Dallas Morning News: PCCI reports Upwards of 95% of Dallas County residents need protection against COVID-19 to reach herd immunity

According to a report in the Dallas Morning news, PCCI data indicates that upwards of 95% of Dallas County residents need protection against COVID-19 to reach herd immunity. Herd immunity refers to the condition in which a population is indirectly protected from infection because enough people are vaccinated or have natural immunity to a disease.

Click this link to read the full story:

https://www.dallasnews.com/news/2021/09/17/upwards-of-90-of-dallas-county-residents-need-protection-against-covid-19-to-reach-herd-immunity/?outputType=amp

 

 

 

Parkland and PCCI’s suicide screening program show who is most at-risk in Dallas County

By Jacqueline Naeem, MD, PCCI’s Senior Medical Director

By Kimberly Roaten, PhD, CRC, Parkland Health & Hospital System’s Director of Quality for Safety, Education, and Implementation

The month of September is designated as Suicide Prevention and Awareness Month, offering an opportunity to bring awareness and support to mental health organizations and individuals in Dallas who are helping those in need. An initiative led by Parkland Health & Hospital System (PHHS) and Parkland Center for Clinical Innovation (PCCI) reveals important information about suicide risk among Dallas residents.

While national and international efforts to prevent suicide are ongoing, the problem continues to grow. Over the last decade, healthcare systems have seen a rise in the number of individuals with psychiatric needs and suicide risk. As outlined by the American Foundation for Suicide Prevention (AFSP), suicide and suicide attempts continue to plague the healthcare sector:

  • Suicide is the 10th leading cause of death in the US
  • On average there are 130 suicides per day
  • In the US there were an estimated 1.38M suicide attempts in a single year

Many individuals who die by suicide have had contact with a healthcare provider in the weeks and months prior to death, but often this contact is with primary care or emergency medicine providers who may not identify the risk. With the aim of stemming this problem, PHHS implemented a proactive suicide risk identification and prevention program in 2015 which includes screening all patients ages 10 and older for suicide risk regardless of their presenting problems. Approximately 40,000 screenings are completed per month and over 4 million screenings overall. The Universal Suicide Screening Program at PHHS is an example of how meet and exceed The Joint Commission National Patient Safety Goal 15.01.01, targeting suicide risk and has yielded important data about the prevalence of risk in healthcare settings.

Through collaboration with Parkland Clinical Leadership, PCCI has applied data analytics to understand insights from Suicide Screening Program data, which can be used to identify opportunities to improve the current care pathway. Identification of previously undetected suicide risk leads to timely assessment by a health care provider and connection to appropriate services and resources.

Importantly, analysis of data from the program revealed that 2.3% of individuals who have an encounter for a non-psychiatric complaint endorse suicide risk factors (2,735 pediatric patients and 65,000 adults), underscoring the importance of proactive screening and assessment in all patient populations. Patients who are at risk are assessed, provided with brief evidence-based interventions, and then referred for appropriate ongoing care.

Parkland and PCCI are identifying important ways to prevent suicide and self-directed, but everyone can work together to prevent suicide. Knowing the warning signs and how to find help are two important steps in addressing this critical issue. National Suicide Prevention Month is a wonderful way to raise awareness and improve advocacy. If you are someone you know is struggling with suicidal thoughts or suffering and in need of support, there are excellent resources in North Texas including AFSP’s North Texas Chapter. Our collective efforts can help those at risk.

(Are you in Crisis? Call 800-273-8255 or text HOME to 741741.)

 

PCCI Publishing: New England Journal of Medicine – Examining PCCI’s approach to determining COVID-19 herd immunity in Dallas County

The New England Journal of Medicine/Catalyst published an article authored by members of PCCI, the Institute for Healthcare Improvement and the  Cincinnati Children’s Hospital Medical Center that examines PCCI’s approach to determining COVID-19 herd immunity in Dallas County.

The article, “Rethinking Herd Immunity: Managing the Covid-19 Pandemic in a Dynamic Biological and Behavioral Environment,” was published under its “Innovations Care Delivery” section. The authors of the article share how a detailed understanding of local pandemic conditions is necessary to create focused, tailored responses. While achieving high levels of vaccination is important, exclusive focus on national vaccine targets de-emphasizes the complexities of Covid-19 population immunity. Herd immunity is dynamic and depends on the transmissibility of each new Covid-19 strain, the effectiveness of previous immunity due to previous infection and vaccination against these strains, and human behavior in local communities.

The authors developed a potential framework for enumerating and estimating community-wide immunity to Covid-19 with use of data reportable to local county public health authorities. Using data from Dallas County, Texas, they describe the interplay of vaccines and infection in terms of Covid-19 population immunity, the effect of variants on the ever-changing threshold for herd immunity, and how better access, algorithms, and use of real-time local immunity data could lead to more effective local population protection.

To view the article click here:

https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0288

Or to view it as a PDF, click here.

https://catalyst.nejm.org/doi/pdf/10.1056/CAT.21.0288

 

PCCI Published: Building a Vulnerability Index of Biological and Socioeconomic Risk Factors to Combat COVID-19 Spread

In mid-2021, PCCI experts, along with co-authors from William & Mary published an article in the DESRIST 2021: The Next Wave of Sociotechnical Design pp 22-33, outlining how PCCI developed a COVID-19 vulnerability index that was used by Dallas-area health officials to identify populations in Dallas most at-risk.

DESRIST 2021: The Next Wave of Sociotechnical Design pp 22-33

ABSTRACT:
In early 2020, many community leaders faced high uncertainty regarding their local communities’ health and safety, which impacts their response to the pandemic, public health messaging, and other factors in guiding their communities on how to remain healthy. Making decisions regarding resources was particularly difficult in Dallas, Texas, USA where local communities face stark differences in Non Medical Drivers of Health, such as availability of fresh foods and environmental pollution. We use an action design research approach to develop an index to assess vulnerability, which incorporates both long-term COVID-19 community risk measures and ongoing dynamic measures of the pandemic. Community and public health officials utilize the index in making critical policy and strategic decisions while guiding their communities during COVID-19 and in future crises.

AUTHORS
Thomas Roderick, PCCI, Yolande Pengetnze, PCCI, Steve Miff, PCCI, Monica Chiarini Tremblay, College of William and Mary, Rajiv Kohli, College of William and Mary

D Magazine: Dallasites Are Now Six Times More Likely to Get COVID-19

The average Dallas resident is now 600 percent more likely to catch COVID-19 than they were in early June, according the Parkland Center for Clinical Innovation’s COVID-19 Vulnerability Index. Low vaccination rates and rising cases, primarily driven by the delta variant, have created the aggregate increase in vulnerability between the end of June and the end of July.

READ MORE HERE:
https://www.dmagazine.com/healthcare-business/2021/08/dallasites-are-now-six-times-more-likely-to-get-covid-19/

PCCI’s Vulnerability Index: Delta Variant Increasing Ongoing COVID Risk by 600 Percent

DALLAS – Due to low vaccination levels and new COVID-19 cases in Dallas County, the Parkland Center for Clinical Innovation’s COVID-19 Vulnerability Index has recorded a 600 percent aggregate increase between the end of June and the end of July 2021, primarily driven by the fast-spreading COVID-19 Delta variant.

The ZIP code with the highest Vulnerability Index, 75228, in East Dallas bordered by Interstates 30 and 635 and intersected by Highway 12, has a 19.76 vulnerability rating as of July 27, an increase of 17.95 over June 27. The ZIP code with the second highest Vulnerability Index rating, 75243 east of Highway 75 and intersected by Interstate 635, has a 19.66 vulnerability rating, an increase of 16.01 from June 27. The growth in these areas highlight increasing risk for Dallas County.

“Vaccinations help prevent the spread and reduce mortality of COVID-19,” said Thomas Roderick, PhD, Executive in Residence at PCCI. “Our latest Vulnerability Index report shows that COVID-19 risk is increasing, with new cases rising sharply among the unvaccinated. It is important to get the vaccine if you are medically able to do so, both for yourself, your young children, and for your neighbor who may not be able to receive a vaccination.”

One of the hardest hit ZIP Codes during the past year is 75211, which includes the areas around Cockrell Hill and Oak Cliff, which has a vulnerability rating of 14.75. It continues to be in the top 10 most vulnerable ZIP codes, though still far below its high of 157.96 registered in January 2021.

Launched in June of 2020, PCCI’s Vulnerability Index identifies communities at risk by examining comorbidity rates, including chronic illnesses such as hypertension, cancer, diabetes and heart disease; areas with a high density of populations over the age of 65; and increased social deprivation such as lack of access to food, medicine, employment and transportation. These factors are combined with behavioral

factors such as vaccination rates and confirmed COVID-19 cases where a vulnerability index value is scaled relative to July 2020’s COVID-19 peak value. The PCCI COVID-19 Vulnerability Index can be found on its COVID-19 Hub for Dallas County at: https://covid-analytics-pccinnovation.hub.arcgis.com/.

“Without question, vaccinations are the key to Dallas County getting through the Delta surge and hopefully ending the pandemic,” said George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI. “The vaccinations for adults and children over 12 years old, are effective, easily obtained and quickly administered. We should all do our part to get vaccinated and encourage others to do the same. That is the way we will crush COVID.”

Data Sources:
To build Vulnerability Index, PCCI relied on data from Parkland Health & Hospital System, Dallas County Health and Human Services Department, the Dallas-Fort Worth Hospital Council, U.S. Census, and SafeGraph.

About Parkland Center for Clinical Innovation
Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare intelligence organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and Non Medical Drivers of Health to address the needs of vulnerable populations. We believe that data, done right, has the power to galvanize communities, inform leaders, and empower people.

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PCCI Supporting Episcopal Health Foundation’s $8 million Texas Accountable Communities for Health Initiative

Episcopal Health Foundation selects six communities to participate in $8 million Texas Accountable Communities for Health Initiative

TACHI project aims to build sustainable community-based partnerships to address underlying, non-medical causes of poor health

Partners include organizations focused on housing, social services, employment training, health care, and more

HOUSTON – (July 20, 2021) – The Texas Accountable Communities for Health Initiative (TACHI), launched by Episcopal Health Foundation (EHF), has announced that six local communities from across the state have received funding as part of an $8 million project to go beyond the doctor’s office to improve the health and well-being of Texans.
Each community was awarded funding to establish an Accountable Community for Health (ACH) – a community-based partnership formed by local organizations from different sectors to address underlying, non-medical community health needs like safe housing, food security, safe places to exercise, and more. TACHI will grant funds to each ACH site, depending on specific needs, over a four-year period.

The TACHI sites selected are:

• Austin Rundberg
• Bastrop County
• Brazos Valley
• Greater Northside in Houston
• Gregg County
• Williamson County

• Learn more: www.txachi.org

“This is an important step forward to position these community-based organizations to advance community-led, financially-sustainable strategies to improve health, not just health care in their own neighborhoods,” says Shao-Chee Sim, EHF’s Vice President for Research, Innovation and Evaluation. “The goal is to improve health outcomes for under-served Texas communities by focusing on healthy living in communities, not sick care. That’s why the unique ACH partnerships are addressing community conditions outside of hospitals and doctors’ offices.”

ACHs include organizations focused on health care, housing, social services, public health, employment training, economic development, and more. Along with grant funding, TACHI offers the six community collaboratives technical assistance and peer-learning opportunities focused on topics related to health equity, community engagement, governance, data infrastructure, and financial sustainability.

“Essentially, ACHs serve as a local platform for bringing community organizations and residents together to address a shared community health goal, achieve greater health equity, and find ways to pay for the improvements over the long term,” Sim said.

EHF provides funding and leadership for the project. Two key partners are also working to ensure TACHI sites are making positive health impacts in their communities:

• Parkland Center for Clinical Innovation (PCCI) serves as the Project Management Office. PCCI, an independent affiliate of Parkland Health & Hospital System is a nonprofit, data science, and innovation organization known for their ground-breaking work in building connected communities of care.

• Georgia Health Policy Center (GHPC) serves as the external evaluator. GHPC, housed within Georgia State University’s nationally ranked Andrew Young School of Policy Studies, will conduct both formative and summative evaluation of TACHI to help PCCI and EHF understand how the initiative is making progress towards the stated goals.

To learn more, visit https://www.txachi.org/.

More information on TACHI Sites
Austin Rundberg » The Austin Rundberg site is a small, urban community located in the City of Austin bounded by I-35 and Mopac. Lone Star Circle of Care will serve as the backbone for this collaborative.
Bastrop County » Located east of Austin, Bastrop County Cares will serve as the backbone for this collaborative.
Brazos Valley » Located in Bryan/College Station, Texas A&M University will serve as the backbone for this collaborative.
Greater Northside – Houston » Based in Houston, Avenue CDC will serve as the backbone for this collaborative.
Gregg County » Located in Longview in East Texas, Community Healthcore will serve as the backbone for this collaborative.

Williamson County » North of Austin, the Williamson County Health Department will serve as the backbone for this collaborative.

# # #
To schedule an interview, contact Brian Sasser at bsasser@episcopalhealth.org or 832-795-9404.
Related materials:

Texas Accountable Communities for Health Initiative: https://www.txachi.org/

Episcopal Health Foundation: www.episcopalhealth.org

By providing millions of dollars in grants, working with congregations and community partners, and providing important research, Episcopal Health Foundation is supporting solutions that address the underlying causes of poor health. EHF was established in 2013 and is based in Houston. With more than $1.2 billion in estimated assets, the Foundation operates as a supporting organization of the Episcopal Diocese of Texas and works across 57 Texas counties. #HealthNotJustHealthcare

PCCI CEO Statement – Dallas County Reaches Herd Immunity, More Work To Be Done

Statement from PCCI CEO Steve Miff:

“On July 4, Dallas County reached the 80 percent herd immunity threshold. This threshold is made up

by 46.6 percent of the total population being vaccinated and 48.7 percent of the population with natural immunity having recovered from being infected by COVID-19.

While this represents good progress, it is important that we understand the work is not over. We must continue to push for vaccinations so COVID and its variants can’t again take hold and diminish the progress we’ve made. Reaching the 80 percent herd immunity rate is not like flipping a switch, but a continuum in our journey.  It is an important accomplishment which is a credit to the residents and public health leaders who have committed themselves to crush COVID. While the whole community in average reached the 80 percent mark, there are only 49 ZIP codes above the 80 percent threshold with 45 ZIP codes still below the 80 percent mark. There are still significant pockets in the community that remain vulnerable.

How we got here

The calculations used to measure heard immunity track individual level data for both vaccinations administered and COVID test results since the beginning of the pandemic.  For those infected, yet not tested there are a 4x Adjusted Incidence Rate Ratio [AIRR] for the adult population and 5x for the pediatric group based on national and local seroprevalence data. The model also calculates an overlap 28 percent of vaccinated population of Dallas estimated to have had prior COVID-19 infection and recovered.

Delta Variant

Further, the current Delta variant is predicted to make up about 25 percent of COVID-19 cases locally, doubling approximately every two weeks. In one month, that could put the Delta variant in the range that has caused a new wave in infections in the UK, though their estimated immunity was below the herd immunity threshold for Delta.

The significantly higher viral loads and more infectious nature of the Delta variant could put the herd immunity target as high as 88 percent to suppress infection spikes when the Delta variant becomes the dominant variant in a few weeks’ time.

Vaccinations Lag

As a county, we’re still behind on vaccinations: Only 38 percent of the total population with completed vaccination series and 47 percent of the total population with at least one dose (61 percent of adults and 80 percent of those over the age of 65 years).  While previous infections and partial vaccinations do provide a level of protection, all evidence suggests that full vaccinations are the most effective way to stay safe against the delta variant.

Why is getting vaccinated still very important:

  • Infections remain very low for those vaccinated – local data from Parkland and the Dallas County Health & Human Services Department suggests an infection rate of only 0.04 percent for those vaccinated. Getting vaccinated doesn’t only protect you, but those around you, including the children who are not yet eligible for a vaccine.
  • Long COVID (prolonged COVID related symptoms such as fatigue, brain fog, muscle pain, shortness of breath, and loss of taste and smell) is prevalent in 10-30 percent of those infected and mortality for those unvaccinated is still a concern. Not getting vaccinated is rolling the dice on dying or dealing with long-term medical issues. 

The message is simple: don’t wait to get vaccinated. For those still hesitant, the safety and efficacy studies to date are overwhelmingly positive.  There are also two key upcoming milestones that should give further confidence to those who remain hesitant: Full FDA approvals for the mRNA vaccines expected in the upcoming weeks and approval for the under 12-year-old groups in the fall.”

-Steve Miff, PhD, President & CEO of Parkland Center for Clinical Innovation (PCCI) 

To monitor herd immunity and vaccination progress in Dallas County go to PCCI’s COVID-19 Vaccination and Herd Immunity Dashboard hosted on the Dallas County Health and Human Services’ website: https://www.dallascounty.org/covid-19/.

Background on PCCI’s herd immunity measurements

PCCI’s forecast for herd immunity is based on an innovative yet vetted statistical and immunological model and analysis of spread and management of diseases within communities. Further, PCCI’s 80 percent range for reaching herd immunity is in line with national estimates, such as that of Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, who recently gave a range of 70 to 90 percent and the World Health Organization which gave a 60 to 70 percent range of infections and vaccines to reach herd immunity*.

PCCI’s forecast and estimates have been developed in coordination with community health leaders in Dallas County, including the DCHHS and Parkland Health & Hospital System.  Recently, PCCI has been collaborating with the leadership and expert teams at the Institute for Health Improvement on modeling.

*New York Times, Dec. 24, 2020: “How Much Herd Immunity Is Enough?”

https://www.nytimes.com/2020/12/24/health/herd-immunity-covid-coronavirus.html

 

News Release: PCCI, Dallas County Release COVID-19 Vaccination and Herd Immunity Dashboard

Dallas, Texas – Parkland Center for Clinical Innovation (PCCI), which improves healthcare for vulnerable populations using advanced data science and clinical experts, has developed a COVID-19 Vaccination and Herd Immunity Dashboard to give residents of Dallas County up-to-date data about herd immunity levels, infections and vaccinations rates and corresponding demographic information.

The Dallas County Health and Human Services Department (DCHHS) will host the COVID-19 Vaccination and Herd Immunity Dashboard, which will supplement its rich set of COVID-19 resources. The COVID-19 Vaccination and Herd Immunity Dashboard can be accessed here: https://www.dallascounty.org/covid-19/

The COVID-19 Vaccination and Herd Immunity Dashboard provides exclusive data for Dallas County, including herd immunity by percentage of the county’s population at the ZIP code level. This is helpful for monitoring the county’s efforts to drive vaccination efforts to reach the herd immunity threshold of 80 percent of the whole county’s population who either have recovered from COVID-19 or who have received vaccinations. The dashboard’s data also includes vaccinations by manufacturer, estimated active COVID cases and important information resources about the pandemic.

“The COVID-19 Vaccination and Herd Immunity Dashboard provides the relevant available information to help estimate how far along Dallas County is toward reaching the herd immunity goal as well as the rates of vaccinations across the whole community,” DCHHS Director Dr. Philip Huang said. “It is important that we understand that once the indicators suggest that we are at the estimated herd immunity threshold, the work is not over. We need to continue the push for vaccinations, which is the crucial element to reaching herd immunity. The data in this dashboard will allow us to monitor our fight against COVID in every corner of the county in order for us to take the necessary steps to maintain our positive momentum.”

For each ZIP code in Dallas County, the COVID-19 Vaccination and Herd Immunity Dashboard also includes insightful, localized vaccination demographic information, such as ethnicity, age, sex and race. This data is used to continue to ensure equity in all our efforts and to continue to reach the population in the most convenient and effective way.

“This is critical information that we need to guide and coordinate our efforts. Dallas County is unique in the country for having these analytics available at such localized levels for all of our residents,” said Dr. Steve Miff, PCCI’s President and CEO. “The way we crush COVID is by coming together as a community and the information from the dashboard empowers everyone with knowledge on what is happening where they live― what the herd immunity level is and what the vaccination level is so they may act accordingly to maintain their safety and that of their families.”

In February, PCCI forecast that Dallas County would reach the 80 percent herd immunity threshold in June. However, that forecast has been pushed back to July due to slowing vaccination rates.

“Our progress toward herd immunity in Dallas County is making a difference as we have seen with slowing rates of community transmission, and it is so important that we aggressively continue our community efforts to vaccinate,” said Dr. Huang. “With the knowledge we gain from the COVID-19 Vaccination and Herd Immunity Dashboard, we can empower all our citizens with the information to stay safe. Vaccines are the best line of defense against COVID-19 and its variants, so it is critical that as many county residents as possible receive a vaccine.”

PCCI’s forecast for herd immunity is based on an innovative yet vetted statistical and immunological model and analysis of spread and management of diseases within communities. Further, PCCI’s 80 percent range for reaching herd immunity is in line with national estimates, such as that of Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, who recently gave a range of 70 to 90 percent and the World Health Organization which gave a 60 to 70 percent range of infections and vaccines to reach herd immunity*.

PCCI’s forecast and estimates have been developed in coordination with community health leaders in Dallas County, including the DCHHS and Parkland Health & Hospital System. Recently, PCCI has been collaborating with the leadership and expert teams at the Institute for Health Improvement on modeling.

The COVID-19 Vaccination and Herd Immunity Dashboard supports the Google Chrome, Microsoft Edge and Mozilla Firefox web browsers.

About Parkland Center for Clinical Innovation
Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare innovation organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and Non Medical Drivers of Health to address the needs of vulnerable populations.
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*New York Times, Dec. 24, 2020: “How Much Herd Immunity Is Enough?”
https://www.nytimes.com/2020/12/24/health/herd-immunity-covid-coronavirus.html