Changes Over Time in COVID-19 Incidence, Vaccinations, Serum Spike IgG, and Viral Neutralizing Potential Among Individuals From a North American Gaming Venue: December 2020-August 2021.

OBJECTIVE: This study aims to evaluate COVID-19 cases and vaccine responses among workers in the gaming/entertainment industry. METHODS: Participants provided detailed information on occupational risk factors, demographics, COVID-19 history, and vaccination status through questionnaire. Enzyme-linked immunosorbent assays were used to measure serum antiviral antibodies and neutralizing capacity. RESULTS: Five hundred-fifty individuals participated with n = 228 (41.5%) returning for follow-up. At least 71% of participants were fully vaccinated within 8 months of vaccine availability and COVID-19 rates declined concomitantly. Serum anti-spike IgG levels and neutralizing capacity were significantly (P < 0.001) associated COVID-19 history and vaccine type, but not occupational risk factors, and declined (on average 36%) within 5 months. Few vaccine nonresponders (n = 12) and "breakthrough" infections (n = 1) were noted. CONCLUSIONS: COVID-19 vaccination was associated with a marked decrease in infections; however, individual humoral responses varied and declined significantly over time.

Virtual Respiratory Urgent Clinics for COVID-19 Symptoms.

BACKGROUND: The COVID-19 pandemic has forced a shift from in-person to virtual care to reduce exposure risks to patients and health care workers. This report aims to describe a large primary care system's implementation of virtual respiratory urgent care clinics (VRUCs). METHODS: The VA Connecticut Healthcare System (VACHS) delivers care to more than 58,000 veterans in at 8 primary care sites. VRUCs were established as part of the VACHS primary care rapid transition to virtual care model. Retrospective analysis and qualitative chart reviews were performed from February 2020 through May 2020 to describe characteristics of patients who received care through the VRUCs. RESULTS: VRUCs were used by > 445 patients, 51% received COVID-19 testing, 10% tested positive, 5% were admitted to the hospital, and 18% had ≥ 1 subsequent emergency department visits. Chart documentation rates of discussion of isolation precautions, high occupational risk, and goals of care were 71%, 25%, and 14%, respectively. CONCLUSIONS: Average wait time for health care provider evaluation was 104 minutes, suggesting VRUCs are an expedient means to provide assessment of COVID-19 symptoms. Use of templated notes may ensure routine counseling about isolation, occupation, and goals of care.