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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).

• Misinformation: Platforms (Facebook, Google, Instagram, Twitter, Apple App Store and Google Play app store): trying to curb misinformation and directing towards government sources of information.  Facebook giving WHO free ad space.
• "Matching" Donations: Google and Facebook pledge 7.5 and 20 million in matched donations respectively, to WHO
• Addressing price-gouging, [I'll need to look into this more] - Amazon
• At the beginning, tech companies led the work-from-home before it became mandated, and voluntarily closing stores was also protrayed as CSR
• App-supported delivery services adding non-contact options seems portrayed as social responsibility 

The authors all work at University of California San Francisco. Their names are Vicanne Adams, Taslim Van Hattum, and Diana English. Adams works at USCF and was the former director and vice-chair in the department of anthropology, history, and social medicine. She focuses her research in Global Health, Asian Medical Systems, Social Theory, Critical Medical Anthropology, Sexuality and Gender, Safe Motherhood, Disaster Recovery, Tibet, Nepal, China and the US. She has been involved in various publications and has received numerous grants from the NIH. Van Hattum and English are also within the department for Anthropology, History, and Social Medicine. 

The main argument made in this article is that the term "chronic disaster syndrome" can be used as a diagnosis of Katrina survivors as opposed to PTSD. They use this term on the basis of factors including: individual suffering (trauma), the workings of disaster capitalism tied to the undermining of public infrastructures of social welfare and their replacement with private-sector service provision through contracts with for-profit corporations, and the ways that displacement functions within disaster capitalism. They make the point that this term can be used in link with disasters. In this case, Katrina caused "chronic disaster syndrome" to most survivors in that they were affected (and still are) socially, politically, and individually. The trauma experienced and the lack of leadership and governmental response created stressful situations for all residents of New Orleans pre-Katrina. 

The argument is supported through various anecdotes and testimonials. The authors use quotes from various victims in order to highlight the ways in which they were affected by Katrina. Notably, Sally, a 56-year-old woman from St. Bernard Parish who was still living in a FEMA trailer 50 miles from her original residence 2 1/2 years after the storm was interviewed. She talks about the living conditions post-Katrina. She describes families being torn apart, the National Guard using unnecessary force, and dead bodies floating in the water. The authors also use statistics and facts in order to back up their point about the horrendous conditions the survivors were in post-Katrina. A psychological and anthropological analysis also helps strengthen their argument regarding chronic disaster syndrome.

1. "Despite the overwhelming need for mental health services, few residents were able to access mental health support for their symptoms, simply because health care facilities and health care personnel were so scarce. Most health personnel were themselves experiencing the trauma of displacement, and few clinical facilities survived the disaster."
2. "...in the months following Katrina, that the suicide rate had tripled..."
3. "Lakeview, a predominantly Caucasian upper-middle class community, had perhaps made the most progress in rebuilding."
4. "However, for most urban poor residents, it became clear fairly soon after the disaster that they would not be welcomed back to the city."

Through extensive data analysis and interviews, the authors were able to produce claims and formulate their argument. They used information from the NIH and other research and data already obtained to explore displacement in relation to race, ethnicity, socioeconomic status, and age. 

Emergency response is a vital aspect of this article. The authors highlight the ways in which lack of leadership and reaction to Katrina had devastating results. Initially, emergency response had no idea what it was dealing with. Lack of resources and personnel created great issues. Many people helped neighbors and others instead of waiting for help. Long-term discussion of emergency response is also discussed and critiqued as there were vast issues with that. Inappropriate allocation of funds and the lack of leadership created a mess for both emergency responders and the survivors.