Preparing Pandemic Vaccine Capacity

Among the challenges of a pandemic is the need to scale up to billions of doses, at a larger scale than typically needed for vaccines, from raw materials all the way through to the materials for the containers for fill/finish. Having adequate raw materials, building and staffing the facilities, and tech transfer are all keys to success. [...]we can plug into existing infrastructure, including services (gas, water, waste, etc.) as well as analytics and quality labs." Emergent BioSolutions says that its flexible CDMO capacity deployment model can respond quickly to demand fluctuations. The company's facilities in France, Switzerland, and the US are working on the project;at CordenPharma Colorado, unique high-pressure chromatography systems usually used for manufacturing peptides have been reallocated for purifying lipids.

At last, a silver lining

Medical Director, International Patient Services Program, Co-Director, Pediatric Travel Medicine Clinic, Director, International Adoptee Clinic, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois contributing editors Bernard A. Cohen, MD Section Editor for Dermcase, Professor of Pediatrics and Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland Jon Matthew Farber, MD Section Editor for Journal Club, pediatrician, ALL Pediatrics, Woodbridge, Virginia Carlton K.K. Lee, PharmD.MPH, FASHP.FPPAG Section Editor for The Clinical Pharmacologist's Notebook, Pediatric Clinical Pharmacy Specialist, Department of Pharmacy, and Associate Professor, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland MinaL.Alfieri.MD, MS nstructor of Pediatrics, Feinberg Schoo of Medicine, Northwestern University Attending Physician, Academic General Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois AminJ. MSCE Assistant Professor of Pediatrics, George Washington University School of Medicine and Health Sciences;Pediatric Infectious Diseases Attending, Director, Antimicrobial Stewardship Program, Associate Fellowship Program Director, Children's National Hospital, Washington, DC Michael S. Jellinek, MD Professor of Psychiatry and of Pediatrics, Harvard Medical School, Boston, Massachusetts Candice Jones, MD Board-certified general pediatrician in group practice in Orlando, Florida, former National Health Service Corps Scholar, AAP member, spokesperson and author Andrew J. Schuman, MD Clinical Assistant Professor of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire Steven M. Selbst, MD Professor of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, Attending Physician, Pediatric Emergency Medicine, Nemours/Alfred I duPont Hospital for Children, Wilmington, Delaware As 2021 gets underway and an increasing number of coronavirus disease 2019 (COVID-19) vaccines are administered, I believe that 2021 will be much more of a "normal" year, especially with the hope of COVID-19 vaccine availability for children by fall 2021. Issues discussed include illnesses more prevalent in children of color, such as asthma, sickle cell disease, and COVID-19;the difference in pain managementfor White children versus children of color;and how bias impacts mental health issues in children of color.

A Novel Approach to Locating Community Clinics to Promote Health Care Accessibility and Reduce Health Disparities in Baltimore, Maryland.

Baltimore, Maryland's entrenched racial residential segregation renders the city's world-class medical facilities and services inaccessible to many Black residents living in its most divested neighborhoods. Arguing the need for post-pandemic health care facilities to address health inequities as a practice of care-giving, this article describes a project funded by the National Institutes of Health (NIH) to define a novel, transdisciplinary methodology for identifying ideal vacant sites for conversion into community clinics in Baltimore's most vulnerable neighborhoods. Positioning architecture as a social determinant of health, this paper suggests ethical and methodological reorientations toward a compassionate approach to clinic design and placement.

Thermal Comfort Analysis Using System Dynamics Modeling—A Sustainable Scenario Proposition for Low-Income Housing in Brazil

As a riveting example of social housing in Brazil, the Minha Casa Minha Vida program was set in 2009 to diminish the 6-million-home housing deficit by offering affordable dwellings for low-income families. However, recurrent thermal discomfort complaints occur among dwellers, especially in the Baltimore Residential sample in Uberlândia City. To avoid negative effects of energy poverty, such as family budget constraints from the purchase of electric appliances and extra costs from power consumption, a simulation based on system dynamics modeling shows a natural ventilation strategy with a mixed combination of sustainable and energy-efficient materials (tilting window with up to 100% opening, green tempered glass, and expanded polystyrene wall) to observe the internal room temperature variation over time. With a 50% window opening ratio combined with a 3 mm regular glass window and a 12.5 cm rectangular 8-hole brick wall, this scenario presents the highest internal room temperature value held during the entire period. From the worst to the best-case scenario, a substantial reduction in the peak temperature was observed from window size variation, demonstrating that natural ventilation and constructive elements of low complexity and wide availability in the market contribute to the thermal comfort of residential rooms.

The impact of the COVID-19 pandemic on stress, substance use, and teen dating violence among young adult women in Baltimore City

OBJECTIVES/GOALS: Social distancing practices during COVID-19 may impact experience of stress, substance use and violence exposure. This study aims to describe the effect of the COVID-19 stay-at-home orders on stress, substance use, and teen dating violence (TDV) among young women living in Baltimore City. METHODS/STUDY POPULATION: Study participants were recruited from an observational study examining TDV before the COVID-19 pandemic, through snowball sampling, pediatric and adolescent primary care clinics, the pediatric emergency department, and a registry for patients interested in participating in COVID-19 research. Participants were between the ages of 16 and 22, identified as female, and lived in Baltimore, Maryland. They were asked to complete a baseline survey. March 16, 2020 (Maryland governor's stay-at-home order) through June 2022 defined the COVID-19 pandemic period. The survey assessed stress experiences, including isolation, finances, job loss, transportation, school stress, substance use, experiences of violence and adherence to COVID-19 safety measures. We conducted descriptive and bivariate analyses. RESULTS/ANTICIPATED RESULTS: Participants (n=105) had a mean age of 19.4 years (SD 1.73). Preliminary analyses demonstrate that stress associated with isolation, finances, transportation, and school increased during the pandemic compared to pre-pandemic. In addition, the majority of participants who used marijuana, e-cigarettes, and alcohol used about the same amount or more of each substance during the pandemic. For the next steps, we will examine experiences of TDV for young women during the pandemic and examine whether experiences of TDV differ for young women who reported a greater adherence to COVID-19 safety measures compared to participants who adhered less. DISCUSSION/SIGNIFICANCE: Assessing the impact of COVID-19 safety measures on stress, substance use, and TDV is critical to informing and designing future public health interventions. In addition, the information obtained from this study may be used to address the unique challenges faced by disenfranchised populations while curbing the spread of infectious diseases.

Lessons learned to improve COVID-19 response in communities with greatest socio-economic vulnerabilities.

BACKGROUND: Vulnerable communities are susceptible to and disproportionately affected by the impacts of the COVID-19 pandemic. Understanding the challenges faced, perceptions, lessons learned, and recommendations of the organizations that provide services in response to COVID-19 to vulnerable communities is critical to improving emergency response and preparedness in these communities. METHODS: This study employed GIS mapping to identify the needs and assets that exist in communities in Baltimore City, where vulnerabilities related to social determinants of health and the burden of the COVID-19 pandemic were greatest. We also conducted an online survey between September 1, 2021, and May 30, 2022, to assess the COVID-19-related services provided by local organizations, challenges faced, perceptions, lessons learned, and recommendations to inform policies, programs, and funding related to improving the COVID-19 response in underserved communities. The survey was disseminated through the online Kobo Toolbox platform to leaders and representatives of organizations in Baltimore City. RESULTS: Based on GIS mapping analysis, we identified three communities as the most vulnerable and 522 organizations involved in the COVID-19 response across Baltimore City. 247 surveys were disseminated, and 50 survey responses were received (20.24% response rate). Out of these organizations, nearly 80% provided services in response to COVID-19 to the identified vulnerable communities. Challenges experienced ranged from funding (29%), and outreach/recruitment (26%), to not having access to updated and accurate information from local officials (32%). CONCLUSIONS: This research highlights critical insights gained related to the experiences of vulnerable populations and suggests ways forward to address challenges faced during the emergency response by providing recommendations for policy and program changes. Furthermore, the findings will help better prepare vulnerable communities for public health emergencies and build more community resilience.

Virtual Learning, Now and Beyond

The pandemic-fueled expansion of online learning will certainly persist beyond the pandemic, and schools must ensure that the transition creates accessible, high-quality options for all students. Most recently, the surge in COVID-19 Omicron variant cases and persistent ambiguity around whether and how to close schools reinforces the fact that we have failed to build intentional on-ramps to virtual education. State and local leaders can employ evidence from past online learning efforts, emerging best practices, and data from the pandemic to understand how to build a path forward that capitalizes on the potential of online learning, while avoiding the pitfalls. Virtual learning is not going away, but it must improve, especially for students of color and those facing economic insecurity. The bottom line is that students cannot afford to repeat the emergency distance learning that took place in 2020 and 2021. This brief provides a guide for education leaders and policymakers building a path to sustainable and quality virtual learning. It includes four steps school system leaders can take in the short and longer term to harness the potential of online learning, avoid pitfalls that made it ineffective, and ensure students have equitable access to high-quality learning opportunities that meet their needs.

Assessing the Impact and Effectiveness of a Community Leadership Development Program on Black Leaders

Community leaders working in Black communities are faced with countless challenges yet require unique skills for which evidence-based training is often limited or difficult to find. The current study employed a mixed-methods approach using archival data to evaluate a promising and much needed neighborhood leadership program for Black community leaders, the Bunting Neighborhood Leadership Program. The three primary foci of the program were to examine who were selected as fellows, the goals fellows presented with upon entering the program, and the primary outcomes following immediate program completion and follow-up. Nineteen fellows have matriculated through the program, and all completed pre- and post-surveys, and were each contacted about current awards and other leadership successes. Additionally, seven fellows were interviewed about their experiences with and outcomes following the program. Surveys demonstrated important gains in knowledge and skill development for fellows. Following participation, many fellows developed their own organizations, and some secured funding and received awards for their community leadership work. Three key themes emerged from coded interviews, namely (1) characteristics of those who seek a community leadership training, (2) successes in community impact and activities observed among fellows following program completion, and (3) skills-based outcomes for fellows following program completion. The COVID-19 pandemic and killings of Black civilians by police also impacted participants' responses. The role of blackness in Black community leadership was observed across themes that emerged. Overall, this is a promising community leadership program with important implications for leaders who serve Black communities.

A Role for the Library in Public Research: The Global COVID-19 Dashboard

As the novel coronavirus (COVID-19) spread, a team from the Sheridan Libraries and Museums at Johns Hopkins University (JHU) provided technical support to the JHU Global COVID-19 Dashboard. This paper reflects on the lessons learned from working on a highly publicized, heavily trafficked resource and explores the role of academic libraries in supporting research in the public interest. The authors argue that engagement with projects of this nature not only leverages the existing strengths and expertise of libraries but also positions them to contribute to cutting-edge opportunities in academic institutions.

SEVENTY-SEVEN YEARS OF SUCCESSFUL EDUCATION ADVOCACY IN A BALTIMORE CITY PUBLIC HOUSING PROJECT

[...]the polio nightmare was over when, in 1953, Dr. Jonas Salk announced the invention of the first polio vaccine. In October 1937, President Franklin Roosevelt signed the Wagner-Steagall Act creating the United States Housing Authority, established to administer federal funding in the form of loans and grants to local jurisdictions for low-income housing. In February of 1939, Baltimore obtained a loan of 26,390,000 dollars to demolish slums and build five public housing projects-in addition to two other projects-on vacant land. The final vacant land project took two more years of political wrangling: no white neighborhoods would condone a public housing project for African Americans being built.

Historical News and Notices

In cooperation and consultation with the Southern Poverty Law Center, the SHA is building a database of historical experts who can speak to issues relevant to both organizations, including the history of disenfranchisement, hate crimes, and civil rights violations against all legally protected classes in the United States. SHA 2023 CALL FOR PAPERS Over the last few years, we have witnessed the flourishing of a deep conservatism in the South, from the embrace of former U.S. president Donald J. Trump's politics of resentment, to rampant voter suppression, to negative responses to COVID-19 restrictions and vaccine recommendations, to efforts to limit what can be taught in public schools about racism, to the undermining of abortion rights and gay rights. The SHA Program Committee invites proposals that will help us understand the landscape of employment, the rural/urban divide, the state of cultural conservatism, the rise of conservative political movements, and the development of political strategies deployed by conservatives in the region. What have been the relationships between conservatism and environmental transformation (including clearance of forest land to make room for plantation agriculture, the dredging of swamps to facilitate settlement, and environmental disasters such as oil spills)?

Becoming the Public Health Leaders We Need to Be

[...]from her vantage points as a medical student, a resident, an emergency room doctor, a public health professional, and a political commentator, Wen provides a capsule history of several major public health events of the last few decades, including the continuing burden of HIV, the opioid epidemic, food insecurity, the Affordable Care Act, the rising toll of gun violence, the COVID-19 pandemic, the climate emergency, and more. [...]Wen describes her interactions with a glittering cast of mentors and role models as well as her efforts to pay this support forward by advising, assisting, and advancing the careers of her colleagues and students and the life success of her patients. Wen devotes limited space to a very public phase of her career, her brief stint as president of the Planned Parenthood Federation of America (PPFA).7 Hoping to provide a new direction for PPFA, she reports she had taken the job with the goal of repositioning the organization from being a leading advocate for abortion and reproductive rights into becoming a women's health organization that speaks for the health care needs of all women.

Missed Opportunity: The West Baltimore Opportunity Zones Story

This paper presents a qualitative evaluation of how Opportunity Zones (OZs) have attracted capital and economic development to highly distressed neighborhoods in West Baltimore. Based on 76 interviews with community and government officials, program managers, developers, businesses, and fund managers, we assess the strengths and weaknesses of OZs in West Baltimore and Baltimore City. We find that OZs are stimulating new investment conversations and building local economic development capacity. However, we also find OZs fail at oversight and community engagement, do not spur new development, and are a missed opportunity to incentivize actors and institutions critical to revitalizing distressed neighborhoods. To spur development in distressed neighborhoods, OZs require reporting standards, the removal of non-distressed census tracts, dollars for education and infrastructure, the incorporation of Community Development Financial Institutions, and incentives for non-capital gains holding investors.

From Strategic Goal to Reality: The Development of the Myrtle Beach Invitational Basketball Tournament

The Myrtle Beach, South Carolina, area was selected to serve as one-time hosts for two tournaments in 2017: the ACC Women's Basketball Tournament and the Puerto Rico Tip-Off Men's College Basketball Tournament, when circumstances required those events to relocate on very short notice. Following the success of these two one-time events, the region sought to become a permanent host of an annual men's college basketball tournament to be played in November or December. This manuscript examines the development process of this tournament and illustrates how tournament organizers addressed the most common elements found in such events.

COVID-19 Exposure and Care-Seeking Behaviors Among Vulnerable Urban Adolescents and Young Adults–Baltimore, Maryland USA

OBJECTIVES/GOALS: This study seeks to determine the relationship between fear of COVID-19 infection and care-seeking behaviors including provider visit and telemedicine utilization among vulnerable adolescent and young adults in Baltimore, Maryland METHODS/STUDY POPULATION: Participants enrolled in the COVID-19 Youth study were 13-25 years old and recruited from four existing sexual health studies based in Baltimore, MD which focused on 1) PID, 2) HIV, 3) emerging sexually transmitted infections, and 4) a dyadic STI prevention, respectively. Participants agreed to be re-contacted for future studies and completed a telephone survey developed to inquire about the impacts of COVID-19 on care seeking behaviors. Bivariate analyses tested for correlations between fear of COVID-19 infection, demographic variables, and care-seeking behaviors. Multivariable logistic regression modeled associations between fear of COVID-19 infection and care-seeking behaviors. RESULTS/ANTICIPATED RESULTS: Adjusted multivariable logistic regression revealed a statistically significant association between fear of COVID-19 infection and having a provider visit;AYA who feared COVID-19 were at greater than two times increased odds of a provider visit compared to AYA who did not fear COVID-19 infection (OR: 2.37, 95%CI: 1.02, 6.15). Among those with a provider visit, fear of COVID-19 infection was associated with two-fold increased odds of having a telemedicine visit vs. an in-person visit (OR: 2.23, 95%CI: 1.09, 4.51), however this was not statistically significant in the adjusted model. There were however significant associations detected in the adjusted model for HIV status, insurance type and telemedicine utilization respectively. DISCUSSION/SIGNIFICANCE: This study demonstrates the ongoing need for health services during the recent pandemic and overall willingness of AYA to utilize telemedicine. Given the sexual health disparities faced by AYA, who bear more than half of the 50 million STI cases in the US, optimizing services for AYA is essential and consistent with new laws expanding telehealth use.

Dynamic Panel Data Modeling and Surveillance of COVID-19 in Metropolitan Areas in the United States: Longitudinal Trend Analysis.

BACKGROUND: The COVID-19 pandemic has had profound and differential impacts on metropolitan areas across the United States and around the world. Within the United States, metropolitan areas that were hit earliest with the pandemic and reacted with scientifically based health policy were able to contain the virus by late spring. For other areas that kept businesses open, the first wave in the United States hit in mid-summer. As the weather turns colder, universities resume classes, and people tire of lockdowns, a second wave is ascending in both metropolitan and rural areas. It becomes more obvious that additional SARS-CoV-2 surveillance is needed at the local level to track recent shifts in the pandemic, rates of increase, and persistence. OBJECTIVE: The goal of this study is to provide advanced surveillance metrics for COVID-19 transmission that account for speed, acceleration, jerk and persistence, and weekly shifts, to better understand and manage risk in metropolitan areas. Existing surveillance measures coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until, and after, an effective vaccine is developed. Here, we provide values for novel indicators to measure COVID-19 transmission at the metropolitan area level. METHODS: Using a longitudinal trend analysis study design, we extracted 260 days of COVID-19 data from public health registries. We used an empirical difference equation to measure the daily number of cases in the 25 largest US metropolitan areas as a function of the prior number of cases and weekly shift variables based on a dynamic panel data model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: Minneapolis and Chicago have the greatest average number of daily new positive results per standardized 100,000 population (which we refer to as speed). Extreme behavior in Minneapolis showed an increase in speed from 17 to 30 (67%) in 1 week. The jerk and acceleration calculated for these areas also showed extreme behavior. The dynamic panel data model shows that Minneapolis, Chicago, and Detroit have the largest persistence effects, meaning that new cases pertaining to a specific week are statistically attributable to new cases from the prior week. CONCLUSIONS: Three of the metropolitan areas with historically early and harsh winters have the highest persistence effects out of the top 25 most populous metropolitan areas in the United States at the beginning of their cold weather season. With these persistence effects, and with indoor activities becoming more popular as the weather gets colder, stringent COVID-19 regulations will be more important than ever to flatten the second wave of the pandemic. As colder weather grips more of the nation, southern metropolitan areas may also see large spikes in the number of cases.

Teaching and Learning as "CANVAS Ambassadors" during the COVID-19 Pandemic: Faculty Experiences at One Historically Black College and University

In this article, we explore the experiences and self-reflections of faculty as CANVAS Ambassadors at Morgan State University, a Historically Black University in Baltimore, Maryland, during the COVID-19 global pandemic. The university transitioned to remote/online instruction using the CANVAS™ learning management system in March of 2020. The findings include several themes and lessons: the positive impact on colleagueship when faculty train faculty, the ability to close technology gaps, and the opportunity to broaden overall faculty teaching and learning development at the university. The paper suggests an example of transferable learning experience to other universities and suggests future research plans in preparation for unpredictable teaching and learning in education.