Creating Novel Surveillance Data Products for Briefing Health Department Leadership and Elected Officials During the COVID-19 Pandemic in Texas.

Beginning in March 2020, the Texas Department of State Health Services (DSHS) developed several internal surveillance tools for briefing state health department leadership and elected officials on the status of the COVID-19 pandemic in Texas. This case study describes the initial conceptualization and daily production of 3 of these internal surveillance tools: (1) a COVID-19 data book displaying daily case, fatality, hospitalization, and testing data by county; (2) graphs and data files displaying new daily COVID-19 fatalities among residents of long-term care facilities in Texas; and (3) graphs and data files comparing COVID-19 cases and hospitalizations between the 4 COVID-19 waves in Texas. In addition, this case study uses qualitative interview data to describe how DSHS leadership used these surveillance products during the pandemic. Finally, details on challenges and lessons learned around creating and maintaining these tools are provided. These surveillance products are easily replicable, and our methods and lessons learned may be helpful for researchers or health department officials working on COVID-19 or other disease surveillance teams.

Quantitative Reverse Transcription PCR Surveillance of SARS-CoV-2 Variants of Concern in Wastewater of Two Counties in Texas, United States

After its emergence in late November/December 2019, the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) rapidly spread globally. Recognizing that this virus is shed in feces of individuals and that viral RNA is detectable in wastewater, testing for SARS-CoV-2 in sewage collections systems has allowed for the monitoring of a community's viral burden. Over a 9 month period, the influents of two regional wastewater treatment facilities were concurrently examined for wild-type SARS-CoV-2 along with variants B.1.1.7 and B.1.617.2 incorporated as they emerged. Epidemiological data including new confirmed COVID-19 cases and associated hospitalizations and fatalities were tabulated within each location. RNA from SARS-CoV-2 was detectable in 100% of the wastewater samples, while variant detection was more variable. Quantitative reverse transcription PCR (RTqPCR) results align with clinical trends for COVID-19 cases, and increases in COVID-19 cases were positively related with increases in SARS-CoV-2 RNA load in wastewater, although the strength of this relationship was location specific. Our observations demonstrate that clinical and wastewater surveillance of SARS-CoV-2 wild type and constantly emerging variants of concern can be combined using RT-qPCR to characterize population infection dynamics. This may provide an early warning for at-risk communities and increases in COVID-19 related hospitalizations.

Factors Associated with COVID-19 Vaccine Hesitancy among Texas Households

COVID-19 vaccinations are an important tool for alleviating the effects of the pandemic. However, many Americans, including many Texans, are hesitant to receive a COVID-19 vaccine. This study examined who, among Texans, is most likely to experience COVID-19 vaccine hesitancy and determined the reasons behind COVID-19 vaccine hesitancy among Texans. To address our objectives, we used six weeks of repeated cross-sectional data from January 6, 2021, through March 29, 2021, from the United States Census Bureau's Household Pulse Survey. An average of 4,145 Texas household responded to the survey each week. We found that 52 percent of Texans who had not yet received a COVID-19 vaccine (as of January - March 2021) reported vaccine hesitancy. Female and black Texans had the highest odds of reporting COVID-19 vaccine hesitancy, while Texans of Asian descent, Texans who have college degrees or higher, and Texans 40 years and older had a lower odds of reporting hesitancy. The most common reasons for vaccine hesitancy among Texans were: they plan to wait and see if the vaccine is safe and they may get it later;they are concerned about possible side effects of a COVID-19 vaccine;and they think other people need the vaccine more than they do at the present moment. Efforts to promote COVID-19 vaccination in Texas may benefit from a focus on black, female, and younger (<40 years) Texans. Additionally, to increase COVID-19 vaccination rates, public health messages could address the two most commonly reported reasons for Texans' vaccine hesitancy: (1) I plan to wait and see if it is safe and may get it later, and (2) I am concerned about possible side effects of a COVID-19 vaccine. [ FROM AUTHOR] Copyright of Texas Public Health Journal is the property of Texas Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)