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2.
BioScience ; 2021.
Article in English | Oxford Academic | ID: covidwho-1085359

ABSTRACT

The COVID-19 pandemic imposed new norms on human interactions, perhaps best reflected in the widespread application of social distancing. But social distancing is not a human invention and has evolved independently in species as dissimilar as apes and lobsters. Epidemics are common in the wild, where their spread is enhanced by animal movement and sociality while curtailed by population fragmentation, host behavior, and the immune systems of hosts. In the present article, we explore the phenomenon of behavioral immunity in wild animals as compared with humans and its relevance to the control of disease in nature. We start by explaining the evolutionary benefits and risks of sociality, look at how pathogens have shaped animal evolution, and provide examples of pandemics in wild animal populations. Then we review the known occurrences of social distancing in wild animals, the cues used to enforce it, and its efficacy in controlling the spread of diseases in nature.

3.
JAMA Netw Open ; 3(12): e2026881, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-959048

ABSTRACT

Importance: Black and Hispanic populations have higher rates of coronavirus disease 2019 (COVID-19) hospitalization and mortality than White populations but lower in-hospital case-fatality rates. The extent to which neighborhood characteristics and comorbidity explain these disparities is unclear. Outcomes in Asian American populations have not been explored. Objective: To compare COVID-19 outcomes based on race and ethnicity and assess the association of any disparities with comorbidity and neighborhood characteristics. Design, Setting, and Participants: This retrospective cohort study was conducted within the New York University Langone Health system, which includes over 260 outpatient practices and 4 acute care hospitals. All patients within the system's integrated health record who were tested for severe acute respiratory syndrome coronavirus 2 between March 1, 2020, and April 8, 2020, were identified and followed up through May 13, 2020. Data were analyzed in June 2020. Among 11 547 patients tested, outcomes were compared by race and ethnicity and examined against differences by age, sex, body mass index, comorbidity, insurance type, and neighborhood socioeconomic status. Exposures: Race and ethnicity categorized using self-reported electronic health record data (ie, non-Hispanic White, non-Hispanic Black, Hispanic, Asian, and multiracial/other patients). Main Outcomes and Measures: The likelihood of receiving a positive test, hospitalization, and critical illness (defined as a composite of care in the intensive care unit, use of mechanical ventilation, discharge to hospice, or death). Results: Among 9722 patients (mean [SD] age, 50.7 [17.5] years; 58.8% women), 4843 (49.8%) were positive for COVID-19; 2623 (54.2%) of those were admitted for hospitalization (1047 [39.9%] White, 375 [14.3%] Black, 715 [27.3%] Hispanic, 180 [6.9%] Asian, 207 [7.9%] multiracial/other). In fully adjusted models, Black patients (odds ratio [OR], 1.3; 95% CI, 1.2-1.6) and Hispanic patients (OR, 1.5; 95% CI, 1.3-1.7) were more likely than White patients to test positive. Among those who tested positive, odds of hospitalization were similar among White, Hispanic, and Black patients, but higher among Asian (OR, 1.6, 95% CI, 1.1-2.3) and multiracial patients (OR, 1.4; 95% CI, 1.0-1.9) compared with White patients. Among those hospitalized, Black patients were less likely than White patients to have severe illness (OR, 0.6; 95% CI, 0.4-0.8) and to die or be discharged to hospice (hazard ratio, 0.7; 95% CI, 0.6-0.9). Conclusions and Relevance: In this cohort study of patients in a large health system in New York City, Black and Hispanic patients were more likely, and Asian patients less likely, than White patients to test positive; once hospitalized, Black patients were less likely than White patients to have critical illness or die after adjustment for comorbidity and neighborhood characteristics. This supports the assertion that existing structural determinants pervasive in Black and Hispanic communities may explain the disproportionately higher out-of-hospital deaths due to COVID-19 infections in these populations.


Subject(s)
COVID-19/mortality , Hospitalization/statistics & numerical data , /statistics & numerical data , Adult , Aged , COVID-19/therapy , Female , Humans , Male , Middle Aged , New York City/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
4.
Arch Dis Child Educ Pract Ed ; 106(5): 264-268, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-807935

ABSTRACT

The COVID-19 pandemic has changed how we work in paediatrics with increasing use of virtual consultations. When optimised, a great deal can be achieved through video consultation compared with telephone, but accessibility and clinical risk need to be carefully considered and managed. This article aims to provide a structured approach with top tips for planning and delivering video consultations effectively in paediatrics.


Subject(s)
COVID-19 , Information Technology , Referral and Consultation , Telemedicine , Adolescent , Child , Humans , Pandemics , SARS-CoV-2
5.
Pediatr Infect Dis J ; 39(9): e257-e260, 2020 09.
Article in English | MEDLINE | ID: covidwho-643742

ABSTRACT

BACKGROUND: To date, although neonatal infections with severe acute respiratory syndrome coronovirus 2 (SARS-CoV-2) have been described, none of these have been proven to be the result of vertical transmission of SARS-CoV-2. METHODS: We describe the probable vertical transmission of SARS-CoV-2 in a neonate born to a mother with coronavirus disease 2019 (COVID-19). RESULTS: Following cesarean section, the neonate was kept in strict isolation. Molecular tests for SARS-CoV-2 on respiratory samples, blood, and meconium were initially negative, but positive on a nasopharyngeal aspirate on the third day of life. On day 5, the neonate developed fever and coryza, which spontaneously resolved. Viral genomic analysis from the mother and neonate showed identical sequences except for 1 nucleotide. CONCLUSION: This report has important implications for infection control and clinical management of pregnant women with COVID-19 and their newborns.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical , Pneumonia, Viral/transmission , Pregnancy Complications, Infectious/virology , Adult , COVID-19 , Cesarean Section , Coronavirus Infections/virology , Female , Humans , Infant, Newborn , Pandemics , Pneumonia, Viral/virology , Pregnancy , SARS-CoV-2
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