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1.
Public Health Rep ; 137(2_suppl): 40S-45S, 2022.
Article in English | MEDLINE | ID: covidwho-2098161

ABSTRACT

OBJECTIVES: We evaluated 2 innovative approaches that supported COVID-19 case investigation and contact tracing (CI/CT) in Chicago communities: (1) early engagement of people diagnosed with COVID-19 by leveraging the existing Healthcare Alert Network to send automated telephone calls and text messages and (2) establishment of a network of on-site case investigators and contact tracers within partner health care facilities (HCFs) and community-based organizations (CBOs). METHODS: The Chicago Department of Public Health used Healthcare Alert Network data to calculate the proportion of people with confirmed COVID-19 who successfully received an automated telephone call or text message during December 27, 2020-April 24, 2021. The department also used CI/CT data to calculate the proportion of cases successfully interviewed and named contacts successfully notified, as well as the time to successful case interview and to successful contact notification. RESULTS: Of 67 882 people with COVID-19, 94.3% (n = 64 011) received an automated telephone call and 91.7% (n = 62 239) received a text message. Of the 65 470 COVID-19 cases pulled from CI/CT data, 24 450 (37.3%) interviews were completed, including 6212 (61.3%) of the 10 126 cases diagnosed in HCFs. The median time from testing to successful case interview was 3 days for Chicago Department of Public Health investigators and 4 days for HCF investigators. Overall, 34 083 contacts were named; 13 117 (38.5%) were successfully notified, including 9068 (36.6%) of the 24 761 contacts assigned to CBOs. The median time from contact elicitation to completed notification by CBOs was <24 hours. CONCLUSIONS: Partnerships with HCFs and CBOs helped deliver timely CI/CT during the COVID-19 pandemic, suggesting a potential benefit of engaging non-public health institutions in CI/CT for existing and emerging diseases.


Subject(s)
COVID-19 , Contact Tracing , Humans , COVID-19/epidemiology , Pandemics , Chicago/epidemiology , Public Health
2.
PLoS One ; 17(10): e0275714, 2022.
Article in English | MEDLINE | ID: covidwho-2079749

ABSTRACT

To curb the spread of the ongoing 2019 novel coronavirus (COVID-19), authorities have adopted several non-pharmaceutical (NPIs) and pharmaceutical interventions, which significantly affected our daily activities and mobility patterns. However, it is still unclear how severity of NPIs, COVID-19-related variables, and vaccination rates have affected demand for ridesourcing services, and whether these effects vary across small towns and large cities. We analyzed over 220 million ride requests in the City of Chicago (population: 2.7 million), Illinois, and 52 thousand in the Town of Innisfil (population: 37 thousand), Ontario, to investigate the impact of the COVID-19 pandemic on the ridesourcing demand in the two locations. Overall, the pandemic resulted in fewer trips in areas with higher proportions of seniors and more trips to parks and green spaces. Ridesourcing demand was adversely affected by the stringency index and COVID-19-related variables, and positively affected by vaccination rates. However, compared to Innisfil, ridesourcing services in Chicago experienced higher reductions in demand, were more affected by the number of hospitalizations and deaths, were less impacted by vaccination rates, and had lower recovery rates.


Subject(s)
COVID-19 , COVID-19/epidemiology , Chicago/epidemiology , Cities/epidemiology , Humans , Pandemics , SARS-CoV-2
3.
Nat Commun ; 13(1): 5547, 2022 09 22.
Article in English | MEDLINE | ID: covidwho-2036824

ABSTRACT

Public health indicators typically used for COVID-19 surveillance can be biased or lag changing community transmission patterns. In this study, we investigate whether sentinel surveillance of recently symptomatic individuals receiving outpatient diagnostic testing for SARS-CoV-2 could accurately assess the instantaneous reproductive number R(t) and provide early warning of changes in transmission. We use data from community-based diagnostic testing sites in the United States city of Chicago. Patients tested at community-based diagnostic testing sites between September 2020 and June 2021, and reporting symptom onset within four days preceding their test, formed the sentinel population. R(t) calculated from sentinel cases agreed well with R(t) from other indicators. Retrospectively, trends in sentinel cases did not precede trends in COVID-19 hospital admissions by any identifiable lead time. In deployment, sentinel surveillance held an operational recency advantage of nine days over hospital admissions. The promising performance of opportunistic sentinel surveillance suggests that deliberately designed outpatient sentinel surveillance would provide robust early warning of increasing transmission.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , Chicago/epidemiology , Humans , Outpatients , Retrospective Studies , Sentinel Surveillance , United States/epidemiology
4.
J Health Care Poor Underserved ; 33(3): 1215-1229, 2022.
Article in English | MEDLINE | ID: covidwho-2021450

ABSTRACT

Race, income, and their role in COVID-19 infection in the community have been extensively reported, but their impact on outcomes in hospitalized patients is less well defined. We retrospectively analyzed the first 509 COVID-19 patients in our hospital network, examining associations between median household income, 30-day mortality, and ambulatory state at discharge (using the modified Rankin scale (mRS)), adjusting for hospitalization at the academic medical center (AMC) and other variables. Income did not predict mortality. Higher income was associated with slightly increased odds of ability to ambulate at discharge only when accounting for hospital type. At the AMC, income and mortality were lower and functional outcomes more favorable. Patients with lower incomes had greater comorbidity burden. That income was not associated with measures of morbidity and mortality from COVID-19 is a remarkable and encouraging finding. Academic medical centers may mitigate detrimental effects of socioeconomic disparities on COVID-19 seen at the community level.


Subject(s)
COVID-19 , Chicago/epidemiology , Delivery of Health Care , Hospitalization , Humans , Income , Retrospective Studies
5.
BMC Womens Health ; 22(1): 218, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-1951176

ABSTRACT

BACKGROUND: The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health. METHODS: We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic. RESULTS: The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants. CONCLUSIONS: We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.


Subject(s)
COVID-19 , HIV Infections , Chicago/epidemiology , Female , HIV Infections/epidemiology , HIV Infections/psychology , Humans , Pandemics , Social Stigma , Socioeconomic Factors
6.
AIDS Behav ; 26(8): 2581-2587, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1919830

ABSTRACT

The COVID-19 pandemic has created increased need for telehealth appointments. To assess differences in appointment adherence for telehealth compared to in-person HIV medical care visits, we conducted a cross-sectional study of patients receiving HIV care in a safety-net hospital-based outpatient infectious disease clinic in a large urban area (Chicago, IL). The sample (N = 347) was predominantly Black (n = 251) and male (62.5%, n = 217); with a mean age of 44.2 years. Appointment attendance was higher for telehealth (78.9%) compared to in-person (61.9%) appointments. Compared to patients without drug use, those with drug use had 19.4 percentage point lower in-person appointment attendance. Compared to those with stable housing, those in unstable housing arrangements had 15.0 percentage point lower in-person appointment attendance. Telehealth as a modality will likely have some staying power as it offers patients newfound flexibility, but barriers to telehealth need to be assessed and addressed.


Subject(s)
COVID-19 , HIV Infections , Telemedicine , Adult , COVID-19/epidemiology , Chicago/epidemiology , Cross-Sectional Studies , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Male , Pandemics
7.
PLoS One ; 17(5): e0267436, 2022.
Article in English | MEDLINE | ID: covidwho-1910599

ABSTRACT

The COVID-19 outbreak has impacted urban transportation mobility throughout the world. In this paper, we investigate the impact of COVID-19 on the urban mobility network's structural characteristics. We contribute to the literature by discussing how various community areas in the city traffic network are impacted by the pandemic. We analyze a large dataset on urban mobility from the city of Chicago and derive various insights. Our analysis of the mobility network structure is important because a better understanding of such networks can help control the spread of the disease by reducing interactions among individuals. We find that the pandemic significantly impacted the structure of the mobility network of taxis in Chicago. Our study reveals some important pointers for policymakers that could potentially aid in developing urban transportation policies during the pandemic.


Subject(s)
COVID-19 , COVID-19/epidemiology , Chicago/epidemiology , Cities , Humans , Pandemics , Transportation
8.
PLoS One ; 17(6): e0270311, 2022.
Article in English | MEDLINE | ID: covidwho-1902643

ABSTRACT

COVID-19 has impacted and increased risks for healthcare providers, including orthodontists. There is no information regarding the potential transmission risks in the orthodontic community. This study aims to compare the positivity rate of SARS-CoV-2 infection in orthodontic patients at the University of Illinois Chicago (UIC) orthodontic clinic to the positivity rate of the local population in Chicago. All orthodontic patients who sought treatment at the UIC orthodontic clinic from June 16 to October 31, 2021, were invited to participate in the study. Three milliliters of saliva from the participants were collected in the sample collection tubes and subjected to a polymerase chain reaction (PCR) based assay to detect SAR-CoV-2. All participants' age, sex, history of COVID-19 infection, and vaccination status were recorded. The COVID-19 positivity rates of Chicago, Cook County of Illinois, and the orthodontic clinic at UIC were compared. One thousand four hundred and thirty-seven orthodontic patients aged 6 to 70 years old (41.8% males and 58.2% females) participated in the study. Among all participants, nine participants tested positive for SARS-CoV-2 (5 males and 4 females). During the study, the average COVID-19 positivity rate at the UIC orthodontic clinic was 0.626%. All of the positive participants were asymptomatic, and two of the participants had a history of COVID-19 infection. Among all positive participants, three participants had received complete COVID-19 vaccination. An increased frequency of positive cases at the orthodontic clinic was observed during the time of high positivity rate in Chicago and Cook County. A potential risk of COVID-19 transmission from patients to orthodontic providers remains, even with asymptomatic and vaccinated patients.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19 Vaccines , Chicago/epidemiology , Child , Female , Health Personnel , Humans , Male , Middle Aged , Young Adult
9.
AIDS Behav ; 26(12): 3939-3949, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1899209

ABSTRACT

We examined associations between COVID-19 conspiracy beliefs and HIV status neutral care engagement among Black cisgender sexual minority men (BCSMM) and Black transgender women (BTW). Throughout April-July 2020, a total of 226 (222 in the current analysis: 196 BCSMM, 20 BTW, and 6 other) participants in Chicago's Neighborhoods and Networks (N2) cohort study completed virtual assessments. Participants reported their HIV status, changes in the frequency of PrEP/ART use, and COVID-19 conspiracy beliefs. Three-quarters of the sample believed at least one conspiracy theory that COVID-19 was either government-created or lab-created accidentally or purposefully. Believing one or more COVID-19 conspiracy theories was significantly associated with better PrEP or ART engagement (using PrEP more frequently or continuously using PrEP/Missing ART less or continuously using ART) (aPR = 0.75 [95% CI 0.56-0.99], p < 0.05). Believing COVID-19 came about naturally was strongly associated with worse PrEP engagement (i.e., use PrEP less or not on PrEP) or worse ART engagement (i.e., missed ART more or not on ART) (aPR = 1.56 [95% CI 1.23, 1.98], p < 0.001). Findings suggested substantial COVID-19 conspiracies among BCSMM and BTW, and this was associated with HIV care engagement.


Subject(s)
COVID-19 , HIV Infections , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Transgender Persons , Male , Female , Humans , COVID-19/epidemiology , HIV Infections/epidemiology , Pandemics , Cohort Studies , Chicago/epidemiology , Homosexuality, Male
10.
Ann Epidemiol ; 76: 165-173, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1894778

ABSTRACT

PURPOSE: Even with an efficacious vaccine, protective behaviors (social distancing, masking) are essential for preventing COVID-19 transmission and could become even more important if current or future variants evade immunity from vaccines or prior infection. METHODS: We created an agent-based model representing the Chicago population and conducted experiments to determine the effects of varying adult out-of-household activities (OOHA), school reopening, and protective behaviors across age groups on COVID-19 transmission and hospitalizations. RESULTS: From September-November 2020, decreasing adult protective behaviors and increasing adult OOHA both substantially impacted COVID-19 outcomes; school reopening had relatively little impact when adult protective behaviors and OOHA were maintained. As of November 1, 2020, a 50% reduction in young adult (age 18-40) protective behaviors resulted in increased latent infection prevalence per 100,000 from 15.93 (IQR 6.18, 36.23) to 40.06 (IQR 14.65, 85.21) and 19.87 (IQR 6.83, 46.83) to 47.74 (IQR 18.89, 118.77) with 15% and 45% school reopening. Increasing adult (age ≥18) OOHA from 65% to 80% of prepandemic levels resulted in increased latent infection prevalence per 100,000 from 35.18 (IQR 13.59, 75.00) to 69.84 (IQR 33.27, 145.89) and 38.17 (IQR 15.84, 91.16) to 80.02 (IQR 30.91, 186.63) with 15% and 45% school reopening. Similar patterns were observed for hospitalizations. CONCLUSIONS: In areas without widespread vaccination coverage, interventions to maintain adherence to protective behaviors, particularly among younger adults and in out-of-household settings, remain a priority for preventing COVID-19 transmission.


Subject(s)
COVID-19 , Latent Infection , Young Adult , Humans , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Chicago/epidemiology , Hospitalization , Household Work
11.
JAMA Netw Open ; 5(5): e2214753, 2022 05 02.
Article in English | MEDLINE | ID: covidwho-1872110

ABSTRACT

Importance: There has been large geographic inequity in vaccination coverage across Chicago, Illinois, with higher vaccination rates in zip codes with residents who predominantly have high incomes and are White. Objective: To determine the association between inequitable zip code-level vaccination coverage and COVID-19 mortality in Chicago. Design, Setting, and Participants: This retrospective cohort study used Chicago Department of Public Health vaccination and mortality data and Cook County Medical Examiner mortality data from March 1, 2020, through November 6, 2021, to assess the association of COVID-19 mortality with zip code-level vaccination rates. Data were analyzed from June 1, 2021, to April 13, 2022. Exposures: Zip code-level first-dose vaccination rates before the Alpha and Delta waves of COVID-19. Main Outcomes and Measures: The primary outcome was deaths from COVID-19 during the Alpha and Delta waves. The association of a marginal increase in zip code-level vaccination rate with weekly mortality rates was estimated with a mixed-effects Poisson regression model, and the total number of preventable deaths in the least vaccinated quartile of zip codes was estimated with a linear difference-in-difference design. Results: The study population was 2 686 355 Chicago residents in 52 zip codes (median [IQR] age 34 [32-38] years; 1 378 658 [51%] women; 773 938 Hispanic residents [29%]; 783 916 non-Hispanic Black residents [29%]; 894 555 non-Hispanic White residents [33%]). Among residents in the least vaccinated quartile, 80% were non-Hispanic Black, compared with 8% of residents identifying as non-Hispanic Black in the most vaccinated quartile (P < .001). After controlling for age distribution and recovery from COVID-19, a 10-percentage point increase in zip code-level vaccination 6 weeks before the peak of the Alpha wave was associated with a 39% lower relative risk of death from COVID-19 (incidence rate ratio [IRR], 0.61 [95% CI, 0.52-0.72]). A 10-percentage point increase in zip code vaccination rate 6 weeks before the peak of the Delta wave was associated with a 24% lower relative risk of death (IRR, 0.76 [95% CI, 0.66-0.87]). The difference-in-difference estimate was that 119 Alpha wave deaths (72% [95% CI, 63%-81%]) and 108 Delta wave deaths (75% [95% CI, 66%-84%]) might have been prevented in the least vaccinated quartile of zip codes if it had had the vaccination coverage of the most vaccinated quartile. Conclusions and Relevance: These findings suggest that low zip code-level vaccination rates in Chicago were associated with more deaths during the Alpha and Delta waves of COVID-19 and that inequitable vaccination coverage exacerbated existing racial and ethnic disparities in COVID-19 deaths.


Subject(s)
COVID-19 , Adult , COVID-19/prevention & control , Chicago/epidemiology , Female , Humans , Illinois/epidemiology , Infant , Male , Retrospective Studies , Vaccination
12.
Emerg Infect Dis ; 28(6): 1281-1283, 2022 06.
Article in English | MEDLINE | ID: covidwho-1862553

ABSTRACT

Bars and restaurants are high-risk settings for SARS-CoV-2 transmission. A multistate outbreak after a bar gathering in Chicago, Illinois, USA, highlights Omicron variant transmissibility, the value of local genomic surveillance and interstate coordination, vaccination value, and the potential for rapid transmission of a novel variant across multiple states after 1 event.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Chicago/epidemiology , Disease Outbreaks , Humans , Illinois/epidemiology , SARS-CoV-2/genetics
14.
Soc Sci Med ; 299: 114881, 2022 04.
Article in English | MEDLINE | ID: covidwho-1730112

ABSTRACT

Studies show that older adults were lonelier during versus before the COVID-19 pandemic. This may be due in part to guidelines particularly recommending that older adults stay at home, given their elevated risk of COVID-19 complications. However, little is known about the extent to which this population experienced greater intensity in momentary loneliness during versus before the pandemic, and how this relates to their real-time contexts. Here, we build upon recent findings from the Chicago Health and Activity Space in Real-Time (CHART) study that revealed associations between momentary contexts and loneliness among older adults. We analyze ecological momentary assessments (EMAs) from both pre- and during COVID-19 among a subsample of CHART respondents (N = 110 older adults age 65-88 in 2020). Pre-pandemic data were collected across three waves from April 2018-October 2019, and pandemic data were collected across three additional waves from June-September 2020. Participants responded to smartphone "pings" (five per day for 7 days per wave; N = 5596 and N = 7826 before and during the pandemic, respectively) by reporting their momentary loneliness and context (e.g., home). Findings from multi-level regression models suggest that respondents were lonelier in mid-2020 than in years prior, as well as when at home and alone; they were also more likely to be at home during the pandemic. However, the loneliness-inducing effects of being at home (vs. outside the home) and alone (vs. with others) were weaker during versus before COVID-19. Results provide important nuance to broader trends in loneliness among older adults during the pandemic. Specifically, older adults may have adopted new technologies to support social connectedness. It is also possible that, during a time in which social and physical distancing characterized public health guidelines, these contexts grew less isolating as they became a shared experience, or that publicly shared spaces provided fewer opportunities for social engagement.


Subject(s)
COVID-19 , Aged , Aged, 80 and over , COVID-19/epidemiology , Chicago/epidemiology , Humans , Loneliness , Pandemics , SARS-CoV-2
15.
Child Care Health Dev ; 48(6): 886-890, 2022 11.
Article in English | MEDLINE | ID: covidwho-1714150

ABSTRACT

PURPOSE: This study aimed to understand the impact of the initial COVID-19 pandemic remote schooling period on self-reported wellness among adolescents in Chicago. METHODS: Students (n = 55) completed a 22-item wellness questionnaire before (February 2020) and shortly after the onset of the COVID-19 outbreak (April 2020). Precomparisons/postcomparisons (overall and by survey item) were evaluated using two-sided paired t-tests with an alpha level of 0.05. Descriptive statistics were used to evaluate mean scores overall by demographic variables. RESULTS: Significant differences were found in the following areas: Balance (Pre: 7.3, During: 6.4, p = 0.02), Education (Pre: 8.4, During 7.7, p = 0.03) and Friends (Pre:8.0, During: 6.3, p = 0.001). Overall wellness scores varied by demographic variables, though not significantly. CONCLUSIONS: Results suggest the onset of the pandemic impacted students' ability to effectively learn, as well as to maintain balance in their lives and social relationships. Comprehensive support is needed in these areas to promote adolescent wellness.


Subject(s)
COVID-19 , Adolescent , COVID-19/epidemiology , Chicago/epidemiology , Humans , Pandemics/prevention & control , Students , Surveys and Questionnaires
16.
Crit Care Med ; 50(2): 256-263, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1691786

ABSTRACT

OBJECTIVES: To describe the clinical characteristics and outcomes of adult patients with coronavirus disease 2019 requiring weaning from prolonged mechanical ventilation. DESIGN: Observational cohort study of patients admitted to two long-term acute care hospitals from April 1, 2020, to March 31, 2021. SETTING: Two long-term acute care hospitals specialized in weaning from prolonged mechanical ventilation in the Chicagoland area, Illinois, United States. PATIENTS: Adult (≥ 18 yr old) ICU survivors of respiratory failure caused by severe acute respiratory syndrome coronavirus 2 pneumonia receiving prolonged mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the study period, 158 consecutive patients were transferred to the long-term acute care hospitals for weaning from prolonged ventilation. Demographic, clinical, and laboratory data were collected and analyzed. Final date of follow-up was June 1, 2021. Prior to long-term acute care hospital transfer, median length of stay at the acute care hospital was 41.0 days and median number of ventilator days was 35. Median age was 60.0 years, 34.8% of patients were women, 91.8% had a least one comorbidity, most commonly hypertension (65.8%) and diabetes (53.2%). The percentage of weaning success was 70.9%. The median duration of successful weaning was 8 days. Mortality was 9.6%. As of June 1, 2021, 19.0% of patients had been discharged home, 70.3% had been discharged to other facilities, and 1.3% were still in the long-term acute care hospitals. CONCLUSIONS: Most patients with coronavirus disease 2019 transferred to two Chicago-area long-term acute care hospitals successfully weaned from prolonged mechanical ventilation.


Subject(s)
COVID-19/therapy , Hospitals, Special , Respiration, Artificial , Respiratory Insufficiency/therapy , SARS-CoV-2 , Ventilator Weaning , Aged , COVID-19/complications , Chicago/epidemiology , Cohort Studies , Female , Humans , Length of Stay , Male , Middle Aged , Patient Discharge , Patient Transfer , Respiratory Insufficiency/etiology , Treatment Outcome
17.
BMJ Open ; 12(1): e052495, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1613003

ABSTRACT

OBJECTIVES: To examine the prevalence of mental health symptoms during the first surge of COVID-19 in the USA, and their associations with COVID-19-related emotional distress, health self-management and healthcare utilisation. DESIGN: Cross-sectional analysis of wave 3 (1-22 May 2020) survey data from the ongoing Chicago COVID-19 Comorbidities (C3) study. SETTING: Seven academic and community health centres in Chicago, Illinois. PARTICIPANTS: 565 adults aged 23-88 with one or more chronic conditions completing at least one prior C3 study wave. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinically relevant anxiety and depressive symptoms as measured using Patient-Reported Outcomes Measurement Information System short forms. Self-reported emotional and health-related responses to COVID-19 were measured through a combination of single-item questions and validated measures. RESULTS: Rates of anxiety and depressive symptoms were 14% (81/563) and 15% (84/563), respectively. Anxiety and depressive symptoms were then each separately associated with greater worry about contracting COVID-19 (relative risk (RR) 2.32, 95% CI 1.52 to 3.53; RR 1.67, 95% CI 1.10 to 2.54), greater stress (RR 4.93, 95% CI 3.20 to 7.59; RR 3.01, 95% CI 1.96 to 4.61) and loneliness (RR 3.82, 95% CI 2.21 to 6.60; RR 5.37, 95% CI 3.21 to 8.98), greater avoidance of the doctor (RR 1.62, 95% CI 1.06 to 2.49; RR 1.54, 95% CI 1.00 to 2.36) and difficulty managing health (least square means (LS Means) 6.09, 95% CI 5.25 to 6.92 vs 4.23, 95% CI 3.70 to 4.75; LS Means 5.85, 95% CI 5.04 to 6.65 vs 4.22, 95% CI 3.70 to 4.75) and medications (LS Means 3.71, 95% CI 2.98 to 4.43 vs 2.47, 95% CI 2.02 to 2.92) due to the pandemic. CONCLUSIONS: Identifying and addressing mental health concerns may be an important factor to consider in COVID-19 prevention and management among high-risk medical populations.


Subject(s)
COVID-19 , Self-Management , Adult , Anxiety/epidemiology , Chicago/epidemiology , Chronic Disease , Cross-Sectional Studies , Depression/epidemiology , Humans , Pandemics , Prevalence , SARS-CoV-2
18.
Emerg Infect Dis ; 28(1): 76-84, 2022 01.
Article in English | MEDLINE | ID: covidwho-1547204

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential for rapid transmission in congregate settings. We describe the multidisciplinary response to an outbreak of coronavirus disease (COVID-19) in a large homeless shelter in Chicago, Illinois, USA. The response to the outbreak included 4 rounds of mass PCR testing of all staff and residents and subsequent isolation of persons who tested positive for SARS-CoV-2. We further describe the dynamics of the shelter outbreak by fitting a modified susceptible-exposed-infectious-recovered compartmental model incorporating the widespread SARS-CoV-2 testing and isolation measures implemented in this shelter. Our model demonstrates that rapid transmission of COVID-19 in the shelter occurred before the outbreak was detected; rates of transmission declined after widespread testing and isolation measures were put in place. Overall, we demonstrate the feasibility of mass PCR testing and isolation in congregate settings and suggest the necessity of prompt response to suspected COVID-19 outbreaks in homeless shelters.


Subject(s)
COVID-19 , Homeless Persons , COVID-19 Testing , Chicago/epidemiology , Disease Outbreaks , Humans , Illinois/epidemiology , SARS-CoV-2
19.
Health Aff (Millwood) ; 40(11): 1784-1791, 2021 11.
Article in English | MEDLINE | ID: covidwho-1496547

ABSTRACT

Racial health inequities exemplified during the COVID-19 crisis have awakened a sense of urgency among public health and policy experts to examine contributing factors. One potential factor includes the socioeconomic disadvantage of racially segregated neighborhoods. This study quantified associations of neighborhood socioeconomic disadvantage in Chicago, Illinois, as measured by the Area Deprivation Index (ADI), with racial disparities in COVID-19 positivity. A retrospective cohort included 16,684 patients tested for COVID-19 at an academic medical center and five community-based testing sites during Chicago's "first wave" (March 12, 2020-June 25, 2020). Patients living in Black majority neighborhoods had two times higher odds of COVID-19 positivity relative to those in White majority neighborhoods. The ADI accounted for 20 percent of the racial disparity; however, COVID-19 positivity remained substantially higher at every decile of the ADI in Black relative to White neighborhoods. The remaining disparities (80 percent) suggest a large, cumulative effect of other structural disadvantages in urban communities of color.


Subject(s)
COVID-19 , Chicago/epidemiology , Humans , Residence Characteristics , Retrospective Studies , SARS-CoV-2 , Socioeconomic Factors
20.
Ann Epidemiol ; 66: 44-51, 2022 02.
Article in English | MEDLINE | ID: covidwho-1487600

ABSTRACT

To date, COVID-19 case rates are disproportionately higher in Black and Latinx communities across the US, leading to more hospitalizations, and deaths in those communities. These differences in case rates are evident in comparisons of Chicago neighborhoods with differing race and/or ethnicities of their residents. Disparities could be due to neighborhoods with more adverse health outcomes associated with poverty and other social determinants of health experiencing higher prevalence of SARS-CoV-2 infection or due to greater morbidity and mortality resulting from equivalent SARS-CoV-2 infection prevalence. We surveyed five pairs of adjacent ZIP codes in Chicago with disparate COVID-19 case rates for highly specific and quantitative serologic evidence of any prior infection by SARS-CoV-2 to compare with their disparate COVID-19 case rates. Dried blood spot samples were self-collected at home by internet-recruited participants in summer 2020, shortly after Chicago's first wave of the COVID-19 pandemic. Pairs of neighboring ZIP codes with very different COVID-19 case rates had similar seropositivity rates for anti-SARS-CoV-2 receptor binding domain IgG antibodies. Overall, these findings of comparable exposure to SARS-CoV-2 across neighborhoods with very disparate COVID-19 case rates are consistent with social determinants of health, and the co-morbidities related to them, driving differences in COVID-19 rates across neighborhoods.


Subject(s)
COVID-19 , COVID-19/epidemiology , Chicago/epidemiology , Humans , Pandemics , Residence Characteristics , SARS-CoV-2
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