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Abstract
Correctional facilities house millions of residents in communities throughout the United States. Such congregate settings are critical for national infection prevention and control (IPC) efforts. Carceral settings can be sites where infectious diseases are detected in patient populations who may not otherwise have access to health care services, and as highlighted by the COVID-19 pandemic, where outbreaks of infectious diseases may result in spread to residents, correctional staff, and the community at large. Correctional IPC, while sharing commonalities with IPC in other settings, is unique programmatically and operationally. In this article, we identify common challenges with correctional IPC program implementation and recommend action steps for advancing correctional IPC as a national public health priority.
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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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Brown TW, Park GW, Wittry B, Barclay L, Person M, Relja B, Daly S, Chhabra P, Kincaid E, Johnson J, Ahmad A, Herzegh O, Vinjé J, Murphy J. SARS-CoV-2 surface contamination in metro-Atlanta grocery stores. PLoS One 2023; 18:e0291747. [PMID: 37725625 PMCID: PMC10508621 DOI: 10.1371/journal.pone.0291747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
While the COVID-19 pandemic has had a detrimental impact on many businesses worldwide, essential businesses, such as grocery stores, continued to operate despite potential disease transmission. Although the principal mode by which people are infected with SARS-CoV-2, the virus that causes COVID-19, is through exposure to respiratory droplets and very small particles carrying infectious virus, contaminated surfaces might play a role in transmission. We collected swab samples from frequently touched surfaces, including grocery carts, touchscreen monitors, credit card keypads, pharmacy counters, self-service food utensils, and refrigerator and freezer handles, in two metro-Atlanta grocery stores over the course of two sampling events in March 2021. Of the 260 swab samples collected, 6 (2.3%) samples were positive for SARS-CoV-2 RNA by reverse transcriptase quantitative polymerase chain reaction. Positive samples were collected from pharmacy (12.0% [3/25] samples), refrigerator/freezer aisles (2.5% [1/39] samples), and self-service food court (5.0% [2/40] samples) areas. Table/counter edge and underside surfaces represented 33% (2/6) of positive samples. These data suggest that risk of exposure to SARS-CoV-2 from frequently touched surfaces in grocery store settings is likely low; however, more frequent cleaning of surfaces in pharmacy and self-service food courts might be warranted.
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Affiliation(s)
- Travis W. Brown
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Geun W. Park
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Beth Wittry
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leslie Barclay
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Margaret Person
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Boris Relja
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Daly
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Preeti Chhabra
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin Kincaid
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jona Johnson
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ausaf Ahmad
- Division of Scientific Resources, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Owen Herzegh
- Division of Scientific Resources, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer Murphy
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Hershow RB, Burnett JC, Nicolae L, Marquez N, Everett M, Tyagi E, Williams SP. COVID-19 Burden in Adult Correctional or Detention Facilities and the Surrounding Communities, January 1, 2020-July 20, 2021. JOURNAL OF CORRECTIONAL HEALTH CARE 2023; 29:241-246. [PMID: 37163216 PMCID: PMC10527881 DOI: 10.1089/jchc.22.02.0012] [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] [Indexed: 05/11/2023]
Abstract
We estimated the COVID-19 burden in adult correctional or detention facilities and associated counties by state, facility jurisdiction, and county urbanicity. COVID-19 cumulative incidence (cases per 1,000 persons) for each U.S. correctional or detention facility and people ages 18 years and older in the associated county was estimated between January 1, 2020 and July 20, 2021. Across 46 U.S. states, 1,083 correctional or detention facilities in 718 counties were included. The median COVID-19 incidence rate was higher in facilities than in associated counties for 42 of 46 states and for all facility jurisdictions and county urbanicity categories. COVID-19 burden was higher in most facilities than in associated counties. Implementing COVID-19 mitigation measures in correctional settings is needed to prevent SARS-CoV-2 transmission in facilities and associated counties.
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Affiliation(s)
- Rebecca B. Hershow
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet C. Burnett
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lavinia Nicolae
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- CDC COVID-19 Response, State, Tribal, Local, and Territories Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Neal Marquez
- UCLA Law COVID Behind Bars Data Project, University of California Los Angeles School of Law, Los Angeles, California, USA
| | - Michael Everett
- UCLA Law COVID Behind Bars Data Project, University of California Los Angeles School of Law, Los Angeles, California, USA
| | - Erika Tyagi
- UCLA Law COVID Behind Bars Data Project, University of California Los Angeles School of Law, Los Angeles, California, USA
| | - Samantha P. Williams
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Gouvea-Reis FA, Soares da Silva DC, Borja LS, Dias PDO, Percio J, Peterka C, de Oliveira J, Sodré G, Feres CM, Dos Santos W, Souza F, Passarella Teixeira AI, Cilião-Alves DC, Romero GAS, Ferreira Noronha E, Croda J, Haddad R, Ramalho WM, de Moraes C, Araújo WND. SARS CoV-2 seroprevalence and diagnostic accuracy during a COVID-19 outbreak in a major penitentiary complex in Brazil, June to July 2020. Int J Prison Health 2023; 19:143-156. [PMID: 38899623 DOI: 10.1108/ijph-08-2021-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19 outbreak in a prison complex housing over 13,000 prisoners in Brasília. DESIGN/METHODOLOGY/APPROACH The authors obtained a randomized, stratified representative sample of each prison unit and conducted a repeated serosurvey among prisoners between June and July 2020, using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and 21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the diagnostic accuracy of the LFIA test. FINDINGS This study identified 485 eligible individuals and enrolled 460 participants. Baseline and 21-days follow-up seroprevalence were estimated at 52.0% (95% CI 44.9-59.0) and 56.7% (95% CI 48.2-65.3) with LFIA; and 80.7% (95% CI 74.1-87.3) and 81.1% (95% CI 74.4-87.8) with CLIA, with an overall IFR of 0.02%. There were 78.2% (95% CI 66.7-89.7) symptomatic individuals among the positive cases. Sensitivity and specificity of LFIA were estimated at 43.4% and 83.3% for IgM; 46.5% and 91.5% for IgG; and 59.1% and 77.3% for combined tests. ORIGINALITY/VALUE The authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the prison complex. The occurrence of asymptomatic infection highlights the importance of periodic mass testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA tests should be validated. This study recommends that vaccination strategies consider the inclusion of prisoners and prison staff in priority groups.
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Affiliation(s)
| | | | | | | | | | - Cassio Peterka
- Secretaria de Estado da Saúde do Distrito Federal, Brasilia, Brazil
| | | | - Giselle Sodré
- Secretaria de Estado da Saúde do Distrito Federal, Brasilia, Brazil
| | | | | | - Fábio Souza
- Secretaria de Estado de Administração Penitenciária do Distrito Federal, Brasília, Brazil
| | | | | | | | | | - Julio Croda
- Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil; Yale University School of Public Health, New Haven, Connecticut, USA and Fundação Oswaldo Cruz, Campo Grande, Brazil
| | | | | | - Camile de Moraes
- Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasilia, Brazil
| | - Wildo Navegantes de Araújo
- Universidade de Brasilia, Brasilia, Brazil and National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, Brazil
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Dahiya S, Simpson PL, Butler T. Rethinking standards on prison cell size in a (post)pandemic world: a scoping review. BMJ Open 2023; 13:e069952. [PMID: 37015783 PMCID: PMC10083520 DOI: 10.1136/bmjopen-2022-069952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE To describe the current international, regional and national standards on prison cell spatial density and the evidence for the association between COVID-19 transmission and prison crowding measures to provide recommendations on prison cell spatial density standards for a (post) pandemic world. DESIGN Scoping review. DATA SOURCES PubMed, ProQuest, Informit, Criminal Justice Abstracts, Cochrane, Web of Science, Scopus, EMBASE, Google Scholar and Google were searched up to November 2021. ELIGIBILITY CRITERIA Guidelines were included provided they described standards of prison accommodation with respect to prison cells. Studies were included provided they examined an association between COVID-19 cases and a crowding measure. DATA EXTRACTION AND SYNTHESIS Data were extracted by one reviewer and cross-checked by another. Quantitative and qualitative data on prison cell standards and characteristics of studies examining an association between COVID-19 and prison crowding were collected.Findings were synthesised qualitatively. RESULTS Seventeen reports and six studies met eligibility criteria. International and regional standards on cell spatial density were mostly qualitative, with two quantifiable international standards located (3.4 m2 and 3.5 m2 per person for multiple occupancy cells), and two quantifiable regional standards located (4 m2 per person (Europe) and 5.75 m2 or 4 m2 per person (Australia and New Zealand)). Country-based standards varied substantially, ranging from 1.25 m2 per person (Pakistan) to 10 m2 per person (Netherlands). Consideration of airborne transmission of disease in prisons were mostly overlooked or absent to rationalise standards. There was consistent evidence that prison crowding measures were associated with COVID-19 transmission/cases. CONCLUSION Considering the physics of respiratory emissions, we recommend prison cell spatial density standards be updated to reflect graded levels of risk that consider other factors that combine to inform airborne transmission risk. Decarceration strategies should be considered and become vital if standards are not met.
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Affiliation(s)
- Simran Dahiya
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Leslie Simpson
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Davidson A, Aggarwal S, Eissa M, Benjamins L, Will J, Beyda R. Public Health Measures and SARS-CoV-2 Cases in the Juvenile Justice System: Implications for Pandemic Response in the Detention Setting. South Med J 2023; 116:195-201. [PMID: 36724535 PMCID: PMC9897111 DOI: 10.14423/smj.0000000000001505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to examine severe acute respiratory syndrome-coronavirus-2 case positivity in juvenile justice facilities of two different states alongside institutional, local, and state public health policies during the first 6 months of the coronavirus disease 2019 pandemic. METHODS This retrospective chart review examined two large, urban juvenile justice centers in California and Texas. Positive intake or day 12 tests were considered suggestive of community-acquired severe acute respiratory syndrome-coronavirus-2 infection. Researchers examined state and county restrictions, closings, and openings. The study included all of the youths 10 to 18 years residing in the facilities between March and August 2020. The main outcomes measured case positivity in each facility and compared it with community positivity rates and state public health measures. RESULTS In total, 530 youth were included (Texas, n = 319; California, n = 211). The Texas facility reported a higher number of positive cases (24) versus the California facility (3) (P < 0.05). Of the positive youth, 70% were asymptomatic, and none required hospitalization. Intake and day 12 tests were positive in <1% of California youth compared with a rate of 4% in Texas (P < 0.05). California and Texas instituted mask mandates in May and July 2020, respectively. California restricted indoor capacity until August, but Texas varied from 25% to 75% capacity through July. CONCLUSIONS The Texas facility reported a higher percentage of community-acquired infections compared with California, coinciding with reopening measures in Texas. Texas also enacted a mask mandate later than California. These public health measures, among other factors, likely contributed to higher community rates in Texas, thereby affecting rates among the detained youth.
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Affiliation(s)
- Asha Davidson
- From Department of Pediatrics, Division of Adolescent Medicine, McGovern Medical School, UTHealth Houston, Houston, Texas
| | | | - Mona Eissa
- From Department of Pediatrics, Division of Adolescent Medicine, McGovern Medical School, UTHealth Houston, Houston, Texas
| | | | - John Will
- the Santa Clara Valley Medical Center, San Jose, California
| | - Rebecca Beyda
- From Department of Pediatrics, Division of Adolescent Medicine, McGovern Medical School, UTHealth Houston, Houston, Texas
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Knust B, Wongjindanon N, Moe AA, Herath L, Kaloy W, Soe TT, Sataranon P, Oo HM, Myat KZ, Win Z, Htet M, Htike M, Sudhiprapha B, Pyone AA, Win TP, Win HZ, Sawatwong P, Watthanaworawit W, Ling C, Gunaratne S, Lynn SA, Bhandari L, Nosten F, Skaggs B. Enhancing Respiratory Disease Surveillance to Detect COVID-19 in Shelters for Displaced Persons, Thailand-Myanmar Border, 2020-2021. Emerg Infect Dis 2022; 28:S17-S25. [PMID: 36502383 PMCID: PMC9745244 DOI: 10.3201/eid2813.220324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We developed surveillance guidance for COVID-19 in 9 temporary camps for displaced persons along the Thailand-Myanmar border. Arrangements were made for testing of persons presenting with acute respiratory infection, influenza-like illness, or who met the Thailand national COVID-19 Person Under Investigation case definition. In addition, testing was performed for persons who had traveled outside of the camps in outbreak-affected areas or who departed Thailand as resettling refugees. During the first 18 months of surveillance, May 2020-October 2021, a total of 6,190 specimens were tested, and 15 outbreaks (i.e., >1 confirmed COVID-19 cases) were detected in 7 camps. Of those, 5 outbreaks were limited to a single case. Outbreaks during the Delta variant surge were particularly challenging to control. Adapting and implementing COVID-19 surveillance measures in the camp setting were successful in detecting COVID-19 outbreaks and preventing widespread disease during the initial phase of the pandemic in Thailand.
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Bhatia R, Sledge I, Baral S. Missing science: A scoping study of COVID-19 epidemiological data in the United States. PLoS One 2022; 17:e0248793. [PMID: 36223335 PMCID: PMC9555641 DOI: 10.1371/journal.pone.0248793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.
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Affiliation(s)
- Rajiv Bhatia
- Primary Care and Population Health, Stanford University, Stanford, CA, United States of America
| | | | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
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Shragai T, Pratt C, Castro Georgi J, Donnelly MAP, Schwartz NG, Soto R, Chuey M, Chu VT, Marcenac P, Park GW, Ahmad A, Albanese B, Totten SE, Austin B, Bunkley P, Cherney B, Dietrich EA, Figueroa E, Folster JM, Godino C, Herzegh O, Lindell K, Relja B, Sheldon SW, Tong S, Vinjé J, Thornburg NJ, Matanock AM, Hughes LJ, Stringer G, Hudziec M, Beatty ME, Tate JE, Kirking HL, Hsu CH. Household characteristics associated with surface contamination of SARS-CoV-2 and frequency of RT-PCR and viral culture positivity-California and Colorado, 2021. PLoS One 2022; 17:e0274946. [PMID: 36215247 PMCID: PMC9550039 DOI: 10.1371/journal.pone.0274946] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
While risk of fomite transmission of SARS-CoV-2 is considered low, there is limited environmental data within households. This January-April 2021 investigation describes frequency and types of surfaces positive for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) among residences with ≥1 SARS-CoV-2 infection, and associations of household characteristics with surface RT-PCR and viable virus positivity. Of 1232 samples from 124 households, 27.8% (n = 342) were RT-PCR positive with nightstands (44.1%) and pillows (40.9%) most frequently positive. SARS-CoV-2 lineage, documented household transmission, greater number of infected persons, shorter interval between illness onset and sampling, total household symptoms, proportion of infected persons ≤12 years old, and persons exhibiting upper respiratory symptoms or diarrhea were associated with more positive surfaces. Viable virus was isolated from 0.2% (n = 3 samples from one household) of all samples. This investigation suggests that while SARS-CoV-2 on surfaces is common, fomite transmission risk in households is low.
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Affiliation(s)
- Talya Shragai
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Caroline Pratt
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Marisa A. P. Donnelly
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Noah G. Schwartz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Raymond Soto
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Meagan Chuey
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria T. Chu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Perrine Marcenac
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Geun Woo Park
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ausaf Ahmad
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bernadette Albanese
- Tri-County Health Department, Adams, Arapahoe, and Douglas Counties, Colorado, United States of America
| | - Sarah Elizabeth Totten
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Brett Austin
- Health and Human Services, San Diego County, California, United States of America
| | - Paige Bunkley
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Blake Cherney
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A. Dietrich
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erica Figueroa
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer M. Folster
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire Godino
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Owen Herzegh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristine Lindell
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Boris Relja
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah W. Sheldon
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Natalie J. Thornburg
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Almea M. Matanock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Laura J. Hughes
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Meghan Hudziec
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Mark E. Beatty
- Health and Human Services, San Diego County, California, United States of America
| | - Jacqueline E. Tate
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hannah L. Kirking
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher H. Hsu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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11
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Sá R, Isidro J, Borges V, Duarte S, Vieira L, Gomes JP, Tedim S, Matias J, Leite A. Unraveling the hurdles of a large COVID-19 epidemiological investigation by viral genomics. J Infect 2022; 85:64-74. [PMID: 35609706 PMCID: PMC9123803 DOI: 10.1016/j.jinf.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/16/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 local outbreak response relies on subjective information to reconstruct transmission chains. We assessed the concordance between epidemiologically linked cases and viral genetic profiles, in the Baixo Vouga Region (Portugal), from March to June 2020. A total of 1925 COVID-19 cases were identified, with 1143 being assigned to 154 epiclusters. Viral genomic data was available for 128 cases. Public health authorities identified two large epiclusters (280 and 101 cases each) with a central role on the spread of the disease. Still, the genomic data revealed that each epicluster included two distinct SARS-CoV-2 genetic profiles and thus more than one transmission network. We were able to show that the initial transmission dynamics reconstruction was most likely accurate, but the increasing dimension of the epiclusters and its extension to densely populated settings (healthcare and nursing home settings) triggered the misidentification of links. Genomics was also key to resolve some sporadic cases and misidentified direction of transmission. The epidemiological investigation showed a sensitivity of 70%-86% to detect transmission chains. This study contributes to the understanding of the hurdles and caveats associated with the epidemiological investigation of hundreds of community cases in the context of a massive outbreak caused by a highly transmissible and new respiratory virus.
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Affiliation(s)
- Regina Sá
- Public Health Unit of the Baixo Vouga Health Center Grouping, Regional Health Administration of the Center Portugal (ARSC), Aveiro, Portugal.
| | - Joana Isidro
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Vítor Borges
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Sílvia Duarte
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Vieira
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João P Gomes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Sofia Tedim
- Department of Mathematics, University of Aveiro (UA), Aveiro, Portugal
| | - Judite Matias
- Public Health Unit of the Baixo Vouga Health Center Grouping, Regional Health Administration of the Center Portugal (ARSC), Aveiro, Portugal
| | - Andreia Leite
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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12
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Kim H, Hughes E, Cavanagh A, Norris E, Gao A, Bondy SJ, McLeod KE, Kanagalingam T, Kouyoumdjian FG. The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review. PLoS One 2022; 17:e0268866. [PMID: 35594288 PMCID: PMC9122186 DOI: 10.1371/journal.pone.0268866] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/09/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. OBJECTIVES To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. DATA SOURCES We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. STUDY ELIGIBILITY CRITERIA Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. STUDY APPRAISAL AND SYNTHESIS METHODS We used the Joanna Briggs Institute's Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. RESULTS We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. LIMITATIONS Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. CONCLUSIONS Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. PROSPERO REGISTRATION NUMBER 239324.
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Affiliation(s)
- Hannah Kim
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily Hughes
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alice Cavanagh
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emily Norris
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Angela Gao
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Susan J. Bondy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Katherine E. McLeod
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tharsan Kanagalingam
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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13
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Xu J, Lim A, Rutherford G. High Incidence of SARS-CoV-2 Within Incarcerated Populations and Possible Implications for Herd Immunity. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:71-74. [PMID: 35143356 DOI: 10.1089/jchc.21.03.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Controlling the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been challenging in the community and prison systems. Where herd immunity lies for this virus is unknown, although estimates have ranged from 60% to 80%. Since the start of the pandemic, there have been multiple SARS-CoV-2 outbreaks within U.S. prison systems, which may provide more insight on where true herd immunity lies. We reviewed data from the California Department of Corrections and Rehabilitation to investigate the cumulative incidence of infection and found levels in 14 (40%) of 35 prisons were >60%. These data and existing literature suggest that in prison environments, prevalence of immunity often needs to reach >70% before transmission slows. Similar levels may be needed in the general population before transmission is suppressed.
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Affiliation(s)
- James Xu
- Department of Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Andrea Lim
- Department of Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
| | - George Rutherford
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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14
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Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from pre and asymptomatic infected individuals: a systematic review. Clin Microbiol Infect 2022; 28:178-189. [PMID: 34757116 PMCID: PMC8555342 DOI: 10.1016/j.cmi.2021.10.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/13/2021] [Accepted: 10/23/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The role of SARS-Cov-2-infected persons who develop symptoms after testing (presymptomatics) or not at all (asymptomatics) in the pandemic spread is unknown. OBJECTIVES To determine infectiousness and probable contribution of asymptomatic persons (at the time of testing) to pandemic SARS-CoV-2 spread. DATA SOURCES LitCovid, medRxiv, Google Scholar, and WHO Covid-19 databases (to 31 March 2021) and references in included studies. STUDY ELIGIBILITY CRITERIA Studies with a proven or hypothesized transmission chain based either on serial PCR cycle threshold readings and/or viral culture and/or gene sequencing, with adequate follow-up. PARTICIPANTS People exposed to SARS-CoV-2 within 2-14 days to index asymptomatic (at time of observation) infected individuals. INTERVENTIONS Reliability of symptom and signs was assessed within contemporary knowledge; transmission likelihood was assessed using adapted causality criteria. METHODS Systematic review. We contacted all included studies' corresponding authors requesting further details. RESULTS We included 18 studies from a diverse setting with substantial methodological variation (this field lacks standardized methodology). At initial testing, prevalence of asymptomatic cases was 12.5-100%. Of these, 6-100% were later determined to be presymptomatic, this proportion varying according to setting, methods of case ascertainment and population. Nursing/care home facilities reported high rates of presymptomatic: 50-100% (n = 3 studies). Fourteen studies were classified as high risk of, and four studies as at moderate risk of symptom ascertainment bias. High-risk studies may be less likely to distinguish between presymptomatic and asymptomatic cases. Six asymptomatic studies and four presymptomatic studies reported culturing infectious virus; data were too sparse to determine infectiousness duration. Three studies provided evidence of possible and three of probable/likely asymptomatic transmission; five studies provided possible and two probable/likely presymptomatic SARS-CoV-2 transmission. CONCLUSION High-quality studies provide probable evidence of SARS-CoV-2 transmission from presymptomatic and asymptomatic individuals, with highly variable estimated transmission rates.
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15
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Zhou N, Agathis N, Lees Y, Stevens H, Clark J, Reede D, Kunkel A, Balajee SA. Implementation of a COVID-19 Screening Testing Program in a Rural, Tribal Nation: Experience of the San Carlos Apache Tribe, January-February 2021. Public Health Rep 2022; 137:220-225. [PMID: 35023417 DOI: 10.1177/00333549211061770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has disproportionately affected tribal populations, including the San Carlos Apache Tribe. Universal screening testing in a community using rapid antigen tests could allow for near-real-time identification of COVID-19 cases and result in reduced SARS-CoV-2 transmission. Published experiences of such testing strategies in tribal communities are lacking. Accordingly, tribal partners, with support from the Centers for Disease Control and Prevention, implemented a serial testing program using the Abbott BinaxNOW rapid antigen test in 2 tribal casinos and 1 detention center on the San Carlos Apache Indian Reservation for a 4-week pilot period from January to February 2021. Staff members at each setting, and incarcerated adults at the detention center, were tested every 3 or 4 days with BinaxNOW. During the 4-week period, 3834 tests were performed among 716 participants at the sites. Lessons learned from implementing this program included demonstrating (1) the plausibility of screening testing programs in casino and prison settings, (2) the utility of training non-laboratory personnel in rapid testing protocols that allow task shifting and reduce the workload on public health employees and laboratory staff, (3) the importance of building and strengthening partnerships with representatives from the community and public and private sectors, and (4) the need to implement systems that ensure confidentiality of test results and promote compliance among participants. Our experience and the lessons learned demonstrate that a serial rapid antigen testing strategy may be useful in work settings during the COVID-19 pandemic as schools and businesses are open for service.
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Affiliation(s)
- Natsai Zhou
- Department of Health and Human Services, San Carlos Apache Tribe, San Carlos, AZ, USA
| | - Nickolas Agathis
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yvonne Lees
- Department of Health and Human Services, San Carlos Apache Tribe, San Carlos, AZ, USA
| | - Heidi Stevens
- Department of Health and Human Services, San Carlos Apache Tribe, San Carlos, AZ, USA
| | - James Clark
- San Carlos Apache Health Corporation, San Carlos Apache Tribe, Peridot, AZ, USA
| | - David Reede
- Department of Health and Human Services, San Carlos Apache Tribe, San Carlos, AZ, USA
| | - Amber Kunkel
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Arunmozhi Balajee
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Montgomery MP, Hong K, Clarke KEN, Williams S, Fukunaga R, Fields VL, Park J, Schieber LZ, Kompaniyets L, Ray CM, Lambert LA, D’Inverno AS, Ray TK, Jeffers A, Mosites E. Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness. JAMA Netw Open 2022; 5:e2143407. [PMID: 35024835 PMCID: PMC8759002 DOI: 10.1001/jamanetworkopen.2021.43407] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. OBJECTIVE To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. EXPOSURES Incarceration or homelessness. MAIN OUTCOMES AND MEASURES Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. RESULTS In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P < .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). CONCLUSIONS AND RELEVANCE In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.
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Affiliation(s)
- Martha P. Montgomery
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kai Hong
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristie E. N. Clarke
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samantha Williams
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rena Fukunaga
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Victoria L. Fields
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joohyun Park
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyna Z. Schieber
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyudmyla Kompaniyets
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Colleen M. Ray
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lauren A. Lambert
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashley S. D’Inverno
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tapas K. Ray
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alexiss Jeffers
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily Mosites
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
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17
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Montgomery MP, Eckert M, Hofmeister MG, Foster MA, Weng MK, Augustine R, Gupta N, Cooley LA. Strategies for Successful Vaccination Among Two Medically Underserved Populations: Lessons Learned From Hepatitis A Outbreaks. Am J Public Health 2021; 111:1409-1412. [PMID: 34464196 PMCID: PMC8489637 DOI: 10.2105/ajph.2021.306308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Martha P Montgomery
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Maribeth Eckert
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Megan G Hofmeister
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Monique A Foster
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Mark K Weng
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Ryan Augustine
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Neil Gupta
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
| | - Laura A Cooley
- The authors are with the Centers for Disease Control and Prevention, Atlanta, GA. Martha P. Montgomery, Megan G. Hofmeister, Monique A. Foster, Mark K. Weng, Ryan Augustine, Neil Gupta, and Laura A. Cooley are with the Division of Viral Hepatitis. Maribeth Eckert is with the Immunization Services Division
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18
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Mba IE, Sharndama HC, Osondu-chuka GO, Okeke OP. Immunobiology and nanotherapeutics of severe acute respiratory syndrome 2 (SARS-CoV-2): a current update. Infect Dis (Lond) 2021; 53:559-580. [PMID: 33905282 PMCID: PMC8095391 DOI: 10.1080/23744235.2021.1916071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes the most significant global public health challenge in a century. It has reignited research interest in coronavirus. While little information is available, research is currently in progress to comprehensively understand the general biology and immune response mechanism against SARS-CoV-2. The spike proteins (S protein) of SARS-CoV-2 perform a crucial function in viral infection establishment. ACE2 and TMPRSS2 play a pivotal role in viral entry. Upon viral entry, the released pro-inflammatory proteins (cytokines and chemokines) cause the migration of the T cells, monocytes, and macrophages to the infection site. IFNϒ released by T cells initiates a loop of pro-inflammatory feedback. The inflammatory state may further enhance with an increase in immune dysfunction responsible for the infection's progression. A treatment approach that prevents ACE2-mediated viral entry and reduces inflammatory response is a crucial therapeutic intervention strategy, and nanomaterials and their conjugates are promising candidates. Nanoparticles can inhibit viral entry and replication. Nanomaterials have also found application in targeted drug delivery and also in developing a vaccine against SARS-CoV-2. Here, we briefly summarize the origin, transmission, and clinical features of SARS-CoV-2. We then discussed the immune response mechanisms of SARS-CoV-2. Finally, we further discussed nanotechnology's potentials as an intervention strategy against SARS-CoV-2 infection. All these understandings will be crucial in developing therapeutic strategies against SARS-CoV-2.
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19
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Shragai T, Smith-Jeffcoat SE, Koh M, Schechter MC, Rebolledo PA, Kasinathan V, Wang Y, Hoffman A, Miller H, Tejada-Strop A, Jain S, Tamin A, Harcourt JL, Thornburg NJ, Wong P, Medrzycki M, Folster JM, Semenova V, Steward-Clark E, Drobenuic J, Biedron C, Stewart RJ, da Silva J, Kirking HL, Tate JE. Epidemiologic, immunologic, and virus characteristics in patients with paired SARS-CoV-2 serology and reverse transcription polymerase chain reaction testing. J Infect Dis 2021; 225:229-237. [PMID: 34216468 DOI: 10.1093/infdis/jiab349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The natural history and clinical progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can be better understood using combined serological and reverse transcription polymerase chain reaction (RT-PCR) testing. METHODS Nasopharyngeal swabs and serum were collected at a single time-point from patients at an urban, public hospital August - November 2020 and tested for SARS-CoV-2 using RT-PCR, viral culture, and anti-Spike pan-Ig antibody testing. Participant demographics and symptoms were collected through interview. Chi-squared and Fisher's exact tests were used to identify associations between RT-PCR and serology results with presence of viable virus and frequency of symptoms. RESULTS Among 592 participants, 129 (21.8%) had evidence of SARS-CoV-2 infection by RT-PCR or serology. Presence of SARS-CoV-2 antibodies was strongly associated with lack of viable virus (p-value=0.016). COVID-19 symptom frequency was similar for patients testing RT-PCR positive/seronegative and patients testing RT-PCR positive/seropositive. Patients testing RT-PCR positive/seronegative reported headaches, fatigue, diarrhea and vomiting at rates not statistically significantly different from those testing RT-PCR negative/seropositive. CONCLUSIONS While patients testing SARS-CoV-2 seropositive were unlikely to test positive for viable virus and were therefore low-risk for forward transmission, COVID-19 symptoms were common. Paired SARS-CoV-2 RT-PCR and antibody testing provides more nuanced understanding of patients' COVID-19 status.
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Affiliation(s)
- Talya Shragai
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | - Mitsuki Koh
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | - Marcos C Schechter
- Emory University, Atlanta, GA, USA.,Grady Memorial Hospital, Atlanta, GA, USA
| | | | | | - Yun Wang
- Emory University, Atlanta, GA, USA
| | - Adam Hoffman
- Emory University, Atlanta, GA, USA.,Grady Memorial Hospital, Atlanta, GA, USA
| | - Halie Miller
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | - Shilpi Jain
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | - Azaibi Tamin
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | | | - Phili Wong
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | | | - Vera Semenova
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | - Jan Drobenuic
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | - Caitlin Biedron
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | | | - Juliana da Silva
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
| | - Hannah L Kirking
- Centers for Disease Control and Prevention, Atlanta, GA, 30308, USA
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20
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Puskarich MA, Cummins NW, Ingraham NE, Wacker DA, Reilkoff RA, Driver BE, Biros MH, Bellolio F, Chipman JG, Nelson AC, Beckman K, Langlois R, Bold T, Aliota MT, Schacker TW, Voelker HT, Murray TA, Koopmeiners JS, Tignanelli CJ. A multi-center phase II randomized clinical trial of losartan on symptomatic outpatients with COVID-19. EClinicalMedicine 2021; 37:100957. [PMID: 34195577 PMCID: PMC8225661 DOI: 10.1016/j.eclinm.2021.100957] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 virus enters cells via Angiotensin-converting enzyme 2 (ACE2), disrupting the renin-angiotensin-aldosterone axis, potentially contributing to lung injury. Treatment with angiotensin receptor blockers (ARBs), such as losartan, may mitigate these effects, though induction of ACE2 could increase viral entry, replication, and worsen disease. METHODS This study represents a placebo-controlled blinded randomized clinical trial (RCT) to test the efficacy of losartan on outpatients with COVID-19 across three hospital systems with numerous community sites in Minnesota, U.S. Participants included symptomatic outpatients with COVID-19 not already taking ACE-inhibitors or ARBs, enrolled within 7 days of symptom onset. Patients were randomized to 1:1 losartan (25 mg orally twice daily unless estimated glomerular filtration rate, eGFR, was reduced, when dosing was reduced to once daily) versus placebo for 10 days, and all patients and outcome assesors were blinded. The primary outcome was all-cause hospitalization within 15 days. Secondary outcomes included functional status, dyspnea, temperature, and viral load. (clinicatrials.gov, NCT04311177, closed to new participants). FINDINGS From April to November 2020, 117 participants were randomized 58 to losartan and 59 to placebo, and all were analyzed under intent to treat principles. The primary outcome did not differ significantly between the two arms based on Barnard's test [losartan arm: 3 events (5.2% 95% CI 1.1, 14.4%) versus placebo arm: 1 event (1.7%; 95% CI 0.0, 9.1%)]; proportion difference -3.5% (95% CI -13.2, 4.8%); p = 0.32]. Viral loads were not statistically different between treatment groups at any time point. Adverse events per 10 patient days did not differ signifcantly [0.33 (95% CI 0.22-0.49) for losartan vs. 0.37 (95% CI 0.25-0.55) for placebo]. Due to a lower than expected hospitalization rate and low likelihood of a clinically important treatment effect, the trial was terminated early. INTERPRETATION In this multicenter blinded RCT for outpatients with mild symptomatic COVID-19 disease, losartan did not reduce hospitalizations, though assessment was limited by low event rate. Importantly, viral load was not statistically affected by treatment. This study does not support initiation of losartan for low-risk outpatients.
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Affiliation(s)
- Michael A. Puskarich
- Department of Emergency Medicine, University of Minnesota, Minneapolis, MN, USA
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Nathan W. Cummins
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nicholas E. Ingraham
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - David A. Wacker
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Ronald A. Reilkoff
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Brian E Driver
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Michelle H. Biros
- Department of Emergency Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Fernanda Bellolio
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Andrew C. Nelson
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Kenneth Beckman
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, MN, USA
| | - Ryan Langlois
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Tyler Bold
- Division of Infectious Diseases, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Matthew T. Aliota
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Twin Cities, St. Paul, MN, USA
| | - Timothy W. Schacker
- Division of Infectious Diseases, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Helen T. Voelker
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas A Murray
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph S. Koopmeiners
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Christopher J. Tignanelli
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
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21
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Pedro N, Fernandes V, Cavadas B, Guimarães JT, Barros H, Tavares M, Pereira L. Field and Molecular Epidemiology: How Viral Sequencing Changed Transmission Inferences in the First Portuguese SARS-CoV-2 Infection Cluster. Viruses 2021; 13:1116. [PMID: 34200621 PMCID: PMC8226748 DOI: 10.3390/v13061116] [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] [Received: 04/26/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/31/2022] Open
Abstract
Field epidemiology and viral sequencing provide a comprehensive characterization of transmission chains and allow a better identification of superspreading events. However, very few examples have been presented to date during the COVID-19 pandemic. We studied the first COVID-19 cluster detected in Portugal (59 individuals involved amongst extended family and work environments), following the return of four related individuals from work trips to Italy. The first patient to introduce the virus would be misidentified following the traditional field inquiry alone, as shown by the viral sequencing in isolates from 23 individuals. The results also pointed out family, and not work environment, as the primary mode of transmission.
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Affiliation(s)
- Nicole Pedro
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
- ICBAS, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Veronica Fernandes
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - Bruno Cavadas
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - João Tiago Guimarães
- CHUSJ, Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal; (J.T.G.); (M.T.)
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Henrique Barros
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Margarida Tavares
- CHUSJ, Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal; (J.T.G.); (M.T.)
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Luisa Pereira
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
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22
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Hershow RB, Segaloff HE, Shockey AC, Florek KR, Murphy SK, DuBose W, Schaeffer TL, Powell Mph JA, Gayle K, Lambert L, Schwitters A, Clarke KEN, Westergaard R. Rapid Spread of SARS-CoV-2 in a State Prison After Introduction by Newly Transferred Incarcerated Persons - Wisconsin, August 14-October 22, 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:478-482. [PMID: 33793462 PMCID: PMC8022877 DOI: 10.15585/mmwr.mm7013a4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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