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1.
Int J Environ Res Public Health ; 19(6)2022 03 16.
Article in English | MEDLINE | ID: covidwho-1742470

ABSTRACT

Grocery workers were essential to the workforce and exempt from lockdown requirements as per Minnesota Executive Order 20-20. The risk of COVID-19 transmission in grocery settings is not well documented. This study aimed to determine which factors influenced seropositivity among grocery workers. We conducted a cross-sectional study of Minnesota grocery workers aged 18 and older using a convenience sample. Participants were recruited using a flyer disseminated electronically via e-mail, social media, and newspaper advertising. Participants were directed to an electronic survey and were asked to self-collect capillary blood for IgG antibody testing. Data were analyzed using logistic regression and adjusted for urbanicity, which confounded the relationship between number of job responsibilities in a store and seropositivity. Of 861 Minnesota grocery workers surveyed, 706 (82%) were tested as part of this study, of which 56 (7.9%) tested positive for IgG antibodies. Participants aged 65-74 years had the highest percent positivity. Having multiple job responsibilities in a store was significantly associated with seropositivity in our adjusted model (OR: 1.14 95% CI: 1.01-1.27). Workplace factors influenced seropositivity among Minnesota grocery workers. Future research will examine other potential factors (e.g., in-store preventive measures and access to PPE) that may contribute to increased seropositivity.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Aged , COVID-19/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Humans , Minnesota/epidemiology , Seroepidemiologic Studies , Supermarkets
2.
JAMA Netw Open ; 5(3): e220873, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1718202

ABSTRACT

Importance: Early in the SARS-CoV-2 pandemic, the M Health Fairview Hospital System established dedicated hospitals for establishing cohorts and caring for patients with COVID-19, yet the association between treatment at COVID-19-dedicated hospitals and mortality and complications is not known. Objective: To analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals. Design, Setting, and Participants: This retrospective cohort study evaluated data prospectively collected from March 1, 2020, through June 30, 2021, from 11 hospitals in Minnesota, including 2 hospitals created solely to care for patients with COVID-19. Data obtained included demographic characteristics, treatments, and outcomes of interest for all patients with a confirmed COVID-19 infection admitted to this hospital system during the study period. Exposures: Patients were grouped based on whether they received treatment from 1 of the 2 COVID-19-dedicated hospitals compared with the remainder of the hospitals within the hospital system. Main Outcomes and Measures: Multivariate analyses, including risk-adjusted logistic regression and propensity score matching, were performed to evaluate the primary outcome of in-hospital mortality and secondary outcomes, including complications and use of COVID-specific therapeutics. Results: There were 5504 patients with COVID-19 admitted during the study period (median age, 62.5 [IQR, 45.0-75.6] years; 2854 women [51.9%]). Of these, 2077 patients (37.7%) (median age, 63.4 [IQR, 50.7-76.1] years; 1080 men [52.0%]) were treated at 1 of the 2 COVID-19-dedicated hospitals compared with 3427 (62.3%; median age, 62.0 [40.0-75.1] years; 1857 women (54.2%) treated at other hospitals. The mortality rate was 11.6% (n = 241) at the dedicated hospitals compared with 8.0% (n = 274) at the other hospitals (P < .001). However, risk-adjusted in-hospital mortality was significantly lower for patients in the COVID-19-dedicated hospitals in both the unmatched group (n = 2077; odds ratio [OR], 0.75; 95% CI, 0.59-0.95) and the propensity score-matched group (n = 1317; OR, 0.78; 95% CI, 0.58-0.99). The rate of overall complications in the propensity score-matched group was significantly lower (OR, 0.81; 95% CI, 0.66-0.99) and the use of COVID-19-specific therapeutics including deep vein thrombosis prophylaxis (83.9% vs 56.9%; P < .001), high-dose corticosteroids (56.1% vs 22.2%; P < .001), remdesivir (61.5% vs 44.5%; P < .001), and tocilizumab (7.9% vs 2.0; P < .001) was significantly higher. Conclusions and Relevance: In this cohort study, COVID-19-dedicated hospitals had multiple benefits, including providing high-volume repetitive treatment and isolating patients with the infection. This experience suggests improved in-hospital mortality for patients treated at dedicated hospitals owing to improved processes of care and supports the use of establishing cohorts for future pandemics.


Subject(s)
COVID-19/mortality , COVID-19/therapy , Hospital Mortality , Hospitalization , Hospitals, Special , Outcome and Process Assessment, Health Care , Aged , COVID-19/complications , Cohort Studies , Female , Humans , Male , Middle Aged , Minnesota/epidemiology , Multivariate Analysis , Odds Ratio , Propensity Score , Quality of Health Care , Retrospective Studies , SARS-CoV-2
3.
JAMA Netw Open ; 5(2): e220536, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1711992

ABSTRACT

Importance: Characterizing rates of SARS-CoV-2 infection among vaccinated and unvaccinated persons with the same exposure is critical to understanding the association of vaccination with the risk of infection with the Delta variant. Additionally, evidence of Delta variant transmission by children to vaccinated adults has important public health implications. Objective: To characterize transmission and infection of SARS-CoV-2 among vaccinated and unvaccinated attendees of an indoor wedding reception. Design, Setting, and Participants: This cohort study included attendees at an indoor wedding reception in Minnesota in July 2021. Data were collected from REDCap surveys and routine surveillance interviews. The full list of attendees and a partial list of emails were obtained. Fifty-seven attendees completed the emailed survey. Eighteen additional attendees were identified from the state health department COVID-19 surveillance database. Exposures: Attendance at an indoor event. Main Outcomes and Measures: Risk of SARS-CoV-2 infection among vaccinated and unvaccinated attendees, identification of an index case, whole genome sequencing (WGS) to identify the COVID-19 variant, understanding of transmission patterns, and assessment of secondary transmission. The primary case definition was an individual with a positive SARS-CoV-2 test who attended the wedding in the 14 days prior to their illness. Results: Data were gathered for 75 attendees (mean [SE] age, 37.5 [13.7] years; 57 [76%] female individuals), of whom 56 (75%) were fully vaccinated, 4 (5%) were partially vaccinated, and 15 (20%) were unvaccinated. Of 62 attendees who were tested, 29 (47%) tested positive, including 16 of 46 fully vaccinated attendees (35%), 2 of 4 partially vaccinated attendees (50%), and 11 of 12 unvaccinated attendees (92%). Being unvaccinated was associated with a higher risk of infection compared with being vaccinated (risk ratio, 2.64; 95% CI, 1.71-4.06; P = .001). One unvaccinated adult required hospitalization. An unvaccinated child who was symptomatic on the event date was identified as the index case. Eleven specimens were available for WGS. All sequenced specimens were closely related and were identified as the Delta variant. WGS supported secondary transmission from a vaccinated individual with SARS-CoV-2. Conclusions and Relevance: This cohort study identified a COVID-19 Delta variant outbreak at an indoor event despite a high proportion of vaccinated attendees. It found that vaccination was associated with a reduced risk of infection.


Subject(s)
COVID-19/transmission , Vaccination Coverage/statistics & numerical data , Adult , COVID-19/epidemiology , COVID-19 Vaccines/immunology , Child , Cohort Studies , Disease Outbreaks , Humans , Middle Aged , Minnesota/epidemiology , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
4.
Public Health Rep ; 137(2): 263-271, 2022.
Article in English | MEDLINE | ID: covidwho-1643028

ABSTRACT

OBJECTIVE: Robust disease and syndromic surveillance tools are underdeveloped in the United States, as evidenced by limitations and heterogeneity in sociodemographic data collection throughout the COVID-19 pandemic. To monitor the COVID-19 pandemic in Minnesota, we developed a federated data network in March 2020 using electronic health record (EHR) data from 8 multispecialty health systems. MATERIALS AND METHODS: In this serial cross-sectional study, we examined patients of all ages who received a COVID-19 polymerase chain reaction test, had symptoms of a viral illness, or received an influenza test from January 3, 2016, through November 7, 2020. We evaluated COVID-19 testing rates among patients with symptoms of viral illness and percentage positivity among all patients tested, in aggregate and by zip code. We stratified results by patient and area-level characteristics. RESULTS: Cumulative COVID-19 positivity rates were similar for people aged 12-64 years (range, 15.1%-17.6%) but lower for adults aged ≥65 years (range, 9.3%-10.7%). We found notable racial and ethnic disparities in positivity rates early in the pandemic, whereas COVID-19 positivity was similarly elevated across most racial and ethnic groups by the end of 2020. Positivity rates remained substantially higher among Hispanic patients compared with other racial and ethnic groups throughout the study period. We found similar trends across area-level income and rurality, with disparities early in the pandemic converging over time. PRACTICE IMPLICATIONS: We rapidly developed a distributed data network across Minnesota to monitor the COVID-19 pandemic. Our findings highlight the utility of using EHR data to monitor the current pandemic as well as future public health priorities. Building partnerships with public health agencies can help ensure data streams are flexible and tailored to meet the changing needs of decision makers.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Data Collection/methods , Electronic Health Records/organization & administration , Program Development , Cross-Sectional Studies , Humans , Minnesota/epidemiology , Public Health Surveillance , SARS-CoV-2 , Sentinel Surveillance , Social Determinants of Health
5.
J Med Virol ; 93(12): 6611-6618, 2021 12.
Article in English | MEDLINE | ID: covidwho-1544309

ABSTRACT

The objective of this longitudinal cohort study was to determine the seroprevalence of antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in healthcare workers employed at healthcare settings in three rural counties in eastern South Dakota and western Minnesota from May 13, 2020, through December 22, 2020. Three blood draws were performed at five clinical sites and tested for the presence of antibodies against the SARS-CoV-2. Serum samples were tested for the presence of antibodies using a fluorescent microsphere immunoassay (FMIA), neutralization of SARS-CoV-2 spike-pseudotyped particles (SARS-CoV-2pp) assay, and serum virus neutralization (SVN) assay. The seroprevalence was determined to be 1/336 (0.29%) for samples collected from 5/13/20 to 7/13/20, 5/260 (1.92%) for samples collected from 8/13/20 to 9/25/20, and 35/235 (14.89%) for samples collected from 10/16/20 to 12/22/20. Eight of the 35 (22.8%) seropositive individuals identified in the final draw did not report a previous diagnosis with COVID-19. There was a high correlation (>90%) between the FMIA and virus neutralization assays. Each clinical site's seroprevalence was higher than the cumulative incidence for the general public in the respective county as reported by state public health agencies. As of December 2020, there was a high percentage (85%) of seronegative individuals in the study population.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Rural Health Services/statistics & numerical data , SARS-CoV-2/immunology , Adolescent , Adult , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/blood , COVID-19/diagnosis , Female , Fluorescent Antibody Technique , Humans , Male , Middle Aged , Minnesota/epidemiology , Neutralization Tests , Seroepidemiologic Studies , South Dakota/epidemiology , Young Adult
6.
Sci Rep ; 11(1): 21368, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1493221

ABSTRACT

There is a need for wastewater based epidemiological (WBE) methods that integrate multiple, variously sized surveillance sites across geographic areas. We developed a novel indexing method, Melvin's Index, that provides a normalized and standardized metric of wastewater pathogen load for qPCR assays that is resilient to surveillance site variation. To demonstrate the utility of Melvin's Index, we used qRT-PCR to measure SARS-CoV-2 genomic RNA levels in influent wastewater from 19 municipal wastewater treatment facilities (WWTF's) of varying sizes and served populations across the state of Minnesota during the Summer of 2020. SARS-CoV-2 RNA was detected at each WWTF during the 20-week sampling period at a mean concentration of 8.5 × 104 genome copies/L (range 3.2 × 102-1.2 × 109 genome copies/L). Lag analysis of trends in Melvin's Index values and clinical COVID-19 cases showed that increases in indexed wastewater SARS-CoV-2 levels precede new clinical cases by 15-17 days at the statewide level and by up to 25 days at the regional/county level. Melvin's Index is a reliable WBE method and can be applied to both WWTFs that serve a wide range of population sizes and to large regions that are served by multiple WWTFs.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2/genetics , Suburban Population , Urban Population , Waste Disposal Facilities , Waste Water/virology , Wastewater-Based Epidemiological Monitoring , Water Purification , COVID-19/virology , Genome, Viral , Humans , Minnesota/epidemiology , Prevalence , Prognosis , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction/methods , Risk Factors
7.
Health Aff (Millwood) ; 40(10): 1644-1653, 2021 10.
Article in English | MEDLINE | ID: covidwho-1480468

ABSTRACT

Substantial racial and ethnic disparities in COVID-19 mortality have been observed at the state and national levels. However, less is known about how race and ethnicity and neighborhood-level disadvantage may intersect to contribute to both COVID-19 mortality and excess mortality during the pandemic. To assess this potential interaction of race and ethnicity with neighborhood disadvantage, we link death certificate data from Minnesota from the period 2017-20 to the Area Deprivation Index to examine hyperlocal disparities in mortality. Black, Indigenous, and people of color (BIPOC) standardized COVID-19 mortality was 459 deaths per 100,000 population in the most disadvantaged neighborhoods compared with 126 per 100,000 in the most advantaged. Total mortality increased in 2020 by 14 percent for non-Hispanic White people and 41 percent for BIPOC. Statistical decompositions show that most of this growth in racial and ethnic disparity is associated with mortality gaps between White people and communities of color within the same levels of area disadvantage, rather than with the fact that White people live in more advantaged areas. Policy interventions to reduce COVID-19 mortality must consider neighborhood context.


Subject(s)
COVID-19 , Humans , Minnesota/epidemiology , SARS-CoV-2
8.
Int Psychogeriatr ; 33(10): 1105-1109, 2021 10.
Article in English | MEDLINE | ID: covidwho-1434038

ABSTRACT

Delirium is reported to be one of the manifestations of coronavirus infectious disease 2019 (COVID-19) infection. COVID-19 hospitalized patients are at a higher risk of delirium. Pathophysiology behind the association of delirium and COVID-19 is uncertain. We analyzed the association of delirium occurrence with outcomes in hospitalized COVID-19 patients, across all age groups, at Mayo Clinic hospitals.A retrospective study of all hospitalized COVID-19 patients at Mayo Clinic between March 1, 2020 and December 31, 2020 was performed. Occurrence of delirium and outcomes of mortality, length of stay, readmission, and 30-day mortality after hospital discharge were measured. Chi-square test, student t-test, survival analysis, and logistic regression analysis were performed to measure and compare outcomes of delirium group adjusted for age, sex, Charlson comorbidity score, and COVID-19 severity with no-delirium group.A total of 4351 COVID-19 patients were included in the study. Delirium occurrence in the overall study population was noted to be 22.4%. The highest occurrence of delirium was also noted in patients with critical COVID-19 illness severity. A statistically significant OR 4.35 (3.27-5.83) for in-hospital mortality and an OR 4.54 (3.25-6.38) for 30-day mortality after discharge in the delirium group were noted. Increased hospital length of stay, 30-day readmission, and need for skilled nursing facility on discharge were noted in the delirium group. Delirium in hospitalized COVID-19 patients is a marker for increased mortality and morbidity. In this group, outcomes appear to be much worse when patients are older and have a critical severity of COVID-19 illness.


Subject(s)
COVID-19/mortality , Delirium/epidemiology , Hospitalization/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , Child , Child, Preschool , Delirium/complications , Humans , Infant , Infant, Newborn , Intensive Care Units , Length of Stay , Male , Middle Aged , Minnesota/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
9.
MMWR Morb Mortal Wkly Rep ; 70(10): 346-347, 2021 Mar 12.
Article in English | MEDLINE | ID: covidwho-1389864

ABSTRACT

Since December 2020, the Minnesota Department of Health (MDH) Public Health Laboratory has been receiving 100 specimens per week (50 from each of two clinical partners) with low cycle threshold (Ct) values for routine surveillance for SARS-CoV-2, the virus that causes COVID-19. On January 25, 2021, MDH identified the SARS-CoV-2 variant P.1 in one specimen through this surveillance system using whole genome sequencing, representing the first identified case of this variant in the United States. The P.1 variant was first identified in travelers from Brazil during routine airport screening in Tokyo, Japan, in early January 2021 (1). This variant has been associated with increased transmissibility (2), and there are concerns that mutations in the spike protein receptor-binding domain might disrupt both vaccine-induced and natural immunity (3,4). As of February 28, 2021, a total of 10 P.1 cases had been identified in the United States, including the two cases described in this report, followed by one case each in Alaska, Florida, Maryland, and Oklahoma (5).


Subject(s)
COVID-19/diagnosis , COVID-19/virology , Public Health Surveillance , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , Humans , Minnesota/epidemiology , Travel-Related Illness , United States/epidemiology
10.
J Affect Disord ; 295: 771-780, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1385796

ABSTRACT

BACKGROUND: Previous COVID-19 pandemic research has focused on assessing the severity of psychological responses to pandemic-related stressors. Little is understood about (a) resilience as a mental health protective factor during these stressors, and (b) whether families from Eastern and Western cultures cope differently. This study examines how individual resilience and family resilience moderate the associations between pandemic-related stressors and symptoms of depression, anxiety, and stress in two culturally distinct regions. METHODS: A total of 1,039 adults (442 from Minnesota, United States, and 597 from Hong Kong) living with at least one family member completed an online survey about COVID-19-related experiences, mental health, individual resilience and family resilience from May 20 to June 30, 2020. Predictors of depression, anxiety, and stress symptoms were examined separately using hierarchical regression analyses. RESULTS: In both regions, pandemic-related stressors predicted higher symptoms of depression, anxiety, and stress. Individual resilience and two domains of family resilience were associated with positive mental health. In Minnesota, higher levels of individual resilience buffered the negative relationship between pandemic-related stressors and depressive symptoms; higher levels of family communication and problem solving also buffered the negative relationship between pandemic-related stressors and stress symptoms. In Hong Kong, higher family-level positive outlook magnified the negative relationship between pandemic-related stressors and anxiety symptoms. CONCLUSIONS: Individual and family resilience is protective against the adverse psychological effects of pandemic stressors, but they vary across cultures and as exposure to pandemic-related stressors increases.


Subject(s)
COVID-19 , Resilience, Psychological , Adult , Depression/epidemiology , Family Health , Hong Kong/epidemiology , Humans , Mental Health , Minnesota/epidemiology , Pandemics , SARS-CoV-2 , United States
11.
MMWR Morb Mortal Wkly Rep ; 69(43): 1605-1610, 2020 Oct 30.
Article in English | MEDLINE | ID: covidwho-1389857

ABSTRACT

Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP† exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk§ (3). Higher-risk exposures involved direct patient care (66%) and nonpatient care interactions (e.g., with coworkers and social and household contacts) (34%). Within 14 days following a higher-risk exposure, nearly one third (31%) of HCP who were enrolled in monitoring reported COVID-19-like symptoms,¶ and more than one half (52%) of enrolled HCP with symptoms received positive SARS-CoV-2 test results. Among all HCP with higher-risk exposures, irrespective of monitoring enrollment, 7% received positive SARS-CoV-2 test results. Compared with HCP with higher-risk exposures working in acute care settings, those working in congregate living or long-term care settings more often returned to work (57%), worked while symptomatic (5%), and received a positive test result (10%) during 14-day postexposure monitoring than did HCP working outside of such settings. These data highlight the need for awareness of nonpatient care SARS-CoV-2 exposure risks and for targeted interventions to protect HCP, in addition to residents, in congregate living and long-term care settings. To minimize exposure risk among HCP, health care facilities need improved infection prevention and control, consistent personal protective equipment (PPE) availability and use, flexible sick leave, and SARS-CoV-2 testing access. All health care organizations and HCP should be aware of potential exposure risk from coworkers, household members, and social contacts.


Subject(s)
Coronavirus Infections/transmission , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Patient-to-Professional , Occupational Exposure/adverse effects , Pneumonia, Viral/transmission , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Middle Aged , Minnesota/epidemiology , Occupational Exposure/statistics & numerical data , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Risk Assessment , Young Adult
12.
J Health Care Poor Underserved ; 32(3): 1096-1101, 2021.
Article in English | MEDLINE | ID: covidwho-1369548

ABSTRACT

Psychologists housed in two family medicine residency clinics located in underserved communities quickly transitioned their mode of psychotherapy from in-person to completely virtual at the beginning of the COVID-19 pandemic. We share numerous successes and advantages of a telehealth model in serving our community and describe challenges we have encountered.


Subject(s)
Communicable Disease Control , Medically Underserved Area , Psychotherapy , Telemedicine , Behavior Therapy , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Minnesota/epidemiology , Pandemics , Videoconferencing
13.
Transfusion ; 61(8): 2250-2254, 2021 08.
Article in English | MEDLINE | ID: covidwho-1346017

ABSTRACT

BACKGROUND: The year 2020 presented the transfusion community with unprecedented events and challenges, including the ongoing SARS-CoV-2 (COVID-19) pandemic, and more recently by civil unrest, following the death of George Floyd in late May of 2020. As a level 1 trauma center located in Minneapolis, Minnesota, Hennepin Healthcare (HCMC) offers a unique perspective into the changes in massive transfusion protocol (MTP) activations and usage during this tumultuous period. This may provide insight for addressing similar future events. STUDY DESIGN AND METHODS: MTP logs from March 2020 to August 2020 were compared to logs from March to August 2019. The data were de-identified, and MTP activations and component usage were categorized by activation reason. These categories were compared across the 2-year period to examine the impact of COVID-19, including stay-at-home orders, and civil unrest. RESULTS: For the examined 6 months of the year 2020, there were a total of 140 MTP activations, compared to 143 in 2019. There were more activations for violent trauma (VT) in 2020 than 2019 (44 vs. 32). This increase in activations for VT was offset by a decrease in non-trauma activations (54 vs. 66). There was a significant increase in the number of components used in VT activations. DISCUSSION: During 2020, the initial mild decrease in MTP activations was followed by a dramatic increase in the number of activations and component usage for VT in June and July of that year.


Subject(s)
Blood Transfusion/methods , COVID-19 , COVID-19/epidemiology , Civil Disorders , Humans , Minnesota/epidemiology , Pandemics , Trauma Centers
14.
Clin Infect Dis ; 74(7): 1265-1267, 2022 Apr 09.
Article in English | MEDLINE | ID: covidwho-1322621

ABSTRACT

The Minnesota Department of Health investigated a coronavirus disease 2019 (COVID-19) outbreak at a fitness center in Olmsted County, Minnesota. Twenty-three severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections (5 employees and 18 members) were identified. An epidemiological investigation supported by whole genome sequencing demonstrated that transmission of SARS-CoV-2 occurred at the fitness center despite following recommended prevention strategies.


Subject(s)
COVID-19 , Fitness Centers , Disease Outbreaks , Humans , Minnesota/epidemiology , SARS-CoV-2
15.
J Acad Nutr Diet ; 121(9): 1679-1694, 2021 09.
Article in English | MEDLINE | ID: covidwho-1322177

ABSTRACT

BACKGROUND: A steep rise in food insecurity is among the most pressing US public health problems that has resulted from the COVID-19 pandemic. OBJECTIVE: This study aimed to (1) describe how food-insecure emerging adults are adapting their eating and child-feeding behaviors during COVID-19 and (2) identify barriers and opportunities to improve local food access and access to food assistance. DESIGN: The COVID-19 Eating and Activity Over Time study collected survey data from emerging adults during April to October 2020 and completed interviews with a diverse subset of food-insecure respondents. PARTICIPANTS/SETTING: A total of 720 emerging adults (mean age: 24.7 ± 2.0 years; 62% female; 90% living in Minnesota) completed an online survey, and a predominately female subsample (n = 33) completed an interview by telephone or videoconference. MAIN OUTCOME MEASURES: Survey measures included the short-form of the US Household Food Security Survey Module and 2 items to assess food insufficiency. Interviews assessed eating and feeding behaviors along with barriers to healthy food access. ANALYSES PERFORMED: Descriptive statistics and a hybrid deductive and inductive content analysis. RESULTS: Nearly one-third of survey respondents had experienced food insecurity in the past year. Interviews with food-insecure participants identified 6 themes with regard to changes in eating and feeding behavior (eg, more processed food, sporadic eating), 5 themes regarding local food access barriers (eg, limited enforcement of COVID-19 safety practices, experiencing discrimination), and 4 themes regarding barriers to accessing food assistance (eg, lack of eligibility, difficulty in locating pantries). Identified recommendations include (1) expanding the distribution of information about food pantries and meal distribution sites, and (2) increasing fresh fruit and vegetable offerings at these sites. CONCLUSIONS: Interventions of specific relevance to COVID-19 (eg, stronger implementation of safety practices) and expanded food assistance services are needed to improve the accessibility of healthy food for emerging adults.


Subject(s)
COVID-19/epidemiology , Diet/standards , Food Assistance/standards , Food Insecurity , Adult , Feeding Behavior , Female , Humans , Male , Minnesota/epidemiology , Prevalence , Racism/ethnology , SARS-CoV-2 , Social Discrimination/ethnology , Socioeconomic Factors , Young Adult
16.
Emerg Infect Dis ; 27(8): 2052-2063, 2021 08.
Article in English | MEDLINE | ID: covidwho-1278367

ABSTRACT

Coronavirus disease has disproportionately affected persons in congregate settings and high-density workplaces. To determine more about the transmission patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in these settings, we performed whole-genome sequencing and phylogenetic analysis on 319 (14.4%) samples from 2,222 SARS-CoV-2-positive persons associated with 8 outbreaks in Minnesota, USA, during March-June 2020. Sequencing indicated that virus spread in 3 long-term care facilities and 2 correctional facilities was associated with a single genetic sequence and that in a fourth long-term care facility, outbreak cases were associated with 2 distinct sequences. In contrast, cases associated with outbreaks in 2 meat-processing plants were associated with multiple SARS-CoV-2 sequences. These results suggest that a single introduction of SARS-CoV-2 into a facility can result in a widespread outbreak. Early identification and cohorting (segregating) of virus-positive persons in these settings, along with continued vigilance with infection prevention and control measures, is imperative.


Subject(s)
COVID-19 , SARS-CoV-2 , Disease Outbreaks , Humans , Minnesota/epidemiology , Phylogeny
17.
Virulence ; 12(1): 1597-1609, 2021 12.
Article in English | MEDLINE | ID: covidwho-1268053

ABSTRACT

The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 is continuing to spread globally. SARS-CoV-2 infections of feline and canine species have also been reported. However, it is not entirely clear to what extent natural SARS-CoV-2 infection of pet dogs and cats is in households. We have developed enzyme-linked immunosorbent assays (ELISAs) using recombinant SARS-CoV-2 nucleocapsid (N) protein and the receptor-binding-domain (RBD) of the spike protein, and the SARS-CoV-2 spike-pseudotyped vesicular stomatitis virus (VSV)-based neutralization assay to screen serum samples of 239 pet cats and 510 pet dogs in Minnesota in the early phase of the COVID-19 pandemic from mid-April to early June 2020 for evidence of SARS-CoV-2 exposures. A cutoff value was used to identify the seropositive samples in each experiment. The average seroprevalence of N- and RBD-specific antibodies in pet cats were 8% and 3%, respectively. Among nineteen (19) N-seropositive cat sera, fifteen (15) exhibited neutralizing activity and seven (7) were also RBD-seropositive. The N-based ELISA is also specific and does not cross react with antigens of common feline coronaviruses. In contrast, SARS-CoV-2 antibodies were detected at a very low percentage in pet dogs (~ 1%) and were limited to IgG antibodies against SARS-CoV-2 N protein with no neutralizing activities. Our results demonstrate that SARS-CoV-2 seropositive rates are higher in pet cats than in pet dogs in MN early in the pandemic and that SARS-CoV-2 N-specific IgG antibodies can detect SARS-CoV-2 infections in companion animals with higher levels of specificity and sensitivity than RBD-specific IgG antibodies in ELISA-based assays.


Subject(s)
COVID-19 Serological Testing/veterinary , COVID-19/veterinary , Pets/virology , SARS-CoV-2/isolation & purification , Animals , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , Cats , Coronavirus Nucleocapsid Proteins/immunology , Coronavirus, Feline/immunology , Coronavirus, Feline/isolation & purification , Dogs , Enzyme-Linked Immunosorbent Assay/veterinary , Minnesota/epidemiology , Phosphoproteins/immunology , SARS-CoV-2/immunology , Sensitivity and Specificity , Seroepidemiologic Studies , Spike Glycoprotein, Coronavirus/immunology
18.
Prehosp Disaster Med ; 36(2): 131-134, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1164739

ABSTRACT

BACKGROUND: Although first responders (FRs) represent a high-risk group for exposure, little information is available regarding their risk of coronavirus disease 2019 (COVID-19) infection. The purpose of the current study was to determine the serological prevalence of past COVID-19 infection in a cohort of municipal law enforcement (LE) and firefighters (FFs). METHODS: Descriptive analysis of a de-identified data reporting Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) immunoglobulin G (IgG), or COR2G, serology results for municipal FRs. As part of the serology process, FRs were surveyed for COVID-19-like symptoms since February 2020 and asked to report any prior COVID-19 nasal swab testing. Descriptive statistics and two-sided Chi Square tests with Yates correction were used to compare groups. RESULTS: Of 318 FRs, 225 (80.2%) underwent serology testing (LE: 163/207 [78.7%]; FF: 92/111 [82.9%]). The prevalence of positive serology for all FRs tested was 3/255 (1.2%). Two LE (1.2%) and one FF (1.1%) had positive serology (P = 1.0). Two hundred and twenty-four FRs responded to a survey regarding prior symptoms and testing. Fifty-eight (25.9%) FRs (44 LE; 14 FFs) reported the presence of COVID-19-like symptoms. Of these, only nine (15.5%) received reverse transcriptase - polymerase chain reaction (RT-PCR) testing; none were positive. Two of the three FRs with positive serology reported no COVID-19-like symptoms and none of these responders had received prior nasal RT-PCR swabs. The overall community positive RT-PCR rate was 0.36%, representing a three-fold higher rate of positive seroprevalence amongst FRs compared with the general population (P = .07). CONCLUSIONS: Amongst a cohort of municipal FRs with low community COVID-19 prevalence, the seroprevalence of SARS-CoV-19 IgG Ab was three-fold greater than the general community. Two-thirds of positive FRs reported a lack of symptoms. Only 15.5% of FRs with COVID-19-like symptoms received RT-PCR testing. In addition to workplace control measures, increased testing availability to FRs is critical in limiting infection spread and ensuring response capability.


Subject(s)
Antibodies, Viral/blood , COVID-19/blood , COVID-19/epidemiology , Emergency Responders , Immunoglobulin G/blood , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Adult , COVID-19 Testing , Female , Humans , Male , Minnesota/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Seroepidemiologic Studies
19.
Int J Eat Disord ; 54(7): 1189-1201, 2021 07.
Article in English | MEDLINE | ID: covidwho-1130479

ABSTRACT

OBJECTIVE: The present study aimed to describe the experience of, and factors associated with, disordered eating in a population-based sample of emerging adults during the COVID-19 outbreak. METHOD: Participants in the EAT 2010-2018 (Eating and Activity over Time) study were invited to complete the C-EAT (COVID-19 EAT) survey in April-May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID-19 pandemic were examined as cross-sectional correlates of disordered eating in 2020. Open-ended questions assessed the perceived impact of the pandemic on eating behaviors. RESULTS: Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic-related reductions in dietary intake; and (f) re-emergence or marked increase in eating disorder symptoms. DISCUSSION: Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID-19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises.


Subject(s)
COVID-19/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/epidemiology , Pandemics , Adaptation, Psychological , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Minnesota/epidemiology , Psychological Distress , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
20.
MMWR Morb Mortal Wkly Rep ; 70(10): 346-347, 2021 Mar 12.
Article in English | MEDLINE | ID: covidwho-1128178

ABSTRACT

Since December 2020, the Minnesota Department of Health (MDH) Public Health Laboratory has been receiving 100 specimens per week (50 from each of two clinical partners) with low cycle threshold (Ct) values for routine surveillance for SARS-CoV-2, the virus that causes COVID-19. On January 25, 2021, MDH identified the SARS-CoV-2 variant P.1 in one specimen through this surveillance system using whole genome sequencing, representing the first identified case of this variant in the United States. The P.1 variant was first identified in travelers from Brazil during routine airport screening in Tokyo, Japan, in early January 2021 (1). This variant has been associated with increased transmissibility (2), and there are concerns that mutations in the spike protein receptor-binding domain might disrupt both vaccine-induced and natural immunity (3,4). As of February 28, 2021, a total of 10 P.1 cases had been identified in the United States, including the two cases described in this report, followed by one case each in Alaska, Florida, Maryland, and Oklahoma (5).


Subject(s)
COVID-19/diagnosis , COVID-19/virology , Public Health Surveillance , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , Humans , Minnesota/epidemiology , Travel-Related Illness , United States/epidemiology
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