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Littlefield J, Longacre ML. Use of Community Health Workers Among U.S. Male Latino Population: A Scoping Review. J Immigr Minor Health 2024; 26:738-760. [PMID: 38536639 DOI: 10.1007/s10903-024-01586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 07/31/2024]
Abstract
Community Health Workers (CHWs) are an effective strategy to address the health needs of specified communities. The purpose of this scoping review was to explore the use of CHWs to address the health needs of the Latino male population. This project used specific search terms to identify relevant articles from PubMed, PsycINFO, and Google Scholar. Eligible articles included studies, conducted in the U.S. and in English from 2010 to 2022, that assessed the use of CHWs among a predominantly male (≥ 50%) Latino population. Twenty articles consisting of 13 interventions were identified for review and were further categorized into male-only participant samples (n = 10) and mixed-gender but predominantly-male participant samples (n = 10) for synthesis. Male-only participant samples focused on occupational health and participant's social support and networks. Predominantly-male, mixed-gender participant sample interventions were disease-centered and emphasized the longitudinal support of CHWs as well as social networks. Of the 13 interventions reviewed, almost all (n = 10) utilized existing social networks for engagement and nearly half (n = 6) employed community-based participatory research (CBPR) principles. Findings suggest that recruiting CHWs from within existing social networks and using CBPR are important factors for successful health promotion among male Latinos.
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Affiliation(s)
- J Littlefield
- College of Health Sciences, Arcadia University, 450 S. Easton Rd, Glenside, PA, USA
| | - M L Longacre
- College of Health Sciences, Arcadia University, 450 S. Easton Rd, Glenside, PA, USA.
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Compton WM, Hooper MW, Hodes RJ, Pérez-Stable EJ. Lessons From COVID-19 Testing Research: The Power of Rapid Response. Am J Public Health 2024; 114:S343-S346. [PMID: 38776500 PMCID: PMC11111383 DOI: 10.2105/ajph.2024.307653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Wilson M Compton
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Monica Webb Hooper
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Richard J Hodes
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Eliseo J Pérez-Stable
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
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Rowe JT, Parrillo E, Stanford O, Wenzel J, Johnston FM. Individual and Systemic Barriers Blocking Community Health Workers from Helping the Seriously Ill. J Palliat Med 2024; 27:358-366. [PMID: 38010809 PMCID: PMC10903179 DOI: 10.1089/jpm.2022.0516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Palliative care is a valuable component of health care that improves a patient's quality of life, yet its availability to patients with serious chronic illness remains relatively low. Due to their knowledge of community preferences and ability to improve patient education and access to care, community health workers (CHWs) can increase palliative care usage by patients. Notably, barriers to CHWs helping patients with serious chronic illness remain poorly understood. Objective: Explore the perception of barriers CHWs feel they face when attempting to support the health care of patients with serious chronic illness. Design: Qualitative semistructured individual interviews of CHWs and qualitative descriptive analysis. Setting/Subjects: Twelve CHWs who have worked with patients with serious chronic illness were recruited from the Johns Hopkins Healthcare LLC and the Baltimore Alliance for Careers in Healthcare organizations to virtually participate. Results: CHWs perceived both active and passive barriers that obstructed their efforts to work with seriously ill patients. CHWs shared that these barriers were dependent on themselves, their peers, and their work environments. Prevalent themes included interprofessional conflict, poor health care worker understanding of the CHW's role, and lack of access to quality resource organizations. CHWs noted job-specific training, better means to identify needed resources for patients, and inclusive health care teams as solutions to support their professional goals, while helping patients with serious illness. Conclusions: There are multiple perceived barriers to CHWs helping seriously ill patients. CHWs aiding patients with serious illness can be supported through better job training, better resource management tools, and improved communication between health care team members.
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Affiliation(s)
- Julian T. Rowe
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elaina Parrillo
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Olivia Stanford
- Community Outreach and Engagement Department, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fabian M. Johnston
- Division of Surgical Oncology, Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
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Agustina R, Rianda D, Lamuri A, Ekawidyani KR, Siregar DAS, Sari DS, Wulan PM, Devana ND, Syam AF, Rahyussalim AJ, Handayani DO, Widyastuti W, Shankar AH, Salama N. The impact of government pandemic policies on the vulnerability of healthcare workers to SARS-CoV-2 infection and mortality in Jakarta Province, Indonesia. Ann Med 2024; 55:2293306. [PMID: 38206905 PMCID: PMC10786428 DOI: 10.1080/07853890.2023.2293306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Healthcare workers (HCWs) are on the frontlines of the COVID-19 pandemic, putting them at a higher risk of infection and disease than non-HCWs. We analysed the effects of government policies for the public and for HCWs on the likelihood of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality among HCWs during the first 8 months of the pandemic in Jakarta province, the capital city and COVID-19 hotspot in Indonesia. METHODS We conducted a retrospective cohort study using secondary data from the Jakarta provincial government from March to October 2020, which included sociodemographic characteristics, symptoms, comorbidities and COVID-19 diagnosis history for all cases. A generalized linear mixed-effect regression model was used to determine the effect of each month on the odds ratio (OR) of COVID-19 cases and deaths for HCW compared with non-HCW, assuming that monthly trends were influenced by varying government policies. RESULTS A total of 894,487 suspected and confirmed COVID-19 cases in health facilities in Jakarta province were analysed. The OR of confirmed cases for HCW was 2.04 (95% CI 2.00-2.08; p < .001) compared to non-HCW. Despite this higher OR for infection, the case fatality rate (2.32 per 100) and OR (1.02, 95% CI 0.93-1.11; p = .65) of COVID-19 deaths for HCW were similar to those of non-HCW. We observed a trend towards a lower number of COVID-19 patients in hospitals and lower odds of COVID-19 cases among HCWs during the April-to-July 2020 phase compared to the August-to-October phase. This chronologically aligned with more extensive policies to support hospital-based, community-based and well-being-related actions to protect HCW. CONCLUSIONS HCW had higher odds of having SARS-CoV-2 infection, yet similar odds of death from COVID-19, as compared to non-HCW. Government policies with collective efforts to prevent hospital overcapacity during high transmission and burden periods of the pandemic should be prioritized.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Davrina Rianda
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Nutrition, University of California at Davis, Davis, CA, USA
| | - Aly Lamuri
- Big Data Center, Indonesian Medical Education and Research Institute (BDC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Karina Rahmadia Ekawidyani
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, Indonesia
| | - Deviana Ayushinta Sani Siregar
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dyana Santika Sari
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Prashti Mutia Wulan
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Natasha Dianasari Devana
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ari Fahrial Syam
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ahmad Jabir Rahyussalim
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | | | - Anuraj Harish Shankar
- Oxford University Clinical Research Unit – Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ngabila Salama
- Health Office, Government of Jakarta Province, Jakarta, Indonesia
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Abdi N, Ebengho S, Mohamed N, Scallon A, Mohamed A, Ahmed A, Abdi A, Ahmed R, Mohamed F, Ibrahim A, Ali A, West KM, Ronen K. Early Pandemic Access to COVID-19 Testing in the Somali Community in King County, Washington, USA: a Mixed-Methods Evaluation. J Racial Ethn Health Disparities 2023; 10:2930-2943. [PMID: 36478269 PMCID: PMC9734463 DOI: 10.1007/s40615-022-01470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Racial and ethnic disparities in COVID-19 infection and outcomes have been documented, but few studies have examined disparities in access to testing. METHODS We conducted a mixed methods study of access to COVID-19 testing in the Somali immigrant community in King County, Washington, USA, early during the COVID-19 pandemic. In September 2020-February 2021, we conducted quantitative surveys in a convenience sample (n = 528) of individuals who had accessed PCR testing, recruited at King County testing sites near Somali population centers and through social media outreach in the Somali community. We compared self-identified Somali and non-Somali responses using Chi-square and Wilcoxon rank sum tests. We also conducted three Somali-language focus groups (n = 26) by video conference to explore Somali experiences with COVID-19 testing, and in-depth interviews with King County-based policymakers and healthcare workers (n = 13) recruited through the research team's professional network to represent key demographics and roles. Data were analyzed using qualitative rapid analysis to explore the county's COVID-19 testing landscape. RESULTS Among 420 survey respondents who had received COVID-19 testing in the prior 90 days, 29% of 140 Somali vs. 11% of 280 non-Somali respondents tested because of symptoms (p = 0.001), with a trend for longer time from symptom onset to testing (a measure of testing access) among Somali respondents (median 3.0 vs. 2.0 days, p = 0.06). Focus groups revealed barriers to testing, including distrust, misinformation, stigma, language, lack of awareness, and transportation. Stakeholders responding from all sectors highlighted the importance of community partnership to improve access. CONCLUSION Somali communities experience barriers to COVID-19 testing, as evidenced by the longer time from symptom onset to testing and corroborated by our qualitative findings. These barriers, both structural and community-derived, may be overcome through partnerships between government and community to support community-led, multilingual service delivery and racial representation among medical staff.
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Affiliation(s)
- Najma Abdi
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Sabrina Ebengho
- School of Public Health, University of Washington, Seattle, WA, USA
- Somali Health Board, Tukwila, WA, USA
| | | | - Andrea Scallon
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ayan Mohamed
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Asiya Ahmed
- School of Public Health, University of Washington, Seattle, WA, USA
- Somali Health Board, Tukwila, WA, USA
| | | | - Ruweida Ahmed
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Anisa Ibrahim
- Somali Health Board, Tukwila, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
| | - Kathleen McGlone West
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Keshet Ronen
- Department of Global Health, University of Washington, Seattle, WA, USA.
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Johannesson JM, Glover WA, Petti CA, Veldman TH, Tsalik EL, Taylor DH, Hendren S, Neighbors CE, Tillekeratne LG, Kennedy SW, Harper B, Kibbe WA, Corbie G, Cohen-Wolkowiez M, Woods CW, Lee MJ. Access to COVID-19 testing by individuals with housing insecurity during the early days of the COVID-19 pandemic in the United States: a scoping review. Front Public Health 2023; 11:1237066. [PMID: 37841714 PMCID: PMC10568314 DOI: 10.3389/fpubh.2023.1237066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction The COVID-19 pandemic focused attention on healthcare disparities and inequities faced by individuals within marginalized and structurally disadvantaged groups in the United States. These individuals bore the heaviest burden across this pandemic as they faced increased risk of infection and difficulty in accessing testing and medical care. Individuals experiencing housing insecurity are a particularly vulnerable population given the additional barriers they face. In this scoping review, we identify some of the barriers this high-risk group experienced during the early days of the pandemic and assess novel solutions to overcome these barriers. Methods A scoping review was performed following PRISMA-Sc guidelines looking for studies focusing on COVID-19 testing among individuals experiencing housing insecurity. Barriers as well as solutions to barriers were identified as applicable and summarized using qualitative methods, highlighting particular ways that proved effective in facilitating access to testing access and delivery. Results Ultimately, 42 studies were included in the scoping review, with 143 barriers grouped into four categories: lack of cultural understanding, systemic racism, and stigma; medical care cost, insurance, and logistics; immigration policies, language, and fear of deportation; and other. Out of these 42 studies, 30 of these studies also suggested solutions to address them. Conclusion A paucity of studies have analyzed COVID-19 testing barriers among those experiencing housing insecurity, and this is even more pronounced in terms of solutions to address those barriers. Expanding resources and supporting investigators within this space is necessary to ensure equitable healthcare delivery.
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Affiliation(s)
- Jon M. Johannesson
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - William A. Glover
- North Carolina State Laboratory of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, United States
| | - Cathy A. Petti
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Healthspring Global Inc., Bradenton, FL, United States
| | - Timothy H. Veldman
- Duke Global Health Institute, Durham, NC, United States
- Hubert-Yeargan Center for Global Health, Duke University, Durham, NC, United States
| | - Ephraim L. Tsalik
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Donald H. Taylor
- Sanford School of Public Policy, Duke University, Durham, NC, United States
| | - Stephanie Hendren
- Duke University Medical Center Library, Duke University, Durham, NC, United States
| | - Coralei E. Neighbors
- Hubert-Yeargan Center for Global Health, Duke University, Durham, NC, United States
| | | | - Scott W. Kennedy
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - Barrie Harper
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - Warren A. Kibbe
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, United States
| | - Giselle Corbie
- Center for Health Equity Research, University of North Carolina, Chapel Hill, NC, United States
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, United States
- Department of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Department of Internal Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Michael Cohen-Wolkowiez
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Christopher W. Woods
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Hubert-Yeargan Center for Global Health, Duke University, Durham, NC, United States
| | - Mark J. Lee
- Department of Pathology, Duke University School of Medicine, Durham, NC, United States
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Sachdev DD, Petersen M, Havlir DV, Schwab J, Enanoria WT, Nguyen TQ, Mercer MP, Scheer S, Bennett A, Tenner AG, Marks JD, Bobba N, Philip S, Colfax G. San Francisco's Citywide COVID-19 Response: Strategies to Reduce COVID-19 Severity and Health Disparities, March 2020 Through May 2022. Public Health Rep 2023; 138:747-755. [PMID: 37408322 PMCID: PMC10323495 DOI: 10.1177/00333549231181353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
San Francisco implemented one of the most intensive, comprehensive, multipronged COVID-19 pandemic responses in the United States using 4 core strategies: (1) aggressive mitigation measures to protect populations at risk for severe disease, (2) prioritization of resources in neighborhoods highly affected by COVID-19, (3) timely and adaptive data-driven policy making, and (4) leveraging of partnerships and public trust. We collected data to describe programmatic and population-level outcomes. The excess all-cause mortality rate in 2020 in San Francisco was half that seen in 2019 in California as a whole (8% vs 16%). In almost all age and race and ethnicity groups, excess mortality from COVID-19 was lower in San Francisco than in California overall, with markedly diminished excess mortality among people aged >65 years. The COVID-19 response in San Francisco highlights crucial lessons, particularly the importance of community responsiveness, joint planning, and collective action, to inform future pandemic response and advance health equity.
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Affiliation(s)
| | - Maya Petersen
- Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Diane V. Havlir
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joshua Schwab
- Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | - Trang Q. Nguyen
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Mary P. Mercer
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Susan Scheer
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Ayanna Bennett
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Andrea G. Tenner
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - James D. Marks
- Department of Anesthesia, University of California, San Francisco, San Francisco, CA, USA
| | - Naveena Bobba
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Susan Philip
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Grant Colfax
- San Francisco Department of Public Health, San Francisco, CA, USA
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Li D, Shelby T, Brault M, Manohar R, Vermund S, Hagaman A, Forastiere L, Caruthers T, Egger E, Wang Y, Manohar N, Manohar P, Davis JL, Zhou X. Implementation of a Hardware-Assisted Bluetooth-Based COVID-19 Tracking Device in a High School: Mixed Methods Study. JMIR Form Res 2023; 7:e39765. [PMID: 36525333 PMCID: PMC10131711 DOI: 10.2196/39765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Contact tracing is a vital public health tool used to prevent the spread of infectious diseases. However, traditional interview-format contact tracing (TCT) is labor-intensive and time-consuming and may be unsustainable for large-scale pandemics such as COVID-19. OBJECTIVE In this study, we aimed to address the limitations of TCT. The Yale School of Engineering developed a Hardware-Assisted Bluetooth-based Infection Tracking (HABIT) device. Following the successful implementation of HABIT in a university setting, this study sought to evaluate the performance and implementation of HABIT in a high school setting using an embedded mixed methods design. METHODS In this pilot implementation study, we first assessed the performance of HABIT using mock case simulations in which we compared contact tracing data collected from mock case interviews (TCT) versus Bluetooth devices (HABIT). For each method, we compared the number of close contacts identified and identification of unique contacts. We then conducted an embedded mixed methods evaluation of the implementation outcomes of HABIT devices using pre- and postimplementation quantitative surveys and qualitative focus group discussions with users and implementers according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. RESULTS In total, 17 students and staff completed mock case simulations in which 161 close contact interactions were detected by interview or Bluetooth devices. We detected significant differences in the number of close contacts detected by interview versus Bluetooth devices (P<.001), with most (127/161, 78.9%) contacts being reported by interview only. However, a significant number (26/161, 16.1%; P<.001) of contacts were uniquely identified by Bluetooth devices. The interface, ease of use, coherence, and appropriateness were highly rated by both faculty and students. HABIT provided emotional security to users. However, the prototype design and technical difficulties presented barriers to the uptake and sustained use of HABIT. CONCLUSIONS Implementation of HABIT in a high school was impeded by technical difficulties leading to decreased engagement and adherence. Nonetheless, HABIT identified a significant number of unique contacts not reported by interview, indicating that electronic technologies may augment traditional contact tracing once user preferences are accommodated and technical glitches are overcome. Participants indicated a high degree of acceptance, citing emotional reassurance and a sense of security with the device.
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Affiliation(s)
- Dan Li
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Tyler Shelby
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Marie Brault
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Rajit Manohar
- Yale School of Engineering and Applied Science, New Haven, CT, United States
| | - Sten Vermund
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Ashley Hagaman
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Laura Forastiere
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Tyler Caruthers
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Emilie Egger
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Yizhou Wang
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Nathan Manohar
- IBM T.J. Watson Research Center, Yorktown Heights, NY, United States
| | - Peter Manohar
- Carnegie Mellon University, Pittsburgh, NY, United States
| | - J Lucian Davis
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Xin Zhou
- Yale School of Public Health, Yale University, New Haven, CT, United States
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Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 2023; 14:599. [PMID: 36737447 PMCID: PMC9897623 DOI: 10.1038/s41467-023-36267-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
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Affiliation(s)
- Lili Li
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Araz Taeihagh
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Si Ying Tan
- Alexandra Research Centre for Healthcare in The Virtual Environment (ARCHIVE), Department of Healthcare Redesign, Alexandra Hospital, National University Health System, Singapore, Singapore
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Aghajafari F, Hansen B, McBrien K, Leslie M, Chiew A, Ward R, Li B, Hu J. The primary care COVID-19 integrated pathway: a rapid response to health and social impacts of COVID-19. BMC PRIMARY CARE 2022; 23:333. [PMID: 36539700 PMCID: PMC9765374 DOI: 10.1186/s12875-022-01916-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The first wave of COVID-19 in Calgary, Alberta accelerated the integration of primary care with the province's centrally managed health system. This integration aimed to deliver wraparound in-community patient care through two interventions that combined to create the COVID-19 Integrated Pathway (CIP). The CIP's interventions were: 1) a data sharing platform that ensured COVID-19 test results were directly available to family physicians (FPs), and 2) a clinical algorithm that supported FPs in delivering in-community follow up to improve patient outcomes. We describe the CIP function and its capacity to facilitate FP follow-up with COVID-19 patients and evaluate its impact on Emergency Department (ED) visits and hospitalization. METHOD We generated descriptive statistics by analyzing data from a Calgary Zone hub clinic called the Calgary COVID-19 Care Clinic (C4), provincially maintained records of hospitalization, ED visits, and physician claims. RESULTS Between Apr. 16 and Sep. 27, 2020, 7289 patients were referred by the Calgary Public Health team to the C4 clinic. Of those, 48.6% were female, the median age was 37.4 y. 97% of patients had at least one visit with a healthcare professional, where follow-up was conducted using the CIP's algorithm. 5.1% of patients visited an ED and 1.9% were hospitalized within 30 days of diagnosis. 75% of patients had a median of 4 visits with their FP. DISCUSSION Our data suggest that information exchange between Primary Care (PC) and central systems facilitates primary care-based management of patients with COVID-19 in the community and has potential to reduce acute care visits.
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Affiliation(s)
- Fariba Aghajafari
- grid.22072.350000 0004 1936 7697Department of Family Medicine, Sunridge Family Medicine Teaching Centre, University of Calgary, 2685 - 36 Street NE, Calgary, AB T1Y 5S3 Canada
| | | | - Kerry McBrien
- grid.22072.350000 0004 1936 7697Department of Family Medicine, Sunridge Family Medicine Teaching Centre, University of Calgary, 2685 - 36 Street NE, Calgary, AB T1Y 5S3 Canada
| | - Myles Leslie
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Alexandra Chiew
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Rick Ward
- grid.413574.00000 0001 0693 8815Alberta Health Services, Calgary, AB Canada
| | - Bing Li
- grid.413574.00000 0001 0693 8815Alberta Health Services, Calgary, AB Canada
| | - Jia Hu
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada
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Reproducibility and implementation of a rapid, community-based COVID-19 "test and respond" model in low-income, majority-Latino communities in Northern California. PLoS One 2022; 17:e0276257. [PMID: 36301834 PMCID: PMC9612491 DOI: 10.1371/journal.pone.0276257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate implementation of a community-engaged approach to scale up COVID-19 mass testing in low-income, majority-Latino communities. METHODS In January 2021, we formed a community-academic "Latino COVID-19 Collaborative" with residents, leaders, and community-based organizations (CBOs) from majority-Latinx, low-income communities in three California counties (Marin/Merced/San Francisco). The collaborative met monthly to discuss barriers/facilitators for COVID-19 testing, and plan mass testing events informed by San Francisco's Unidos en Salud "test and respond" model, offering community-based COVID-19 testing and post-test support in two US-census tracts: Canal (Marin) and Planada (Merced). We evaluated implementation using the RE-AIM framework. To further assess testing barriers, we surveyed a random sample of residents who did not attend the events. RESULTS Fifty-five residents and CBO staff participated in the Latino collaborative. Leading facilitators identified to increase testing were extended hours of community-based testing and financial support during isolation. In March-April 2021, 1,217 people attended mass-testing events over 13 days: COVID-19 positivity was 3% and 1% in Canal and Planada, respectively. The RE-AIM evaluation found: census tract testing coverage of 4.2% and 6.3%, respectively; 90% of event attendees were Latino, 89% had household income <$50,000/year, and 44% first-time testers (reach), effectiveness in diagnosing symptomatic cases early (median isolation time: 7 days) and asymptomatic COVID-19 (41% at diagnosis), high adoption by CBOs in both counties, implementation of rapid testing (median: 17.5 minutes) and disclosure, and post-event maintenance of community-based testing. Among 265 non-attendees surveyed, 114 (43%) reported they were aware of the event: reasons for non-attendance among the 114 were insufficient time (32%), inability to leave work (24%), and perceptions that testing was unnecessary post-vaccination (24%) or when asymptomatic (25%). CONCLUSION Community-engaged mass "test and respond" events offer a reproducible approach to rapidly increase COVID-19 testing access in low-income, Latinx communities.
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Graber E, Rouhani S, Khidir H, De Luca M, Noyes E, Hernandez C, Tulip J, Hasdiana MA, Jambaulikar G, Marsh R, Wilson M. Reducing COVID-19 Health Inequities by Identifying Social Needs and Clinical Deterioration of Discharged Emergency Department Patients. West J Emerg Med 2022; 23:794-801. [PMID: 36409948 PMCID: PMC9683770 DOI: 10.5811/westjem.2022.8.55253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The decision to discharge a patient from the hospital with confirmed or suspected coronavirus 2019 (COVID-19) is fraught with challenges. Patients who are discharged home must be both medically stable and able to safely isolate to prevent disease spread. Socioeconomically disadvantaged patient populations in particular may lack resources to safely quarantine and are at high risk for COVID-19 morbidity. METHODS We developed a telehealth follow-up program for emergency department (ED) patients who received testing for COVID-19 from April 24-June 29, 2020 and were discharged home. Patients who were discharged with a pending COVID-19 test received follow-up calls on Days 1, 4, and 8. The objective of our program was to screen and provide referrals for health-related social needs (HRSN), conduct clinical screening for worsening symptoms, and deliver risk-reduction strategies for vulnerable individuals. We conducted retrospective chart reviews on all patients in this cohort to collect demographic information, testing results, and outcomes of clinical symptom and HRSN screening. Our primary outcome measurement was the need for clinical reassessment and referral for an unmet HRSN. RESULTS From April 24-June 29, 2020, we made calls to 1,468 patients tested for COVID-19 and discharged home. On Day 4, we reached 67.0% of the 1,468 patients called. Of these, 15.9% were referred to a physician's assistant (PA) out of concern for clinical worsening and 12.4% were referred to an emergency department (ED) patient navigator for HRSNs. On Day 8, we reached 81.8% of the 122 patients called. Of these, 19.7% were referred to a PA for clinical reassessment and 14.0% were referred to an ED patient navigator for HRSNs. Our intervention reached 1,069 patients, of whom 12.6% required referral for HRSNs and 1.3% (n = 14) were referred to the ED or Respiratory Illness Clinic due to concern for worsening clinical symptoms. CONCLUSION In this patient population, the demand for interventions to address social needs was as high as the need for clinical reassessment. Similar ED-based programs should be considered to help support patients' interdependent social and health needs beyond those related to COVID-19.
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Affiliation(s)
- Eleanor Graber
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Shada Rouhani
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
- Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Hazar Khidir
- Yale National Clinician Scholars Program, New Haven, Connecticut
| | - Michael De Luca
- George Washington University School of Medicine, Department of Emergency Medicine, Washington, DC
| | - Elizabeth Noyes
- Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Carlos Hernandez
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Joe Tulip
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - M Adrian Hasdiana
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
- Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | | | - Regan Marsh
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
- Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Michael Wilson
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts
- Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
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13
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Cohen SE, Stookey J, Anderson N, Morris D, Singzon T, Dann M, Burk K, Chen CC. Using Geocoding to Identify COVID-19 Outbreaks in Congregate Residential Settings: San Francisco's Outbreak Response in Single-Room Occupancy Hotels. Public Health Rep 2022; 138:7-13. [PMID: 36239486 PMCID: PMC9574538 DOI: 10.1177/00333549221128301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
More than 500 single-room occupancy hotels (SROs), a type of low-cost congregate housing with shared bathrooms and kitchens, are available in San Francisco. SRO residents include essential workers, people with disabilities, and multigenerational immigrant families. In March 2020, with increasing concerns about the potential for rapid transmission of COVID-19 among a population with disproportionate rates of comorbidity, poor access to care, and inability to self-isolate, the San Francisco Department of Public Health formed an SRO outbreak response team to identify and contain COVID-19 clusters in this congregate residential setting. Using address-matching geocoding, the team conducted active surveillance to identify new cases and outbreaks of COVID-19 at SROs. An outbreak was defined as 3 separate households in the SRO with a positive test result for COVID-19. From March 2020 through February 2021, the SRO outbreak response team conducted on-site mass testing of all residents at 52 SROs with outbreaks identified through geocoding. The rate of positive COVID-19 tests was significantly higher at SROs with outbreaks than at SROs without outbreaks (12.7% vs 6.4%; P < .001). From March through May 2020, the rate of COVID-19 cases among SRO residents was higher than among residents of other settings (ie, non-SRO residents), before decreasing and remaining at an equal level to non-SRO residents during later periods of 2020. The annual case fatality rate for SRO residents and non-SRO residents was similar (1.8% vs 1.5%). This approach identified outbreaks in a setting at high risk of COVID-19 and facilitated rapid deployment of resources. The geocoding surveillance approach could be used for other diseases and in any setting for which a list of addresses is available.
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Affiliation(s)
- Stephanie E. Cohen
- Disease Prevention and Control Branch, Population Health Division, San Francisco Department of Public Health, San Francisco, CA, USA,COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA,Stephanie E. Cohen, MD, MPH, San Francisco Department of Public Health, Disease Prevention and Control Branch, Population Health Division, 356 7th St, San Francisco, CA 94103, USA.
| | - Jodi Stookey
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA,Maternal, Child & Adolescent Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Nora Anderson
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA,Community Health Equity and Promotion Branch, Population Health Division, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Devan Morris
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Trudy Singzon
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Maggie Dann
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Katie Burk
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA,Community Health Equity and Promotion Branch, Population Health Division, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Carol C. Chen
- COVID Command Center, San Francisco Department of Public Health, San Francisco, CA, USA,Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
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McCollum CG, Creger TN, Rana AI, Matthews LT, Baral SD, Burkholder GA, Curry WA, Elopre L, Fletcher FE, Grooms S, Levitan EB, Michael M, Van Der Pol B, Mugavero MJ. COVID Community-Engaged Testing in Alabama: Reaching Underserved Rural Populations Through Collaboration. Am J Public Health 2022; 112:1399-1403. [PMID: 35952331 PMCID: PMC9480487 DOI: 10.2105/ajph.2022.306985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/04/2022]
Abstract
Rural communities are often underserved by public health testing initiatives in Alabama. As part of the National Institutes of Health's Rapid Acceleration of Diagnostics‒Underserved Populations initiative, the University of Alabama at Birmingham, along with community partners, sought to address this inequity in COVID-19 testing. We describe the participatory assessment, selection, and implementation phases of this project, which administered more than 23 000 COVID-19 tests throughout the state, including nearly 4000 tests among incarcerated populations. (Am J Public Health. 2022;112(10):1399-1403. https://doi.org/10.2105/AJPH.2022.306985).
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Affiliation(s)
- Christopher Greer McCollum
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Thomas N Creger
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Aadia I Rana
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Lynn T Matthews
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Stefan D Baral
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Greer A Burkholder
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - William A Curry
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Latesha Elopre
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Faith E Fletcher
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Sydney Grooms
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Emily B Levitan
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Max Michael
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Barbara Van Der Pol
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
| | - Michael J Mugavero
- Christopher Greer McCollum, Thomas N. Creger, Aadia I. Rana, Lynn T. Matthews, Greer A. Burkholder, William A. Curry, Latesha Elopre, Sydney Grooms, Barbara Van Der Pol, and Michael J. Mugavero are with the Heersink School of Medicine, University of Alabama at Birmingham. Stefan D. Baral is with the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Faith E. Fletcher is with the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX. Emily B. Levitan and Max Michael III are with the Ryals School of Public Health, University of Alabama at Birmingham
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Aparicio Betancourt M, Duarte-Díaz A, Vall-Roqué H, Seils L, Orrego C, Perestelo-Pérez L, Barrio-Cortes J, Beca-Martínez MT, Molina Serrano A, Bermejo-Caja CJ, González-González AI. Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10332. [PMID: 36011970 PMCID: PMC9408445 DOI: 10.3390/ijerph191610332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.
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Affiliation(s)
- Mariana Aparicio Betancourt
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Laura Seils
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 El Rosario, Spain
| | - Jaime Barrio-Cortes
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria, 28003 Madrid, Spain
| | | | | | - Carlos Jesús Bermejo-Caja
- Unidad de Apoyo Técnico Dirección Técnica de Sistemas de información, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, 28035 Madrid, Spain
- Departamento de Enfermería. Universidad Autónoma de Madrid, 28034 Madrid, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Innovación y Proyectos Internacionales, Dirección General de Investigación, Docencia y Documentación, Consejería de Sanidad, 28034 Madrid, Spain
- Institute of General Practice, Goethe University, 60323 Frankfurt, Germany
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Ntontis E, Fernandes-Jesus M, Mao G, Dines T, Kane J, Karakaya J, Perach R, Cocking C, McTague M, Schwarz A, Semlyen J, Drury J. Tracking the nature and trajectory of social support in Facebook mutual aid groups during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 76:103043. [PMID: 35601394 PMCID: PMC9106594 DOI: 10.1016/j.ijdrr.2022.103043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/21/2022] [Accepted: 05/10/2022] [Indexed: 05/19/2023]
Abstract
At the onset of the COVID-19 pandemic, thousands of mutual aid groups were established on social media and operated as platforms through which people could offer or request social support. Considering the importance of Facebook mutual aid groups during the early stages of the COVID-19 pandemic in the United Kingdom but also the lack of empirical research regarding the trajectories and types of social support rendered available through the groups, our aims in this paper are threefold; first, to examine the trajectory of social support-related activity during the period between March-December 2020; second, to compare offers and requests of support during the peaks of the first and second waves; third to provide a rich analysis of the types of social support that were offered or requested through the online mutual aid groups. Quantitative findings suggest that online social support activity declined soon after the peak of the first pandemic wave and, at least in Facebook mutual aid groups, did not reach the levels observed during the first wave. Also, the number of offers of support during the first wave was higher compared to offers during the second wave, and similar was the case for requests for support. Additionally, offers for support were higher compared to requests for support during both the first and second waves. Finally, qualitative analysis showed that people used the Facebook mutual aid groups to offer and request various types of practical, emotional, and informational support. Limitations as well as implications of our study are considered.
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Affiliation(s)
- Evangelos Ntontis
- School of Psychology and Counselling, The Open University, United Kingdom
| | - Maria Fernandes-Jesus
- School of Education, Languages and Psychology, York St John University, United Kingdom
- School of Psychology, University of Sussex, United Kingdom
| | - Guanlan Mao
- School of Psychology, University of Sussex, United Kingdom
| | - Tom Dines
- School of Psychology and Life Sciences, Canterbury Christ Church University, United Kingdom
| | - Jazmin Kane
- School of Psychology and Life Sciences, Canterbury Christ Church University, United Kingdom
| | - Joshua Karakaya
- School of Psychology and Life Sciences, Canterbury Christ Church University, United Kingdom
| | - Rotem Perach
- School of Psychology, University of Sussex, United Kingdom
| | - Chris Cocking
- School of Humanities & Applied Social Sciences, University of Brighton, United Kingdom
| | | | - Anna Schwarz
- The World Food Project, Hot Food for Hollingdean, Brighton, United Kingdom
| | - Joanna Semlyen
- Norwich Medical School, University of East Anglia, United Kingdom
- NR2 Mutual Aid/COVID-19 Community Response, United Kingdom
| | - John Drury
- School of Psychology, University of Sussex, United Kingdom
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17
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Kerkhoff AD, Rojas S, Black D, Ribeiro S, Rojas S, Valencia R, Lemus J, Payan J, Schrom J, Jones D, Manganelli S, Bandi S, Chamie G, Tulier-Laiwa V, Petersen M, Havlir D, Marquez C. Integrating Rapid Diabetes Screening Into a Latinx Focused Community-Based Low-Barrier COVID-19 Testing Program. JAMA Netw Open 2022; 5:e2214163. [PMID: 35616939 PMCID: PMC9136625 DOI: 10.1001/jamanetworkopen.2022.14163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Community-based COVID-19 testing and vaccination programs play a crucial role in mitigating racial and ethnic disparities in COVID-19 service delivery. They also represent a platform that can be leveraged to expand access to testing for chronic diseases, including diabetes, that disproportionately affect the Latinx community and other marginalized communities. OBJECTIVE To evaluate outcomes associated with a diabetes testing strategy designed to reach low-income Latinx persons by leveraging COVID-19 testing infrastructure and community trust developed during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This health care improvement study was conducted from August 1 to October 5, 2021, at an outdoor, community-based COVID-19 testing site at a transport hub in the Mission Neighborhood in San Francisco, California. Because the program was designed to expand access to diabetes screening to the local community, all individuals presenting for on-site testing were eligible. Data were analyzed in November 2021. INTERVENTIONS Integration of rapid, point-of-care hemoglobin A1c screening as a testing option in an existing low-barrier COVID-19 testing program. MAIN OUTCOMES AND MEASURES Evaluation was guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework and utilized programmatic data and structured surveys among clients and staff. RESULTS Of 6631 individuals tested (median [IQR] age 39.3 [29.7-51.3] years; 3417 [52.3%] female, 4348 [65.6%] Latinx), 923 (13.9%) underwent hemoglobin A1c testing with or without COVID-19 testing and 5708 (86.1%) underwent COVID-19 testing only. Individuals tested for diabetes were more likely to be Latinx (763 of 923 individuals [82.7%] who underwent testing were Latinx vs 3585 of 5708 [62.8%] not undergoing testing), have an annual household income of less than $50 000 (450 individuals [81.2%] vs 2409 individuals [66.0%]), and not have health insurance (381 individuals [47.2%] vs 1858 individuals [39.9%]), and 206 (48.0%) had never tested for diabetes before. Overall, 313 (33.9%) and 113 (12.2%) individuals had prediabetes and diabetes, respectively; only 141 of 354 of these individuals (39.8%) had a primary care clinician whom they had seen in the prior 12 months, which was lower among Latinx individuals (113 of 307 individuals [36.8%] vs 28 of 47 [59.6%]). Acceptability of the rapid testing program was high-98% were satisfied with their visit and 96% said they would return for future services; key factors underpinning acceptability included friendly staff, efficiency, and a convenient location. CONCLUSIONS AND RELEVANCE In this health care improvement study conducted within an existing community-based COVID-19 testing program, integrating rapid testing for diabetes was feasible, reached low-income Latinx individuals, and identified many persons with prediabetes and diabetes, most of whom lacked access to services in formal health care settings. Leveraging pandemic-related public health responses represents an important opportunity for engaging socioeconomically disadvantaged populations into care for diabetes.
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Affiliation(s)
- Andrew D. Kerkhoff
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | - Susana Rojas
- San Francisco Latino Task Force–Response to COVID-19, San Francisco, California
| | - Douglas Black
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | | | - Susy Rojas
- Unidos en Salud, San Francisco, California
| | | | | | | | - John Schrom
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | | | | | | | - Gabriel Chamie
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | | | - Maya Petersen
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley
| | - Diane Havlir
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | - Carina Marquez
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
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18
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Schrom J, Marquez C, Pilarowski G, Wang CY, Mitchell A, Puccinelli R, Black D, Rojas S, Ribeiro S, Tulier-Laiwa V, Martinez J, Payan J, Rojas S, Jones D, Martinez D, Nakamura R, Chamie G, Jain V, Petersen M, DeRisi J, Havlir D. Comparison of SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction and BinaxNOW Rapid Antigen Tests at a Community Site During an Omicron Surge : A Cross-Sectional Study. Ann Intern Med 2022; 175:682-690. [PMID: 35286144 PMCID: PMC8943844 DOI: 10.7326/m22-0202] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND SARS-CoV-2 rapid antigen tests are an important public health tool. OBJECTIVE To evaluate field performance of the BinaxNOW rapid antigen test (Abbott) compared with reverse transcriptase polymerase chain reaction (RT-PCR) for detecting infection with the Omicron variant of SARS-CoV-2. DESIGN Cross-sectional surveillance study. SETTING Free, walk-up, outdoor, urban community testing and vaccine site led by Unidos en Salud, serving a predominantly Latinx community highly impacted by COVID-19. PARTICIPANTS Persons seeking COVID-19 testing in January 2022. MEASUREMENTS Simultaneous BinaxNOW and RT-PCR from nasal, cheek, and throat swabs, including cycle threshold (Ct) measures; a lower Ct value is a surrogate for higher amounts of virus. RESULTS Among 731 persons tested with nasal swabs, there were 296 (40.5%) positive results on RT-PCR; 98.9% were the Omicron variant. BinaxNOW detected 95.2% (95% CI, 91% to 98%) of persons who tested positive on RT-PCR with a Ct value below 30, 82.1% (CI, 77% to 87%) of those who tested positive on RT-PCR with a Ct value below 35, and 65.2% (CI, 60% to 71%) of all who were positive on RT-PCR. Among 75 persons with simultaneous nasal and cheek swabs, BinaxNOW using a cheek swab failed to detect 91% (20 of 22) of specimens that were positive on BinaxNOW with a nasal swab. Among persons with simultaneous nasal and throat swabs who were positive on RT-PCR with a Ct value below 30, 42 of 49 (85.7%) were detected by nasal BinaxNOW, 23 of 49 (46.9%) by throat BinaxNOW, and 44 of 49 (89.8%) by either. LIMITATION Participants were a cross-sectional sample from a community-based sentinel surveillance site, precluding study of viral or symptom dynamics. CONCLUSION BinaxNOW detected persons with high SARS-CoV-2 levels during the Omicron surge, enabling rapid responses to positive test results. Cheek or throat swabs should not replace nasal swabs. As currently recommended, high-risk persons with an initial negative BinaxNOW result should have repeated testing. PRIMARY FUNDING SOURCE University of California, San Francisco.
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Affiliation(s)
- John Schrom
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
| | - Carina Marquez
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
| | - Genay Pilarowski
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Chung-Yu Wang
- Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.)
| | - Anthea Mitchell
- Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.)
| | - Robert Puccinelli
- University of California, Berkeley, Berkeley, California (R.P., M.P.)
| | - Doug Black
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
| | - Susana Rojas
- Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas)
| | - Salustiano Ribeiro
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Valerie Tulier-Laiwa
- Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas)
| | - Jacqueline Martinez
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Joselin Payan
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Susy Rojas
- Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas)
| | - Diane Jones
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Daniel Martinez
- Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.)
| | - Robert Nakamura
- California Department of Public Health, Richmond, California (R.N.)
| | - Gabriel Chamie
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
| | - Vivek Jain
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
| | - Maya Petersen
- University of California, Berkeley, Berkeley, California (R.P., M.P.)
| | - Joe DeRisi
- Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.)
| | - Diane Havlir
- University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.)
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19
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Olateju Z, Olufunlayo T, MacArthur C, Leung C, Taylor B. Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria-A qualitative study. PLoS One 2022; 17:e0265092. [PMID: 35259204 PMCID: PMC8903241 DOI: 10.1371/journal.pone.0265092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs' ability and willingness to work in the COVID-19 pandemic in Lagos. DESIGN A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria. METHODS 15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos' Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers' attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method. RESULTS Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers' perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced. CONCLUSION Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria's policies and infrastructure to better support Community Health Workers during both current and future outbreaks.
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Affiliation(s)
- Zahra Olateju
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Tolulope Olufunlayo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Yaba, Lagos State, Nigeria
| | - Christine MacArthur
- Department of Maternal Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Charlotte Leung
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Beck Taylor
- Department of Public Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
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20
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Rajan S, McKee M, Hernández-Quevedo C, Karanikolos M, Richardson E, Webb E, Cylus J. What have European countries done to prevent the spread of COVID-19? Lessons from the COVID-19 Health System Response Monitor. Health Policy 2022; 126:355-361. [PMID: 35339282 PMCID: PMC8912990 DOI: 10.1016/j.healthpol.2022.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 01/24/2022] [Accepted: 03/09/2022] [Indexed: 11/07/2022]
Abstract
Although some European countries imposed measures that successfully slowed the transmission of Covid-19 during the first year of the pandemic, others struggled, either because they acted slowly or implemented measures ineffectively. In this paper we consider the European experience with public health measures designed to prevent transmission of COVID-19. Based on literature and country responses described in the COVID-19 Health System Response Monitor from March 2020 to December 2020, we consider some critical aspects of public health policy responses. These include the importance of public health capacity that can scale up surveillance and outbreak control, including effective testing and contract tracing, of clear messaging based on an understanding of human behaviour, policies that address the undesirable consequences of necessary measures, such as support for those isolating or unable to earn, and the ability to implement at pace and scale a major vaccine rollout. We conclude that for countries to be successful at preventing COVID-19 transmission, there is a need for a clear strategy with explicit goals and a whole systems approach to implementation.
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21
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Malmusi D, Pasarín MI, Marí-Dell'Olmo M, Artazcoz L, Diez E, Tolosa S, Rodríguez-Sanz M, Pérez G, Peña-Gallardo C, Borrell C. Multi-level policy responses to tackle socioeconomic inequalities in the incidence of COVID-19 in a European urban area. Int J Equity Health 2022; 21:28. [PMID: 35183189 PMCID: PMC8857870 DOI: 10.1186/s12939-022-01628-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Spain has been hit hard by COVID-19 since March 2020, especially in its metropolitan areas. We share experiences from Barcelona in measuring socioeconomic inequalities in the incidence of COVID-19 in the different waves, and in implementing coordinated and equity-oriented public health policy responses. METHODS We collected daily data on confirmed COVID-19 cases, geocoded the address of residence to assign each case to one of the 73 neighborhoods and 1068 census tracts, and calculated the cumulative incidence of COVID-19 by neighborhood and five income groups (quintiles of census tracts) by sex across four waves of the pandemic. We adjusted hierarchical Bayesian spatial models to obtain the relative risk (RR) of cumulative incidences in each quintile compared with the richest areas. A variety of public health policies implemented to tackle the pandemic and especially these inequalities in COVID-19 incidence and vaccination are selected and described. RESULTS Area-level income inequalities in the incidence of COVID-19 were present at different degree in all four waves. In the second wave (10/1/2020 to 12/6/2020), RR for the poorest income quintile census tracts compared with the richest was 1.43 (95% credible interval-CI-: 1.22-1.67) for men and 1.58 (95% CI: 1.35-1.83) for women. Later, inequalities in vaccination coverage also arose. Equity-oriented policy responses included: "health hotels" or home delivery of basic products for individuals with COVID-19 and without adequate conditions for isolation; new emergency facilities for homeless people, including those with active drug use; mass screening in high incidence areas; contingency plans for nursing homes and schools; adapting community health programs for their early reactivation; digital self-appointment support points and community vaccination days. CONCLUSION COVID-19 hit Barcelona neighborhoods unequally, with variations between waves. The rapid availability of geolocalized data and by socioeconomic level helped public authorities to implement targeted policies and collaborative interventions for the most vulnerable populations. Further studies would be needed to evaluate their impact.
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Affiliation(s)
- Davide Malmusi
- Ajuntament de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Isabel Pasarín
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marc Marí-Dell'Olmo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Lucía Artazcoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Elia Diez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Sara Tolosa
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
| | - Maica Rodríguez-Sanz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Glòria Pérez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Carme Borrell
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023, Barcelona, Spain.
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.
- Universitat Pompeu Fabra, Barcelona, Spain.
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22
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Li D, Nyhan K, Zhou X, Zhu Y, Castro D, Vermund SH, Brault M. School closures and reopenings during the COVID-19 pandemic: a scoping review protocol. BMJ Open 2022; 12:e054292. [PMID: 35110320 PMCID: PMC8811274 DOI: 10.1136/bmjopen-2021-054292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The objective of this scoping review is to provide an overview of existing studies and evidence on the impact of school closures and reopenings during the pandemic. INTRODUCTION The COVID-19 pandemic has necessitated widespread school closures, and reopening schools safely has a pivotal role in the well-being of children and teachers, SARS-CoV-2 transmission control and optimal societal functioning. Widespread school closures in response to the COVID-19 pandemic have caused adverse effects on the education, physical health and mental well-being of children. An understanding of the impact of school closures and reopenings as well as factors influencing school safety is critical to bringing schools' operational status back to normal. Despite the implication of individual concerns and knowledge on disease prevention practices, there is a paucity of research on individual knowledge, needs and behaviours in the context of school reopenings. In the proposed study, we will conduct a scoping review to identify and provide inventory of the current research and evidence on the impact of COVID-19 on K-12 schools (primary and secondary schools) and vice versa. METHODS AND ANALYSIS Eligible studies/literature include members of K-12 (primary and secondary) schools (students, parents, staff, faculty, COVID-19 coordinator, school nurses) in countries affected by the COVID-19 pandemic. We will exclude university or college students. There will be no exclusion based on methods, timing or school operational status.All concepts regarding school closures and reopenings will be considered, and all types of research will be considered.This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews. Sources of evidence published from 2020 to 31 October 2021 will be included. The search will include PubMed, preprints in EuropePMC, ERIC, Scopus, Web of Science Core Collection, PsycINFO, Embase, CINAHL and VHL. We will cover grey literature in Harvard Think Tank Database, COVID-19 Evidence Hub like COVID-END and Google Scholar. The abstract and title screening, full-text screening and data extraction will be done by two independent reviewers.Disagreements will be resolved by an independent third reviewer. Data extract will be done on Qualtrics form to ensure accurate extraction. Citation chaining will be performed on key articles identified. A critical appraisal will be performed.The scoping review will take place from 1 August 2021 to 15 November 2021. We will perform a final round of updated search and citation chaining. ETHICS AND DISSEMINATION The review will be based on published works and grey literature, thus it is exempt from formal ethical approval. This protocol cannot be registered in the Prospective Register of Systematic Reviews because this registry is not for scoping reviews. We will register it in OSF Registration. The paper will appear in a peer-reviewed, open-access journal to ensure a broad dissemination.
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Affiliation(s)
- Dan Li
- Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
| | - Xin Zhou
- Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Yunxu Zhu
- Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Danielle Castro
- Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Sten H Vermund
- Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Marie Brault
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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23
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Naso J, Rojas S, Peng J, Marquez C, Contreras M, Castellanos E, Rojas S, Rubio L, Jones D, Jacobo J, Black D, Tulier-Laiwa V, Martinez J, Chamie G, Pilarowski G, DeRisi J, Havlir D, Petersen M. High Parental Vaccine Motivation at a Neighborhood-Based Vaccine and Testing Site Serving a Predominantly Latinx Community. Health Equity 2022; 5:840-846. [PMID: 35018317 PMCID: PMC8742294 DOI: 10.1089/heq.2021.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To understand vaccine attitudes of Latinx parents highly impacted by COVID-19. Methods: In April 2021, we surveyed parents about their attitudes for COVID-19 vaccination of their children at a community-based outdoor testing/vaccination site serving predominantly low-income Latinx persons in San Francisco. Results: Among 1033 parents (75% Latinx), 92% would "definitely" or "probably" vaccinate their children. Vaccine concerns were higher for younger children and included side effects and impacts on fertility. Doctors and community organizations were noted as trusted sources of information, including among vaccine-concerned parents. Conclusion: Latinx parents accessing neighborhood-based COVID-19 testing/vaccination services are highly motivated to vaccinate their children for COVID-19.
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Affiliation(s)
- Jamie Naso
- Unidos en Salud, San Francisco, California, USA
| | - Susy Rojas
- The San Francisco Latino Task Force on COVID-19, San Francisco, California, USA
| | - James Peng
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Carina Marquez
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | | | | | - Susana Rojas
- The San Francisco Latino Task Force on COVID-19, San Francisco, California, USA
| | - Luis Rubio
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Diane Jones
- Unidos en Salud, San Francisco, California, USA
| | - Jon Jacobo
- The San Francisco Latino Task Force on COVID-19, San Francisco, California, USA
| | - Douglas Black
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | | | | | - Gabriel Chamie
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, USA
| | - Diane Havlir
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Maya Petersen
- Division of Biostatistics, The School of Public Health, University of California, Berkeley, Berkeley, California, USA
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24
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Peng J, Liu J, Mann SA, Mitchell AM, Laurie MT, Sunshine S, Pilarowski G, Ayscue P, Kistler A, Vanaerschot M, Li LM, McGeever A, Chow ED, Marquez C, Nakamura R, Rubio L, Chamie G, Jones D, Jacobo J, Rojas S, Rojas S, Tulier-Laiwa V, Black D, Martinez J, Naso J, Schwab J, Petersen M, Havlir D, DeRisi J. Estimation of Secondary Household Attack Rates for Emergent Spike L452R Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants Detected by Genomic Surveillance at a Community-Based Testing Site in San Francisco. Clin Infect Dis 2022; 74:32-39. [PMID: 33788923 PMCID: PMC8083548 DOI: 10.1093/cid/ciab283] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sequencing of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral genome from patient samples is an important epidemiological tool for monitoring and responding to the pandemic, including the emergence of new mutations in specific communities. METHODS SARS-CoV-2 genomic sequences were generated from positive samples collected, along with epidemiological metadata, at a walk-up, rapid testing site in the Mission District of San Francisco, California during 22 November to 1 December, 2020, and 10-29 January 2021. Secondary household attack rates and mean sample viral load were estimated and compared across observed variants. RESULTS A total of 12 124 tests were performed yielding 1099 positives. From these, 928 high-quality genomes were generated. Certain viral lineages bearing spike mutations, defined in part by L452R, S13I, and W152C, comprised 54.4% of the total sequences from January, compared to 15.7% in November. Household contacts exposed to the "California" or "West Coast" variants (B.1.427 and B.1.429) were at higher risk of infection compared to household contacts exposed to lineages lacking these variants (0.36 vs 0.29, risk ratio [RR] = 1.28; 95% confidence interval [CI]: 1.00-1.64). The reproductive number was estimated to be modestly higher than other lineages spreading in California during the second half of 2020. Viral loads were similar among persons infected with West Coast versus non-West Coast strains, as was the proportion of individuals with symptoms (60.9% vs 64.3%). CONCLUSIONS The increase in prevalence, relative household attack rates, and reproductive number are consistent with a modest transmissibility increase of the West Coast variants. Summary: We observed a growing prevalence and modestly elevated attack rate for "West Coast" severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in a community testing setting in San Francisco during January 2021, suggesting its modestly higher transmissibility.
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Affiliation(s)
- James Peng
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jamin Liu
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
- University of California, Berkeley—University of California, San Francisco Graduate Program in Bioengineering, Berkeley, California, USA
| | - Sabrina A Mann
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Anthea M Mitchell
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Matthew T Laurie
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Sara Sunshine
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Genay Pilarowski
- Department of Pathology, Stanford University, Stanford, California, USA
| | | | - Amy Kistler
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | | | - Lucy M Li
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | | | - Eric D Chow
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Carina Marquez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Robert Nakamura
- California Department of Public Health, Richmond, California, USA
| | - Luis Rubio
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Diane Jones
- Unidos en Salud, San Francisco, California, USA
| | - Jon Jacobo
- Unidos en Salud, San Francisco, California, USA
| | | | - Susy Rojas
- Unidos en Salud, San Francisco, California, USA
| | | | - Douglas Black
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Jamie Naso
- Unidos en Salud, San Francisco, California, USA
| | - Joshua Schwab
- Division of Biostatistics, University of California, Berkeley, Berkeley, California, USA
| | - Maya Petersen
- Division of Biostatistics, University of California, Berkeley, Berkeley, California, USA
| | - Diane Havlir
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Joseph DeRisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - IDseq Team
- Chan Zuckerberg Initiative, Redwood City, CaliforniaUSA
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25
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Méllo LMBDDE, Santos RCD, Albuquerque PCD. Agentes Comunitárias de Saúde na pandemia de Covid-19: scoping review. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este artigo teve por objetivo sistematizar e analisar a literatura que aborda o trabalho das Agentes Comunitárias de Saúde (ACS) no enfrentamento da pandemia de Covid-19. Trata-se de uma revisão de escopo, realizada na Embase, Lilacs, SciELO, Medline e Cochrane Library. Envolve publicações no período de janeiro a dezembro de 2020, tendo os estudos selecionados sido submetidos à análise, considerando as seguintes categorias: práticas, formação, condições de trabalho e legitimidade. Foram incluídos 29 estudos na revisão cujo cenário de atuação das ACS foram países da África, América do Sul, América do Norte, Ásia e Europa. Os resultados revelaram enfoques diversificados de práticas nos países estudados que envolvem ações de cuidado, vigilância, comunicação e educação em saúde, práticas administrativas, articulação intersetorial e mobilização social. A formação recebida parece não corresponder ao rol de práticas e impacto esperado do trabalho das ACS. As condições de trabalho continuam precarizadas com alguns incentivos extras sendo ofertados em diferentes cenários. O reconhecimento e a legitimidade perante as autoridades sanitárias revelam a disputa em torno do próprio rumo dos modelos de atenção à saúde e abrangência dos sistemas de proteção social nos diversos países.
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26
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Méllo LMBDDE, Santos RCD, Albuquerque PCD. Community Health Workers in the Covid-19 pandemic: scoping review. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e125i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This paper aimed to systematize and analyze the literature that addresses the role of Community Health Workers (CHWs) in addressing the Covid-19 pandemic. This scoping review was conducted in the Embase, Lilacs, SciELO, Medline, and Cochrane Virtual Libraries databases. It includes publications from January to December 2020, and the selected studies were submitted to analysis, considering the following categories: practices, training, working conditions, and legitimacy. Twenty-nine studies were included in the review whose CHW performance backdrops were African, South American, North American, Asian, and European countries. The results revealed diversified approaches to practice in the countries studied that involve care, surveillance, health communication, education, administrative, intersectoral articula- tion, and social mobilization actions. The training received does not seem to correspond to the list of practices and expected impact of the CHWs. Working conditions remain substandard, with some extra incentives offered in different backdrops. The recognition and legitimacy before the health authorities reveal the dispute over the direction of health care models and the scope of social protection systems in different countries.
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27
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Makhlouf MD. Stemming the Shadow Pandemic: Integrating Sociolegal Services in Contact Tracing and Beyond. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:719-725. [PMID: 36883384 PMCID: PMC10009374 DOI: 10.1017/jme.2023.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.
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Affiliation(s)
- Medha D Makhlouf
- PENNSYLVANIA STATE UNIVERSITY, DICKINSON SCHOOL OF LAW, CARLISLE, PA, USA
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28
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Wu S, Neill R, De Foo C, Chua AQ, Jung AS, Haldane V, Abdalla SM, Guan WJ, Singh S, Nordström A, Legido-Quigley H. Aggressive containment, suppression, and mitigation of covid-19: lessons learnt from eight countries. BMJ 2021; 375:e067508. [PMID: 34840136 PMCID: PMC8624062 DOI: 10.1136/bmj-2021-067508] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Shishi Wu
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Rachel Neill
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Chuan De Foo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alvin Qijia Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Anne-Sophie Jung
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Victoria Haldane
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada
| | - Salma M Abdalla
- Independent Panel for Pandemic Preparedness and Response Secretariat
- School of Public Health, Boston University, USA
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, China
- Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, China
| | - Sudhvir Singh
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Anders Nordström
- Independent Panel for Pandemic Preparedness and Response Secretariat
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Independent Panel for Pandemic Preparedness and Response Secretariat
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29
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Fernandes-Jesus M, Mao G, Ntontis E, Cocking C, McTague M, Schwarz A, Semlyen J, Drury J. More Than a COVID-19 Response: Sustaining Mutual Aid Groups During and Beyond the Pandemic. Front Psychol 2021; 12:716202. [PMID: 34744875 PMCID: PMC8563598 DOI: 10.3389/fpsyg.2021.716202] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Mutual aid groups have been an indispensable part of the public response to the COVID-19 pandemic. They have provided many forms of support, in particular grocery shopping which has enabled people to self-isolate if required. While community solidarity during emergencies and disasters is common, previous studies have shown that such solidarity behaviors tend to decline over time, even when needs remain high. In this study, we address how mutual aid groups can be sustained over time in the context of the COVID-19 pandemic. We conducted 32 interviews with organizers of COVID-19 mutual aid and community support groups in the United Kingdom between September 2020 and January 2021. Based on a reflexive thematic analysis, we identified several community and group level experiences and strategies that were related to sustained participation in COVID-19 mutual aid groups. Meeting community needs over time with localized action and resources and building trust and community-based alliances were foundational elements in the COVID-19 mutual aid groups. Group processes strategies, such as a culture of care and support and regular group meetings, were used to help to sustain involvement. Some experiences resulting from participation in COVID-19 mutual aid groups were also related to sustained participation, including positive emotions (e.g., joy, pride), well-being and sense of efficacy, and an increasing sense of local community belonging and cohesion. Based on these findings, we propose four practical recommendations for sustaining mutual aid groups to assist public engagement with protective behaviors in the COVID-19 pandemic and beyond. We recommend providing practical and financial support to COVID-19 mutual aid groups; to mobilize the knowledge and the experiences acquired by COVID-19 mutual aid groups for developing programs and interventions for addressing the medium and long-term impacts of COVID-19; to prioritize community-level interventions; and to recognize the role of group processes as these have the potential to lead to long-term community responses. These approaches will be key for ensuring that communities effectively recover from the COVID-19 pandemic.
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Affiliation(s)
- Maria Fernandes-Jesus
- School of Psychology, University of Sussex, Brighton, United Kingdom
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Guanlan Mao
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Evangelos Ntontis
- School of Psychology and Counselling, The Open University, Milton Keynes, United Kingdom
| | - Chris Cocking
- School of Humanities and Applied Social Sciences, University of Brighton, Brighton, United Kingdom
| | | | - Anna Schwarz
- The World Food Project, Hot Food for Hollingdean, Brighton, United Kingdom
| | - Joanna Semlyen
- Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
- NR2 Mutual Aid/COVID-19 Community Response, Norwich, United Kingdom
| | - John Drury
- School of Psychology, University of Sussex, Brighton, United Kingdom
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30
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Fernandes-Jesus M, Mao G, Ntontis E, Cocking C, McTague M, Schwarz A, Semlyen J, Drury J. More Than a COVID-19 Response: Sustaining Mutual Aid Groups During and Beyond the Pandemic. Front Psychol 2021; 12:716202. [PMID: 34744875 DOI: 10.31235/osf.io/p5sfd] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/29/2021] [Indexed: 05/25/2023] Open
Abstract
Mutual aid groups have been an indispensable part of the public response to the COVID-19 pandemic. They have provided many forms of support, in particular grocery shopping which has enabled people to self-isolate if required. While community solidarity during emergencies and disasters is common, previous studies have shown that such solidarity behaviors tend to decline over time, even when needs remain high. In this study, we address how mutual aid groups can be sustained over time in the context of the COVID-19 pandemic. We conducted 32 interviews with organizers of COVID-19 mutual aid and community support groups in the United Kingdom between September 2020 and January 2021. Based on a reflexive thematic analysis, we identified several community and group level experiences and strategies that were related to sustained participation in COVID-19 mutual aid groups. Meeting community needs over time with localized action and resources and building trust and community-based alliances were foundational elements in the COVID-19 mutual aid groups. Group processes strategies, such as a culture of care and support and regular group meetings, were used to help to sustain involvement. Some experiences resulting from participation in COVID-19 mutual aid groups were also related to sustained participation, including positive emotions (e.g., joy, pride), well-being and sense of efficacy, and an increasing sense of local community belonging and cohesion. Based on these findings, we propose four practical recommendations for sustaining mutual aid groups to assist public engagement with protective behaviors in the COVID-19 pandemic and beyond. We recommend providing practical and financial support to COVID-19 mutual aid groups; to mobilize the knowledge and the experiences acquired by COVID-19 mutual aid groups for developing programs and interventions for addressing the medium and long-term impacts of COVID-19; to prioritize community-level interventions; and to recognize the role of group processes as these have the potential to lead to long-term community responses. These approaches will be key for ensuring that communities effectively recover from the COVID-19 pandemic.
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Affiliation(s)
- Maria Fernandes-Jesus
- School of Psychology, University of Sussex, Brighton, United Kingdom
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Guanlan Mao
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Evangelos Ntontis
- School of Psychology and Counselling, The Open University, Milton Keynes, United Kingdom
| | - Chris Cocking
- School of Humanities and Applied Social Sciences, University of Brighton, Brighton, United Kingdom
| | | | - Anna Schwarz
- The World Food Project, Hot Food for Hollingdean, Brighton, United Kingdom
| | - Joanna Semlyen
- Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
- NR2 Mutual Aid/COVID-19 Community Response, Norwich, United Kingdom
| | - John Drury
- School of Psychology, University of Sussex, Brighton, United Kingdom
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31
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Marquez C, Kerkhoff AD, Naso J, Contreras MG, Castellanos Diaz E, Rojas S, Peng J, Rubio L, Jones D, Jacobo J, Rojas S, Gonzalez R, Fuchs JD, Black D, Ribeiro S, Nossokoff J, Tulier-Laiwa V, Martinez J, Chamie G, Pilarowski G, DeRisi J, Petersen M, Havlir DV. A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: From theory to practice. PLoS One 2021; 16:e0257111. [PMID: 34543291 PMCID: PMC8452046 DOI: 10.1371/journal.pone.0257111] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and "activation" components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. METHODS Our community-academic-public health partnership, "Unidos en Salud," utilized a theory-informed approach to design our "Motivate, Vaccinate, and Activate" COVID-19 vaccination strategy. Our strategy's design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, "neighborhood" vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients ≥16 years old were used in the evaluation. RESULTS There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32-56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experience; these findings did not substantially differ according to ethnicity. There were 40.3% of vaccinated clients who said they still knew at least one unvaccinated person (64.6% knew ≥3). Among clients who received both vaccine doses (n = 729), 91.0% said that after their vaccination experience, they had personally reached out to at least one unvaccinated person they knew (61.6% reached out to ≥3) to recommend getting vaccinated; 83.0% of clients reported that one or more friends, and/or family members got vaccinated as a result of their outreach, including 18.9% who reported 6 or more persons got vaccinated as a result of their influence. CONCLUSIONS A multi-component, "Motivate, Vaccinate, and Activate" community-based strategy addressing barriers to COVID-19 vaccination for the Latinx population reached the intended population, and vaccinated individuals served as ambassadors to recruit other friends and family members to get vaccinated.
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Affiliation(s)
- Carina Marquez
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Andrew D. Kerkhoff
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Jamie Naso
- Unidos en Salud, San Francisco, California, United States of America
| | - Maria G. Contreras
- Unidos en Salud, San Francisco, California, United States of America
- Department of Medicine, University of California, San Francisco, California, United States of America
- Clínica Martín Baró, San Francisco, California, United States of America
- The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California, United States of America
| | - Edgar Castellanos Diaz
- Unidos en Salud, San Francisco, California, United States of America
- Clínica Martín Baró, San Francisco, California, United States of America
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America
| | - Susana Rojas
- The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California, United States of America
| | - James Peng
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Luis Rubio
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Diane Jones
- Unidos en Salud, San Francisco, California, United States of America
| | - Jon Jacobo
- The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California, United States of America
| | - Susy Rojas
- The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California, United States of America
| | - Rafael Gonzalez
- San Francisco Department of Public Health, San Francisco, California, United States of America
| | - Jonathan D. Fuchs
- San Francisco Department of Public Health, San Francisco, California, United States of America
| | - Douglas Black
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Salustiano Ribeiro
- Bay Area Phlebotomy and Laboratory Services (BayPLS), San Francisco, California, United States of America
| | - Jen Nossokoff
- Bay Area Phlebotomy and Laboratory Services (BayPLS), San Francisco, California, United States of America
| | - Valerie Tulier-Laiwa
- The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California, United States of America
| | | | - Gabriel Chamie
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
| | - Genay Pilarowski
- Department of Pathology, Stanford University, Stanford, California, United States of America
| | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, California, United States of America
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, United States of America
| | - Maya Petersen
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Diane V. Havlir
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America
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Geng EH, Schwab J, Foraker R, Fox B, Hoehner CM, Schootman M, Mody A, Powderly W, Yount B, Woeltje K, Petersen M. Outcomes Associated With Social Distancing Policies in St Louis, Missouri, During the Early Phase of the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2123374. [PMID: 34468756 PMCID: PMC8411298 DOI: 10.1001/jamanetworkopen.2021.23374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/27/2021] [Indexed: 01/10/2023] Open
Abstract
Importance In the absence of a national strategy in response to the COVID-19 pandemic, many public health decisions fell to local elected officials and agencies. Outcomes of such policies depend on a complex combination of local epidemic conditions and demographic features as well as the intensity and timing of such policies and are therefore unclear. Objective To use a decision analytical model of the COVID-19 epidemic to investigate potential outcomes if actual policies enacted in March 2020 (during the first wave of the epidemic) in the St Louis region of Missouri had been delayed. Design, Setting, and Participants A previously developed, publicly available, open-source modeling platform (Local Epidemic Modeling for Management & Action, version 2.1) designed to enable localized COVID-19 epidemic projections was used. The compartmental epidemic model is programmed in R and Stan, uses bayesian inference, and accepts user-supplied demographic, epidemiologic, and policy inputs. Hospital census data for 1.3 million people from St Louis City and County from March 14, 2020, through July 15, 2020, were used to calibrate the model. Exposures Hypothetical delays in actual social distancing policies (which began on March 13, 2020) by 1, 2, or 4 weeks. Sensitivity analyses were conducted that explored plausible spontaneous behavior change in the absence of social distancing policies. Main Outcomes and Measures Hospitalizations and deaths. Results A model of 1.3 million residents of the greater St Louis, Missouri, area found an initial reproductive number (indicating transmissibility of an infectious agent) of 3.9 (95% credible interval [CrI], 3.1-4.5) in the St Louis region before March 15, 2020, which fell to 0.93 (95% CrI, 0.88-0.98) after social distancing policies were implemented between March 15 and March 21, 2020. By June 15, a 1-week delay in policies would have increased cumulative hospitalizations from an observed actual number of 2246 hospitalizations to 8005 hospitalizations (75% CrI: 3973-15 236 hospitalizations) and increased deaths from an observed actual number of 482 deaths to a projected 1304 deaths (75% CrI, 656-2428 deaths). By June 15, a 2-week delay would have yielded 3292 deaths (75% CrI, 2104-4905 deaths)-an additional 2810 deaths or a 583% increase beyond what was actually observed. Sensitivity analyses incorporating a range of spontaneous behavior changes did not avert severe epidemic projections. Conclusions and Relevance The results of this decision analytical model study suggest that, in the St Louis region, timely social distancing policies were associated with improved population health outcomes, and small delays may likely have led to a COVID-19 epidemic similar to the most heavily affected areas in the US. These findings indicate that an open-source modeling platform designed to accept user-supplied local and regional data may provide projections tailored to, and more relevant for, local settings.
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Affiliation(s)
- Elvin H. Geng
- Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri
- Institute for Public Health, Washington University in St Louis
| | - Joshua Schwab
- Division Biostatistics, School of Public Health, University of California, Berkely
| | - Randi Foraker
- Division of General Internal Medicine, Department of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Branson Fox
- Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri
| | | | - Mario Schootman
- SSM Health Saint Louis University Hospital, St Louis, Missouri
| | - Aaloke Mody
- Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri
| | - William Powderly
- Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri
- Institute for Public Health, Washington University in St Louis
| | | | - Keith Woeltje
- Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri
- BJC HealthCare, St Louis, Missouri
| | - Maya Petersen
- Division of Biostatistics, School of Public Health, University of California at Berkeley, Berkeley
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Chugg B, Lu L, Ouyang D, Anderson B, Ha R, D’Agostino A, Sujeer A, Rudman SL, Garcia A, Ho DE. Evaluation of Allocation Schemes of COVID-19 Testing Resources in a Community-Based Door-to-Door Testing Program. JAMA HEALTH FORUM 2021; 2:e212260. [PMID: 35977196 PMCID: PMC8796878 DOI: 10.1001/jamahealthforum.2021.2260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Question What are effective mechanisms to identify and reach vulnerable populations and equalize access to COVID-19 testing resources in the presence of substantial demographic disparities? Findings In this cohort study of 756 participants, a door-to-door program with community-based health workers was associated with a substantial increase in the proportion of Latinx and elderly individuals undergoing testing, relative to neighborhood testing sites. The protocol associated with the greatest increase in testing at-risk individuals was uncertainty sampling, followed by local knowledge, and then targeting households in areas with a high number of index cases. Meaning These findings suggest that community-based testing programs that allocate resources using uncertainty sampling might effectively reduce COVID-19 testing disparities. Importance Overcoming social barriers to COVID-19 testing is an important issue, especially given the demographic disparities in case incidence rates and testing. Delivering culturally appropriate testing resources using data-driven approaches in partnership with community-based health workers is promising, but little data are available on the design and effect of such interventions. Objectives To assess and evaluate a door-to-door COVID-19 testing initiative that allocates visits by community health workers by selecting households in areas with a high number of index cases, by using uncertainty sampling for areas where the positivity rate may be highest, and by relying on local knowledge of the health workers. Design, Setting, and Participants This cohort study was performed from December 18, 2020, to February 18, 2021. Community health workers visited households in neighborhoods in East San Jose, California, based on index cases or uncertainty sampling while retaining discretion to use local knowledge to administer tests. The health workers, also known as promotores de salud (hereinafter referred to as promotores) spent a mean of 4 days a week conducting door-to-door COVID-19 testing during the 2-month study period. All residents of East San Jose were eligible for COVID-19 testing. The promotores were selected from the META cooperative (Mujeres Empresarias Tomando Acción [Entrepreneurial Women Taking Action]). Interventions The promotores observed self-collection of anterior nasal swab samples for SARS-CoV-2 reverse transcriptase–polymerase chain reaction tests. Main Outcomes and Measures A determination of whether door-to-door COVID-19 testing was associated with an increase in the overall number of tests conducted, the demographic distribution of the door-to-door tests vs local testing sites, and the difference in positivity rates among the 3 door-to-door allocation strategies. Results A total of 785 residents underwent door-to-door testing, and 756 were included in the analysis. Among the 756 individuals undergoing testing (61.1% female; 28.2% aged 45-64 years), door-to-door COVID-19 testing reached different populations than standard public health surveillance, with 87.6% (95% CI, 85.0%-89.8%) being Latinx individuals. The closest available testing site only reached 49.0% (95% CI, 48.3%-49.8%) Latinx individuals. Uncertainty sampling provided the most effective allocation, with a 10.8% (95% CI, 6.8%-16.0%) positivity rate, followed by 6.4% (95% CI, 4.1%-9.4%) for local knowledge, and 2.6% (95% CI, 0.7%-6.6%) for index area selection. The intervention was also associated with increased overall testing capacity by 60% to 90%, depending on the testing protocol. Conclusions and Relevance In this cohort study of 785 participants, uncertainty sampling, which has not been used conventionally in public health, showed promising results for allocating testing resources. Community-based door-to-door interventions and leveraging of community knowledge were associated with reduced demographic disparities in testing.
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Affiliation(s)
- Ben Chugg
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
| | - Lisa Lu
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
| | - Derek Ouyang
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
| | - Benjamin Anderson
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
| | - Raymond Ha
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
- Department of Political Science, Stanford University, Stanford, California
| | | | - Anandi Sujeer
- Santa Clara County Public Health Department, San Jose, California
| | - Sarah L. Rudman
- Santa Clara County Public Health Department, San Jose, California
| | - Analilia Garcia
- Santa Clara County Public Health Department, San Jose, California
| | - Daniel E. Ho
- Regulation, Evaluation, and Governance Laboratory, Stanford University, Stanford, California
- Department of Political Science, Stanford University, Stanford, California
- Stanford Institute for Economic Policy Research, Stanford University, Stanford, California
- Stanford Institute for Human-Centered Artificial Intelligence, Stanford University, Stanford, California
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Murphy M, Dhrolia I, Zanowick-Marr A, Tao J, Coats CS, Napoleon S, Malyuta Y, Adams E, Arnold T, Chan PA, Nunn A. A Community-Adapted Approach to SARS-CoV-2 Testing for Medically Underserved Populations, Rhode Island, USA. Emerg Infect Dis 2021; 27:2445-2449. [PMID: 34424174 PMCID: PMC8386794 DOI: 10.3201/eid2709.204874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We developed a testing program for severe acute respiratory syndrome coronavirus 2 in an urban Latinx neighborhood in Providence, Rhode Island, USA. Approximately 11% of Latinx participants (n = 180) tested positive. Culturally tailored, community-based programs that reduce barriers to testing help identify persons at highest risk for coronavirus disease.
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Crozier A, Dunning J, Rajan S, Semple MG, Buchan IE. Could expanding the covid-19 case definition improve the UK's pandemic response? BMJ 2021; 374:n1625. [PMID: 34193527 DOI: 10.1136/bmj.n1625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Alex Crozier
- Division of Biosciences, University College London, London, UK
| | - Jake Dunning
- Royal Free London NHS Foundation Trust, London, UK
- Epidemic Diseases Research Group Oxford, University of Oxford, Oxford, UK
| | - Selina Rajan
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections and Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - Iain E Buchan
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections and Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Institute of Population Health, University of Liverpool, Liverpool, UK
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36
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Pilarowski G, Lebel P, Sunshine S, Liu J, Crawford E, Marquez C, Rubio L, Chamie G, Martinez J, Peng J, Black D, Wu W, Pak J, Laurie MT, Jones D, Miller S, Jacobo J, Rojas S, Rojas S, Nakamura R, Tulier-Laiwa V, Petersen M, Havlir DV, DeRisi J. Performance Characteristics of a Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Antigen Detection Assay at a Public Plaza Testing Site in San Francisco. J Infect Dis 2021; 223:1139-1144. [PMID: 33394052 PMCID: PMC7799021 DOI: 10.1093/infdis/jiaa802] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/27/2020] [Indexed: 12/04/2022] Open
Abstract
We evaluated the performance of the Abbott BinaxNOW rapid antigen test for coronavirus disease 2019 (Binax-CoV2) to detect virus among persons, regardless of symptoms, at a public plaza site of ongoing community transmission. Titration with cultured severe acute respiratory syndrome coronavirus 2 yielded a human observable threshold between 1.6 × 104-4.3 × 104 viral RNA copies (cycle threshold [Ct], 30.3–28.8). Among 878 subjects tested, 3% (26 of 878) were positive by reverse-transcription polymerase chain reaction, of whom 15 of 26 had a Ct <30, indicating high viral load; of these, 40% (6 of 15) were asymptomatic. Using this Ct threshold (<30) for Binax-CoV2 evaluation, the sensitivity of Binax-CoV2 was 93.3% (95% confidence interval, 68.1%–99.8%) (14 of 15) and the specificity was 99.9% (99.4%–99.9%) (855 of 856).
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Affiliation(s)
- Genay Pilarowski
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Paul Lebel
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Sara Sunshine
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Jamin Liu
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Emily Crawford
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Department of Microbiology and Immunology, University of California, San Francisco, California
| | - Carina Marquez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Luis Rubio
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jackie Martinez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - James Peng
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Douglas Black
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Wesley Wu
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - John Pak
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Matthew T Laurie
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Diane Jones
- Unidos en Salud, San Francisco, California, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jon Jacobo
- Latino Task Force-COVID-19, San Francisco, California, USA
| | - Susana Rojas
- Latino Task Force-COVID-19, San Francisco, California, USA
| | - Susy Rojas
- Latino Task Force-COVID-19, San Francisco, California, USA
| | - Robert Nakamura
- California Department of Public Health, Microbial Diseases Laboratory, Richmond, California, USA
| | | | - Maya Petersen
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, California, USA
| | - Diane V Havlir
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
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Affiliation(s)
- Jay Patel
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
- Global Health Governance Programme, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Genevie Fernandes
- Global Health Governance Programme, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Devi Sridhar
- Global Health Governance Programme, Usher Institute, University of Edinburgh, Edinburgh, UK
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Peng J, Mann SA, Mitchell AM, Liu J, Laurie MT, Sunshine S, Pilarowski G, Ayscue P, Kistler A, Vanaerschot M, Li LM, McGeever A, Chow ED, Team ID, Marquez C, Nakamura R, Rubio L, Chamie G, Jones D, Jacobo J, Rojas S, Rojas S, Tulier-Laiwa V, Black D, Martinez J, Naso J, Schwab J, Petersen M, Havlir D, DeRisi J. Estimation of secondary household attack rates for emergent SARS-CoV-2 variants detected by genomic surveillance at a community-based testing site in San Francisco. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.01.21252705. [PMID: 33688689 PMCID: PMC7941666 DOI: 10.1101/2021.03.01.21252705] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sequencing of the SARS-CoV-2 viral genome from patient samples is an important epidemiological tool for monitoring and responding to the pandemic, including the emergence of new mutations in specific communities. METHODS SARS-CoV-2 genomic sequences were generated from positive samples collected, along with epidemiological metadata, at a walk-up, rapid testing site in the Mission District of San Francisco, California during November 22-December 2, 2020 and January 10-29, 2021. Secondary household attack rates and mean sample viral load were estimated and compared across observed variants. RESULTS A total of 12,124 tests were performed yielding 1,099 positives. From these, 811 high quality genomes were generated. Certain viral lineages bearing spike mutations, defined in part by L452R, S13I, and W152C, comprised 54.9% of the total sequences from January, compared to 15.7% in November. Household contacts exposed to "West Coast" variants were at higher risk of infection compared to household contacts exposed to lineages lacking these variants (0.357 vs 0.294, RR=1.29; 95% CI:1.01-1.64). The reproductive number was estimated to be modestly higher than other lineages spreading in California during the second half of 2020. Viral loads were similar among persons infected with West Coast versus non-West Coast strains, as was the proportion of individuals with symptoms (60.9% vs 64.1%). CONCLUSIONS The increase in prevalence, relative household attack rates, and reproductive number are consistent with a modest transmissibility increase of the West Coast variants; however, additional laboratory and epidemiological studies are required to better understand differences between these variants. SUMMARY We observed a growing prevalence and elevated attack rate for "West Coast" SARS-CoV-2 variants in a community testing setting in San Francisco during January 2021, suggesting its modestly higher transmissibility.
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Affiliation(s)
- James Peng
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sabrina A Mann
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Anthea M Mitchell
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Jamin Liu
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
- University of California, Berkeley—University of California, San Francisco Graduate Program in Bioengineering, Berkeley, CA 94720, USA
| | - Matthew T. Laurie
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Sara Sunshine
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Genay Pilarowski
- Department of Pathology, Stanford University, Stanford, CA 94305, USA
| | | | - Amy Kistler
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | | | - Lucy M. Li
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | | | - Eric D. Chow
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - IDseq Team
- Chan Zuckerberg Initiative, Redwood City, CA 94063, USA
| | - Carina Marquez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Robert Nakamura
- California Department of Public Health, Richmond, CA 94804, USA
| | - Luis Rubio
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Diane Jones
- Unidos en Salud, San Francisco, CA 94143, USA
| | - Jon Jacobo
- Unidos en Salud, San Francisco, CA 94143, USA
| | | | - Susy Rojas
- Unidos en Salud, San Francisco, CA 94143, USA
| | | | - Douglas Black
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | | | - Jamie Naso
- Unidos en Salud, San Francisco, CA 94143, USA
| | - Joshua Schwab
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Maya Petersen
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Diane Havlir
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
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Intergenerational conflicts of interest and prosocial behavior during the COVID-19 pandemic. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 171:110535. [PMID: 35502313 PMCID: PMC9045808 DOI: 10.1016/j.paid.2020.110535] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic presents threats, such as severe disease and economic hardship, to people of different ages. These threats can also be experienced asymmetrically across age groups, which could lead to generational differences in behavioral responses to reduce the spread of the disease. We report a survey conducted across 56 societies (N = 58,641), and tested pre-registered hypotheses about how age relates to (a) perceived personal costs during the pandemic, (b) prosocial COVID-19 responses (e.g., social distancing), and (c) support for behavioral regulations (e.g., mandatory quarantine, vaccination). We further tested whether the relation between age and prosocial COVID-19 responses can be explained by perceived personal costs during the pandemic. Overall, we found that older people perceived more costs of contracting the virus, but less costs in daily life due to the pandemic. However, age displayed no clear, robust associations with prosocial COVID-19 responses and support for behavioral regulations. We discuss the implications of this work for understanding the potential intergenerational conflicts of interest that could occur during the COVID-19 pandemic.
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40
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Smith ML, Harden SM. Full Comprehension of Theories, Models, and Frameworks Improves Application: A Focus on RE-AIM. Front Public Health 2021; 9:599975. [PMID: 33681126 PMCID: PMC7930006 DOI: 10.3389/fpubh.2021.599975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/11/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Samantha M Harden
- Physical Activity Research and Community Implementation, Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
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Grumbach K, Cottler LB, Brown J, LeSarre M, Gonzalez-Fisher RF, Williams CD, Michener JL, Nease DE, Tandon D, Varma DS, Eder M. It should not require a pandemic to make community engagement in research leadership essential, not optional. J Clin Transl Sci 2021; 5:e95. [PMID: 34192052 PMCID: PMC8134899 DOI: 10.1017/cts.2021.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
Efforts to move community engagement in research from marginalized to mainstream include the NIH requiring community engagement programs in all Clinical and Translational Science Awards (CTSAs). However, the COVID-19 pandemic has exposed how little these efforts have changed the dominant culture of clinical research. When faced with the urgent need to generate knowledge about prevention and treatment of the novel coronavirus, researchers largely neglected to involve community stakeholders early in the research process. This failure cannot be divorced from the broader context of systemic racism in the US that has contributed to Black, Indigenous, and People of Color (BIPOC) communities bearing a disproportionate toll from COVID-19, being underrepresented in COVID-19 clinical trials, and expressing greater hesitancy about COVID-19 vaccination. We call on research funders and research institutions to take decisive action to make community engagement obligatory, not optional, in all clinical and translational research and to center BIPOC communities in this process. Recommended actions include funding agencies requiring all research proposals involving human participants to include a community engagement plan, providing adequate funding to support ongoing community engagement, including community stakeholders in agency governance and proposal reviews, promoting racial and ethnic diversity in the research workforce, and making a course in community engaged research a requirement for Masters of Clinical Research curricula.
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Affiliation(s)
- Kevin Grumbach
- Department of Family and Community Medicine and Clinical and Translational Science Institute, University of California, San Francisco, CA, USA
| | - Linda B. Cottler
- Department of Epidemiology and Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA
| | - Jen Brown
- Alliance for Research in Chicagoland Communities and Clinical and Translational Sciences Institute, Northwestern University, Evanston, IL, USA
| | - Monique LeSarre
- Rafiki Coalition and African American Community Health Equity Council, San Francisco, CA, USA
| | | | - Carla D. Williams
- Georgetown-Howard University Center for Clinical and Translational Science, Washington, DC, USA
| | - J. Lloyd Michener
- Department of Family Medicine and Community Health, Duke School of Medicine, Durham, NC, USA
| | - Donald E. Nease
- Department of Family Medicine and the Colorado Clinical and Translational Sciences Institute, University of Colorado – Anschutz Medical Campus, Aurora, CO, USA
| | - Darius Tandon
- Department of Medical Social Sciences and Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Deepthi S. Varma
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Milton Eder
- Department of Family Medicine and Community Health, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
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Affiliation(s)
- Alex Crozier
- Division of Biosciences, University College London, London, UK
| | - Selina Rajan
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Iain Buchan
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- European Observatory on Health Systems and Policies, London, UK
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43
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Affiliation(s)
- Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St Andrews, St Andrews, UK
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Alex Crozier
- Division of Biosciences, University College London, London, UK
| | - Jackie A Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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Rubio LA, Peng J, Rojas S, Rojas S, Crawford E, Black D, Jacobo J, Tulier-Laiwa V, Hoover CM, Martinez J, Jones D, Sachdev D, Cox C, Herrera E, Valencia R, Zurita KG, Chamie G, DeRisi J, Petersen M, Havlir DV, Marquez C. The COVID-19 Symptom to Isolation Cascade in a Latinx Community: A Call to Action. Open Forum Infect Dis 2021; 8:ofab023. [PMID: 33623805 PMCID: PMC7888566 DOI: 10.1093/ofid/ofab023] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/13/2021] [Indexed: 12/27/2022] Open
Abstract
Background Rapid coronavirus disease 2019 (COVID-19) diagnosis and isolation of infectious persons are critical to stopping forward transmission, and the care cascade framework can identify gaps in the COVID-19 response. Methods We described a COVID-19 symptom to isolation cascade and barriers among symptomatic persons who tested polymerase chain reaction positive for severe acute respiratory disease coronavirus 2 (SARS-CoV-2) at a low-barrier testing site serving a low-income Latinx community in San Francisco. Steps in the cascade are defined as days from symptom onset to test, test to result, and result to counseling on self-isolation. We examined SARS-CoV-2 cycle threshold (Ct) values to assess the likelihood of infectiousness on the day of testing and during missed isolation days. Results Among 145 persons, 97% were Latinx and 81% had an income of <$50 000. The median time from symptom onset to isolation (interquartile range [IQR]) was 7 (5–10) days, leaving a median (IQR) of 3 (0–6) days of isolation. Eighty-three percent had moderate to high levels of virus (Ct <33), but by disclosure 23% were out of their isolation period. The longest intervals were symptom onset to test (median [IQR], 4 [2–9] days) and test to results notification (median [IQR], 3 [2–4] days). Access to a test site was the most common barrier to testing, and food and income loss was the most common barrier to isolation. Conclusions Over half of the 10-day isolation period passed by the time of disclosure, and over a fifth of people were likely outside the window of infectiousness by the time they received results. Improvements in test access and turnaround time, plus support for isolation, are needed for epidemic control of SARS-CoV-2 in highly impacted communities.
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Affiliation(s)
- Luis A Rubio
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - James Peng
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Susy Rojas
- Latino Task Force-COVID-19, San Francisco, California, USA
| | - Susana Rojas
- Latino Task Force-COVID-19, San Francisco, California, USA
| | - Emily Crawford
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Department of Microbiology and Immunology, University of California San Francisco, San Francisco, California, USA
| | - Douglas Black
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jon Jacobo
- Latino Task Force-COVID-19, San Francisco, California, USA
| | | | - Christopher M Hoover
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, California, USA
| | | | - Diane Jones
- Unidos en Salud, San Francisco, California, USA
| | - Darpun Sachdev
- San Francisco Department of Public Health, San Francisco, California, USA
| | - Chesa Cox
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | | | | | - Gabriel Chamie
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Joe DeRisi
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, USA
| | - Maya Petersen
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, California, USA
| | - Diane V Havlir
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Carina Marquez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
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Pilarowski G, Marquez C, Rubio L, Peng J, Martinez J, Black D, Chamie G, Jones D, Jacobo J, Tulier-Laiwa V, Rojas S, Rojas S, Cox C, Petersen M, DeRisi J, Havlir DV. Field performance and public health response using the BinaxNOW TM Rapid SARS-CoV-2 antigen detection assay during community-based testing. Clin Infect Dis 2020; 73:e3098-e3101. [PMID: 33367619 PMCID: PMC7799223 DOI: 10.1093/cid/ciaa1890] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022] Open
Abstract
Among 3,302 persons tested for SARS-CoV-2 by BinaxNOW TM and RT-PCR in a community setting, rapid assay sensitivity was 100%/98.5%/89% using RT-PCR Ct thresholds of 30, 35 and none. The specificity was 99.9%. Performance was high across ages and those with and without symptoms. Rapid resulting permitted immediate public health action.
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Affiliation(s)
| | | | - Luis Rubio
- University of California, San Francisco, CA
| | - James Peng
- University of California, San Francisco, CA
| | | | | | | | - Diane Jones
- Unidos en Salud/United in Health, San Francisco, CA
| | - Jon Jacobo
- Unidos en Salud/United in Health, San Francisco, CA
| | | | - Susana Rojas
- Unidos en Salud/United in Health, San Francisco, CA
| | - Susy Rojas
- Unidos en Salud/United in Health, San Francisco, CA
| | - Chesa Cox
- University of California, San Francisco, CA
| | | | - Joe DeRisi
- Chan Zuckerberg Biohub, San Francisco, CA
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Pilarowski G, Lebel P, Sunshine S, Liu J, Crawford E, Marquez C, Rubio L, Chamie G, Martinez J, Peng J, Black D, Wu W, Pak J, Laurie MT, Jones D, Miller S, Jacobo J, Rojas S, Rojas S, Nakamura R, Tulier-Laiwa V, Petersen M, Havlir DV, DeRisi J. Performance characteristics of a rapid SARS-CoV-2 antigen detection assay at a public plaza testing site in San Francisco. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.02.20223891. [PMID: 33173911 PMCID: PMC7654907 DOI: 10.1101/2020.11.02.20223891] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We evaluated the performance of the Abbott BinaxNOW™ Covid-19 rapid antigen test to detect virus among persons, regardless of symptoms, at a public plaza site of ongoing community transmission. Titration with cultured clinical SARS-CoV-2 yielded a human observable threshold between 1.6×104-4.3×104 viral RNA copies (cycle threshold (Ct) of 30.3-28.8 in this assay). Among 878 subjects tested, 3% (26/878) were positive by RT-PCR, of which 15/26 had a Ct<30, indicating high viral load. 40% (6/15) of Ct<30 were asymptomatic. Using this Ct<30 threshold for Binax-CoV2 evaluation, the sensitivity of the Binax-CoV2 was 93.3% (14/15), 95% CI: 68.1-99.8%, and the specificity was 99.9% (855/856), 95% CI: 99.4-99.9%.
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Affiliation(s)
- Genay Pilarowski
- Department of Pathology, Stanford University, Stanford, CA 94305, USA
| | - Paul Lebel
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Sara Sunshine
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Jamin Liu
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Emily Crawford
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
- Department of Microbiology and Immunology, University of California San Francisco, CA 94143
| | - Carina Marquez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Luis Rubio
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jackie Martinez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - James Peng
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Douglas Black
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Wesley Wu
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - John Pak
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Matthew T. Laurie
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
| | - Diane Jones
- Unidos en Salud, San Francisco, CA 94143, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California San Francisco CA 94131, USA
| | - Jon Jacobo
- Latino Task Force-COVID-19, San Francisco, CA 94110, USA
| | - Susana Rojas
- Latino Task Force-COVID-19, San Francisco, CA 94110, USA
| | - Susy Rojas
- Latino Task Force-COVID-19, San Francisco, CA 94110, USA
| | - Robert Nakamura
- California Department of Public Health, Microbial Diseases Laboratory, Richmond, CA, 94804, USA
| | | | - Maya Petersen
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Diane V. Havlir
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | | | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
- Department of Biochemistry and Biophysics, University of California San Francisco, CA 94143, USA
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