Predictive Modeling of COVID-19 Case Growth Highlights Evolving Demographic Risk Factors in Tennessee and Georgia

The COVID-19 pandemic has exposed the need to understand the unique risk drivers that contribute to uneven morbidity and mortality in US communities. Addressing the community-specific social determinants of health that correlate with spread of SARS-CoV-2 provides an opportunity for targeted public health intervention to promote greater resilience to viral respiratory infections in the future. Our work combined publicly available COVID-19 statistics with county-level social determinants of health information. Machine learning models were trained to predict COVID-19 case growth and understand the unique social, physical and environmental risk factors associated with higher rates of SARS-CoV-2 infection in Tennessee and Georgia counties. Model accuracy was assessed comparing predicted case counts to actual positive case counts in each county. The predictive models achieved a mean r-squared (R(2)) of 0.998 in both states with accuracy above 90% for all time points examined. Using these models, we tracked the social determinants of health, with a specific focus on demographics, that were strongly associated with COVID-19 case growth in Tennessee and Georgia counties. The demographic results point to dynamic racial trends in both states over time and varying, localized patterns of risk among counties within the same state. Identifying the specific risk factors tied to COVID-19 case growth can assist public health officials and policymakers target regional interventions to mitigate the burden of future outbreaks and minimize long-term consequences including emergence or exacerbation of chronic diseases that are a direct consequence of infection.