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Full-Text Articles in Public Health

2021-05-20_Michiganoverview_Misc, Michigan Department Of Health & Human Services May 2021

2021-05-20_Michiganoverview_Misc, Michigan Department Of Health & Human Services

Michigan COVID-19 MIS-C Data

The MIS-C Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_104661---,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by health care providers and local health departments. Data is updated on the first and third Thursdays of the month.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition in children and adolescents under 21 years of age where multiple organ systems become inflamed or dysfunctional which occurs in association with illness. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, …


2021-05-20_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services May 2021

2021-05-20_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …


2021-05-20_Michiganoverview_Covidoutbreak, Michigan Department Of Health & Human Services May 2021

2021-05-20_Michiganoverview_Covidoutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_102057---,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

COVID-19 outbreaks are generally defined as two or more cases with a link by place and time indicating a shared exposure outside of a household. Local health departments report the number of new and ongoing outbreaks they are investigating by the setting of the outbreak. New outbreaks are those outbreaks that were first identified during the current reporting week. Ongoing outbreaks are …


Development And Psychometric Properties Of Surveys To Assess Provider Perspectives On The Barriers And Facilitators Of Effective Care Transitions, Maurice C. Johnson Jr., Helen Liu, Joann Sorra, Jane Brock, Brianna Gass, Jing Li, Jessica Miller Clouser, Karen Hirschman, Deborah Carpenter, Huong Q. Nguyen, Mark V. Williams May 2021

Development And Psychometric Properties Of Surveys To Assess Provider Perspectives On The Barriers And Facilitators Of Effective Care Transitions, Maurice C. Johnson Jr., Helen Liu, Joann Sorra, Jane Brock, Brianna Gass, Jing Li, Jessica Miller Clouser, Karen Hirschman, Deborah Carpenter, Huong Q. Nguyen, Mark V. Williams

Center for Health Services Research Faculty Publications

Background
The quality of the discharge process and effective care transitions between settings of care are critical to minimize gaps in patient care and reduce hospital readmissions. Few studies have explored which care transition components and strategies are most valuable to patients and providers. This study describes the development, pilot testing, and psychometric analysis of surveys designed to gain providers’ perspectives on current practices in delivering transitional care services.

Methods
We underwent a comprehensive process to develop items measuring unique aspects of care transitions from the perspectives of the three types of providers (downstream, ambulatory, and hospital providers). The process …


Cost Estimation Alongside A Multi-Regional, Multi-Country Randomized Trial Of Antenatal Ultrasound In Five Low-And-Middle-Income Countries, B W. Bresnahan, E Vodicka, J B. Babigumira, Ashar Muhammad Malik, F Yego, A Lokangaka, B M. Chitah, Z Bauer, H Chavez, Sarah Saleem May 2021

Cost Estimation Alongside A Multi-Regional, Multi-Country Randomized Trial Of Antenatal Ultrasound In Five Low-And-Middle-Income Countries, B W. Bresnahan, E Vodicka, J B. Babigumira, Ashar Muhammad Malik, F Yego, A Lokangaka, B M. Chitah, Z Bauer, H Chavez, Sarah Saleem

Community Health Sciences

Background: Improving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency.
Methods: We collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency. We assessed typical antenatal outpatient and …


Improving Surface Cleaning And Hand Hygiene Using Fluorescent Markers, Taryn Whitman May 2021

Improving Surface Cleaning And Hand Hygiene Using Fluorescent Markers, Taryn Whitman

Master's Projects and Capstones

Problem: Compared to inpatient units, ambulatory care clinics have differences in staffing available and frequency to perform room turnover (RTO). Pre-intervention data revealed poor Hand hygiene (HH) and high-touch surface cleaning (HTSC) knowledge and low RTO compliance reliability. Currently, there is no process for objectively monitoring RTO compliance and staff self-evaluation of HH, HTSC, and RTO performance is incongruent with observations.

Context: HH and HTSC are a crucial component of preventing healthcare-associated infections (HAIs). Estimated loss of revenue for one northern California tertiary university hospital system (HCO) campus was nearly $1.8 million dollars in Medicare penalties for 2018.

Intervention: …


Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers May 2021

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …


Museums & Community Resilience: Improving Post-Crisis Outreach In Latinx Communities By Combining Library And Museum Practices, Sua Lorena Mendez May 2021

Museums & Community Resilience: Improving Post-Crisis Outreach In Latinx Communities By Combining Library And Museum Practices, Sua Lorena Mendez

Seton Hall University Dissertations and Theses (ETDs)

Museums are held in the public trust and are accountable to their communities, including minority groups such as the Latinx population. Despite this, museums struggle to engage with Latinx communities, who are particularly affected during and after a crisis or emergency. Currently, museums do not have professional guidelines on supporting community resilience, or a community’s ability to respond to and recover from a crisis. In contrast, libraries, which function as similar community organizations, have field-wide community resilience plans and professional librarians have actively researched how libraries can assist their communities after a significant crisis. Using a multi-case library and museum …


An Examination Of Oppression Via Anti-Abortion Legislation, Saphronia P. Carson May 2021

An Examination Of Oppression Via Anti-Abortion Legislation, Saphronia P. Carson

The Pegasus Review: UCF Undergraduate Research Journal

Significant disparities in reproductive health care access and outcomes exist along race, ethnicity, and income lines. One of the starkest examples of this is the dramatic reduction in abortion access over the past 45 years that disproportionately affects minority and low-income women. While existing literature has exposed these disparities and potential reasons for them, there is less attention to the ways reduced access to reproductive health care, specifically abortion, can coerce, exploit, and systematically oppress women of color and low-income women. This research uses a reproductive justice framework to discuss the impact of anti-abortion legislation and the anti-abortion movement on …


2021-05-19_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services May 2021

2021-05-19_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.


2021-05-19_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services May 2021

2021-05-19_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …


Meeting Minutes, Wku Council Of Academic Deans May 2021

Meeting Minutes, Wku Council Of Academic Deans

Council of Academic Deans

Meeting regarding post-COVID instructional modality and international travel.


2021-05-19_Michigandaily_Covidmap, Michigan Department Of Health & Human Services May 2021

2021-05-19_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …


2021-05-19_Michiganoverview_Covidtestingtimes, Michigan Department Of Health & Human Services May 2021

2021-05-19_Michiganoverview_Covidtestingtimes, Michigan Department Of Health & Human Services

Michigan COVID-19 Testing Turnaround Data

The COVID Testing Turnaround Time page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-545615--,00.html.

This report was created by the Michigan Department of Health & Human Services, providing data for the past 14 days on the average time it takes for a diagnostic COVID-19 laboratory test to be reported to the state health department. Testing turnaround time data will be updated weekly on Friday mornings.

MDHHS receives results from commercial labs, hospitals, and public health labs. However, public health laboratories perform limited diagnostic testing and disease surveillance for infectious diseases. Total turnaround time is calculated from the difference of …


Development Of A Multilevel Intervention To Increase Colorectal Cancer Screening In Appalachia, Aaron J. Kruse-Diehr, Jill M. Oliveri, Robin C. Vanderpool, Mira L. Katz, Paul L. Reiter, Darrell M. Gray Ii, Michael L. Pennell, Gregory S. Young, Bin Huang, Darla Fickle, Mark Cromo, Melinda Rogers, David Gross, Ashley Gibson, Jeanne Jellison, Michael D. Sarap, Tonia A. Bivens, Tracy D. Mcguire, Ann Scheck Mcalearney, Timothy R. Huerta, Saurabh Rahurkar, Electra D. Paskett, Mark B. Dignan May 2021

Development Of A Multilevel Intervention To Increase Colorectal Cancer Screening In Appalachia, Aaron J. Kruse-Diehr, Jill M. Oliveri, Robin C. Vanderpool, Mira L. Katz, Paul L. Reiter, Darrell M. Gray Ii, Michael L. Pennell, Gregory S. Young, Bin Huang, Darla Fickle, Mark Cromo, Melinda Rogers, David Gross, Ashley Gibson, Jeanne Jellison, Michael D. Sarap, Tonia A. Bivens, Tracy D. Mcguire, Ann Scheck Mcalearney, Timothy R. Huerta, Saurabh Rahurkar, Electra D. Paskett, Mark B. Dignan

Health, Behavior & Society Faculty Publications

Background

Colorectal cancer (CRC) screening rates are lower in Appalachian regions of the United States than in non-Appalachian regions. Given the availability of various screening modalities, there is critical need for culturally relevant interventions addressing multiple socioecological levels to reduce the regional CRC burden. In this report, we describe the development and baseline findings from year 1 of “Accelerating Colorectal Cancer Screening through Implementation Science (ACCSIS) in Appalachia,” a 5-year, National Cancer Institute Cancer MoonshotSM-funded multilevel intervention (MLI) project to increase screening in Appalachian Kentucky and Ohio primary care clinics.

Methods

Project development was theory-driven and included the …


Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson May 2021

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Presentations

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …


Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson May 2021

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Global Health Faculty Research

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …


Infectious Disease Transmission By Arline Travel, Daniele Provenzano, Sofy Barocio May 2021

Infectious Disease Transmission By Arline Travel, Daniele Provenzano, Sofy Barocio

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

Improvements in aviation technology have led to considerable growth of domestic and international flights worldwide especially during the past four decades. Commercial flights have increased the movement of and have connected people from virtually all corners of the globe since the end of World War II to exceed 3 billion passengers a year since 2013: a sizable proportion of the global human population. Flight times have decreased considerably from the onset of commercial aviation and the range of airliners has extended substantially. A passenger harboring an infectious agent embarking a flight on one continent can be deplaning on another continent …


Covid-19 Newsletter (Vol. 72), Center For Disaster Medicine, New York Medical College May 2021

Covid-19 Newsletter (Vol. 72), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.


Forum 8: Logistics And The Vaccine, Ashlea Milburn May 2021

Forum 8: Logistics And The Vaccine, Ashlea Milburn

Vaccine Course

This presentation summarizes the goals of the COVID-19 vaccination program and provides an overview of its status as of May 2021. Next, the logistics requirements of Community Vaccination Centers (CVCs), which are common venues for mass vaccine dispensing, are presented. According to this dispensing method, people travel to where the vaccine is being administered (people-to-shots). Finally, the logistics requirements of an alternative dispensing method that brings the vaccine to people in their homes (shots-to-people) are addressed. This dispensing method can increase vaccine access for homebound individuals.


2021-05-18_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services May 2021

2021-05-18_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …


2021-05-18_Michigandaily_Covidmap, Michigan Department Of Health & Human Services May 2021

2021-05-18_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …


2021-05-18_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services May 2021

2021-05-18_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …


2021-05-18_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services May 2021

2021-05-18_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.


Physician Skin Cancer Screening Among U.S. Military Veterans: Results From The National Health Interview Survey, Elliot J. Coups, Baichen Xu, Carolyn J. Heckman, Sharon L. Manne, Jerod L. Stapleton May 2021

Physician Skin Cancer Screening Among U.S. Military Veterans: Results From The National Health Interview Survey, Elliot J. Coups, Baichen Xu, Carolyn J. Heckman, Sharon L. Manne, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

Introduction

Although military veterans are at increased risk for skin cancer, little is known about the extent to which they have been screened for skin cancer. The study objective was to examine the prevalence and correlates of physician skin cancer screening among U.S. military veterans.

Methods

Data were drawn from the National Health Interview Survey. The study sample consisted of 2,826 individuals who reported being military veterans. Receipt of a physician skin examination was measured using a single question that asked participants whether they had ever had all of their skin from head to toe checked for cancer by a …


2021-05-18_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services May 2021

2021-05-18_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …


Building Back Healthier: The Role Of Public Health In State Disaster Recovery Law, Claire Pendergrast, Nicole Errett May 2021

Building Back Healthier: The Role Of Public Health In State Disaster Recovery Law, Claire Pendergrast, Nicole Errett

Population Health Research Brief Series

When communities are impacted by disasters, state officials must implement efficient and competent recovery strategies with the health and wellbeing of residents in mind. This research brief summarizes findings from a peer-reviewed study showing that few U.S. states explicitly integrate public health into their disaster recovery laws, and the types of public health requirements and authorizations vary substantially across states.


2021-05-17_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services May 2021

2021-05-17_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …


2021-05-17_Michigandaily_Covidmap, Michigan Department Of Health & Human Services May 2021

2021-05-17_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …


2021-05-17_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services May 2021

2021-05-17_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was downloaded as an Excel spreadsheet which appeared in the Public Use Datasets section under the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html.

Cases are aggregated by the date of onset of COVID-19 symptoms, if known, otherwise by laboratory specimen date if known, otherwise by case referral date. Deaths are aggregated by the date of death if known, otherwise by the last date of a change to the case status.