia Callisperis, Hector Carvallo, Shankara Chetty, Robert Enzenauer, Carlos Franco-Paredes, Raul Pineda, Panagis Polykretis, Rachel Wilkenson, Peter Mccullough

Secrecy and Society

Ideological and financial motivations have undermined science for decades. In this narrative review, we explore how organizations and governments used misinformation, disinformation, censorship, and secrecy to manage the COVID-19 pandemic. Various rationales for employing censorship and secrecy during the COVID-19 pandemic are examined including how organizations and governments create confusion about the risks associated with their products and blame avoidance to shift responsibility and to avoid accountability for their actions. Methods of censorship employed during the COVID-19 pandemic are reviewed, examples are provided, and the consequences of these actions are reviewed. Information included in this review was obtained from scientific …

Covid Cover-Up: Secrecy, Censorship And Suppression During The Pandemic, Brian Martin

Secrecy and Society

During the height of the COVID-19 pandemic, most health authorities, governments, and mass media organizations presented a single official view concerning lockdowns, masking, distancing, and vaccines. The methods used against contrary views can be classified into four types: flooding, ignoring, censoring, and attacking. The method of information flooding involves presenting dominant views in a unified front, overwhelming contrary views by volume and consistency. The method of ignoring includes the absence of research on alternative approaches, failure to report on research contrary to orthodoxy, and not mentioning challenging views. Censoring involves active measures to prevent the circulation of contrary information and …

Association Of Messenger Rna Coronavirus Disease 2019 (Covid-19) Vaccination And Reductions In Post Covid Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection In A Us Prospective Cohort Of Essential Workers, Josephine Mak, Sana Khan, Amadea Britton, Spencer Rose, Lisa Gwynn, Katherine D Ellingson, Jennifer Meece, Leora R Feldstein, Harmony Tyner, Laura J Edwards, Matthew S Thiese, Allison Naleway, Manjusha Gaglani, Natasha Solle, Jefferey L Burgess, Julie Mayo Lamberte, Meghan Shea, Taryn Hunt-Smith, Alberto Caban-Martinez, Cynthia Porter, Ryan Wiegand, Ramona Rai, Kurt T Hegmann, James Hollister, Ashley Fowlkes, Meredith Wesley, Andrew L Philips, Patrick Rivers, Robin Bloodworth, Gabriella Newes-Adeyi, Lauren E W Olsho, Sarang K Yoon, Sharon Saydah, Karen Lutrick

Center for Medical Ethics and Health Policy Staff Publications

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was …

Supporting Local-Food Businesses To Conduct E-Commerce During Covid-19 Through Remote Student Internships, Angel Cruz, Barry Nash, Daniel Holloman, Joyce Yao

Journal of Extension

During the peak of the COVID-19 pandemic, the global lockdowns changed the way food was accessed and prepared. These changes at the consumer level impacted farms and fisheries of all types and sizes. To compensate for the loss of larger markets and restaurant revenue, small-scale food producers pivoted to direct marketing to remain viable during the pandemic. However, not all businesses and producers had the time, skills or flexibility needed for a direct marketing business model. To support producers, the North Carolina Local Food Council developed a new internship program: Remote Internship to Support Enterprises (RISE) for Local Foods. The …

Regional Government Preparedness In Response To The Covid-19 Pandemic In Indonesia, Eme Stepani Sitepu, Dumilah Ayuningtyas, Purnawan Junadi, Satibi Satibi

Journal of Health Research

Background: The high number of COVID-19 cases in Indonesia, with 6,811,201 people affected and 161,844 deaths up to June 2023, was influenced by regional governments' varying approaches to disease control. This study aimed to analyze regional government preparedness in response to the COVID-19 pandemic and the factors that influenced their preparedness.

Methods: We conducted a qualitative research study using purposive sampling. We collected data from September 2023 to April 2024 via semi-structured interviews with staff at health and disaster agencies in Bali and West Java. The interview guide was developed using the Six Building Blocks of World Health Organization (WHO)’s …

Experiences Of Caregivers Of Children With Covid-19 In Isolation Rooms: A Qualitative Study Conducted At Queen Sirikit National Institute Of Child Health In Bangkok, Thailand, Kidjapan Pinchai, Surasak Treenai, Chollada Jongsomjitt

Journal of Health Research

Background: Children were significantly impacted during COVID-19 surges, especially with highly transmissible variants like Delta. This study explored caregivers' experiences of children with COVID-19 in hospital isolation rooms, focusing on psychological and practical challenges.

Methods: Qualitative methods were used to describe the experiences of caregivers of children with COVID-19. Data were collected through in-depth interviews and from field and observation notes to capture reflections, ideas, and meanings. Content analysis was used to generate themes until saturation was reached with seven participants. The study was conducted at the Queen Sirikit National Institute of Child Health (QSNICH) in Bangkok, Thailand.

Results: The …

Impact Of Changes In Gestational Diabetes Mellitus Diagnostic Criteria During The Covid-19 Pandemic, Jessica Neville, Kelly Foley, Seán Lacey, Antoinette Tuthill, Oratile Kgosidialwa, Mairead O’Riordan, Fiona O’Halloran, Seán J. Costelloe

Department of Biological Sciences Publications

Background/Aims

During the COVID-19 pandemic, the Health Service Executive (HSE) and Royal College of Obstetricians and Gynaecologists (RCOG) recommended fasting and random plasma glucose (FPG/RPG) alongside glycated haemoglobin (HbA1c) to replace the oral glucose tolerance test (OGTT) for diagnosing Gestational Diabetes Mellitus (GDM).

Methods

The study compared testing patterns and diagnostic rates for GDM before and after implementing the RCOG guidelines (01/05/2020) in pregnancies beginning 01/11/2018 to 31/03/2021. Trends were inspected using Cochrane-Armitage tests. Differences between General Practice (GP) and Secondary Care (SCare) were assessed by chi-square analysis. A significance level of p <  0.05 was used for all analyses. Information on maternal and pregnancy characteristics was accessed where available.

Results

Data indicated a significant reduction in …

Digital Storytelling To Communicate Covid-19 Research Efforts, Carolyn E. Gray, Kelly Waters, Kathyrn Bizier, Brenda M. Joly

Journal of Maine Medical Center

Problem statement: COVID-19 was a once-in-a-century pandemic that hit the world in March 2020. Overnight, the SARS-CoV-2 virus threatened not only survival, but also food security, social supports, transportation issues, financial constraints, and more. Timely research became crucial to understanding how to mitigate viral spread, treat patients, and address the consequences and health implications.

Background: Advancing the infrastructure to support research in northern New England has been the focus of the Northern New England Clinical and Translational Research (NNE-CTR) Network since 2017. The NNE-CTR Network is a multi-year initiative in Maine, Vermont, and New Hampshire that brings together academic institutions, …

New Onset Atrial Fibrillation In Hospitalized Patients, Arafat Ali Farooqui, Syed Mohammad Mazhar Uddin, Sanjay Kumar Maheshwari, Kevin Clements, Rabiah Ashraf, Jay Keith, Neha Sharma, Haris Bilal, Naira Saleem, Vijay S. Shetty

Journal of Community Hospital Internal Medicine Perspectives

Objectives: To evaluate different factors precipitating new onset atrial fibrillation (AF) in hospitalized patients and their effect on in-patient mortality.

Design: Retrospective cross-sectional study

Setting: Urban tertiary care center in New York City

Measurements:

Primary outcomes:

• Determine different factors precipitating new onset atrial fibrillation in hospitalized patients and their effect on in-patient mortality

Secondary outcomes:

• Determine the duration of hospital stay after admission precipitating new onset atrial fibrillation and its effect on mortality
• Evaluate different factors in COVID-19 patients with new onset atrial fibrillation

Results: Out of 464 patients; 62.3% were males and 37.72% were females. Evaluation of patients before …

Overcoming Vaccine Hesitancy: Evidence From Italy During The Covid-19 Pandemic, Alessandro Del Ponte, Audrey De Dominicis, Paolo Canofari

Political Science Faculty Articles and Research

Objectives

Study design

Investing In Residential Real Estate: Understanding Homebuilder Exchange-Traded Fund Performance, Robert W. Mcleod, Davinder K. Malhotra

School of Business Faculty Papers

Homebuilder ETFs provide investors with a diversified portfolio of residential construction and sales companies which reduces risks associated with individual stock selection in the sector. This study examines the net monthly returns of homebuilder exchange-traded funds (ETFs) through various performance evaluation models and market situations. The results reveal that these ETFs outperformed benchmark indices in absolute returns. Despite homebuilding being part of the real estate sector, the correlation between monthly returns of homebuilder ETFs and the Dow Jones US Real Estate Index, though positive, is not very high. The performance of ETFs varied across market conditions, demonstrating both outperformance and …

The Cost-Effectiveness Of Long-Term Post-Treatment Peer Recovery Support Services In The United States, Sierra Castedo De Martell, Margaret Brannon Moore, Hannah Wang, Lori Holleran Steiker, J Michael Wilkerson, Nalini Ranjit, Sheryl A Mccurdy, H Shelton Brown

Faculty, Staff and Student Publications

Background:

Peer recovery support services (PRSS) have been widely adopted across a variety of settings, but little is known about their economic impact.

Objectives:

To conduct a cost-effectiveness analysis of long-term, PRSS delivered after specialty substance use disorder (SUD) treatment (post-treatment), and to describe the development of a free, web-based cost-effectiveness calculator based on this analysis.

Methods:

Using publicly-available data from a variety of sources, post-treatment PRSS were compared to specialty SUD treatment from the societal (broad perspective including costs like participant time) and health systems perspectives (only costs borne by health system), and in terms of quality-adjusted life years …

Trends In Respiratory Pathogen Testing At Us Children's Hospitals., Matthew J. Molloy, Matthew Hall, Jessica L. Markham, Jillian M. Cotter, Elisha Mccoy, Michael J. Tchou, Megan E. Collins, Michael J. Steiner, John R. Stephens, Andrew G. Yu, Irma T. Ugalde, Rustin B. Morse, Monika K. Goyal, Samantha A. House

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood.

OBJECTIVE: To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (agedyears) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective serial cross-sectional study included emergency department (ED) encounters and hospitalizations in US children's hospitals among children and adolescents with a primary acute infectious respiratory illness diagnosis. Data were ascertained from the …

The Importance Of Country Of Origin In Vaccine Messaging For H-2a Farmworkers, Anna M. Scheyett, Maria Bowie, Virginia Brown, Andrea Scarrow

Journal of the Georgia Public Health Association

Background: H-2A farmworkers are disproportionately vulnerable to COVID-19 and understanding their beliefs regarding COVID-19 vaccines is important for public health outreach, yet to date little research has examined the influence of country of origin (COO) on the vaccine beliefs of this uniquely transient population.

Methods: Three focus groups (N=30) were held with H-2A farmworkers in South Georgia to explore their beliefs on COVID-19 vaccines, using thematic analyses to identify COO influences on these beliefs.

Results: Family in COO influenced worker vaccine beliefs through direct advice, commonly held beliefs in COO about harmful government agendas via vaccines increased worker vaccine fears, …

Rising Mortality Rates Linked To Type-2 Diabetes And Obesity In The United States: An Observational Analysis From 1999 To 2022, Mushood Ahmed, Abdullah Nofal, Aimen Shafiq, Hira Javaid, Areeba Ahsan, Zain Ali Nadeem, Raheel Ahmed, Mahboob Alam, Mamas A Mamas, Marat Fudim, Gregg C Fonarow

Faculty, Staff and Students Publications

Background: The prevalence of type 2 diabetes (T2D) and obesity are increasing in the United States. However, population-level data for mortality trends due to T2D and obesity are limited. This study aims to assess these death trends among adults in the United States categorized by sex, race, and geographical location.

Methods: We queried the CDC-WONDER database for multiple cause of death data of adults aged ≥25 years. The crude mortality rates (CMR), age-adjusted mortality rates (AAMRs), annual percent change (APC), and the average APC (AAPC) along with a 95% confidence interval (CI) were analyzed.

Results: From 1999 to 2022, a …

Scaling Covid-19 Rates With Population Size In The United States, Austin R. Cruz, Brian J. Enquist, Joseph R. Burger

Biology Faculty Publications

Using county-level data from the United States, we assessed allometric scaling relationships of coronavirus disease (COVID-19) cases, deaths and age structure within and across the first four major waves of the pandemic (wild-type, alpha, delta, omicron). Results generally indicate that the burden of cases disproportionately impacted larger-sized counties, while the burden of deaths disproportionately impacted smaller counties. This may be partially due to multiple interacting social mechanisms, including a higher proportion of older adults who live in smaller counties. Moreover, these likely social mechanisms interacting with vaccinations and virus waves created a dynamic pattern whereby the rate and magnitude of …