Community Support Organizations in Gay Neighborhoods: Assessing Engagement During the Covid-19 Pandemic

Volunteerism, grassroots activism, and mutual aid have been critical to the advancement of rights and opportunities for LGBTQ+ people. These activities are institutionally anchored within supportive organizations embedded in LGBTQ+ communities. But these supportive organizations can be stressed by external crises, such as the Covid-19 pandemic, limiting the capacity for providing routine services. This article provides a typology of community support organizations-including healthcare providers, business improvement districts, neighborhood planning organizations, and social groups and clubs- to better understand how non-governmental organizations and non-profit entities provide services not traditionally provided by government agencies for LGBTQ+ people. We characterize how community support organizations continued to provide critical services to the LGBTQ+ community-consistent with the missions and aims of these organizations-while also providing services and information related to health and safety during the Covid-19 pandemic. The article concludes with takeaway messages that synthesize the functions and services of community support organizations and explain how various types of supportive organizations in gay neighborhoods responded to the Covid-19 pandemic.

Profound racial disparities in COVID-19 associated hospitalizations in rural Southwest Georgia

Background: The coronavirus disease 2019 (COVID-19) is responsible for one of the largest public health crises the United States has seen to date. This study explores the outcomes of African American and non-African American COVID-19-positive patients hospitalized in rural Southwest Georgia to identify differences in morbidity and mortality between the groups. Methods: We performed a retrospective cohort analysis among adults aged >= 18 years admitted with COVID-19 between March 2, 2020 and June 17, 2020 at Phoebe Putney Health System. Data on demographics, comorbidities, presenting symptoms, and hospital course were obtained. Patients were divided into two groups: African Americans and non-African Americans. We examined differences in patient characteristics between groups using chi-square tests for categorical variables, t test for parametric continuous variables, and Wilcoxon rank-sum tests for non-parametric continuous variables. Statistical Analysis Software (SAS) version 9.4 was used for statistical analysis. Results: Among 710 patients, median age was 63 years, 43.8% were males, and 83.3% were African Americans. African Americans had higher prevalence of obesity and hypertension, were more likely to present with fever, and present with longer duration of symptoms prior to presentation. In-hospital mortality was similar between the groups, as was need for mechanical ventilation, ICU care, and new dialysis. African Americans were more likely to be discharged home compared to non-African Americans. Conclusions: There was no difference in in-hospital mortality;however, African Americans had disproportionately higher hospitalizations, likely to significantly increase the morbidity burden in this population. Urgent measures are needed to address this profound racial disparity.

Healthcare-associated infection impact with bioaerosol treatment and COVID-19 mitigation measures.

BACKGROUND: The real-world impact of breathing zone air purification and coronavirus disease 2019 (COVID-19) mitigation measures on healthcare-associated infections is not well documented. Engineering solutions to treat airborne transmission of disease may yield results in controlled test chambers or single rooms, but have not been reported on hospital-wide applications, and the impact of COVID-19 mitigation measures on healthcare-associated infection rates is unknown. AIM: To determine the impact of hospital-wide bioaerosol treatment and COVID-19 mitigation measures on clinical outcomes. METHODS: The impact of the step-wise addition of air disinfection technology and COVID-19 mitigation measures to standard multi-modal infection control on particle counts, viral and bacterial bioburden, and healthcare-associated infection rates was investigated in a 124-bed hospital (>100,000 patient-days over 30 months). FINDINGS AND CONCLUSION: The addition of air disinfection technology and COVID-19 mitigation measures reduced airborne ultrafine particles, altered hospital bioburden, and reduced healthcare-associated infections from 11.9 to 6.6 (per 1000 patient-days) and from 6.6 to 1.0 (per 1000 patient-days), respectively (P<0.0001, R2=0.86). No single technology, tool or procedure will eliminate healthcare-associated infections, but the addition of a ubiquitous facility-wide engineering solution at limited expense and with no alteration to patient, visitor or staff traffic or workflow patterns reduced infections by 45%. A similar impact was documented with the addition of comprehensive, restrictive, and labour- and material-intensive COVID-19 mitigation measures. To the authors' knowledge, this is the first direct comparison between traditional infection control, an engineering solution and COVID-19 mitigation measures.

COVID-19 and neurological symptoms: is the SARS-CoV-2 virus neurotropic?

Importance: The most notable symptoms of the Coronavirus Disease 2019 (COVID-19) pandemic are fever, cough, dyspnea, and in severe cases, adult respiratory distress syndrome (ARDS.) But neurological symptoms including confusion, stroke, and encephalopathy are reported, and anosmia and hypogeusia are also common indicating that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be neurotropic. Observations: The SARS-Co-1 and 2 viruses bind to angiotensin converting enzyme 2 (ACE2), which is present on human brain endothelium and non-neuronal cells in the nasopharynx and lingual epithelium. However, SARS-CoV-1 and 2 do not bind rodent ACE2 avidly, which has required the generation of humanized ACE2 transgenic animal models of disease. Transgenic mouse models suggest that the SARS- CoV-1 and Middle East respiratory syndrome (MERS)-CoV are neurotropic and infect and damage the brain, including the cardiorespiratory centers in the medulla. The symptoms of anosmia and hypogeusia indicate a portal to the brain. The relationship between encephalitis lethargica and post encephalitis parkinsonism to the Spanish Flu (H1N1 influenza virus) is unclear but raises the question of long term neurological complications of pandemics. Conclusions and Relevance: There is a concern that there may be long term neurological sequelae of infection with SARS-CoV-2. Registries and long term neurological follow up with longitudinal cohort studies of COVID19 positive patients are needed.