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1.
Preprint in English | EuropePMC | ID: ppcovidwho-293081

ABSTRACT

Background: Prisons are high–risk environments for Covid–19. Vaccination levels among prison staff remain troublingly low – lower than levels among residents and members of the surrounding community. The situation is troubling because prison staff are a key vector for Covid–19 transmission. Objective To assess patterns and timing of staff vaccination in California state prisons and identify individual– and community–level factors associated with being unvaccinated. Design We calculated fractions of prison staff and incarcerated residents in California state prisons who remained unvaccinated. Adjusted analyses identified demographic, community, and peer factors associated with vaccination uptake among staff. Setting California Department of Corrections and Rehabilitation prisons. Participants Custody and healthcare staff who worked in direct contact with residents. Main Outcomes and Measures Remaining unvaccinated through June 30, 2021. Results A total of 26 percent of custody staff and 52 percent of healthcare staff took ≥ 1 dose in the first two months of vaccine offer;uptake stagnated thereafter. By June 30, 2021, 61 percent of custody and 37 percent of healthcare staff remained unvaccinated. Remaining unvaccinated was positively associated with younger age, prior Covid–19, residing in a community with relatively low vaccination rates, and sharing shifts with co–workers who had relatively low vaccination rates. Conclusions and Relevance Vaccine uptake among prison staff in California in regular contact with incarcerated residents has plateaued at levels that pose ongoing risks – both of further outbreaks in the prisons and transmission into surrounding communities. Staff decisions to forego vaccination appear to be complex and multifactorial. Achieving safe levels of vaccine protection among frontline staff may necessitate requiring vaccination as condition of employment.

2.
J Christ Nurs ; 38(4): 234-239, 2021.
Article in English | MEDLINE | ID: covidwho-1483559

ABSTRACT

ABSTRACT: The number of older adults worldwide is growing; the incidence of social isolation and loneliness among this population is also increasing. Social isolation and loneliness can have significant physical, mental, and spiritual impacts. Faith community nurses are in an optimal position to identify and intervene to help faith communities reduce the social isolation and loneliness among community-dwelling older adults. Risk factors and tools to identify both circumstances are discussed along with interventions and a case study.


Subject(s)
Loneliness , Parish Nursing , Aged , Humans , Independent Living , Risk Factors , Social Isolation
4.
Am J Public Health ; 111(10): 1768-1771, 2021 10.
Article in English | MEDLINE | ID: covidwho-1403351

ABSTRACT

Racial disparities and racism are pervasive public health threats that have been exacerbated by the COVID-19 pandemic. Thus, it is critical and timely for researchers to communicate with policymakers about strategies for reducing disparities. From April through July 2020, across four rapid-cycle trials disseminating scientific products with evidence-based policy recommendations for addressing disparities, we tested strategies for optimizing the reach of scientific messages to policymakers. By getting such research into the hands of policymakers who can act on it, this work can help combat racial health disparities.(Am J Public Health. 2021;111(10):1768-1771. https://doi.org/10.2105/AJPH.2021.306404).


Subject(s)
COVID-19/ethnology , Health Policy , Healthcare Disparities , Public Health Administration , Racism , Scholarly Communication , COVID-19/epidemiology , Humans , Pandemics , Policy Making , SARS-CoV-2 , United States/epidemiology
5.
Lancet Public Health ; 6(10): e760-e770, 2021 10.
Article in English | MEDLINE | ID: covidwho-1345513

ABSTRACT

BACKGROUND: Residents of prisons have experienced disproportionate COVID-19-related health harms. To control outbreaks, many prisons in the USA restricted in-person activities, which are now resuming even as viral variants proliferate. This study aims to use mathematical modelling to assess the risks and harms of COVID-19 outbreaks in prisons under a range of policies, including resumption of activities. METHODS: We obtained daily resident-level data for all California state prisons from Jan 1, 2020, to May 15, 2021, describing prison layouts, housing status, sociodemographic and health characteristics, participation in activities, and COVID-19 testing, infection, and vaccination status. We developed a transmission-dynamic stochastic microsimulation parameterised by the California data and published literature. After an initial infection is introduced to a prison, the model evaluates the effect of various policy scenarios on infections and hospitalisations over 200 days. Scenarios vary by vaccine coverage, baseline immunity (0%, 25%, or 50%), resumption of activities, and use of non-pharmaceutical interventions (NPIs) that reduce transmission by 75%. We simulated five prison types that differ by residential layout and demographics, and estimated outcomes with and without repeated infection introductions over the 200 days. FINDINGS: If a viral variant is introduced into a prison that has resumed pre-2020 contact levels, has moderate vaccine coverage (ranging from 36% to 76% among residents, dependent on age, with 40% coverage for staff), and has no baseline immunity, 23-74% of residents are expected to be infected over 200 days. High vaccination coverage (90%) coupled with NPIs reduces cumulative infections to 2-54%. Even in prisons with low room occupancies (ie, no more than two occupants) and low levels of cumulative infections (ie, <10%), hospitalisation risks are substantial when these prisons house medically vulnerable populations. Risks of large outbreaks (>20% of residents infected) are substantially higher if infections are repeatedly introduced. INTERPRETATION: Balancing benefits of resuming activities against risks of outbreaks presents challenging trade-offs. After achieving high vaccine coverage, prisons with mostly one-to-two-person cells that have higher baseline immunity from previous outbreaks can resume in-person activities with low risk of a widespread new outbreak, provided they maintain widespread NPIs, continue testing, and take measures to protect the medically vulnerable. FUNDING: Horowitz Family Foundation, National Institute on Drug Abuse, Centers for Disease Control and Prevention, National Science Foundation, Open Society Foundation, Advanced Micro Devices.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Disease Outbreaks , Prisons , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Vaccines/administration & dosage , California/epidemiology , Female , Humans , Male , Middle Aged , Models, Theoretical , Organizational Policy , Prisons/organization & administration , Risk Assessment , Vaccination/statistics & numerical data , Young Adult
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