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“Since asthma surveillance data were not available at the census tract level for most of Louisiana, we estimated asthma burden using the inpatient discharge data available through LDH.”  (4)

“Case counts are not provided for CTs with a 2018 population of less than 800 to safeguard privacy.” (4)

“To minimize the need for suppression, inpatient discharge data was aggregated for the three most recent years available (2017–2019) and average annual crude rates were calculated for cases where asthma (ICD-10 code J45) was the primary diagnosis, as well as where asthma was any diagnosis.” (4)

“Spearman’s Rank Correlation was utilized to analyze the correlation between various social and environmental vulnerability factors, COVID-19 incidence, and the measures of asthma risk by CT.” (4)

“This was performed by first ranking the values in each dataset using RANK.AVG function in MS Excel 2016, followed by applying the PEARSON function to compare two datasets. Significance was set at alpha less than 0.05 (α < 0.05), with degrees of freedom (df) equal to two less than the total number of data points represented in both datasets” (4)

The research team works for the Section of Environmental Epidemiology and Toxicology, Office of Public Health, Louisiana Department of Health in Baton Rouge. Team members included Arundhati Bakshi; Shanon Soileau; Collete Stewart; Kate Friedman; Collete Maser; Alexis Williams; Kathleen Aubin; and Alicia Van Doren. 

“Currently, much of the environmental focus of the pandemic remains on PM2.5 levels; however, we noted that higher levels of ozone was consistently associated with higher incidence rates of COVID-19, and it was the only environmental factor that appeared to have an additive effect over SVI on COVID-19 incidence (Fig 1).” (11)

“Specifically, our data show a moderately strong positive correlation between SVI due to minority status/language barrier and three health data variables: asthma hospitalization; estimated asthma prevalence; and cumulative COVID-19 incidence at 3 months (Table 2). Interestingly, SVI measures were either negatively or not significantly correlated COVID-19 incidence at the 9-and 12-month time points, indicating that social vulnerability factors may have played a greater role in COVID-19 spread early in the pandemic, but may have been of diminishing importance as the pandemic wore on (Fig 1 and Table 2).” (9)

Bakshi A, Van Doren A, Maser C, Aubin K, Stewart C, Soileau S, et al. (2022) Identifying Louisiana communities at the crossroads of environmental and social vulnerability, COVID-19, and asthma. PLoS ONE 17(2): e0264336. https:// doi.org/10.1371/journal.pone.0264336. 

This document uses data resources from the Center for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR), the Environmental Protection Agency (EPA), and the Louisiana Department of Health (LDH).

These data resources include the Social Vulnerability Index (2018 - CDC/ATSDR), the NATA Respiratory Hazard Index (EPA 2014), PM2.5level (average annual concentration in ug/m3, EPA 2016), ozone level (summer seasonal average of daily maximum 8-hour concentration in air in parts per billion, EPA 2016), indoor mold concerns reported to IEQES program (average annual number of calls, LDH 2017-2019), cumulative COVID-19 incidence rate at 3-, 6-, 9- and 12-month increments (LDH March 2020 - March 2021), asthma hospitalization (average annual crude rate, where asthma was a primary diagnosis among hospitalization cases, LDH 2017-2019), and estimated asthma prevalence (average annual crude rate, where asthma was any diagnosis among hospitalization cases, LDH 2017-2019).

“… the murders occurred where it all began — in the remote forests of southeast Guinea, where superstition overwhelms education and whispers of Ebola stoke fear and sometimes violence.”

“The increase in violence marks a new dark chapter in the fight against Ebola…”

The information of the article was collected by investigating several news agencies. For example, a team of journalists from the Guardian and health works went to the distant village of Guinea to cross the words about Ebola. From the words of the Guinea village chief, journalists from other news agencies are also known.

The article has reveal the trust issue (crisis) dealing between the local publics and the health department workers on the spread of Ebola (and anyone that assist with the work of spreading the awareness of Ebola). This issue is revealed via the several violence acts happened in the area. These cases are reported with briefs of scenes and relevant data.

In this article, the main agencies been depicted are the local publics and the health centers. From the reports, Guinea medical centers and aid works are the main targets that received violence acts and harassments from the general publics. Whereas the publics have the perception that aid workers such as doctors and nurses are the transporters of the virus within the local communities.  

Due to the trust crisis between the groups, public health cannot be improved via the service from the medical centers. General publics are refused to get into contacts with aid workers.

1. With the lack of understanding of new disease (in this case, Ebola for the villagers), the trust crisis is easily raised up between publics and aid workers due to the fear of unknown things.
2. The number of death been announced can violate the faith that publics put into the aid workers. Acts of violence are the fears from the publics.
3. There is a lack of medical education in the area like Western African, Ebola has been there for three times since 1970s, and the publics still not having the correct perception on the disease awareness.