RAPID: A comparison of the 1918 influenza pandemic and COVID-19 in Missouri: implications for current mitigation strategies in rural versus urban locations

该RAPID项目将比较1918年流感大流行与目前COVID-19大流行期间的流行模式和密苏里州居民的反应，主要关注城乡差异。这项研究将增进对城市与农村环境中的生活状况如何影响流行病经历的了解，并将提供关于在当前流行病期间使居民面临更大风险的重要社区特征的知识。这项研究还将揭示一个地区的哪些特征在很长一段时间内是稳定的，哪些是现代生活的方面，也许更具可塑性。因此，这项研究具有时间敏感性，因为研究人员将迅速向密苏里州卫生和高级服务部传达与当前流行病相关的项目发现。此外，该项目将为学生提供数据收集方面的培训和进行研究的第一手经验，以帮助处理不可预见的严重公共卫生事件。一种新的冠状病毒，SARS-CoV-2，人类对它几乎没有潜在的免疫力，已经在整个地球仪传播。在这种大流行背景下，农村地区可能面临城市地区不存在的挑战。由于目前没有疫苗，因此必须迅速制定有效的战略，以保护农村地区免受可能在未来几年传播的病毒的影响。1918- 1919年，当一种新的致命流感病毒开始感染人类时，世界经历了类似的情况。虽然这两种流行病之间存在显著差异，但病毒的传播方式和对人类社区的总体影响相似。了解农村居民对这两种流行病的经历和反应提供了重要的见解，可能会导致新的公共卫生战略，更适合农村居民在重大疾病爆发期间的需求。该项目涉及对密苏里州1918年流感大流行和当前COVID-19大流行期间的死亡率和发病率模式进行深入比较分析。分析将侧重于在县一级汇总的数据，并将确定县的特点（例如，人口密度、医院数量、家庭组成、与大城市地区的接近程度、种族组成、流动模式），这些因素与两次大流行病期间的死亡率和/或患病率有关。将对密苏里州1918年流感大流行的历史数据进行检查，以确定大流行期间不同县使用的控制策略，确定其有效性，并评估它们在当前大流行期间是否有用。这反过来又可以帮助发展潜在的战略，公共卫生当局可以添加到已经在农村县使用的武库。这个奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

This RAPID project will compare epidemic patterns and Missouri residents’ responses in the 1918 influenza pandemic to those occurring at present during the COVID-19 pandemic, with primary attention paid to urban-rural differences. The research will increase understanding of how life situations in urban versus rural settings affect epidemic disease experiences and will provide knowledge of important community characteristics that put residents at greater risk during the current pandemic. The study will also shed light on which characteristics of a region have been stable over long periods of time and which are aspects of modern life and perhaps more malleable. The research is therefore time-sensitive because the investigators will expeditiously communicate project findings relevant to the current pandemic to the Missouri Department of Health and Senior Services. In addition, this project will provide student training in data collection and first-hand experience in conducting research to help deal with an unforeseen and serious public health event. A new coronavirus, SARS-CoV-2, to which humans possess little underlying immunity, has been spreading throughout the globe. In this pandemic setting, rural regions may face challenges that are not present in urban areas. As there is currently no vaccine, it is critical to devise effective strategies quickly, to protect rural regions from echo waves of the virus that may circulate over the next few years. The world experienced a similar situation in 1918-19 when a new, lethal strain of influenza began to infect humans. Although there are significant differences between these two pandemics, the viruses have similar modes of transmission and overall impacts on human communities. Understanding the experiences and responses of rural citizens to these two pandemics provides important insights that may lead to new public health strategies that are more tailored to the needs of rural residents during major disease outbreaks. The project involves in-depth comparative analysis of mortality and morbidity patterns during the 1918 influenza pandemic and the present COVID-19 pandemic in the state of Missouri. Analysis will focus on data aggregated at the county level and will determine county characteristics (e.g., population density, number of hospitals, household composition, proximity to large urban area, ethnic composition, mobility patterns) that are associated with death and/or illness rates during the two pandemics. Historical data from the Missouri 1918 influenza pandemic will be examined to identify control strategies used in different counties during the pandemic, determine their effectiveness, and assess whether they would be of use during the present pandemic. This in turn can aid in the development of potential strategies that public health authorities can add to the arsenal already being used in rural counties.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.