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1.
Infect Control Hosp Epidemiol ; 43(2): 156-166, 2022 02.
Article in English | MEDLINE | ID: covidwho-1243263

ABSTRACT

This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.


Subject(s)
COVID-19 , Delivery of Health Care , Health Personnel , Humans , Pandemics , Personal Protective Equipment , SARS-CoV-2
2.
Infect Control Hosp Epidemiol ; 42(3): 341-343, 2021 03.
Article in English | MEDLINE | ID: covidwho-1131954

ABSTRACT

We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/epidemiology , Preoperative Care/methods , Surgical Procedures, Operative/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , North Carolina/epidemiology , Personal Protective Equipment/supply & distribution
3.
Pediatrics ; 147(4)2021 04.
Article in English | MEDLINE | ID: covidwho-1063251

ABSTRACT

BACKGROUND AND OBJECTIVES: As schools reopen nationwide, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in youth settings remains a concern. Here, we describe transmission of SARS-CoV-2 among >6800 youth and staff at YMCA of the Triangle day camps in North Carolina (March to August 2020). METHODS: We performed a retrospective analysis of deidentified SARS-CoV-2 cases reported by YMCA day camps in 6 counties (Chatham, Durham, Johnston, Lee, Orange, Wake) over 147 days. Inclusion criteria were youth and staff who enrolled or worked in camps during the study period. Individual-level youth and staff demographics (age, sex, race and ethnicity) were self-reported and linked to SARS-CoV-2 case data by using unique identifiers. RESULTS: Youth (n = 5344; 66% white, 54% male, mean age 8.5 years) had a mean camp attendance rate of 88%; staff (n = 1486) were 64% white and 60% female (mean age 22 years). Seventeen primary SARS-CoV-2 infections occurred during the study period among 9 youth (mean age 9.7 years) and 8 staff (mean age 27 years) who were linked to 3030 contacts present in-person during the week before positive cases. Only 2 secondary infections (1 youth and 1 staff) were linked to primary cases. SARS-CoV-2 primary case attack rate was 0.6% (17/3030), and secondary case transmission rate was 0.07% (2/3011). CONCLUSIONS: Extremely low youth and staff symptomatic SARS-CoV-2 attack and transmission rates were observed over a 147-day period across 54 YMCA camps from March to August 2020, when local coronavirus disease 2019 prevalence peaked. These findings suggest that the benefit of in-person programming in recreation settings with appropriate mitigation may outweigh the risk of viral transmission.


Subject(s)
COVID-19/transmission , Camping , Adult , Child , Female , Humans , Male , North Carolina , Retrospective Studies , Workforce , Young Adult
4.
Pediatrics ; 147(4)2021 04.
Article in English | MEDLINE | ID: covidwho-1015975

ABSTRACT

BACKGROUND: In an effort to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), North Carolina closed prekindergarten through grade 12 public schools to in-person instruction on March 14, 2020. On July 15, 2020, North Carolina's governor announced schools could open via remote learning or a hybrid model that combined in-person and remote instruction. In August 2020, 56 of 115 North Carolina school districts joined The ABC Science Collaborative (ABCs) to implement public health measures to prevent SARS-CoV-2 transmission and share lessons learned. We describe secondary transmission of SARS-CoV-2 within participating school districts during the first 9 weeks of in-person instruction in the 2020-2021 academic year. METHODS: From August 15, 2020 to October 23, 2020, 11 of 56 school districts participating in ABCs were open for in-person instruction for all 9 weeks of the first quarter and agreed to track incidence and secondary transmission of SARS-CoV-2. Local health department staff adjudicated secondary transmission. Superintendents met weekly with ABCs faculty to share lessons learned and develop prevention methods. RESULTS: Over 9 weeks, 11 participating school districts had >90 000 students and staff attend school in person. Among these students and staff, 773 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, health department staff determined an additional 32 infections were acquired within schools. No instances of child-to-adult transmission of SARS-CoV-2 were reported within schools. CONCLUSIONS: In the first 9 weeks of in-person instruction in North Carolina schools, we found extremely limited within-school secondary transmission of SARS-CoV-2, as determined by contact tracing.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Education, Distance , Schools , Adolescent , COVID-19/prevention & control , Child , Child, Preschool , Cohort Studies , Humans , Incidence , North Carolina/epidemiology
5.
N C Med J ; 82(1): 50-56, 2021.
Article in English | MEDLINE | ID: covidwho-1006790

ABSTRACT

The COVID-19 pandemic resulted in large-scale school closures in an effort to reduce the spread of disease. This article reviews the potential impact of COVID-19-related school closures on the health of children in North Carolina, with particular attention to the impact of school closures on drivers of child health.


Subject(s)
COVID-19 , Pandemics , Child , Child Health , Humans , North Carolina , SARS-CoV-2 , Schools
7.
J Pediatric Infect Dis Soc ; 9(5): 596-608, 2020 Nov 10.
Article in English | MEDLINE | ID: covidwho-919282

ABSTRACT

Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute clinical burden of COVID-19 have largely spared children compared with adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities and the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Here, we summarize the current knowledge, identify resources, and outline research opportunities. Pediatric infectious diseases clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment, and prevention studies to optimize their care as well as to represent children in the development of guidance and policy during pandemic response.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Asymptomatic Diseases , COVID-19 , COVID-19 Testing , Child , Child Health Services , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/epidemiology , Infant, Newborn, Diseases/prevention & control , Infectious Disease Transmission, Vertical , Pandemics/prevention & control , Pediatrics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious , SARS-CoV-2
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