Coronavirus Disease 2019 Case Rates Research Articles

State-specific fertility rate changes across the USA following the first two waves of COVID-19.

How did the first two coronavirus disease 2019 (COVID-19) waves affect fertility rates in the USA? States differed widely in how their fertility rates changed following the COVID-19 outbreak and these changes were influenced more by state-level economic, racial, political, and social factors than by COVID-19 wave severity. The outbreak of the COVID-19 pandemic contributed to already declining fertility rates in the USA, but not equally across states. Identifying drivers of differential changes in fertility rates can help explain variations in demographic shifts across states in the USA and motivate policies that support families in general, not only during crises. This is an ecological study using state-level data from 50 US states and the District of Columbia (n = 51). The study period extends from 2020 to 2021 with historical data from 2016 to 2019. We identified Wave 1 as the first apex for each state after February 2020 and Wave 2 as the second apex, during Fall/Winter 2020-2021. State-level COVID-19 wave severity, defined as case acceleration during each 3-month COVID-19 wave (cases/100 000 population/month), was derived from 7-day weekly moving average COVID-19 case rates from the US Centers for Disease Control and Prevention (CDC). State-level fertility rate changes (change in average monthly fertility rate/100 000 women of reproductive age (WRA)/year) were derived from the CDC Bureau of Vital Statistics and from 2020 US Census and University of Virginia 2021 population estimates 9 months after each COVID-19 wave. We performed univariate analyses to describe national and state-level fertility rate changes following each wave, and simple and multivariable linear regression analyses to assess the relation of COVID-19 wave severity and other state-level characteristics with fertility rate changes. Nationwide, fertility dropped by 17.5 births/month/100 000 WRA/year following Wave 1 and 9.2 births/month/100 000 WRA/year following Wave 2. The declines following Wave 1 were largest among majority-Democrat, more non-White states where people practiced greater social distancing. Greater COVID-19 wave severity was associated with steeper fertility rate decline post-Wave 1 in simple regression, but the association was attenuated when adjusted for other covariates. Adjusting for the economic impact of the pandemic (hypothesized mediator) also attenuated the effect. There was no relation between COVID-19 wave severity and fertility rate change following Wave 2. Our study harnesses state-level data so individual-level conclusions cannot be inferred. There may be residual confounding in our multivariable regression and we were underpowered to detect some effects. The COVID-19 pandemic initially impacted the national fertility rate but, overall, the fertility rate rebounded to the pre-pandemic level following Wave 2. Consistent with prior literature, COVID-19 wave severity did not appear to predict fertility rate change. Economic, racial, political, and social factors influenced state-specific fertility rates during the pandemic more than the severity of the outbreak alone. Future studies in other countries should also consider whether these factors account for internal heterogeneity when examining the impact of the COVID-19 pandemic and other crises on fertility. L.G.K. received funding from the National Institute of Environmental Health Sciences (R00ES030403), M.C. from the National Science Foundation Graduate Research Fellowship Program (20-A0-00-1005789), and M.L. and E.S. from the National Institute of Environmental Health Sciences (R01ES032808). None of the authors have competing interests. N/A.

A Demonstration of Modified Treatment Policies to Evaluate Shifts in Mobility and COVID-19 Case Rates in US Counties.

Mixed evidence exists of associations between mobility data and coronavirus disease 2019 (COVID-19) case rates. We aimed to evaluate the county-level impact of reducing mobility on new COVID-19 cases in summer/fall of 2020 in the United States and to demonstrate modified treatment policies to define causal effects with continuous exposures. Specifically, we investigated the impact of shifting the distribution of 10 mobility indexes on the number of newly reported cases per 100,000 residents 2 weeks ahead. Primary analyses used targeted minimum loss-based estimation with Super Learner to avoid parametric modeling assumptions during statistical estimation and flexibly adjust for a wide range of confounders, including recent case rates. We also implemented unadjusted analyses. For most weeks, unadjusted analyses suggested strong associations between mobility indexes and subsequent new case rates. However, after confounder adjustment, none of the indexes showed consistent associations under mobility reduction. Our analysis demonstrates the utility of this novel distribution-shift approach to defining and estimating causal effects with continuous exposures in epidemiology and public health.

A global spatial analysis of factors associated with case and mortality rates for coronavirus disease 2019 during the first year of the pandemic.

A increasing number of studies have revealed associations between country-level determinants and coronavirus disease 2019 (COVID-19) outcomes. This ecological study was conducted to analyze country-level parameters related to COVID-19 infections and deaths during the first year of the pandemic. The examined predictors comprised demographics, economic factors, disease prevalence and healthcare system status, and the relevant data were obtained from public databases. The index dates were set to 15 July 2020 (Time 1) and 15 December 2020 (Time 2). The adjusted spatial autoregression models used a first-order queen contiguity spatial weight for the main analysis and a second-order queen contiguity spatial weight for a sensitivity analysis to examine the predictors associated with COVID-19 case and mortality rates. Obesity was significantly and positively associated with COVID-19 case and mortality rates in both the main and sensitivity analyses. The sensitivity analysis revealed that a country's gross domestic product, population density, life expectancy and proportion of the population older than 65 y are positively associated with COVID-19 case and mortality rates. With the increasing global prevalence of obesity, the relationship between obesity and COVID-19 disease at the country level must be clarified and continually monitored.

Acute and Postacute Clinical Characteristics of Coronavirus Disease 2019 in Children in Japan.

The clinical features of coronavirus disease 2019 (COVID-19) in children have been changing because of the emergence and rapid spread of variants of concern (VOC). The increase in cases infected with VOC has brought concern with persistent symptoms after COVID-19 in children. This survey aimed to analyze the clinical manifestations and persistent symptoms of pediatric COVID-19 cases in Japan. We analyzed the clinical manifestations of pediatric COVID-19 cases reported between February 2020 and April 2022 in Japan, using a dedicated database updated voluntarily by the members of the Japan Pediatric Society. Using the same database, we also analyzed persistent symptoms after COVID-19 in children who were diagnosed between February 2020 and November 2021. A total of 5411 and 1697 pediatric COVID-19 cases were included for analyzing clinical manifestations and persistent symptoms, respectively. During the Omicron variant predominant period, the percentage of patients with seizures increased to 13.4% and 7.4% in patient groups 1-4 and 5-11 years of age, respectively, compared with the pre-Delta (1.3%, 0.4%) or Delta period (3.1%, 0.0%). Persistent and present symptoms after 28 days of COVID-19 onset were reported in 55 (3.2%). Our survey showed that the rate of symptomatic pediatric COVID-19 cases increased gradually, especially during the Omicron variant predominant period, and a certain percentage of pediatric cases had persistent symptoms. Certain percentages of pediatric COVID-19 patients had severe complications or prolonged symptoms. Further studies are needed to follow such patients.

Assessment of two volumetrically different concentration approaches to improve sensitivities for SARS-CoV-2 detection during wastewater monitoring

Wastewater monitoring for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the virus responsible for the global coronavirus disease 2019 (COVID-19) pandemic, has highlighted the need for methodologies capable of assessing viral prevalence during periods of low population infection. To address this need, two volumetrically different, methodologically similar concentration approaches were compared for their abilities to detect viral nucleic acid and infectious SARS-CoV-2 signal from primary influent samples. For Method 1, 2 L of SARS-CoV-2 seeded wastewater was evaluated using a dead-end hollow fiber ultrafilter (D-HFUF) for primary concentration, followed by the CP Select™ for secondary concentration. For Method 2, 100 mL of SARS-CoV-2 seeded wastewater was evaluated using the CP Select™ procedure. Following D-HFUF concentration (Method 1), significantly lower levels of infectious SARS-CoV-2 were lost (P value range: 0.0398–0.0027) compared to viral gene copy (GC) levels detected by the US Centers for Disease Control (CDC) N1 and N2 reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR) assays. Subsamples at different steps in the concentration process were also taken to better characterize the losses of SARS-CoV-2 during the concentration process. During the centrifugation step (prior to CP Select™ concentration), significantly higher losses (P value range: 0.0003 to <0.0001) occurred for SARS-CoV-2 GC levels compared to infectious virus for Method 1, while between the methods, significantly higher infectious viral losses were observed for Method 2 (P = 0.0002). When analyzing overall recovery of endogenous SARS-CoV-2 in wastewater samples, application of Method 1 improved assay sensitivities (P = <0.0001) compared with Method 2; this was especially evident during periods of lower COVID-19 case rates within the sewershed. This study describes a method which can successfully concentrate infectious SARS-CoV-2 and viral RNA from wastewater. Moreover, we demonstrated that large volume wastewater concentration provides additional sensitivity needed to improve SARS-CoV-2 detection, especially during low levels of community disease prevalence.

Keeping nurses engaged during COVID-19: An i-deal perspective

Orientation: The coronavirus disease 2019 (COVID-19) pandemic has impacted all job sectors. Arguably, the hardest hit were healthcare institutions. Nurses are at the front line, and it is known that the pandemic added pressure to the way nurses performed their duties. Their working schedules became more complex, including longer hours, as nurses dealt with high rates of COVID-19 cases while still dealing with other healthcare issues.Research purpose: The study aimed to establish the relationship between idiosyncratic deals (i-deals) and work engagement of nurses. The study focused on these three types of i-deals - task, flexibility and career. It investigated which i-deals best predict work engagement among nurses.Motivation for the study: There is a need to understand the work arrangements of nurses during the pandemic through i-deals. Although research on idiosyncratic deals has become popular in international research, there is scant research within the South African context.Research approach/design and method: The sample consisted of 220 nurses working in three private hospitals in Gauteng, South Africa. Inferential statistics and regression analysis were used to achieve the research objectives.Main findings: The study’s findings revealed a correlation between the three types of i-deals and work engagement. However, only task and flexibility i-deals predicted work engagement. The COVID-19 pandemic added pressure to the healthcare industry and to nurses’ challenges. The pandemic highlighted the importance of having an engaged nursing workforce. Thus, recommendations and suggestions for nurses, nursing managers and human resource managers are provided.Practical/managerial implications: The concept of i-deals is a reasonably new phenomenon within HR practices, and there is no empirical research within the South African context.Contribution/value-add: The study adds value by providing insight into customised work arrangements, from an i-deal perspective, during a much appropriate time and urgently needed for nurses.

Elevated COVID-19 Case Rates of Government Employees, District of Columbia, 2020-2022.

ObjectivesTo estimate the rate ratio (RR) of reported Coronavirus Disease 2019 (COVID-19) cases among governmental employees from seven District of Columbia (D.C.) departments from March 2020 to February 2022.MethodsPoisson regression models were used to estimate the RR by department, using D.C. residents as the reference and the person-day as the offset. The COVID-19 surveillance data and the full-time equivalent hours for each department were obtained from the D.C. governmental websites.ResultsFive of the seven departments had statistically significant higher COVID-19 case rates than D.C. residents. Stratified by four pandemic stages, RR of Fire and Emergency Medical Services (FEMS), Office of Unified Communication (OUC), and Metropolitan Police Department (MPD) were consistently >1: FEMS: 3.34 (95% confidence interval, CI [2.94, 3.77]), 2.39 (95% CI [2.06, 2.75]), 2.48 (95% CI [2.06, 2.95]), and 3.90 (95% CI [3.56, 4.26]), respectively; OUC: 1.47 (95% CI [0.92, 2.18]), 2.72 (95% CI [1.93, 3.69]), 1.85 (95% CI [1.09, 2.92]), and 2.18 (95% CI [1.62, 2.85]), respectively; and MPD: 2.33 (95% CI [2.11, 2.58]), 1.96 (95% CI [1.75, 2.18]), 1.52 (95% CI [1.29, 1.77]), and 1.76 (95% CI [1.60, 1.92]), respectively.ConclusionsThe results suggested higher case rates for emergency responders and frontline personnel than for general population in D.C.

Lifting the mask mandate puts our priorities in plain sight.

Lifting the mask mandate puts our priorities in plain sight.

Does pre-existing immunity determine the course of SARS-CoV-2 infection in health-care workers? Single-center experience.

ObjectivesTo assess the severity of symptoms, duration of infection and viral loads of health-care workers (HCWs) who tested positive for Coronavirus disease 2019 (COVID-19) during Omicron’s prevalence, in regard to vaccination and previous infection.MethodsDuring 2 weeks of highest rate of COVID-19 cases in Bosnia and Herzegovina, the positive nasopharyngeal swabs were analysed in 141 HCWs by reverse transcription quantitative PCR, targeting four different genes: RdRp, E, N and nsp14. Uniformed questionnaire was used to collect relevant sociodemographic and epidemiological data from HCWs divided into four groups: unvaccinated/not previously infected (group 1); unvaccinated/previously infected (group 2); vaccinated/not previously infected (group 3); and vaccinated/previously infected (group 4).ResultsWe observed that occurrence of fever and smell or taste loss were more frequent in group 1 (86.4% and 25%) and group 3 (76.9% and 19.2%), in comparison to group 2 (64.4% and 6.7%) and group 4 (69.2% and 3.8%), (p = 0.023 and p = 0.003). Although statistically not significant, group 2 (61.9%), group 3 (65.4%), and group 4 (70.8%) experienced negativization within 7 days of positive RT-qPCR test, whereas 51.2% of HCWs from group 1 tested negative later on. There is no significant difference between all four groups regarding Ct values of analysed genes.ConclusionDuring Omicron’s prevalence, the vaccination had less substantial effect on symptomatic disease among HCWs, while fever and loss of smell or taste were considerably less likely to occur upon reinfection. Since viral loads and negativization periods do not seem to significantly vary, irrespective of pre-existing immunity, systemic vaccination and mask-wearing should still be considered among HCWs.

Penggunaan High Flow Nasal Cannula sebagai Terapi Oksigen pada Kasus Covid-19 Berat dengan Obesitas: Laporan Kasus

Coronavirus Disease 2019 (COVID-19) is a disease which caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In December 2019, this disease was encountered in Wuhan, China. Covid-19 is still a global pandemic to this day. Obesity is one of the comorbidities which has been shown to increase the severity of COVID-19 cases. There is research which stated that invasive mechanical ventilation may contribute to mortality rate in severe case of COVID-19. Other than that, the increase rate of severe COVID-19 cases and the limited availability of facilities and infrastructure makes the usage of high flow nasal cannula (HFNC) begins to be considered. Aim of this case report is to represent the outcome of obese COVID-19 patient whom treated with HFNC, furthermore could evoke readers to take further research of the effectiveness of HFC usage as an oxygen therapy in severe COVID-19 cases. Case summary: 21 years old woman came to Emergency Department in Wangaya Regional Hospital with shortness of breath, unproductive cough, sore throat, and inability to smell. Patient was treated and diagnosed with confirmed severe COVID-19. She got obesity as comorbidity (weight 105 kg; height 160 cm; Body Mass Index (BMI) 41.02 kg/m2). Patient was treated for 15 days, which include 10 days of treatment in negative pressure ward in Intensive Care Unit Department (ICU). During the treatment course, patient received pharmacologic and non-pharmacologic treatment, including the administration of HFNC. After five days of HFNC usage, oxygen supplementation was downgraded to conventional oxygen supplementation (non-rebreather mask and nasal cannula). Patient then discharge without any complain and proceed self-quarantine at home. HFNC could be considered as one of non-invasive oxygen supplementation treatment in patient with severe COVID-19 disease. The initiation of usage of HFNC could be started with 30 L/minute flow, with 40% fraction of inspired oxygen (FiO2) in accordance to patient comfort with Sp02 target 92-96%. If there is an increased breathing effort, high respiratory rate, and unachieved Sp02 target, flow and inspiration fraction titrated gradually. ROX index could be used as a treatment failure indication and the need of invasive ventilation.

Prediction and management of household solid waste generation during COVID-19 pandemic in Bandung City using system dynamics model

Abstract WHO declared a novel coronavirus in humans as Coronavirus Disease 2019 (COVID-19) on February 2020, and Indonesia as well as Bandung City have been suffering from COVID-19 since the first case in March, 2020. Currently, the outbreak of COVID-19 has occurred for more than a year. The COVID-19 pandemic had a severe impact on the environment, like the enhancement of household solid waste as a result of work and school from home policies to decrease the rates of COVID-19 cases. This study aimed to predict the amount of household solid waste generation and analyze the waste management during COVID-19 in Bandung City using a system dynamics model. Data for model input was obtained from questionnaire to 200 respondents from Bandung spread across the sub-districts. The results revealed that the household solid waste generation was increased by 1.3 to 3.8% compared to the year before the COVID-19 pandemic. The composition of household solid waste was dominated by food and plastic waste, which have increased to 76.43% and 25.81%, respectively. The system dynamics model has predicted the household waste generation from three management scenarios for 30 years of model simulation. Scenario I: the household solid waste was totally managed by a local sanitary agency (existing condition); Scenario II: each household manage their waste by recycling; and Scenario III: the utilization of a local waste bank to manage the waste. The scenario III showed the most effective waste management to reduce the amount of household solid waste generation up to 24% by using waste bank. This scenario can be applied for more prolonged landfill operations up to 17 years.

Risk Factors for Severity and Mortality in Adult Patients Confirmed with COVID-19 in Sierra Leone: A Retrospective Study.

Background:The coronavirus disease 2019 (COVID-19) is a highly infectious respiratory disease. There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone, and supportive care and protection of vital organ function are performed for the patients. This study summarized the clinical characteristics, drug treatments, and risk factors for the severity and prognosis of COVID-19 in Sierra Leone to provide evidence for the treatment of COVID-19.Methods:Data of 180 adult COVID-19 patients from the 34th Military Hospital in Freetown Sierra Leone between March 31, 2020 and August 11, 2020 were retrospectively collected. Patients with severe and critically ill are classified in the severe group, while patients that presented asymptomatic, mild, and moderate disease were grouped in the non-severe group. The clinical and laboratory information was retrospectively collected to assess the risk factors and treatment strategies for severe COVID-19. Demographic information, travel history, clinical symptoms and signs, laboratory detection results, chest examination findings, therapeutics, and clinical outcomes were collected from each case file. Multivariate logistic analysis was adopted to identify the risk factors for deaths. Additionally, the clinical efficacy of dexamethasone treatment was investigated.Results:Seventy-six (42.22%) cases were confirmed with severe COVID-19, while 104 patients (57.78%) were divided into the non-severe group. Fever (56.67%, 102/180) and cough (50.00%, 90/180) were the common symptoms of COVID-19. The death rate was 18.89% (34/180), and severe pneumonia (44.12%, 15/34) and septic shock (23.53%, 8/34) represented the leading reasons for deaths. The older age population, a combination of hypertension and diabetes, the presence of pneumonia, and high levels of inflammatory markers were significantly associated with severity of COVID-19 development (P < 0.05 for all). Altered level of consciousness [odds ratio (OR) = 56.574, 95% confidence interval (CI) 5.645–566.940, P = 0.001], high levels of neutrophils (OR = 1.341, 95%CI 1.109–1.621, P = 0.002) and C-reactive protein (CRP) (OR = 1.014, 95%CI 1.003–1.025, P = 0.016) might be indicators for COVID-19 deaths. Dexamethasone treatment could reduce mortality [30.36% (17/56) vs. 50.00% (10/20)] among severe COVID-19 cases, but the results were not statistically significant (P > 0.05).Conclusions:The development and prognosis of COVID-19 may be significantly correlated with consciousness status, and the levels of neutrophils and CRP.

Phased Return of Students to 77 Transitional Kindergarten-8th Grade Schools With Cohesive Mitigation Strategies Serving as Protective Factors Against the Increase of COVID-19 Cases in Marin County: September 2020-January 2021.

Background and objectiveEarlier uncertain implications of the coronavirus disease 2019 (COVID-19) pandemic on the pediatric population prompted the authorities to close schools worldwide under the premise that school settings would serve as drivers of an increase in the cases of COVID-19. Safe and equitable full-in-person school instruction is a critical factor in the continued educational gains of children and for their general well-being. The objective of this study was to report epidemiological trends related to the increasing percentage of students returning to in-person instruction, the suspected in-school transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the virus that causes COVID-19, and countywide COVID-19 case rates during the first 21 weeks of school reopening in Marin County, CA, in the fall of 2020.Materials and methodsThe institutional review board (IRB) approval was waived for this study as it did not involve any identifiable human subjects data. Retrospective electronic reviews of countywide COVID-19 daily case count and COVID-19-related reports associated with in-person school participants from 77 schools in Marin County, CA, from September 8, 2020, to January 29, 2021, were conducted. The data were made available in collaboration with the Marin County Office of Education (MCOE) and Marin County Department of Health and Human Services (Marin HHS). Descriptive trends analyses were performed to determine whether the phased increase of students attending in-person learning was a significant contributor to countywide COVID-19 incidence rate, crude rate, and in-school COVID-19 viral transmission. This is the first long retrospective study of COVID-19 data among the reopened school population during the second half of the first pandemic year. It was conducted in a 21-week surveillance period involving an immense collaboration between Marin County’s public health officials and school administrators.ResultsOver the 21-week observational period involving 17,639 students, 4,938 school staff, and 899,175 student days, the countywide COVID-19 crude rate decreased (from 89.9 to 35.89 per 10,000) as more students returned to in-person learning. The schools’ strict adherence to public health guidance and site-specific safety plans against COVID-19 yielded a significantly reduced incidence rate of 0.84% among in-person learning participants; only nine cases were traced to suspected in-school SARS-CoV-2 transmission by way of rigorous contact tracing. The countywide COVID-19 incidence rate was 2.09%.ConclusionsIt is possible to minimize COVID-19 transmissions in in-person learning settings with cohesive mitigation strategies, specifically strict adherence to proper masking by students and staff while on school grounds. There is no clear correlation that the increasing phased return of students to in-person school drove an increase in countywide COVID-19 cases in Marin County, CA. Our findings revealed that schools were capable of safely resuming operations by following public health orders and recommendations. The increasing percentage of students returning to in-person school did not drive an increased COVID-19 case rate in the community. On the contrary, this analysis revealed that there was a drop in countywide COVID-19 cases as the phased student return percentage increased.

Country-level determinants of COVID-19 case rates and death rates: An ecological study.

The Coronavirus Disease 2019 (COVID‐19) pandemic has had a variable worldwide impact, likely related to country‐level characteristics. In this ecological study, we explored the association of COVID‐19 case rates (per 100,000 people) and death rates (per 100,000 people) with country‐level population health characteristics, economic and human development indicators, and habitat‐related variables. To calculate country‐level COVID‐19 case and death rates, the number of cases and deaths were extracted from the Johns Hopkins Coronavirus Resource Center through September 30, 2021. Country‐level population health characteristics, economic, human development, and habitat‐related indicators were extracted from several publicly available online sources of international organizations. Results were tabulated according to world zones and country economies. Unadjusted and adjusted multiple imputation linear regression analyses were performed to examine the association between country‐level variables (per 1‐standard deviation [SD] increase) and COVID‐19 case and death rates. To satisfy the linear regression model assumptions of normality of residuals, we used the square root transformation of both outcomes. A total of 187 countries and territories were analyzed, with a median (25th, 75th percentiles) aggregate COVID‐19 case rate of 3,605 (463, 8,228) per 100,000, a COVID‐19 death rate of 45.9 (8.9, 137.1) per 100,000, and a case‐fatality rate of 1.6% (1.2%, 2.6%). On multivariable analyses, each country‐level 1‐SD higher percentage of adults with obesity (β coefficient 13.7; 95% confidence interval [CI] 13.7; 8.9, 18.4), percentage of smokers (5.8; 95% CI 1.2, 10.5), percentage of adults with high blood pressure (4.9; 95% CI 0.3, 9.6), and gross national income (GNI) per capita (9.5; 95% CI 4.6, 14.5) was independently associated with higher square root of COVID‐19 case rate, while average household size (−1.7; 95% CI −12.3, −3.2) was independently associated with lower square root of COVID‐19 case rate. Similarly, each 1‐SD higher percentage of adults with obesity (1.76; 95% CI 0.99, 2.52), percentage of adults with high blood pressure (1.11; 95% CI 0.48, 1.74), percentage of adults with physical inactivity (1.01; 95% CI 0.10, 1.191), and travel & tourism competitiveness index (1.05; 95% CI 0.06, 2.04) was independently associated with higher square root of COVID‐19 death rate, whereas GNI per capita (−0.92; 95% CI −1.81, −0.03), and average household size (−1.07; 95% CI −1.87, −0.27) was independently associated with lower square root of COVID‐19 death rate. This ecological study informs the need to develop country‐specific public health interventions to better target populations at high risk for COVID‐19, and test interventions to prevent transmission of SARS‐CoV‐2, taking into consideration cross‐country differences in population health characteristics, and economic, human development and habitat‐related factors.

Testing for SARS-CoV-2 in Symptomatic Vaccinated and Unvaccinated Health Care Workers During the Delta Variant Surge.

Background:Infection with SARS- CoV- 2 in health care workers (HCWs) challenges employee health services.Methods:We analyzed telephone Coronavirus Disease 2019 (COVID-19) hotline data over 8 weeks in 2021 during SARS- CoV- 2 Delta variant surge. We calculated COVID-19 case rates among persons-under-investigation (PUIs) for illness at two health care centers (HCs).Results:There were 41 COVID-19 cases among the 285 PUIs (14.4%) at the study HC and 549 (16.9%) of 3244 at the comparison HC. At the study HC, 11.7% of vaccinated PUIs versus 36.6% of unvaccinated PUIs were COVID-19 positive. The COVID-19 positivity rates among vaccinated and unvaccinated PUIs at the comparison HC were 16.1% and 33.3%, respectively.Discussion:In the SARS-CoV-2 Delta variant surge, COVID-19 test positivity rates among unvaccinated symptomatic HCWs are dramatically elevated. Aggressive testing of HCW PUIs is particularly critical during periods of disease upsurge.

Could the ABO Blood Group Types be Associated with COVID-19 Mortality?

Aim: Currently, it is still a matter of debate whether a particular blood types is associated with an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In the present study, we aimed to evaluate the relationship between the ABO blood group types and mortality in patients hospitalized with the diagnosis of Coronavirus disease-2019 (COVID-19). Methods: This cross-sectional study included 427 patients diagnosed with COVID-19 between March 2020 and June 2020. SARS-CoV-2 ribonucleic acid was investigated in the naso/oropharyngeal swab samples of the patients by polymerase chain reaction. The blood group types, clinical and demographic data of the cases were obtained from the hospital automation system and patient files. Results: The age range of the patients was between 18 and 96, and 53.4% (228/427) of them were male. The ABO blood group distribution was 47.1% A, 29.5% O, 15.9% B, 7.5% AB. The overall mortality rate of COVID-19 cases was 16.9%. COVID-19 mortality risks were not significant in any of the ABO blood group types. Conclusion: We did not find a significant relationship between blood group types and mortality in patients who were hospitalized with a diagnosis of COVID-19 and received treatment and follow-up. [ABSTRACT FROM AUTHOR] Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Environmental and Social Determinants of Health Matter in a Pandemic: Predictors of COVID-19 Case and Death Rates in New York City.

Our research objective was to determine which environmental and social factors were predictive of coronavirus disease 2019 (COVID-19) case and death rates in New York City (NYC), the original epicenter of the pandemic in the US, and any differential impacts among the boroughs. Data from various sources on the demographic, health, and environmental characteristics for NYC zip codes, neighborhoods, and boroughs were analyzed along with NYC government’s reported case and death rates by zip code. At the time of analysis, the Bronx had the highest COVID-19 case and death rates, while Manhattan had the lowest rates. Significant predictors of a higher COVID-19 case rate were determined to be proportion of residents aged 65 years plus; proportion of residents under 65 years with a disability; proportion of White residents; proportion of residents without health insurance; number of grocery stores; and a higher ozone level. For COVID-19 death rates, predictors include proportion of residents aged 65 years plus; proportion of residents who are not US citizens; proportion on food stamps; proportion of White residents; proportion of residents under 65 years without health insurance; and a higher level of ozone. Results across boroughs were mixed, which highlights the unique demographic, socioeconomic, and community characteristics of each borough. To reduce COVID-19 inequities, it is vital that the NYC government center the environmental and social determinants of health in policies and community-engaged interventions adapted to each borough.

Effect of COVID-19 pandemic on mental health hospital admissions: comparative population-based study.

The coronavirus disease 2019 (COVID-19) global pandemic caused mental health services to be downscaled to abide by the public health restrictions issued. The aim of this study was to investigate whether the pandemic and resultant restrictions had an impact on Malta's admissions to hospital for mental health issues by assessing the number and nature of psychiatric admissions to our only national mental health hospital. Data collection was carried out retrospectively for the 13-week period between 7 March 2020 and 4 June 2020, compared with the equivalent in 2019. Demographic data was obtained and descriptive statistical analysis through the use of the χ²-test, z-test and logistic regression model were used to compare both data-sets, using a P-value of 0.05. An overall reduction in admissions to hospital was noted in 2020 when compared with 2019, recorded to be lowest in March 2020 with a steady acceleration of admissions up until May 2020 (χ2(3) = 22.573, P < 0.001). This coincided with a decelerated rate of positive COVID-19 cases locally. In 2020, there were significantly higher female admissions (χ2(1) = 10.197, P < 0.001), increased presentations of self-harm/suicidal ideation (P < 0.001) and higher involuntary admissions using the Mental Health Act (χ2(1) = 4.904, P = 0.027). The logistic regression model identified total length of stay in hospital, primary mental health diagnosis, gender and month of admission as variables significantly associated with an admission. Our first population-wide study confirms that the COVID-19 pandemic and subsequent public health restrictions had an impact on the population's hospital admissions for mental health issues.

Chance elections, social distancing restrictions, and KENTUCKY's early COVID-19 experience.

Early in the pandemic, slowing the spread of novel coronavirus disease 2019 (COVID-19) relied on non-pharmaceutical interventions. All U.S. states adopted social-distancing restrictions in March and April of 2020, though policies varied both in timing and scope. Compared to states with Democratic governors, those with Republican governors often adopted measures for shorter durations and with greater resistance from their residents. In Kentucky, an extremely close gubernatorial election immediately prior to the discovery of SARS-CoV-2 replaced a Republican incumbent with a Democrat, despite Republicans easily winning all other statewide races. This chance election result offers a unique opportunity to examine the impact of early social distancing policies in a relatively conservative, rural, white-working-class state. Our study begins by estimating an event-study model to link adoption of several common social distancing measures-public school closures, bans on large gatherings, closures of entertainment-related businesses such as restaurants, and shelter-in-place orders (SIPOs)-to the growth rate of cases across counties in the Midwest and South in the early stages of the pandemic. These policies combined to slow the daily growth rate of COVID-19 cases by 9 percentage points after 16 days, with SIPOs and entertainment establishment closures accounting for the entire effect. In order to obtain results with more direct applicability to Kentucky, we then estimate a model that interacts the policy variables with a "white working class" index characterized by political conservatism, rurality, and high percentages of white, evangelical Christian residents without college degrees. We find that the effectiveness of early social distancing measures decreased with higher values of this index. The results imply that the restrictions combined to slow the spread of COVID-19 by 12 percentage points per day in Kentucky's two largest urban counties but had no statistically detectable effect across the rest of the state.

Severe acute respiratory syndrome coronavirus 2 vaccination for patients with solid cancer: Review and point of view of a French oncology intergroup (GCO, TNCD, UNICANCER)

The impacts of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on cancer care are multiple, entailing a high risk of death from coronavirus disease 2019 (COVID-19) in patients with cancer treated by chemotherapy. SARS-CoV-2 vaccines represent an opportunity to decrease the rate of severe COVID-19 cases in patients with cancer and also to restore normal cancer care. Patients with cancer to be targeted for vaccination are difficult to define owing to the limited contribution of these patients in the phase III trials testing the different vaccines. It seems appropriate to vaccinate not only patients with cancer with ongoing treatment or with a treatment having been completed less than 3 years ago but also household and close contacts. High-risk patients with cancer who are candidates for priority access to vaccination are those treated by chemotherapy. The very high-priority population includes patients with curative treatment and palliative first- or second-line chemotherapy, as well as patients requiring surgery or radiotherapy involving a large volume of lung, lymph node and/or haematopoietic tissue. When possible, vaccination should be carried out before cancer treatment begins. SARS-CoV-2 vaccination can be performed during chemotherapy while avoiding periods of neutropenia and lymphopenia. For organisational reasons, vaccination should be performed in cancer care centres with messenger RNA vaccines (or non-replicating adenoviral vaccines in non-immunocompromised patients). Considering the current state of knowledge, the benefit-risk ratio strongly favours SARS-CoV-2 vaccination of all patients with cancer. To obtain more data concerning the safety and effectiveness of vaccines, it is necessary to implement cohorts of vaccinated patients with cancer.