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1.
Int J Equity Health ; 21(1): 48, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1785154

ABSTRACT

BACKGROUND: The COVID-19 pandemic has shed new light on inequities in healthcare access faced by immigrant and refugee communities. To address ongoing disparities, there is an urgent need for ecological approaches to better understand the barriers that hinder and resources that facilitate access to healthcare. This study investigates barriers to healthcare system access faced by Yazidi refugees in the Midwestern United States. METHODS: Informed by the Interpretative Phenomenological Approach, three focus group meetings with a community advisory board were conducted between September 2019 and January 2020. The nine-member focus group included social workers, healthcare providers, and members of the Yazidi community. Meeting recordings were transcribed into English, coded for themes, and validated. RESULTS: We describe themes related to specific barriers to healthcare access; analyze the influence of relational dynamics in the focus group; explore experiential themes related to healthcare access in the Yazidi community, and finally interpret our findings through a social-ecological lens. CONCLUSION: Community agencies, healthcare organizations, policymakers, and other stakeholders must work together to develop strategies to reduce systemic barriers to equitable care. Community representation in priority-setting and decision-making is essential to ensure relevance, acceptability, and utilization of developed strategies.


Subject(s)
COVID-19 , Refugees , Health Services Accessibility , Humans , Midwestern United States , Pandemics , Qualitative Research
2.
J Pediatr Psychol ; 47(3): 270-278, 2022 03 05.
Article in English | MEDLINE | ID: covidwho-1707611

ABSTRACT

OBJECTIVE: To explore the impact of the COVID-19 pandemic on Black adolescent girls' physical, psychological, and sexual development. METHODS: Semistructured interviews were conducted with 25 girls (9-18 years old) primarily across the Midwestern United States. Interviews were conducted until theoretical saturation was reached. We conducted a conventional content analysis by reviewing transcripts, coding data, and developing themes. RESULTS: Utilizing the social-ecological model findings revealed themes related to the individual-, interpersonal-, institutional-, and community-level changes that Black girls experienced during the COVID-19 pandemic. CONCLUSIONS: Black adolescent girls need opportunities to discuss the changes, receive relevant resources, and have spaces to support their physical, psychological, and sexual development. Systems such as families, schools, and clinics should implement programming to facilitate discussions around the impact of COVID-19 on Black girls.


Subject(s)
COVID-19 , Adolescent , Child , Female , Humans , Midwestern United States , Pandemics , SARS-CoV-2
3.
J Clin Sleep Med ; 18(5): 1225-1234, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1626869

ABSTRACT

STUDY OBJECTIVES: Cultural sleep practices and COVID-19 mitigation strategies vary worldwide. The sleep of infants and toddlers during the COVID-19 pandemic in the United States is understudied. METHODS: Caregivers of children aged < 3 years responded to a cross-sectional survey during 2020 (divided into quarters, with the year quarter 1 being largely prelockdown). We assessed the global effect of year quarter on parent-reported total sleep time (hours) and sleep onset latency (hours) using an analysis of variance. We used multivariable linear regression to assess the adjusted effect of year quarter on total sleep time, sleep onset latency, and parental frustration. We used logistic regression to assess the adjusted effect of year quarter on nap consistency. RESULTS: Of 594 children, the mean age was 18.5 ± 9.7 months; 52% were female. In the adjusted analyses, the reference categories were as follows: quarter 1 (year quarter), ≤ 6 months (age category), and < $25,000 (annual household income). Total sleep time was associated with age category (ages 12 to ≤ 24 months: ß = -2.86; P = .0004; ages 24 to ≤ 36 months: ß = -3.25; P < .0001) and maternal age (ß = -0.04; P = .05). Sleep onset latency was associated with year quarter (year quarter 3: ß = 0.16; P = .04), age category (ages 24 to ≤ 36 months: ß = 0.28; P < .0001), annual household income ($100,000-$150,000: ß = -0.15; P = .03; > $150,000: ß = -0.19; P = .01), and lack of room-sharing (ß = -0.09; P = .05). Parental frustration with sleep increased with age (all P < .05) and lack of room-sharing (P = .01). The effect of lack of room-sharing on nap consistency approached significance (adjusted odds ratio, 1.88; 95% confidence interval, 0.95-3.72). CONCLUSIONS: Social factors such as lower household income and room-sharing affected the sleep of U.S. infants and toddlers as opposed to the COVID-19 lockdown itself. CITATION: Gupta G, O'Brien LM, Dang LT, Shellhaas RA. Sleep of infants and toddlers during 12 months of the COVID-19 pandemic in the midwestern United States. J Clin Sleep Med. 2022;18(5):1225-1234.


Subject(s)
COVID-19 , Child, Preschool , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , Infant , Male , Midwestern United States/epidemiology , Pandemics , Sleep , United States/epidemiology
4.
Viruses ; 14(2)2022 01 19.
Article in English | MEDLINE | ID: covidwho-1625724

ABSTRACT

Bats are a reservoir for coronaviruses (CoVs) that periodically spill over to humans, as evidenced by severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2. A collection of 174 bat samples originating from South Dakota, Minnesota, Iowa, and Nebraska submitted for rabies virus testing due to human exposure were analyzed using a pan-coronavirus PCR. A previously partially characterized CoV, Eptesicus bat CoV, was identified in 12 (6.9%) samples by nested RT-PCR. Six near-complete genomes were determined. Genetic analysis found a high similarity between all CoV-positive samples, Rocky Mountain bat CoV 65 and alphacoronavirus HCQD-2020 recently identified in South Korea. Phylogenetic analysis of genome sequences showed EbCoV is closely related to bat CoV HKU2 and swine acute diarrhea syndrome CoV; however, topological incongruences were noted for the spike gene that was more closely related to porcine epidemic diarrhea virus. Similar to some alphaCoVs, a novel gene, ORF7, was discovered downstream of the nucleocapsid, whose protein lacked similarity to known proteins. The widespread circulation of EbCoV with similarities to bat viruses that have spilled over to swine warrants further surveillance.


Subject(s)
Alphacoronavirus/classification , Alphacoronavirus/genetics , Chiroptera/virology , Disease Reservoirs/veterinary , Disease Reservoirs/virology , Phylogeny , Alphacoronavirus/isolation & purification , Animals , Genome, Viral , Iowa , Midwestern United States , Minnesota , Republic of Korea , Sequence Analysis, DNA , South Dakota , Viral Zoonoses/transmission
5.
PLoS One ; 16(12): e0261704, 2021.
Article in English | MEDLINE | ID: covidwho-1613355

ABSTRACT

This pilot project investigated environmental SARS-CoV-2 presence in seven Midwestern meatpacking plants from May 2020 to January 2021. This study investigated social distancing and infection control practices and incorporated environmental sampling of surfaces and air in employee common areas. All plants increased their social distancing efforts, increased the frequency of cleaning and disinfecting worker areas, and screened for symptomatic people to prevent entry into the workplace. 575 samples from common areas were collected and evaluated with RT-qPCR for the presence of SARS-CoV-2. 42/367 surface samples were positive, while no virus was detected in air samples. Case positive data from the counties surrounding each plant showed peak positive SARS-CoV-2 cases from 12-55 days before the virus was detected in the plant, indicating that environmental sampling is likely a lagging indicator of community and plant infection.


Subject(s)
COVID-19/epidemiology , Environmental Monitoring/statistics & numerical data , Meat-Packing Industry/statistics & numerical data , Disinfection/statistics & numerical data , Humans , Midwestern United States/epidemiology , Physical Distancing , Pilot Projects
6.
BMC Public Health ; 21(1): 2076, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1526610

ABSTRACT

BACKGROUND: This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States. METHODS: Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables. RESULTS: High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms. CONCLUSIONS: Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.


Subject(s)
Musculoskeletal Diseases , Occupational Diseases , Occupational Stress , Aged , Cross-Sectional Studies , Farmers , Farms , Humans , Midwestern United States/epidemiology , Risk Factors , Surveys and Questionnaires , United States/epidemiology
8.
Nursing ; 51(10): 42-48, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1440657

ABSTRACT

ABSTRACT: Patient safety attendants (PSAs) provide constant direct observation to patients who have cognitive impairments or thoughts. Some estimates report that an acute care hospital in the United States may spend more than $1 million annually on PSAs, an expenditure often not reimbursed. With no national defined standards to regulate or monitor PSA use, this study sought to determine the impact of COVID-19 on a PSA reduction program in a large Midwestern healthcare system.


Subject(s)
Allied Health Personnel/statistics & numerical data , COVID-19/epidemiology , Patient Safety , Allied Health Personnel/economics , Cognitive Dysfunction/nursing , Humans , Midwestern United States/epidemiology , Program Evaluation
9.
Med Care ; 59(10): 888-892, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1337299

ABSTRACT

BACKGROUND: Despite many studies reporting disparities in coronavirus disease-2019 (COVID-19) incidence and outcomes in Black and Hispanic/Latino populations, mechanisms are not fully understood to inform mitigation strategies. OBJECTIVE: The aim was to test whether neighborhood factors beyond individual patient-level factors are associated with in-hospital mortality from COVID-19. We hypothesized that the Area Deprivation Index (ADI), a neighborhood census-block-level composite measure, was associated with COVID-19 mortality independently of race, ethnicity, and other patient factors. RESEARCH DESIGN: Multicenter retrospective cohort study examining COVID-19 in-hospital mortality. SUBJECTS: Inclusion required hospitalization with positive SARS-CoV-2 test or COVID-19 diagnosis at three large Midwestern academic centers. MEASURES: The primary study outcome was COVID-19 in-hospital mortality. Patient-level predictors included age, sex, race, insurance, body mass index, comorbidities, and ventilation. Neighborhoods were examined through the national ADI neighborhood deprivation rank comparing in-hospital mortality across ADI quintiles. Analyses used multivariable logistic regression with fixed site effects. RESULTS: Among 5999 COVID-19 patients median age was 61 (interquartile range: 44-73), 48% were male, 30% Black, and 10.8% died. Among patients who died, 32% lived in the most disadvantaged quintile while 11% lived in the least disadvantaged quintile; 52% of Black, 24% of Hispanic/Latino, and 8.5% of White patients lived in the most disadvantaged neighborhoods.Living in the most disadvantaged neighborhood quintile predicted higher mortality (adjusted odds ratio: 1.74; 95% confidence interval: 1.13-2.67) independent of race. Age, male sex, Medicare coverage, and ventilation also predicted mortality. CONCLUSIONS: Neighborhood disadvantage independently predicted in-hospital COVID-19 mortality. Findings support calls to consider neighborhood measures for vaccine distribution and policies to mitigate disparities.


Subject(s)
COVID-19/epidemiology , Hospital Mortality/trends , Residence Characteristics/statistics & numerical data , Age Factors , COVID-19 Testing , Comorbidity , Humans , Insurance, Health/statistics & numerical data , Male , Middle Aged , Midwestern United States/epidemiology , Poverty/statistics & numerical data , Retrospective Studies , Sex Factors
10.
J Occup Environ Med ; 63(5): 374-380, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1301396

ABSTRACT

OBJECTIVE: Determine the industries with the highest proportion of accepted COVID-19 related workers' compensation (WC) claims. METHODS: Study included 21,336 WC claims (1898 COVID-19 and 19,438 other claims) that were filed between January 1, 2020 and August 31, 2020 from 11 states in the Midwest United States. RESULT: The overwhelming proportion of all COVID-19 related WC claims submitted and accepted were from healthcare workers (83.77%). Healthcare was the only industrial classification that was at significantly higher COVID-19 WC claim submission risk (odds ratio [OR]: 4.00; 95% confidence intervals [CI]: 2.77 to 5.79) controlling for type of employment, sex, age, and presumption of COVID-19 work-relatedness. Within healthcare employment, WC claims submitted by workers in medical laboratories had the highest risk (crude rate ratio of 8.78). CONCLUSION: Healthcare employment is associated with an increased risk of developing COVID-19 infections and submitting a workers' compensation claim.


Subject(s)
COVID-19/economics , Health Personnel/classification , Industry/classification , Occupational Diseases/economics , Workers' Compensation/statistics & numerical data , Adult , Aged , Female , Health Personnel/statistics & numerical data , Humans , Industry/statistics & numerical data , Male , Medical Laboratory Personnel/statistics & numerical data , Middle Aged , Midwestern United States/epidemiology , Odds Ratio , SARS-CoV-2
11.
Mayo Clin Proc ; 96(10): 2528-2539, 2021 10.
Article in English | MEDLINE | ID: covidwho-1294052

ABSTRACT

OBJECTIVE: To identify risk factors associated with severe COVID-19 infection in a defined Midwestern US population overall and within different age groups. PATIENTS AND METHODS: We used the Rochester Epidemiology Project research infrastructure to identify persons residing in a defined 27-county Midwestern region who had positive results on polymerase chain reaction tests for COVID-19 between March 1, 2020, and September 30, 2020 (N=9928). Age, sex, race, ethnicity, body mass index, smoking status, and 44 chronic disease categories were considered as possible risk factors for severe infection. Severe infection was defined as hospitalization or death caused by COVID-19. Associations between risk factors and severe infection were estimated using Cox proportional hazard models overall and within 3 age groups (0 to 44, 45 to 64, and 65+ years). RESULTS: Overall, 474 (4.8%) persons developed severe COVID-19 infection. Older age, male sex, non-White race, Hispanic ethnicity, obesity, and a higher number of chronic conditions were associated with increased risk of severe infection. After adjustment, 36 chronic disease categories were significantly associated with severe infection. The risk of severe infection varied significantly across age groups. In particular, persons 0 to 44 years of age with cancer, chronic neurologic disorders, hematologic disorders, ischemic heart disease, and other endocrine disorders had a greater than 3-fold increased risk of severe infection compared with persons of the same age without those conditions. Associations were attenuated in older age groups. CONCLUSION: Older persons are more likely to experience severe infections; however, severe cases occur in younger persons as well. Our data provide insight regarding younger persons at especially high risk of severe COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Health Status Disparities , Severity of Illness Index , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Chronic Disease/epidemiology , Comorbidity , Humans , Infant , Male , Middle Aged , Midwestern United States , Risk Factors , Young Adult
12.
Mycopathologia ; 186(4): 499-505, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1274891

ABSTRACT

Pulmonary aspergillosis has been reported at high rates in patients with coronavirus disease 2019 (COVID-19) and is associated with high morbidity and mortality. We retrospectively assessed all patients admitted to an intensive care unit during the early COVID-19 surge (3/17/20-5/10/20) at our medical center in the midwestern USA for the presence of COVID-19-associated pulmonary aspergillosis (CAPA). Patients were not routinely screened for CAPA; diagnostic work-up for fungal infections was pursued when clinically indicated. Among 256 patients admitted to the ICU with severe COVID-19, 188 (73%) were intubated and 62 (24%) ultimately expired within 30 days of admission to the ICU. Only three patients (1%) were found to have CAPA; diagnosis was made by tracheal aspirate cultures in two cases and by bronchoalveolar lavage fluid Aspergillus galactomannan in one case. None of the patients who developed CAPA had classic risk factors for invasive fungal infection. The occurrence of CAPA was much lower than that reported at other centers, likely reflecting the local epidemiology.


Subject(s)
COVID-19 , Pulmonary Aspergillosis , Academic Medical Centers , Adult , Aged , Aged, 80 and over , COVID-19/complications , Female , Humans , Intensive Care Units , Male , Middle Aged , Midwestern United States/epidemiology , Pulmonary Aspergillosis/diagnosis , Pulmonary Aspergillosis/epidemiology , Retrospective Studies , Young Adult
13.
PLoS One ; 16(6): e0243676, 2021.
Article in English | MEDLINE | ID: covidwho-1264208

ABSTRACT

Since March 2020, the United States has lost over 580,000 lives to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. A growing body of literature describes population-level SARS-CoV-2 exposure, but studies of antibody seroprevalence within school systems are critically lacking, hampering evidence-based discussions on school reopenings. The Lake Central School Corporation (LCSC), a public school system in suburban Indiana, USA, assessed SARS-CoV-2 seroprevalence in its staff and identified correlations between seropositivity and subjective histories and demographics. This study is a cross-sectional, population-based analysis of the seroprevalence of SARS-CoV-2 in LCSC staff measured in July 2020. We tested for seroprevalence with the Abbott Alinity™ SARS-CoV-2 IgG antibody test. The primary outcome was the total seroprevalence of SARS-CoV-2, and secondary outcomes included trends of antibody presence in relation to baseline attributes. 753 participants representative of the staff at large were enrolled. 22 participants (2.9%, 95% CI: 1.8% - 4.4%) tested positive for SARS-CoV-2 antibodies. Correcting for test performance parameters, the seroprevalence is estimated at 1.7% (90% Credible Interval: 0.27% - 3.3%). Multivariable logistic regression including mask wearing, travel history, symptom history, and contact history revealed a 48-fold increase in the odds of seropositivity if an individual previously tested positive for COVID-19 (OR: 48, 95% CI: 4-600). Amongst individuals with no previous positive test, exposure to a person diagnosed with COVID-19 increased the odds of seropositivity by 7-fold (OR: 7.2, 95% CI: 2.6-19). Assuming the presence of antibodies is associated with immunity against SARS-CoV-2 infection, these results demonstrate a broad lack of herd immunity amongst the school corporation's staff irrespective of employment role or location. Protective measures like contact tracing, face coverings, and social distancing are therefore vital to maintaining the safety of both students and staff as the school year progresses.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , School Teachers , Schools , Adolescent , Adult , Aged , Antibodies, Viral/blood , Antibodies, Viral/immunology , COVID-19/blood , COVID-19/immunology , COVID-19 Serological Testing , Cross-Sectional Studies , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Middle Aged , Midwestern United States/epidemiology , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Seroepidemiologic Studies , Young Adult
14.
Nutrients ; 13(6)2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1259555

ABSTRACT

During COVID-19 restrictions in spring 2020, college students experienced closed dormitories and increased unemployment and many students moved in with their families. College students were vulnerable to food insecurity pre-pandemic and this study examined how the living situations and food security status changed for Midwestern university students due to COVID-19 restrictions. An email survey administered to Iowa State University students between the ages of 18 and 30 who physically attended campus prior to its closure produced 1434 responses. Students living with a parent or guardian increased by 44% and were less likely to experience food insecurity or less likely to work. They had lower stress and ate more home-cooked meals. Students living on their own had higher rates of food insecurity, greater stress, poorer health status, higher cooking self-efficacy, and worked more hours. Seventeen percent of all students were food insecure; related factors were non-White ethnicity, lower cooking self-efficacy, undergraduate status, receipt of financial aid, employment, stress, living in the same situation as before the campus closure, and consumption of more take-out or fast food. These individuals had more barriers to food access. Knowledge of these factors provide useful information to inform future support services for this population in similar conditions.


Subject(s)
COVID-19 , Communicable Disease Control , Food Security , Pandemics , Residence Characteristics , Students , Universities , Adolescent , Adult , Cooking , Cross-Sectional Studies , Employment , Family , Fast Foods , Feeding Behavior , Female , Health Status , Humans , Male , Midwestern United States , Socioeconomic Factors , Stress, Psychological , Students/psychology , Surveys and Questionnaires , Young Adult
16.
Psychiatry Res ; 302: 114034, 2021 08.
Article in English | MEDLINE | ID: covidwho-1244805

ABSTRACT

Given concerns of increased suicide risk among university students during the COVID-19 pandemic, this study examined rates of lifetime and past-year suicidal ideation (SI) among university students in Fall 2020 (vs. two earlier semesters), overall and across gender, racial/ethnic background, and sexual identity. Participants included 1700 university students enrolled in a general education psychology course in Fall 2020, Fall 2014, or Fall 2013. Rates of SI were not significantly higher in Fall 2020 versus the earlier semesters and did not differ across racial/ethnic background. However, rates of SI in Fall 2020 were significantly higher among sexual minority than heterosexual students.


Subject(s)
COVID-19/psychology , Pandemics , Students/psychology , Suicidal Ideation , Adolescent , COVID-19/epidemiology , /statistics & numerical data , Female , Humans , Male , Midwestern United States/epidemiology , /statistics & numerical data , Risk Factors , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
17.
Int J Eat Disord ; 54(7): 1213-1223, 2021 07.
Article in English | MEDLINE | ID: covidwho-1196375

ABSTRACT

OBJECTIVE: This study tested the association between food insecurity and eating disorder (ED) pathology, including probable ED diagnosis, among two cohorts of university students before and during the beginning of the COVID-19 pandemic. METHOD: Students (n = 579) from a large Midwestern American university completed self-report questionnaires assessing frequency of ED behaviors, ED-related impairment, and individual food insecurity as measured by the Eating Disorder Diagnostic Scale 5, Clinical Impairment Assessment, and Radimer/Cornell, respectively. Chi-square tests and MANOVA with post-hoc corrections were conducted to compare demographic characteristics, ED pathology, and probable ED diagnosis prevalence between students with and without individual food insecurity. RESULTS: Partially supporting hypotheses, MANOVA indicated significantly greater frequency of objective binge eating, compensatory fasting, and ED-related impairment for students with food insecurity compared with individuals without food insecurity. Chi-squared tests showed higher prevalence of ED diagnoses among individuals with food insecurity compared with those without food security (47.6 vs. 31.1%, respectively, p < .01, NNT = 6.06), specifically bulimia nervosa and other specified feeding and eating disorder. There were no differences in food insecurity before or during the beginning of the COVID-19 pandemic. DISCUSSION: Consistent with prior literature, food insecurity was associated with elevated ED psychopathology in this sample. Findings emphasize the importance of proper ED screening for college students vulnerable to food insecurity and EDs.


Subject(s)
COVID-19/epidemiology , Feeding and Eating Disorders/epidemiology , Food Insecurity , Pandemics , Students/psychology , Adolescent , Adult , Cohort Studies , Feeding and Eating Disorders/diagnosis , Female , Humans , Male , Midwestern United States/epidemiology , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
18.
J Prim Care Community Health ; 12: 21501327211010991, 2021.
Article in English | MEDLINE | ID: covidwho-1186538

ABSTRACT

OBJECTIVE: To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19. PATIENTS AND METHODS: A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020. RESULTS: Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score. CONCLUSION: In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.


Subject(s)
COVID-19/epidemiology , Databases, Factual , Adult , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Female , Humans , Male , Middle Aged , Midwestern United States/epidemiology , Multimorbidity , Retrospective Studies , Risk Factors , SARS-CoV-2 , Young Adult
19.
Public Health Rep ; 136(3): 361-367, 2021 05.
Article in English | MEDLINE | ID: covidwho-1119365

ABSTRACT

OBJECTIVES: Increased exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a result of having an essential job is compounded by factors such as age, race, and ethnicity. We used a cross-sectional study design to describe disparities in the seroprevalence of SARS-CoV-2 immunoglobulin G (IgG) test results by demographic characteristics and clinical roles among a cohort of health care workers employed by the largest Midwestern health care system in the United States. METHODS: We collected 16 233 SARS-CoV-2 IgG serum samples from June 8 through July 10, 2020, from a convenience sample of Illinois- and Wisconsin-based adult health care workers. The research team, in collaboration with ACL Laboratories, used a SARS-CoV-2 IgG assay to detect the presence of SARS-CoV-2 IgG antibodies. Study data included SARS-CoV-2 IgG assay results and demographic characteristics of workers (age, sex, race, ethnicity, clinical role, zip code). We generated crude and adjusted odds ratios (ORs) to describe disparities in seroprevalence distribution among demographic and social factors. RESULTS: Of 16 233 IgG serum samples tested, 622 (3.8%) test results were positive for SARS-CoV-2. We found significant disparities in SARS-CoV-2 positivity by age, race, ethnicity, and clinical role. Participants aged 32-82 had lower adjusted ORs (aORs) of positive IgG than participants aged 18-31 (aOR range, 0.54-0.66). Odds of positivity were higher among Black (aOR = 3.86), Asian (aOR = 1.42), and mixed-race (aOR = 1.99) workers than among White workers; among Hispanic workers (aOR = 1.80) than among non-Hispanic workers; and among coronavirus disease 2019 (COVID-19) clinical workers (aOR = 1.86) than among nonclinical workers. CONCLUSIONS: Public health efforts should focus on increasing COVID-19 safety messaging, testing, vaccination, and other prevention efforts for people who are young, non-White, Hispanic, and working in COVID-19-clinical units.


Subject(s)
COVID-19 Serological Testing , COVID-19/diagnosis , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Immunoglobulin G/blood , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Delivery of Health Care , Female , Humans , Male , Middle Aged , Midwestern United States/epidemiology , Race Factors , Seroepidemiologic Studies , Young Adult
20.
Soc Sci Med ; 272: 113743, 2021 03.
Article in English | MEDLINE | ID: covidwho-1071942

ABSTRACT

Community responses to the SARS-CoV-2, or "coronavirus" outbreaks of 2020 reveal a great deal about society. In the absence of government mandates, debates over issues such as mask mandates and social distancing activated conflicting moral beliefs, dividing communities. Policy scholars argue that such controversies represent fundamental frame conflicts, which arise from incommensurable worldviews, such as contested notions of "liberty" versus "equity". This article investigates frames people constructed to make sense of coronavirus and how this affected social behavior in 2020. We conducted an interpretive framing analysis using ethnographic data from a predominately white, conservative, and rural midwestern tourist town in the United States from June to August 2020. We collected semi-structured interviews with 87 community members, observed meetings, events, and daily life. We identified four frames that individuals constructed to make sense of coronavirus: Concern, Crisis, Constraint, and Conspiracy. Concern frames illustrated how some individuals are uniquely affected and thus protect themselves. Crisis frames recognized coronavirus as a pervasive and profound threat requiring unprecedented action. Constraint frames emphasized the coronavirus response as a threat to financial stability and personal growth that should be resisted. Conspiracy frames denied its biological basis and did not compel action. These four conflicting frames demonstrate how social fragmentation, based on conflicting values, led to an incomplete pandemic response in the absence of government mandates at the national, state, and local levels in rural America. These findings provide a social rationale for public health mandates, such as masking, school/business closures, and social distancing, when contested beliefs impede collective action.


Subject(s)
COVID-19/psychology , Health Knowledge, Attitudes, Practice , Pandemics , Rural Population , COVID-19/prevention & control , Communicable Disease Control , Humans , Midwestern United States
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