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 social determinants 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 COVID-19 Update: Vaccinations Help Dallas County’s COVID-19 Risk Drop 40 Percent in May

DALLAS – Due to vaccination levels and reduction in new COVID-19 cases in Dallas County, the Parkland Center for Clinical Innovation’s COVID-19 Vulnerability Index has recorded a 40 percent drop in average vulnerability from April to the end of May.

The Vulnerability Index decrease can be attributed to a moderate increase in vaccines, a 10 percent increase in vaccinated people (partial or complete) month over month, and a 37 percent decrease in active cases.

The ZIP code with the highest Vulnerability Index, 75243, has a 12.20 vulnerability rating, however that was a decreased by 61 percent from April. This decrease was driven by vaccinations.

Most vulnerable zip codes. The cases have continued to reduce substantially month-over-month. (See list below)

“Thanks to the vaccination programs implemented throughout Dallas County, we continue to see progress in our fight against COVID-19,” said Thomas Roderick, PhD, Executive in Residence at PCCI. “Our latest Vulnerability Index report is the most positive yet, with new cases slowing and modest, but important participation in the vaccination program continuing. This progress is a credit to the outstanding efforts of our public health leaders and residents devoted to crushing COVID.”

One of the hardest hit ZIP Codes during the past year, 75211, which includes the areas around Cockrell Hill and Oak Cliff, continues to be in the top 10 most vulnerable ZIP codes, however, its May rating of 9.63, is a massive improvement over its high of 196.9 in January.

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 dynamic mobility 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/.

Recently, PCCI revised its COVID-19 herd immunity forecast, 80 percent of residents either having recovered from COVID-19 or having received a vaccination, from mid-June to July, due to a slowing rate of immunizations. However, as of the end of May, Dallas County is closing in on the 80 percent goal, at 75.5 percent herd immunity.

“Without question, vaccinations are the key to Dallas County reaching herd immunity,” said George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI. “Vaccinations have been the primary reason we’ve seen a reduction in risk and why we are in sight of reaching the herd immunity threshold. 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 social determinants 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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Updated PCCI Vulnerability Index Highlights Progress, but Ongoing At-Risk Communities

By Thomas Roderick, PCCI’s Executive in Resident
& George “Holt” Oliver, MD, PhD, Vice President, Clinical Informatics

Why this post

More than a year ago, the data scientists at Parkland Center for Clinical Innovation (PCCI) committed to take the fight to COVID-19 by assisting North Texas residents, community leaders and public health officials through delivering actionable pandemic intelligence.

Many of us at PCCI and in the community have suffered the loss of family members, colleagues, coworkers, neighbors and friends. So with great relief we have witnessed tremendous scientific achievements in the development, approval and distribution of COVID-19 vaccines within a year. We have also seen the community evolve and adapt to life with COVID-19 and the actions expand from initial testing strategies to vaccine deployment, herd immunity projections and tracking, to now overcoming vaccination hesitancy and surveillance tracking of emerging variants, re-infections and individual/community immunity.

As our community and pandemic efforts evolve, so does the intelligence it needs. To meet that need, PCCI is evolving its technology and is pleased to announce the next phase of the Vulnerability Index.

What is the Vulnerability Index?

The Vulnerability Index is a measure of risk a community faces due to COVID-19. Higher risk means that people may be more likely to be infected with COVID-19, and if they do, they are more likely to experience symptoms and potentially face hospitalization and even death.

When the Vulnerability Index was first built, it covered factors correlated with COVID-19, including attributes in the community that don’t change quickly (like proportion of elderly population, people living with chronic conditions that are associated with COVID-19, and social determinants of health) as well as dynamic factors that increase immediate risk, like active COVID-19 cases and the mobility of the people living in the community.

How has the Vulnerability Index changed?

The North Texas community has evolved in two very important ways, and so the Vulnerability Index is changing as well.

    • First, as with the rest of the world it has adopted mask-wearing, social distancing, hand washing, and other hygiene and behavioral recommendations from public health authorities to limit the spread of COVID-19. Combined with the full opening of the economy, this means that a mobility factor has less relevance in identifying risk, because people change their behavior when they are out shopping at the grocery store, working, visiting parks, and otherwise engaging in the community. Without these behavior adjustments, mobility would continue to be important to monitor and understand, but not a critical factor in predicting neighborhood vulnerability.
    • Second, the introduction and uptake of the vaccine has started the process of lifting communities to herd immunity (HI), which is where the virus has a hard time finding people to infect because enough people have antibodies. As more people get vaccinated, there are fewer people in the community to become infected, and the community is less vulnerable.

An important caveat is that COVID-19 variants can continue to arise. PCCI is conducting ongoing surveillance on reinfections across Dallas County to assess the emergence of new variants, transmission and potential drop off of previously developed immunity. If this happens it means the mediating effect of the vaccination against COVID-19 risk may be decreased – so more people face infection risk. This is also captured in the updated Vulnerability Index.

How is the Vulnerability Index used?

The Vulnerability Index is used to inform how the communities and municipalities across Dallas County coordinate efforts to improve access to testing, vaccinations and create a path towards herd immunity. Below is a balloon plot, which shows cases on the horizontal axis and vaccinations on the vertical axis. It highlights HI progress in early April for ZIP codes across Dallas County. Each circle represents the current progress; each tail shows the improvement over two weeks. Upward “balloon” trajectory is favorable as it indicates that improvement was a result of vaccinations, not infections.

Source: The Parkland Center for Clinical Innovation

One thing that immediately jumps out is that ZIP codes with higher static vulnerability (or long-term risks in a community that do not change quickly such as age, medical comorbidities and social/economic factors) were slower at vaccine uptake. A potential reason for this is social determinants of health (SDOH) – people who live in these zip codes may be in jobs that are not conducive to have the ability to take time off from work and to travel to vaccine sites to be vaccinated. This information is used by community organizers, public health officials, and health care providers to coordinate efforts and target each community in a way that removes barriers to vaccinations and target information and education via convenient and trusted sources.

Excelsior!

Ongoing vigilance against the virus remains key, and this includes getting vaccinated at your first available opportunity. As we enter the second summer in the pandemic, we at PCCI are committed to monitoring for COVID-19’s continued impact on the community, whether through improving the view into impacted communities, the impact of variants, reinfection risk, and more.

For more information about how PCCI has taken the fight to COVID-19, go to: https://pcci1.wpengine.com/taking-the-fight-to-covid-19/

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PCCI’s Vulnerability Index Shows Lowest COVID-19 Infection Risk Level for Dallas County

DALLAS – Towards the end of March, Parkland Center for Clinical Innovation’s COVID-19 Vulnerability Index has recorded the lowest infection risk since the Vulnerability Index launched in June of last year.

“After the holidays, we had vulnerability index ratings at nearly 200, which meant the COVID-19 virus was running rampant through our community,” said George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI. “It is a great relief to see that the highest vulnerability index rating now is only 16.91. This is a triumph for our county’s public health leaders, providers and residents who have made the sacrifices and efforts needed to bend the curve.”

One of the hardest hit ZIP Codes during the past year, 75211, which includes the areas around Cockrell Hill and Oak Cliff, saw its vulnerability risk hit the high of 196.9 in January. This was the highest level any ZIP code in Dallas County reached. By mid-March, its vulnerability rating was 8.74, a dramatic improvement for an area facing some of the most sever socioeconomic issues.

“This is very good news for the residents of the 75211 ZIP code; however, we advise caution going forward,” said Dr. Oliver. “I believe that our new normal will be continued vigilance. To keep COVID-19 from resurging, everyone who can be vaccinated should seek it, and adhere to local health official guidance that includes direction on social distancing and face covering.”

Launched in June 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 dynamic mobility 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/.

Currently, the 75150 ZIP code, at the intersection of Interstate Highway 30 and 635 has the highest COVID-19 risk at 16.91, down from a high of 107.30 in January. The ZIP code 75204, in east downtown Dallas, has the second highest vulnerability level at 15.81, down from a high of 126.5 in January.

PCCI’s forecast of Dallas County reaching COVID-19 herd immunity is still on-track but reaching that threshold is highly dependent residents receiving their vaccinations.

“With vaccinations available to all adults, we need to get in line and get immunized,” said Dr. Steve Miff, PCCI President and CEO. “We don’t want another year to go by where grandparents can’t hug their grandchildren. We have seen how safe and effective the current vaccines are, so it is the responsible thing to do for our friends, families and co-workers to get immunized.”

While always concerning when adverse reactions emerge, the action by the FDA to pause the J&J vaccine is out of “abundance of caution” and it’s a strong signal of how responsive they are to any potential safety concerns. Cerebral venous sinus thrombosis (CVST) with J&J vaccine has been reported in 6 young women (ages 18-48) among 6.8 million doses in the US. To date, Dallas County has administered 61% Pfizer, 35% Moderna, and 4% J&J. The syndrome has been dubbed vaccine-induced immune thrombotic thrombocytopenia.(VITT), based on a similar syndrome after the commonly-used medication heparin abbreviated HITT. The reported rates are much lower than IV Heparin which is used frequently in the hospital. While the risk benefit ratio of continuing to use J& J vaccine in the US COVID-19 vaccination plan may still make sense given the observed case fatality rate of 1.8% of COVID-19, prudence to understand the situation given the FDA emergency use authorization for use is warranted..

The FDA pause for the J&J vaccine will not significantly impact the PCCI initial estimate for Dallas County’s path to herd immunity by June. We were progressing towards herd immunity at a rate of approximately 3% per week, which was ahead of initial predictions. While the allocations for J&J were scheduled to increase and the latest developments will pause those vaccinations likely for days, up to several weeks, we forecast that Dallas county will continue to make progress at 2-2.5% per  week, which maintains the pace for mid-June.

A year in retrospective
With the COVID-19 pandemic ongoing for over a year, PCCI identified the zip codes with the highest average vulnerability from July 2020 through March 2021. These represent areas which have faced the highest risk during the COVID-19 pandemic to date.

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 social determinants 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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Authors

Steve Miff, PhD., President & CEO of PCCI, George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI and  Thomas Roderick, PhD, Senior Director of Data and Applied Sciences at PCCI.

PCCI’s Vulnerability Index Records 66 Percent Reduction in COVID-19 Risk for Dallas County

DALLAS – Dallas County saw a massive 66 percent reduction in risk values recorded by PCCI’s COVID-19 Vulnerability Index in February, with some of the most vulnerable ZIP codes showing significant reductions.

One of the hardest hit ZIP Codes, 75211, which includes the areas around Cockrell Hill and Oak Hill, saw its vulnerability risk value drop by 151.9 points, going from 196.9 vulnerability rating in January to 44.9 in February. The 75211 ZIP code remains the second most at risk area in Dallas County, however its overall improvement is a positive sign for the hard-hit area.

“The dramatic drop in the county’s vulnerability is positive and offers a hopeful path going forward,” Thomas Roderick, PhD, Senior Director of Data and Applied Sciences at PCCI. “We are remaining cautious as we saw vulnerability rates come down

last summer only to see increase significantly later. The key to continued reduction of vulnerability is ongoing vigilance, including continued adhering to local health official guidance, social distancing, face covering, and registering for vaccinations as soon as you’re able.”

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 dynamic mobility 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/.

In addition to the drop in 75211, the ZIP code 75204, in east downtown Dallas, saw a 104.4 drop in its vulnerability ratings. ZIP code 75224, in southern Dallas, saw a drop of 64.9 in its vulnerability ratings, but now is ranked as the most vulnerable area in Dallas County with a vulnerability value of 45.87. Also, the ZIP code 75227, in east Dallas County intersected by State Highway 12, is the third most vulnerable area in Dallas with a 42.45 value, though it dropped 70.5 in its vulnerability ratings since January.

“Holidays and events are potential super-spreader events,” said Dr. Roderick. “We are in a time of year where these tend to

be limited, which impacts ongoing COVID-19 cases. However, Spring Break and occasional holidays on the calendar represent potential trouble times. PCCI will continue monitoring for things that can push Dallas County into higher levels of vulnerability.”

PCCI recently forecast that Dallas County may reach COVID-19 herd immunity by mid-June. This, Dr. Roderick points out, is only possible though vaccinations.

“We each need to be patient as well as register and receive our COVID-19 vaccination,” said Dr. Roderick. “The only way we will reach herd immunity is by maintaining our vigilance and getting vaccinated. Reaching herd immunity is a community effort and should be a priority for each of us.”

PCCI recently launched the MyPCI App, another program to help inform the residents of Dallas County to their individual risks. The MyPCI App, free to register and use, is a secure, cloud-based tool that doesn’t require personal health information and doesn’t track an individual’s mobile phone data. Instead, it is a sophisticated machine learning algorithm, geomapping and hot-spotting technology that uses daily updated data from the Dallas County Health and Human Services (DCHHS) on confirmed positive COVID-19 cases and the population density in a given neighborhood. Based on density and distances to those nearby who are infected, the MyPCI App generates a dynamic personal risk score.

To use the MyPCI App, go to, https://pcci1.wpengine.com/mypci/, click on the link and register (Using code: GP-7xI6QT). Registration includes a request for individual location information that will be used only for generating a risk assessment, never shared. Once registered, simply login daily and a COVID-19 personal risk level score will be provided along with information to help individuals make informed decisions about how to manage their risk.

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 social determinants 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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