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1.
Transl Behav Med ; 2022 Oct 22.
Article in English | MEDLINE | ID: covidwho-2274916

ABSTRACT

Rapid identification and isolation/quarantine of COVID-19 cases or close contacts, respectively, is a vital tool to support safe, in-person learning. However, safe isolation or quarantine for a young child also necessitates home confinement for at least one adult caregiver, as well as rapid learning material development by the teacher to minimize learning loss. The purpose of this study is to better understand barriers and supports to student home confinement. We conducted a mixed-methods study using focus group discussions and a self-administered online survey with parents and staff members from 12 elementary schools and childcare sites across San Diego County serving low-income and socially vulnerable families. Focus group participants reported that mental distress and loneliness, learning loss, childcare, food, income loss, and overcrowded housing were major barriers related to home confinement. The experiences described by FGD participants were prevalent in a concurrent community survey: 25% of participants reported that isolation would be extremely difficult for a household member who tested positive or was exposed to COVID-19, and 20% were extremely concerned about learning loss while in isolation or quarantine. Our findings suggest that there are serious structural impediments to safely completing the entire recommended course of isolation or quarantine, and that the potential for isolation or quarantine may also lead to increased hesitancy to access diagnostic testing.


BACKGROUND: During the COVID-19 pandemic, home confinement (isolation and quarantine) are important public health tools to keep children learning in-person at schools. However, isolation or quarantine for young children also means that often their caregivers must also go into home confinement, as well as forcing teachers to adapt their lessons to online teaching. PURPOSE: The purpose of this study is to better understand what makes home confinement comfortable or difficult for students and their families. METHODS: We did focus group discussions and shared an online survey with parents and staff members from 12 elementary schools and childcare centers across San Diego County vulnerable families. RESULTS: Focus group participants said that mental distress and loneliness, learning loss, childcare, food, income loss, and overcrowded housing made home confinement hard to do. Also 25% of survey participants said that isolation would be difficult for a household member who tested positive or was exposed to COVID-19, and 20% were really concerned about their child's learning loss if the family had to isolate or do quarantine. CONCLUSIONS: Our study's results suggest that there are serious structural issues for school families to safely go into isolation or quarantine, and because of this may make families more hesitant to get tested for COVID-19.

2.
Lancet Reg Health Am ; 19: 100449, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2240692

ABSTRACT

Background: Schools are high-risk settings for SARS-CoV-2 transmission, but necessary for children's educational and social-emotional wellbeing. Previous research suggests that wastewater monitoring can detect SARS-CoV-2 infections in controlled residential settings with high levels of accuracy. However, its effective accuracy, cost, and feasibility in non-residential community settings is unknown. Methods: The objective of this study was to determine the effectiveness and accuracy of community-based passive wastewater and surface (environmental) surveillance to detect SARS-CoV-2 infection in neighborhood schools compared to weekly diagnostic (PCR) testing. We implemented an environmental surveillance system in nine elementary schools with 1700 regularly present staff and students in southern California. The system was validated from November 2020 to March 2021. Findings: In 447 data collection days across the nine sites 89 individuals tested positive for COVID-19, and SARS-CoV-2 was detected in 374 surface samples and 133 wastewater samples. Ninety-three percent of identified cases were associated with an environmental sample (95% CI: 88%-98%); 67% were associated with a positive wastewater sample (95% CI: 57%-77%), and 40% were associated with a positive surface sample (95% CI: 29%-52%). The techniques we utilized allowed for near-complete genomic sequencing of wastewater and surface samples. Interpretation: Passive environmental surveillance can detect the presence of COVID-19 cases in non-residential community school settings with a high degree of accuracy. Funding: County of San Diego, Health and Human Services Agency, National Institutes of Health, National Science Foundation, Centers for Disease Control.

3.
American Journal of Public Health ; 112:S136-S139, 2022.
Article in English | ProQuest Central | ID: covidwho-1777057

ABSTRACT

In 2020, accelerated by the COVID-19 pandemic, Black Americans and Native Americans died of substance overdoses at higher rates than White Americans, and Latinx overdose deaths increased at record rates.1,2 These deaths were closely linked to inequalities in employment, housing conditions, targeted law enforcement, and disproportionate exposure to unregulated illicit drug supplies3-5-making overdose prevention an urgent racial justice issue. In keeping with Chandra Ford's application of critical race theory to public health,6 we illustrate the unique contributions of Black and Latinx practitioners who (1) center the perspectives of racialized groups to inform harm reduction and substance use disorders (SUD) treatment initiatives;(2) use personal, experiential knowledge to relate and build trust with service users;and (3) inform research and practice with their own lived experiences as part of racialized populations. The impact of family members' roles in providing community members with food (P. G-Z.);growing up in communities where heroin use was rampant and witnessing drug-related deaths unfold in 1970s Brownsville Brooklyn, New York (J. T.);and being influenced by the political awakening of the civil rights movement and the response to the war in Vietnam (J. T.) propelled us into harm reduction and grassroots organizing work. The experiences of working under majority White leadership of a public clinic serving a predominantly Black and Latinx population who resisted engaging community leaders to improve services and did not act on innovative proposals (A. J.) and difficulties implementing evidenced-based interventions in Mexico (P. G-Z.)-where there is much stigma surrounding HIV and substance use-are examples of inadequate institutional support.

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