Bilingual care navigation and enhanced case management during COVID-19

COVID-19 disparities exposed health inequity across socioeconomic status, with community members of color experiencing higher rates of COVID-19 infections, hospitalizations, and death. Racial/ethnic differences were especially disparate in Benton and Washington counties in northwest Arkansas, a region in the United States that experienced high COVID-19 infection rates. To address these disparities and support families with COVID-19, the University of Arkansas for Medical Sciences and Community Clinic (a federally qualified health center) worked with the Arkansas Department of Health and community partners to develop systematic Care Navigation and Enhanced Case Management. During an initial screening process, contact tracers offered Care Navigation and Enhanced Case Management services to individuals who tested positive for COVID-19 within Washington and Benton counties. Bilingual community health navigators, social workers, and nurses began providing enhanced case management to households that accepted services. Between September 9, 2020 and June 19, 2021, 3,502 households representing ∼13,000 individuals were offered services, and 1,511 (43.1%) households requested/accepted services. Based on our experience, we provide four recommendations for practice: (a) provide contact tracing in community members' preferred language, (b) incorporate assessments into the contact tracing process to ensure community members have necessary resources for quarantine, (c) implement comprehensive care navigation and case management services for those who need additional support, and (d) integrate bilingual health navigators who are part of the target community into the process. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact of Sampling Type, Frequency, and Scale of the Collection System on SARS-CoV-2 Quantification Fidelity

With the rapid onset of the COVID-19 pandemic, wastewater-based epidemiology sampling methodologies for SARS-CoV-2 were often implemented quickly and may not have considered the unique drainage catchment characteristics. This study assessed the impact of grab versus composite sampling on the detection and quantification of SARS-CoV-2 in four different catchment scales with flow rates ranging from high flow (wastewater treatment plant influent) to medium flow (neighborhood scale) to low-flow (city block scale) to ultralow flow (building scale). At the high-flow site, grab samples were comparable to 24 h composite samples with SARS-CoV-2 detected in all samples and differed in concentration from the composite by <1 log 10 unit. However, as the size of the catchment decreased, the percentage of negative grab samples increased despite all respective composites being positive, and the SARS-CoV-2 concentrations of grab samples varied from those of the composites by up to almost 2 log 10 units. At the ultra-low-flow site, increased sampling frequencies generated composite samples with higher fidelity to the 5 min composite, which is the closest estimate of the true SARS-CoV-2 composite concentration that could be measured. Thus, composite sampling is more likely to compensate for temporal signal variability while grab samples do not, especially as the catchment basin size decreases.

Removal of SARS-CoV-2 viral markers through a water reclamation facility

There have been multiple reports of COVID-19 virus, SARS-CoV-2 RNA presence in influent wastewater of water reclamation facilities (WRFs) across the world. In this study, the removal of SARS-CoV-2 RNA was investigated in a WRF by collecting samples from various stages relayed to hydraulic retention time (HRT) and analyzed for viral RNA (N1 and N2) gene markers and wastewater characteristics. SARS-CoV-2 RNA was detected in 28 out of 28 influent wastewater and primary effluent samples. Secondary effluent showed 4 out of 9 positive samples, and all tertiary and final effluent samples were below the detection limit for the viral markers. The reduction was significant (p value < 0.005, one-way analysis of variance [ANOVA] test) in secondary treatment, ranging from 1.4 to 2.0 log10 removal. Adjusted N1 viral marker had a positive correlation with total suspended solids, total Kjeldahl nitrogen, and ammonia concentrations (Spearman's ρ = 0.61, 0.67, and 0.53, respectively, p value < 0.05), while demonstrating a strongly negative correlation with HRT (Spearman's ρ = -0.58, p value < 0.01). PRACTITIONER POINTS: Viral RNA was present in all samples taken from influent and primary effluent of a WRF. SARS-CoV-2 gene marker was detected in secondary effluent in 4 out of 9 samples. Tertiary and final effluent samples tested nondetect for SARS-CoV-2 gene markers. Up to 0.5 and 2.0 log10 virus removal values were achieved by primary and secondary treatment, respectively.