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1.
Int J Environ Res Public Health ; 20(11)2023 May 23.
Article in English | MEDLINE | ID: covidwho-20242501

ABSTRACT

BACKGROUND: The COVID-19 pandemic posed new challenges for cognitive aging since it brought interruptions in family relations for older adults in immigrant communities. This study examines the consequences of COVID-19 for the familial and social support systems of aging Middle Eastern/Arab immigrants in Michigan, the largest concentration in the United States. We conducted six focus groups with 45 participants aged 60 and older to explore participant descriptions of changes and difficulties faced during the pandemic relating to their cognitive health, familial and social support systems, and medical care. The findings indicate challenges around social distancing for older Middle Eastern/Arab American immigrants, which generated three overarching themes: fear, mental health, and social relationships. These themes provide unique insights into the lived experiences of older Middle Eastern/Arab American adults during the pandemic and bring to light culturally embedded risks to cognitive health and well-being. A focus on the well-being of older Middle Eastern/Arab American immigrants during COVID-19 advances understanding of how environmental contexts inform immigrant health disparities and the sociocultural factors that shape minority aging.


Subject(s)
COVID-19 , Cognitive Aging , Emigrants and Immigrants , Humans , United States/epidemiology , Middle Aged , Aged , Arabs/psychology , Pandemics , Self Report , COVID-19/epidemiology , Michigan/epidemiology
2.
J Matern Fetal Neonatal Med ; 36(1): 2199343, 2023 Dec.
Article in English | MEDLINE | ID: covidwho-2321812

ABSTRACT

OBJECTIVE: COVID-19 has been reported to increase the risk of prematurity, however, due to the frequent absence of unaffected controls as well as inadequate accounting for confounders in many studies, the question requires further investigation. We sought to determine the impact of COVID-19 disease on preterm birth (PTB) overall, as well as related subcategories such as early prematurity, spontaneous, medically indicated preterm birth, and preterm labor (PTL). We assessed the impact of confounders such as COVID-19 risk factors, a-priori risk factors for PTB, symptomatology, and disease severity on rates of prematurity. METHODS: This was a retrospective cohort study of pregnant women from March 2020 till October 1st, 2020. The study included patients from 14 obstetric centers in Michigan, USA. Cases were defined as women diagnosed with COVID-19 at any point during their pregnancy. Cases were matched with uninfected women who delivered in the same unit, within 30 d of the delivery of the index case. Outcomes of interest were frequencies of prematurity overall and subcategories of preterm birth (early, spontaneous/medically indicated, preterm labor, and premature preterm rupture of membranes) in cases compared to controls. The impact of modifiers of these outcomes was documented with extensive control for potential confounders. A p value <.05 was used to infer significance. RESULTS: The rate of prematurity was 8.9% in controls, 9.4% in asymptomatic cases, 26.5% in symptomatic COVID-19 cases, and 58.8% among cases admitted to the ICU. Gestational age at delivery was noted to decrease with disease severity. Cases were at an increased risk of prematurity overall [adjusted relative risk (aRR) = 1.62 (1.2-2.18)] and of early prematurity (<34 weeks) [aRR = 1.8 (1.02-3.16)] when compared to controls. Medically indicated prematurity related to preeclampsia [aRR = 2.46 (1.47-4.12)] or other indications [aRR = 2.32 (1.12-4.79)], were the primary drivers of overall prematurity risk. Symptomatic cases were at an increased risk of preterm labor [aRR = 1.74 (1.04-2.8)] and spontaneous preterm birth due to premature preterm rupture of membranes [aRR = 2.2(1.05-4.55)] when compared to controls and asymptomatic cases combined. The gestational age at delivery followed a dose-response relation with disease severity, as more severe cases tended to deliver earlier (Wilcoxon p < .05). CONCLUSIONS: COVID-19 is an independent risk factor for preterm birth. The increased preterm birth rate in COVID-19 was primarily driven by medically indicated delivery, with preeclampsia as the principal risk factor. Symptomatic status and disease severity were significant drivers of preterm birth.


Subject(s)
COVID-19 , Obstetric Labor, Premature , Pre-Eclampsia , Premature Birth , Infant, Newborn , Female , Pregnancy , Humans , Premature Birth/epidemiology , Premature Birth/etiology , Retrospective Studies , Michigan/epidemiology , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Pregnancy Outcome
3.
Disaster Med Public Health Prep ; 17: e377, 2023 04 14.
Article in English | MEDLINE | ID: covidwho-2292685

ABSTRACT

BACKGROUND: Historically, the child care industry has been unprepared for emergencies. A previous study identified gaps in Michigan's child care programs' emergency plans. Study objectives were to reassess programs' preparedness plans after introduction of state-mandated emergency plans and to examine the effect of the coronavirus disease 2019 (COVID-19) pandemic on programs' operations. METHODS: A 29-question survey was sent to ∼500 child care programs across Michigan in 2020 to assess emergency plans and response to COVID-19. Data were analyzed using descriptive statistics and qualitative methods. RESULTS: A total of 346 programs (70%) responded. Most (92%) reported having a written plan, but one-third reported having no infectious outbreak plan pre-pandemic. One-third of programs lacked plans for special needs children (vs 40% in 2014); 62% lacked plans for child reunification (vs 60% in 2014); 46% reported staff received no preparedness training. COVID-19 impacted programs substantially: 59% closed, 20% decreased capacity, 27% changed disinfecting protocols. Several themes related to the pandemic's effect on programs were identified: (1) changes in learning, (2) changes in socialization, (3) increased family burden, (4) financial challenges, (5) lack of guidance. CONCLUSIONS: Significant preparedness gaps remain among Michigan's child care programs, suggesting the need for increased support and addition of emergency preparedness to programs' quality ratings.


Subject(s)
COVID-19 , Civil Defense , Disaster Planning , Disasters , Humans , Child , Michigan/epidemiology , Pandemics/prevention & control , Child Care , COVID-19/epidemiology
4.
Front Public Health ; 11: 1144659, 2023.
Article in English | MEDLINE | ID: covidwho-2304503

ABSTRACT

Background: Mass vaccination serves as an effective strategy to combat the COVID-19 pandemic. Vaccine hesitancy is a recognized impediment to achieving a vaccination rate necessary to protect communities. However, solutions and interventions to address this issue are limited by a lack of prior research. Methods: Over 200 patients from 18 Michigan counties participated in this study. Each participant received an initial survey, including demographical questions and knowledge and opinion questions regarding COVID-19 and vaccines. Participants were randomly assigned an educational intervention in either video or infographic format. Patients received a post-survey to assess changes in knowledge and attitudes. Paired sample t-tests and ANOVA were used to measure the effectiveness of the educational interventions. Participants also elected to complete a 3-month follow-up survey. Results: Patients showed increased knowledge after the educational intervention in six out of seven COVID-19 topics (p < 0.005). There was increased vaccine acceptance after the intervention but no difference in the effectiveness between the two intervention modalities. Post-intervention, more patients believed in CDC recommendations (p = 0.005), trusted the vaccine (p = 0.001), believed the vaccines had adequate testing (p = 0.019), recognized prior mistreatment in the medical care system (p = 0.005), agreed that a source they trust told them to receive a vaccine (p = 0.015), and were worried about taking time off of work to get a vaccine (p = 0.023). Additionally, post-intervention, patients were less concerned about mild reactions of the virus (p = 0.005), the rapid development of the vaccines (p < 0.001), and vaccine side effects (p = 0.031). Data demonstrated that attitude and knowledge improved when comparing pre-educational intervention to follow-up but decreased from post-intervention to follow-up. Conclusion: The findings illustrate that educational interventions improved COVID-19 and vaccine knowledge among patients and that the knowledge was retained. Educational interventions serve as powerful tools to increase knowledge within communities and address negative views on vaccination. Interventions should be continually utilized to reinforce information within communities to improve vaccination rates.


Subject(s)
COVID-19 , Pandemics , Humans , Prospective Studies , Michigan , COVID-19/prevention & control , Vaccination
5.
J Pediatr Hematol Oncol ; 45(4): 174-180, 2023 05 01.
Article in English | MEDLINE | ID: covidwho-2301616

ABSTRACT

The sickle cell mutation increases morbidity in those with sickle cell disease (SCD) and potentially sickle cell trait, impacting pulmonary, coagulation, renal, and other systems that are implicated in COVID-19 severity. There are no population-based registries for hemoglobinopathies, and they are not tracked in COVID-19 testing. We used COVID-19 test data from 2 states linked to newborn screening data to estimate COVID outcomes in people with SCD or trait compared with normal hemoglobin. We linked historical newborn screening data to COVID-19 tests, hospitalization, and mortality data and modeled the odds of hospitalization and mortality. Georgia's cohort aged 0 to 12 years; Michigan's, 0 to 33 years. Over 8% of those in Michigan were linked to positive COVID-19 results, and 4% in Georgia. Those with SCD showed significantly higher rates of COVID-19 hospitalization than the normal hemoglobin Black cohort, and Michigan had higher rates of mortality as well. Outcomes among those with the trait did not differ significantly from the normal hemoglobin Black group. People with SCD are at increased risk of COVID-19-related hospitalization and mortality and are encouraged to be vaccinated and avoid infection. Persons with the trait were not at higher risk of COVID-related severe outcomes.


Subject(s)
Anemia, Sickle Cell , COVID-19 , Sickle Cell Trait , Infant, Newborn , Humans , Sickle Cell Trait/diagnosis , Sickle Cell Trait/epidemiology , Sickle Cell Trait/genetics , Neonatal Screening/methods , Georgia/epidemiology , Michigan/epidemiology , COVID-19 Testing , COVID-19/diagnosis , COVID-19/epidemiology , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/epidemiology , Anemia, Sickle Cell/genetics , Hemoglobins
6.
Am J Public Health ; 111(3): 405-406, 2021 03.
Article in English | MEDLINE | ID: covidwho-2270611
7.
J Racial Ethn Health Disparities ; 9(1): 156-164, 2022 02.
Article in English | MEDLINE | ID: covidwho-2249563

ABSTRACT

Racial disparities have been observed in the impacts of COVID-19 in the USA. In the present paper, we used a representative sample of adults in Michigan to examine differences in COVID-19 impacts on Blacks and Whites in four domains: direct, perceived, political, and behavioral. We found that in the initial wave of the outbreak in May 2020, Blacks experienced more severe direct impacts: they were more likely to be diagnosed or know someone who was diagnosed, and more likely to lose their job compared to Whites. In addition, Blacks differed significantly from Whites in their assessment of COVID-19's threat to public health and the economy, the adequacy of government responses to COVID-19, and the appropriateness of behavioral changes to mitigate COVID-19's spread. Although in many cases these views of COVID-19 were also associated with political ideology, this association was significantly stronger for Whites than Blacks. Continued investigation of racial disparities in COVID-19's impact is necessary; however, these preliminary findings of a race-by-ideology interaction are important because they suggest some racial disparities are restricted to conservatives, while more liberal Whites and Blacks exhibit few differences.


Subject(s)
COVID-19 , Adult , Health Status Disparities , Humans , Michigan/epidemiology , SARS-CoV-2 , White People
8.
Soc Psychiatry Psychiatr Epidemiol ; 58(7): 1099-1108, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2284174

ABSTRACT

PURPOSE: The COVID-19 pandemic has had wide-ranging impacts on mental health, however, less is known about predictors of mental health outcomes among adults who have experienced a COVID-19 diagnosis. We examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in the U.S. state of Michigan early in the pandemic. METHODS: Data were from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 1, 2020 (N = 1087). We used weighted prevalence estimates and multinomial logistic regression to examine associations between mental health outcomes (depressive symptoms, anxiety symptoms, and comorbid depressive/anxiety symptoms) and demographic characteristics, pandemic-associated changes in accessing basic needs (accessing food/clean water and paying important bills), self-reported COVID-19 symptom severity, and symptom duration. RESULTS: Relative risks for experiencing poor mental health outcomes varied by sex, age, race/ethnicity, and income. In adjusted models, experiencing a change in accessing basic needs associated with the pandemic was associated with higher relative risks for anxiety and comorbid anxiety/depressive symptoms. Worse COVID-19 symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" (symptom duration greater than 60 days) was associated with all outcomes. CONCLUSION: Adults diagnosed with COVID-19 may face overlapping risk factors for poor mental health outcomes, including pandemic-associated disruptions to household and economic wellbeing, as well as factors related to COVID-19 symptom severity and duration. An integrated approach to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.


Subject(s)
COVID-19 , Adult , Humans , COVID-19 Testing , Michigan , Pandemics , Anxiety , Depression
9.
Medicine (Baltimore) ; 100(40): e27422, 2021 Oct 08.
Article in English | MEDLINE | ID: covidwho-2191077

ABSTRACT

ABSTRACT: As severe acute respiratory syndrome coronavirus 2 continues to spread, easy-to-use risk models that predict hospital mortality can assist in clinical decision making and triage. We aimed to develop a risk score model for in-hospital mortality in patients hospitalized with 2019 novel coronavirus (COVID-19) that was robust across hospitals and used clinical factors that are readily available and measured standardly across hospitals.In this retrospective observational study, we developed a risk score model using data collected by trained abstractors for patients in 20 diverse hospitals across the state of Michigan (Mi-COVID19) who were discharged between March 5, 2020 and August 14, 2020. Patients who tested positive for severe acute respiratory syndrome coronavirus 2 during hospitalization or were discharged with an ICD-10 code for COVID-19 (U07.1) were included. We employed an iterative forward selection approach to consider the inclusion of 145 potential risk factors available at hospital presentation. Model performance was externally validated with patients from 19 hospitals in the Mi-COVID19 registry not used in model development. We shared the model in an easy-to-use online application that allows the user to predict in-hospital mortality risk for a patient if they have any subset of the variables in the final model.Two thousand one hundred and ninety-three patients in the Mi-COVID19 registry met our inclusion criteria. The derivation and validation sets ultimately included 1690 and 398 patients, respectively, with mortality rates of 19.6% and 18.6%, respectively. The average age of participants in the study after exclusions was 64 years old, and the participants were 48% female, 49% Black, and 87% non-Hispanic. Our final model includes the patient's age, first recorded respiratory rate, first recorded pulse oximetry, highest creatinine level on day of presentation, and hospital's COVID-19 mortality rate. No other factors showed sufficient incremental model improvement to warrant inclusion. The area under the receiver operating characteristics curve for the derivation and validation sets were .796 (95% confidence interval, .767-.826) and .829 (95% confidence interval, .782-.876) respectively.We conclude that the risk of in-hospital mortality in COVID-19 patients can be reliably estimated using a few factors, which are standardly measured and available to physicians very early in a hospital encounter.


Subject(s)
COVID-19/mortality , Hospital Mortality/trends , Age Factors , Aged , Aged, 80 and over , Body Mass Index , Comorbidity , Creatinine/blood , Female , Health Behavior , Humans , Logistic Models , Male , Michigan/epidemiology , Middle Aged , Oximetry , Prognosis , ROC Curve , Racial Groups , Retrospective Studies , Risk Assessment , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Socioeconomic Factors
10.
Viruses ; 14(12)2022 11 23.
Article in English | MEDLINE | ID: covidwho-2200865

ABSTRACT

Freshwater mussels (Unionida) are among the world's most imperiled taxa, but the relationship between freshwater mussel mortality events and infectious disease is largely unstudied. We surveyed viromes of a widespread and abundant species (mucket, Actinonaias ligamentina; syn: Ortmanniana ligamentina) experiencing a mortality event of unknown etiology in the Huron River, Michigan, in 2019-2020 and compared them to viromes from mucket in a healthy population in the St. Croix River, Wisconsin and a population from the Clinch River, Virginia and Tennessee, where a mortality event was affecting the congeneric pheasantshell (Actinonaias pectorosa; syn: Ortmanniana pectorosa) population. We identified 38 viruses, most of which were associated with mussels collected during the Huron River mortality event. Viral richness and cumulative viral read depths were significantly higher in moribund mussels from the Huron River than in healthy controls from each of the three populations. Our results demonstrate significant increases in the number and intensity of viral infections for freshwater mussels experiencing mortality events, whereas individuals from healthy populations have a substantially reduced virome comprising a limited number of species at low viral read depths.


Subject(s)
Bivalvia , Humans , Animals , Fresh Water , Rivers , Michigan , Wisconsin
11.
Sci Total Environ ; 864: 161152, 2023 Mar 15.
Article in English | MEDLINE | ID: covidwho-2165831

ABSTRACT

Wastewater-based epidemiology (WBE) has drawn great attention since the Coronavirus disease 2019 (COVID-19) pandemic, not only due to its capability to circumvent the limitations of traditional clinical surveillance, but also due to its potential to forewarn fluctuations of disease incidences in communities. One critical application of WBE is to provide "early warnings" for upcoming fluctuations of disease incidences in communities which traditional clinical testing is incapable to achieve. While intricate models have been developed to determine early warnings based on wastewater surveillance data, there is an exigent need for straightforward, rapid, broadly applicable methods for health departments and partner agencies to implement. Our purpose in this study is to develop and evaluate such early-warning methods and clinical-case peak-detection methods based on WBE data to mount an informed public health response. Throughout an extended wastewater surveillance period across Detroit, MI metropolitan area (the entire study period is from September 2020 to May 2022) we designed eight early-warning methods (three real-time and five post-factum). Additionally, we designed three peak-detection methods based on clinical epidemiological data. We demonstrated the utility of these methods for providing early warnings for COVID-19 incidences, with their counterpart accuracies evaluated by hit rates. "Hit rates" were defined as the number of early warning dates (using wastewater surveillance data) that captured defined peaks (using clinical epidemiological data) divided by the total number of early warning dates. Hit rates demonstrated that the accuracy of both real-time and post-factum methods could reach 100 %. Furthermore, the results indicate that the accuracy was influenced by approaches to defining peaks of disease incidence. The proposed methods herein can assist health departments capitalizing on WBE data to assess trends and implement quick public health responses to future epidemics. Besides, this study elucidated critical factors affecting early warnings based on WBE amid the COVID-19 pandemic.


Subject(s)
COVID-19 , Wastewater , Humans , Michigan/epidemiology , Pandemics , COVID-19/epidemiology , Wastewater-Based Epidemiological Monitoring , Data Collection
12.
JMIR Public Health Surveill ; 7(1): e21327, 2021 01 08.
Article in English | MEDLINE | ID: covidwho-2141283

ABSTRACT

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital-based outpatient clinic in one of the worst-hit areas in the world. OBJECTIVE: Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. METHODS: We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. RESULTS: During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. CONCLUSIONS: There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.


Subject(s)
Pandemics/prevention & control , Telemedicine/methods , Ambulatory Care/methods , COVID-19/complications , COVID-19/transmission , Humans , Michigan , Pandemics/statistics & numerical data , Patient Satisfaction , Prospective Studies , Retrospective Studies , Telemedicine/trends , Tertiary Care Centers/organization & administration , Tertiary Care Centers/trends
13.
MMWR Morb Mortal Wkly Rep ; 71(46): 1471-1478, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2119219

ABSTRACT

During the early stages of the COVID-19 pandemic, use of preventive behaviors was associated with perceived risk for contracting SARS-CoV-2 infection (1,2). Over time, perceived risk has declined along with waning COVID-19-related media coverage (3,4). The extent to which communities continue to be aware of local COVID-19 transmission levels and are implementing recommended preventive behaviors is unknown. During June 1-July 31, 2022, health departments in DuPage County, Illinois and metropolitan Detroit, Michigan surveyed a combined total of 4,934 adults who had received a positive test result for SARS-CoV-2 during the preceding 3 weeks. The association between awareness of local COVID-19 transmission and use of preventive behaviors and practices was assessed, both in response to perceived local COVID-19 transmission levels and specifically during the 2 weeks preceding SARS-CoV-2 testing. Both areas had experienced sustained high COVID-19 transmission during the study interval as categorized by CDC COVID-19 transmission levels.* Overall, 702 (14%) respondents perceived local COVID-19 transmission levels as high, 987 (20%) as substantial, 1,902 (39%) as moderate, and 581 (12%) as low; 789 (16%) reported they did not know. Adjusting for geographic area, age, gender identity, and combined race and ethnicity, respondents who perceived local COVID-19 transmission levels as high were more likely to report having made behavioral changes because of the level of COVID-19 transmission in their area, including wearing a mask in public, limiting travel, and avoiding crowded places or events. Continued monitoring of public perceptions of local COVID-19 levels and developing a better understanding of their influence on the use of preventive behaviors can guide COVID-19 communication strategies and policy making during and beyond the pandemic.


Subject(s)
COVID-19 , Adult , Humans , Female , Male , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , Michigan/epidemiology , COVID-19 Testing , SARS-CoV-2 , Gender Identity , Illinois/epidemiology , Perception
14.
Infect Control Hosp Epidemiol ; 42(4): 392-398, 2021 04.
Article in English | MEDLINE | ID: covidwho-2096426

ABSTRACT

OBJECTIVE: The seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG antibody was evaluated among employees of a Veterans Affairs healthcare system to assess potential risk factors for transmission and infection. METHODS: All employees were invited to participate in a questionnaire and serological survey to detect antibodies to SARS-CoV-2 as part of a facility-wide quality improvement and infection prevention initiative regardless of clinical or nonclinical duties. The initiative was conducted from June 8 to July 8, 2020. RESULTS: Of the 2,900 employees, 51% participated in the study, revealing a positive SARS-CoV-2 seroprevalence of 4.9% (72 of 1,476; 95% CI, 3.8%-6.1%). There were no statistically significant differences in the presence of antibody based on gender, age, frontline worker status, job title, performance of aerosol-generating procedures, or exposure to known patients with coronavirus infectious disease 2019 (COVID-19) within the hospital. Employees who reported exposure to a known COVID-19 case outside work had a significantly higher seroprevalence at 14.8% (23 of 155) compared to those who did not 3.7% (48 of 1,296; OR, 4.53; 95% CI, 2.67-7.68; P < .0001). Notably, 29% of seropositive employees reported no history of symptoms for SARS-CoV-2 infection. CONCLUSIONS: The seroprevalence of SARS-CoV-2 among employees was not significantly different among those who provided direct patient care and those who did not, suggesting that facility-wide infection control measures were effective. Employees who reported direct personal contact with COVID-19-positive persons outside work were more likely to have SARS-CoV-2 antibodies. Employee exposure to SARS-CoV-2 outside work may introduce infection into hospitals.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , SARS-CoV-2 , Seroepidemiologic Studies , United States Department of Veterans Affairs/statistics & numerical data , Adolescent , Adult , COVID-19/etiology , Female , Humans , Male , Michigan/epidemiology , Middle Aged , Occupational Exposure/statistics & numerical data , Risk Factors , United States/epidemiology , Young Adult
16.
Am J Ind Med ; 65(12): 994-1005, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2047437

ABSTRACT

OBJECTIVES: Fragmented industry and occupation surveillance data throughout the COVID-19 pandemic has left public health practitioners and organizations with an insufficient understanding of high-risk worker groups and the role of work in SARS-CoV-2 transmission. METHODS: We drew sequential probability samples of noninstitutionalized adults (18+) in the Michigan Disease Surveillance System with COVID-19 onset before November 16, 2020 (N = 237,468). Among the 6000 selected, 1839 completed a survey between June 23, 2020, and April 23, 2021. We compared in-person work status, source of self-reported SARS-CoV-2 exposure, and availability of adequate personal protective equipment (PPE) by industry and occupation using weighted descriptive statistics and Rao-Scott χ2 tests. We identified industries with a disproportionate share of COVID-19 infections by comparing our sample with the total share of employment by industry in Michigan using 2020 data from the US Bureau of Labor Statistics. RESULTS: Employed respondents (n = 1244) were predominantly female (53.1%), aged 44 and under (54.4%), and non-Hispanic White (64.0%). 30.4% of all employed respondents reported work as the source of their SARS-CoV-2 exposure and 78.8% were in-person workers. Work-related exposure was prevalent in Nursing and Residential Care Facilities (65.2%); Justice, Public Order, and Safety Activities (63.3%); and Food Manufacturing (57.5%). By occupation, work-related exposure was highest among Protective Services (57.9%), Healthcare Support (56.5%), and Healthcare Practitioners (51.9%). Food Manufacturing; Nursing and Residential Care; and Justice, Public Order, and Safety Activities were most likely to report having adequate PPE "never" or "rarely" (36.4%, 27.9%, and 26.7%, respectively). CONCLUSIONS: Workplaces were a key source of self-reported SARS-CoV-2 exposure among employed Michigan residents during the first year of the pandemic. To prevent transmission, there is an urgent need in public health surveillance for the collection of industry and occupation data of people infected with COVID-19, as well as for future airborne infectious diseases for which we have little understanding of risk factors.


Subject(s)
COVID-19 , Personal Protective Equipment , Adult , Female , Humans , Male , COVID-19/epidemiology , Pandemics/prevention & control , SARS-CoV-2 , Self Report , Michigan/epidemiology , Occupations , Health Personnel
17.
PLoS One ; 17(9): e0273638, 2022.
Article in English | MEDLINE | ID: covidwho-2043200

ABSTRACT

BACKGROUND: The COVID-19 pandemic has severely impacted healthcare delivery and patient outcomes globally. AIMS: We aimed to evaluate the influence of the COVID-19 pandemic on the temporal trends and outcomes of patients undergoing percutaneous coronary intervention (PCI) in Michigan. METHODS: We compared all patients undergoing PCI in the BMC2 Registry between March and December 2020 ("pandemic cohort") with those undergoing PCI between March and December 2019 ("pre-pandemic cohort"). A risk-adjusted analysis of in-hospital outcomes was performed between the pre-pandemic and pandemic cohort. A subgroup analysis was performed comparing COVID-19 positive vs. negative patients during the pandemic. RESULTS: There was a 15.2% reduction in overall PCI volume from the pre-pandemic (n = 25,737) to the pandemic cohort (n = 21,822), which was more pronounced for stable angina and non-ST-elevation acute coronary syndromes (ACS) presentations, and between February and May 2020. Patients in the two cohorts had similar clinical and procedural characteristics. Monthly mortality rates for primary PCI were generally higher in the pandemic period. There were no significant system delays in care between the cohorts. Risk-adjusted mortality was higher in the pandemic cohort (aOR 1.26, 95% CI 1.07-1.47, p = 0.005), a finding that was only partially explained by worse outcomes in COVID-19 patients and was more pronounced in subjects with ACS. During the pandemic, COVID-19 positive patients suffered higher risk-adjusted mortality (aOR 5.69, 95% CI 2.54-12.74, p<0.001) compared with COVID negative patients. CONCLUSIONS: During the COVID-19 pandemic, we observed a reduction in PCI volumes and higher risk-adjusted mortality. COVID-19 positive patients experienced significantly worse outcomes.


Subject(s)
Acute Coronary Syndrome , COVID-19 , Percutaneous Coronary Intervention , COVID-19/epidemiology , Humans , Michigan/epidemiology , Pandemics , Percutaneous Coronary Intervention/adverse effects , Registries , Treatment Outcome
18.
Spat Spatiotemporal Epidemiol ; 43: 100536, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2004538

ABSTRACT

COVID-19's rapid onset left many public health entities scrambling. But establishing community-academic partnerships to digest data and create advocacy steps offers an opportunity to link research to action. Here we document disparities in COVID-19 death uncovered during a collaboration between a health department and university research center. We geocoded COVID-19 deaths in Genesee County, Michigan, to model clusters during two waves in spring and fall 2020. We then aggregated these deaths to census block groups, where group-based trajectory modeling identified latent patterns of change and continuity. Linking with socioeconomic data, we identified the most affected communities. We discovered a geographic and racial gap in COVID-19 deaths during the first wave, largely eliminated during the second. Our partnership generated added and immediate value for community partners, including around prevention, testing, treatment, and vaccination. Our identification of the aforementioned racial disparity helped our community nearly eliminate disparities during the second wave.


Subject(s)
COVID-19 , Humans , Michigan/epidemiology , Seasons
19.
Policy Polit Nurs Pract ; 23(4): 249-258, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1986696

ABSTRACT

By enacting administrative rule 325.176 (12), Michigan added a vaccine education component as a precondition to granting vaccine waivers to vaccine-hesitant parents wishing to file a nonmedical vaccine exemption for their school-aged child. The purpose of the study was to identify best practices for reaching vaccine-hesitant parents during face-to-face vaccine education sessions conducted by vaccine waiver educators in Michigan. This study utilized qualitative descriptive content analysis of semi-structured phone interviews with vaccine waiver educators from local health departments (LHDs) in Michigan. Participants were vaccine waiver educators who were employed by a local health department in Michigan and had conducted at least 30 vaccine waiver education sessions. Strategies, resources, and techniques identified by educators as beneficial included using and providing information from a variety of sources, compiling their own educational materials, creating a positive experience, holding personalized sessions, and streamlining exemption and vaccination sessions. However, unexpected themes that emerged from the interviews revealed that vaccine waiver educators need additional training in discussing vaccine ingredients with parents, handling religious vaccine exemption requests, and assessing the role of schools. Implementing successful vaccine education interventions targeting vaccine-hesitancy is crucial to public health. Charging LHDs with overseeing vaccine education via a face-to-face discussion is a novel intervention strategy, the effective implementation of which may inform vaccine education intervention nationwide and may even be translated into international contexts and prove useful to current COVID-19 vaccination efforts.


Subject(s)
COVID-19 , Vaccines , Child , Humans , Michigan , COVID-19 Vaccines , Vaccination , Parents/education
20.
Vet Anaesth Analg ; 49(6): 580-588, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1984186

ABSTRACT

OBJECTIVE: To determine the effects of the COVID-19 associated restrictions on the ability of owners in Michigan (MI), USA versus Ontario (ON) and British Columbia (BC), Canada, to obtain care for their chronically painful dogs. STUDY DESIGN: Cross-sectional survey. POPULATION: A total of 90 owners met the inclusion criteria for the study. METHODS: An anonymous electronic survey was distributed to owners at four veterinary integrative medicine (IM) clinics during July and August 2020. Two clinics in MI and one each in ON and BC were recruited. Owners were asked about availability of IM care preceding and during COVID-19 restrictions and their opinions of the impact of COVID-19 on their dog's health. The survey asked where owners sought care for their dogs, types of chronic conditions treated, therapeutic modalities used, and if owners had a medical background. Comparisons were made within and between groups. Thematic analysis, Fisher's exact test, chi-square analyses, McNemar's and Wilcoxon signed-rank tests for paired comparisons were performed (p < 0.05). RESULTS: During COVID-19 restrictions, access to IM care was better for dogs in ON and BC than in MI (p < 0.001). The negative effect of the pandemic restrictions to IM care on quality of life was perceived greater by owners in MI than those in ON and BC (p < 0.001). The owners' medical backgrounds had no effect on attempts to access care during this time (p = 0.76). CONCLUSIONS AND CLINICAL RELEVANCE: The results suggest that a widespread disease in humans had an adverse impact on animal welfare. Providers of veterinary care should use this experience to establish protocols to ensure continuity of care for chronically painful animals in the event of a similar situation in the future.


Subject(s)
COVID-19 , Dog Diseases , Veterinary Medicine , Animals , Dogs , Humans , British Columbia , Cross-Sectional Studies , Dog Diseases/therapy , Michigan , Ontario , Quality of Life , Surveys and Questionnaires , Health Services Accessibility/statistics & numerical data , Veterinary Medicine/statistics & numerical data , Social Control Policies/legislation & jurisprudence , Social Control Policies/statistics & numerical data , Pain/prevention & control , Pain/veterinary
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