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1.
J Public Health Manag Pract ; 28(1): 60-69, 2022.
Article in English | MEDLINE | ID: covidwho-1607529

ABSTRACT

OBJECTIVE: To identify potential strategies to mitigate COVID-19 transmission in a Utah meat-processing facility and surrounding community. DESIGN/SETTING: During March-June 2020, 502 workers at a Utah meat-processing facility (facility A) tested positive for SARS-CoV-2. Using merged data from the state disease surveillance system and facility A, we analyzed the relationship between SARS-CoV-2 positivity and worker demographics, work section, and geospatial data on worker residence. We analyzed worker survey responses to questions regarding COVID-19 knowledge, beliefs, and behaviors at work and home. PARTICIPANTS: (1) Facility A workers (n = 1373) with specimen collection dates and SARS-CoV-2 RT-PCR test results; (2) residential addresses of all persons (workers and nonworkers) with a SARS-CoV-2 diagnostic test (n = 1036), living within the 3 counties included in the health department catchment area; and (3) facility A workers (n = 64) who agreed to participate in the knowledge, attitudes, and practices survey. MAIN OUTCOME MEASURES: New cases over time, COVID-19 attack rates, worker characteristics by SARS-CoV-2 test results, geospatially clustered cases, space-time proximity of cases among workers and nonworkers; frequency of quantitative responses, crude prevalence ratios, and counts and frequency of coded responses to open-ended questions from the COVID-19 knowledge, attitudes, and practices survey. RESULTS: Statistically significant differences in race (P = .01), linguistic group (P < .001), and work section (P < .001) were found between workers with positive and negative SARS-CoV-2 test results. Geographically, only 6% of cases were within statistically significant spatiotemporal case clusters. Workers reported using handwashing (57%) and social distancing (21%) as mitigation strategies outside work but reported apprehension with taking COVID-19-associated sick leave. CONCLUSIONS: Mitigating COVID-19 outbreaks among workers in congregate settings requires a multifaceted public health response that is tailored to the workforce. IMPLICATIONS FOR POLICY AND PRACTICE: Tailored, multifaceted mitigation strategies are crucial for reducing COVID-19-associated health disparities among disproportionately affected populations.


Subject(s)
COVID-19 , Disease Outbreaks , Humans , Meat , Public Health , SARS-CoV-2 , Utah/epidemiology
3.
PLoS Pathog ; 17(11): e1009952, 2021 11.
Article in English | MEDLINE | ID: covidwho-1593026

ABSTRACT

The breadth of animal hosts that are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may serve as reservoirs for continued viral transmission are not known entirely. In August 2020, an outbreak of SARS-CoV-2 occurred on five mink farms in Utah and was associated with high mink mortality (35-55% of adult mink) and rapid viral transmission between animals. The premise and clinical disease information, pathology, molecular characterization, and tissue distribution of virus within infected mink during the early phase of the outbreak are provided. Infection spread rapidly between independently housed animals and farms, and caused severe respiratory disease and death. Disease indicators were most notably sudden death, anorexia, and increased respiratory effort. Gross pathology examination revealed severe pulmonary congestion and edema. Microscopically there was pulmonary edema with moderate vasculitis, perivasculitis, and fibrinous interstitial pneumonia. Reverse transcriptase polymerase chain reaction (RT-PCR) of tissues collected at necropsy demonstrated the presence of SARS-CoV-2 viral RNA in multiple organs including nasal turbinates, lung, tracheobronchial lymph node, epithelial surfaces, and others. Localization of viral RNA by in situ hybridization revealed a more localized infection, particularly of the upper respiratory tract. Whole genome sequencing from multiple mink was consistent with published SARS-CoV-2 genomes with few polymorphisms. The Utah mink SARS-CoV-2 strains fell into Clade GH, which is unique among mink and other animal strains sequenced to date. While sharing the N501T mutation which is common in mink, the Utah strains did not share other spike RBD mutations Y453F and F486L found in nearly all mink from the United States. Mink in the outbreak reported herein had high levels of SARS-CoV-2 in the upper respiratory tract associated with symptomatic respiratory disease and death.


Subject(s)
COVID-19/veterinary , Mink/virology , Animals , COVID-19/epidemiology , COVID-19/mortality , COVID-19/pathology , Disease Outbreaks/veterinary , Farms , Female , Lung/pathology , Male , RNA, Viral/blood , Real-Time Polymerase Chain Reaction/veterinary , SARS-CoV-2/classification , Utah/epidemiology
4.
PLoS One ; 16(11): e0259097, 2021.
Article in English | MEDLINE | ID: covidwho-1575776

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a high risk of transmission in close-contact indoor settings, which may include households. Prior studies have found a wide range of household secondary attack rates and may contain biases due to simplifying assumptions about transmission variability and test accuracy. METHODS: We compiled serological SARS-CoV-2 antibody test data and prior SARS-CoV-2 test reporting from members of 9,224 Utah households. We paired these data with a probabilistic model of household importation and transmission. We calculated a maximum likelihood estimate of the importation probability, mean and variability of household transmission probability, and sensitivity and specificity of test data. Given our household transmission estimates, we estimated the threshold of non-household transmission required for epidemic growth in the population. RESULTS: We estimated that individuals in our study households had a 0.41% (95% CI 0.32%- 0.51%) chance of acquiring SARS-CoV-2 infection outside their household. Our household secondary attack rate estimate was 36% (27%- 48%), substantially higher than the crude estimate of 16% unadjusted for imperfect serological test specificity and other factors. We found evidence for high variability in individual transmissibility, with higher probability of no transmissions or many transmissions compared to standard models. With household transmission at our estimates, the average number of non-household transmissions per case must be kept below 0.41 (0.33-0.52) to avoid continued growth of the pandemic in Utah. CONCLUSIONS: Our findings suggest that crude estimates of household secondary attack rate based on serology data without accounting for false positive tests may underestimate the true average transmissibility, even when test specificity is high. Our finding of potential high variability (overdispersion) in transmissibility of infected individuals is consistent with characterizing SARS-CoV-2 transmission being largely driven by superspreading from a minority of infected individuals. Mitigation efforts targeting large households and other locations where many people congregate indoors might curb continued spread of the virus.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Family Characteristics , Humans , Incidence , Likelihood Functions , Pandemics/statistics & numerical data , SARS-CoV-2/pathogenicity , Sensitivity and Specificity , Serologic Tests/methods , Utah/epidemiology
5.
J Med Libr Assoc ; 109(4): 677-679, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1538716

ABSTRACT

BACKGROUND: In 2017, an academic health sciences library in Utah developed a multimedia studio for students, faculty, and academic staff. Educational projects needing video, audio, and lecture capture could utilize a one-button studio for recording video sessions, microphones for audio, and various screen capture software for lectures. Since the pandemic, this service has seen rapid growth due to academic lectures going exclusively online. In response, the library launched a dedicated podcasting suite to accommodate the increase in students and faculty needing to record lectures or podcasts for others in the medical profession. DESCRIPTION: This article will outline the process of creating the podcasting suite and provide equipment rosters and methods other libraries may consider for establishing their own studio. Administrating duties of the studio will also be included, such as handling reservations and user assessment. An instructional guide for users is also included to assist patrons in accomplishing their podcast creations. CONCLUSION: Podcasts created in the space range from topics about teaching strategies in medicine to diagnoses and treatments of skin disorders. A podcasting suite is another way libraries can provide valuable services for asynchronous learning and student projects. Students, staff, and faculty have appreciated the ease of the service and the support behind it. A feedback loop was developed to further improve the space to meet the needs of users.


Subject(s)
Libraries, Medical , Medicine , Humans , Learning , Students , Utah
6.
Clin Infect Dis ; 73(10): 1831-1839, 2021 11 16.
Article in English | MEDLINE | ID: covidwho-1522142

ABSTRACT

BACKGROUND: Monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence can complement case reporting to inform more accurate estimates of SARS-CoV-2 infection burden, but few studies have undertaken repeated sampling over time on a broad geographic scale. METHODS: We performed serologic testing on a convenience sample of residual serum obtained from persons of all ages, at 10 sites in the United States from 23 March through 14 August 2020, from routine clinical testing at commercial laboratories. We standardized our seroprevalence rates by age and sex, using census population projections and adjusted for laboratory assay performance. Confidence intervals were generated with a 2-stage bootstrap. We used bayesian modeling to test whether seroprevalence changes over time were statistically significant. RESULTS: Seroprevalence remained below 10% at all sites except New York and Florida, where it reached 23.2% and 13.3%, respectively. Statistically significant increases in seroprevalence followed peaks in reported cases in New York, South Florida, Utah, Missouri, and Louisiana. In the absence of such peaks, some significant decreases were observed over time in New York, Missouri, Utah, and Western Washington. The estimated cumulative number of infections with detectable antibody response continued to exceed reported cases in all sites. CONCLUSIONS: Estimated seroprevalence was low in most sites, indicating that most people in the United States had not been infected with SARS-CoV-2 as of July 2020. The majority of infections are likely not reported. Decreases in seroprevalence may be related to changes in healthcare-seeking behavior, or evidence of waning of detectable anti-SARS-CoV-2 antibody levels at the population level. Thus, seroprevalence estimates may underestimate the cumulative incidence of infection.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Bayes Theorem , Child , Humans , Seroepidemiologic Studies , United States/epidemiology , Utah
7.
J Emerg Manag ; 19(7): 19-37, 2021.
Article in English | MEDLINE | ID: covidwho-1497654

ABSTRACT

The following article addresses the complexities of responding to the Magna, Utah earthquake under conditions of the global corona virus disease (COVID-19) pandemic. The article begins with a brief mention of the literature on complex disasters along with the research methods employed for the study. Contextual information about COVID-19 and the Magna earthquake are then provided along with general issues that had to be addressed in the public health emergency and after the seismic hazard occurred. The following two sections identify how COVID-19 benefited the response to the earthquake as well as how the virus complicated operations after the tremor. The article then discusses major lessons of this research and provides recommendations for future study and practice. Overall, this research reveals that the responses to these two simultaneous events witnessed successes as well as significant challenges. The appearance of COVID-19 may have limited injuries or the loss of life during the Magna earthquake, and it also enabled an early activation of the emergency operations center (EOC). However, COVID-19 presented unique challenges for evacuation, sheltering, and damage assessment functions. The pandemic also altered the nature of EOC operations, created the need for a virtual response, and had distinct implications for financial accounting and personnel workload.


Subject(s)
COVID-19 , Disasters , Earthquakes , Emergencies , Humans , Pandemics , SARS-CoV-2 , Utah
8.
Emerg Infect Dis ; 27(12): 2999-3008, 2021 12.
Article in English | MEDLINE | ID: covidwho-1485010

ABSTRACT

Outcomes and costs of coronavirus disease (COVID-19) contact tracing are limited. During March-May 2020, we constructed transmission chains from 184 index cases and 1,499 contacts in Salt Lake County, Utah, USA, to assess outcomes and estimate staff time and salaries. We estimated 1,102 staff hours and $29,234 spent investigating index cases and contacts. Among contacts, 374 (25%) had COVID-19; secondary case detection rate was ≈31% among first-generation contacts, ≈16% among second- and third-generation contacts, and ≈12% among fourth-, fifth-, and sixth-generation contacts. At initial interview, 51% (187/370) of contacts were COVID-19-positive; 35% (98/277) became positive during 14-day quarantine. Median time from symptom onset to investigation was 7 days for index cases and 4 days for first-generation contacts. Contact tracing reduced the number of cases between contact generations and time between symptom onset and investigation but required substantial resources. Our findings can help jurisdictions allocate resources for contact tracing.


Subject(s)
COVID-19 , Contact Tracing , Humans , Quarantine , SARS-CoV-2 , Utah/epidemiology
9.
Viruses ; 13(10)2021 10 07.
Article in English | MEDLINE | ID: covidwho-1463837

ABSTRACT

In summer 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was detected on mink farms in Utah. An interagency One Health response was initiated to assess the extent of the outbreak and included sampling animals from on or near affected mink farms and testing them for SARS-CoV-2 and non-SARS coronaviruses. Among the 365 animals sampled, including domestic cats, mink, rodents, raccoons, and skunks, 261 (72%) of the animals harbored at least one coronavirus. Among the samples that could be further characterized, 127 alphacoronaviruses and 88 betacoronaviruses (including 74 detections of SARS-CoV-2 in mink) were identified. Moreover, at least 10% (n = 27) of the coronavirus-positive animals were found to be co-infected with more than one coronavirus. Our findings indicate an unexpectedly high prevalence of coronavirus among the domestic and wild free-roaming animals tested on mink farms. These results raise the possibility that mink farms could be potential hot spots for future trans-species viral spillover and the emergence of new pandemic coronaviruses.


Subject(s)
Alphacoronavirus/isolation & purification , COVID-19/epidemiology , COVID-19/veterinary , SARS-CoV-2/isolation & purification , Alphacoronavirus/classification , Alphacoronavirus/genetics , Animals , Animals, Domestic/virology , Animals, Wild/virology , Cats , Disease Hotspot , Female , Male , Mephitidae/virology , Mice , Mink/virology , Raccoons/virology , SARS-CoV-2/classification , SARS-CoV-2/genetics , Utah/epidemiology
10.
JAMA Pediatr ; 176(1): 59-67, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1460123

ABSTRACT

Importance: Data about the risk of SARS-CoV-2 infection among children compared with adults are needed to inform COVID-19 risk communication and prevention strategies, including COVID-19 vaccination policies for children. Objective: To compare incidence rates and clinical characteristics of SARS-CoV-2 infection among adults and children and estimated household infection risks within a prospective household cohort. Design, Setting, and Participants: Households with at least 1 child aged 0 to 17 years in selected counties in Utah and New York City, New York, were eligible for enrollment. From September 2020 through April 2021, participants self-collected midturbinate nasal swabs for reverse transcription-polymerase chain reaction testing for SARS-CoV-2 and responded to symptom questionnaires each week. Participants also self-collected additional respiratory specimens with onset of COVID-19-like illness. For children unable to self-collect respiratory specimens, an adult caregiver collected the specimens. Main Outcomes and Measures: The primary outcome was incident cases of any SARS-CoV-2 infection, including asymptomatic and symptomatic infections. Additional measures were the asymptomatic fraction of infection calculated by dividing incidence rates of asymptomatic infection by rates of any infection, clinical characteristics of infection, and household infection risks. Primary outcomes were compared by participant age group. Results: A total of 1236 participants in 310 households participated in surveillance, including 176 participants (14%) who were aged 0 to 4 years, 313 (25%) aged 5 to 11 years, 163 (13%) aged 12 to 17 years, and 584 (47%) 18 years or older. Overall incidence rates of SARS-CoV-2 infection were 3.8 (95% CI, 2.4-5.9) and 7.7 (95% CI, 4.1-14.5) per 1000 person-weeks among the Utah and New York City cohorts, respectively. Site-adjusted incidence rates per 1000 person-weeks were similar by age group: 6.3 (95% CI, 3.6-11.0) for children 0 to 4 years, 4.4 (95% CI, 2.5-7.5) for children 5 to 11 years, 6.0 (95% CI, 3.0-11.7) for children 12 to 17 years, and 5.1 (95% CI, 3.3-7.8) for adults (≥18 years). The asymptomatic fractions of infection by age group were 52%, 50%, 45%, and 12% among individuals aged 0 to 4 years, 5 to 11 years, 12 to 17 years, and 18 years or older, respectively. Among 40 households with 1 or more SARS-CoV-2 infections, the mean risk of SARS-CoV-2 infection among all enrolled household members was 52% (range, 11%-100%), with higher risks in New York City compared with Utah (80% [95% CI, 64%-91%] vs 44% [95% CI, 36%-53%]; P < .001). Conclusions and Relevance: In this study, children had similar incidence rates of SARS-CoV-2 infection compared with adults, but a larger proportion of infections among children were asymptomatic.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19 Testing/statistics & numerical data , COVID-19/transmission , Adolescent , Adult , COVID-19/epidemiology , Child , Child, Preschool , Contact Tracing/statistics & numerical data , Disease Susceptibility , Family Characteristics , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , New York City/epidemiology , Prospective Studies , Utah/epidemiology , Young Adult
12.
Viruses ; 13(9)2021 09 12.
Article in English | MEDLINE | ID: covidwho-1411082

ABSTRACT

Approximately 67% of U.S. households have pets. Limited data are available on SARS-CoV-2 in pets. We assessed SARS-CoV-2 infection in pets during a COVID-19 household transmission investigation. Pets from households with ≥1 person with laboratory-confirmed COVID-19 were eligible for inclusion from April-May 2020. We enrolled 37 dogs and 19 cats from 34 households. All oropharyngeal, nasal, and rectal swabs tested negative by rRT-PCR; one dog's fur swabs (2%) tested positive by rRT-PCR at the first sampling. Among 47 pets with serological results, eight (17%) pets (four dogs, four cats) from 6/30 (20%) households had detectable SARS-CoV-2 neutralizing antibodies. In households with a seropositive pet, the proportion of people with laboratory-confirmed COVID-19 was greater (median 79%; range: 40-100%) compared to households with no seropositive pet (median 37%; range: 13-100%) (p = 0.01). Thirty-three pets with serologic results had frequent daily contact (≥1 h) with the index patient before the person's COVID-19 diagnosis. Of these 33 pets, 14 (42%) had decreased contact with the index patient after diagnosis and none were seropositive; of the 19 (58%) pets with continued contact, four (21%) were seropositive. Seropositive pets likely acquired infection after contact with people with COVID-19. People with COVID-19 should restrict contact with pets and other animals.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Pets/virology , SARS-CoV-2 , Animals , COVID-19/history , COVID-19/transmission , Cats , Dogs , Family Characteristics , History, 21st Century , Humans , Pets/history , Phylogeny , Population Surveillance , RNA, Viral , SARS-CoV-2/classification , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Seroepidemiologic Studies , Utah/epidemiology , Viral Zoonoses/epidemiology , Wisconsin/epidemiology
13.
Emerg Infect Dis ; 27(11): 2786-2794, 2021 11.
Article in English | MEDLINE | ID: covidwho-1381376

ABSTRACT

We aimed to generate an unbiased estimate of the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in 4 urban counties in Utah, USA. We used a multistage sampling design to randomly select community-representative participants >12 years of age. During May 4-June 30, 2020, we collected serum samples and survey responses from 8,108 persons belonging to 5,125 households. We used a qualitative chemiluminescent microparticle immunoassay to detect SARS-CoV-2 IgG in serum samples. We estimated the overall seroprevalence to be 0.8%. The estimated seroprevalence-to-case count ratio was 2.5, corresponding to a detection fraction of 40%. Only 0.2% of participants from whom we collected nasopharyngeal swab samples had SARS-CoV-2-positive reverse transcription PCR results. SARS-CoV-2 antibody prevalence during the study was low, and prevalence of PCR-positive cases was even lower. The comparatively high SARS-CoV-2 detection rate (40%) demonstrates the effectiveness of Utah's testing strategy and public health response.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Humans , Probability , Seroepidemiologic Studies , Utah/epidemiology
14.
PLoS One ; 16(6): e0252185, 2021.
Article in English | MEDLINE | ID: covidwho-1278170

ABSTRACT

The world is currently dealing with a devastating pandemic. Although growing COVID-19 case numbers, deaths, and hospitalizations are concerning, this spread is particularly alarming in the United States where polarizing opinions, changing policies, and misinformation abound. In particular, American college campuses have been a venue of rampant transmission, with concerning spillover into surrounding, more vulnerable, communities. We surveyed over 600 college students from across the United States and modeled predictors of compliance with non-pharmaceutical interventions. We identified concern with severity, constitutionalism, news exposure, and religiosity as significant positive correlates with compliance, and general trust in science as a significant negative correlate. To determine how applicable nationwide modeling might be to individual local campuses we also administered this same survey to nearly 600 students at two large universities in Utah County. In this population, concern with severity was the only significant positive correlate with compliance; Additionally, feelings of inconvenience were negatively correlated. The effects of feelings of inconvenience, and news exposure were significantly different between populations. These results suggest that we should focus our efforts on increasing knowledge about the pandemic's effects on our society and informing about constitutionality amongst college students. However, we also show that nationwide surveys and modeling are informative, but if campuses are to efficiently curb the spread of COVID-19 this coming semester, they would be best served to utilize data collected from their student populations as these might significantly differ from general consensus data.


Subject(s)
COVID-19/prevention & control , SARS-CoV-2/isolation & purification , Students/statistics & numerical data , Surveys and Questionnaires , Universities , COVID-19/epidemiology , COVID-19/virology , Female , Humans , Male , Models, Theoretical , Pandemics , Population Surveillance/methods , SARS-CoV-2/physiology , United States , Utah , Young Adult
15.
Am J Infect Control ; 49(6): 792-799, 2021 06.
Article in English | MEDLINE | ID: covidwho-1269213

ABSTRACT

BACKGROUND: Antibiotic-resistant Acinetobacter species are a growing public health threat, yet are not nationally notifiable, and most states do not mandate reporting. Additionally, there are no standardized methods to detect Acinetobacter species colonization. METHODS: An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) was identified at a Utah ventilator unit in a skilled nursing facility. An investigation was conducted to identify transmission modes in order to control spread of CRAB. Culture-based methods were used to identify patient colonization and environmental contamination in the facility. RESULTS: Of the 47 patients screened, OXA-23-producing CRAB were detected in 10 patients (21%), with 7 patients (15%) having been transferred from out-of-state facilities. Of patients who screened positive, 60% did not exhibit any signs or symptoms of active infection by chart review. A total of 38 environmental samples were collected and CRAB was recovered from 37% of those samples. Whole genome sequencing analyses of patient and environmental isolates suggested repeated CRAB introduction into the facility and highlighted the role of shared equipment in transmission. CONCLUSIONS: The investigation demonstrated this ventilated skilled nursing facility was an important reservoir for CRAB in the community and highlights the need for improved surveillance, strengthened infection control and inter-facility communication within and across states.


Subject(s)
Acinetobacter Infections , Acinetobacter baumannii , Cross Infection , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , Acinetobacter Infections/prevention & control , Acinetobacter baumannii/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacterial Proteins , Carbapenems/pharmacology , Cross Infection/drug therapy , Cross Infection/epidemiology , Cross Infection/prevention & control , Disease Outbreaks , Humans , Infection Control , Microbial Sensitivity Tests , Skilled Nursing Facilities , Utah/epidemiology , beta-Lactamases/genetics
16.
Environ Res ; 201: 111471, 2021 10.
Article in English | MEDLINE | ID: covidwho-1252855

ABSTRACT

Urban air quality is a growing concern due a range of social, economic, and health impacts. Since the SARS-CoV-19 pandemic began in 2020, governments have produced a range of non-medical interventions (NMIs) (e.g. lockdowns, stay-at-home orders, mask mandates) to prevent the spread of COVID-19. A co-benefit of NMI implementation has been the measurable improvement in air quality in cities around the world. Using the lockdown policy of the COVID-19 pandemic as a natural experiment, we traced the changing emissions patterns produced under the pandemic in a mid-sized, high-altitude city to isolate the effects of human behavior on air pollution. We tracked air pollution over time periods reflecting the Pre-Lockdown, Lockdown, and Reopening stages, using high quality, research grade sensors in both commercial and residential areas to better understand how each setting may be uniquely impacted by pollution downturn events. Based on this approach, we found the commercial area of the city showed a greater decrease in air pollution than residential areas during the lockdown period, while both areas experienced a similar rebound post lockdown. The easing period following the lockdown did not lead to an immediate rebound in human activity and the air pollution increase associated with reopening, took place nearly two months after the lockdown period ended. We hypothesize that differences in heating needs, travel demands, and commercial activity, are responsible for the corresponding observed changes in the spatial distribution of pollutants over the study period. This research has implications for climate policy, low-carbon energy transitions, and may even impact local policy due to changing patterns in human exposure that could lead to important public health outcomes, if left unaddressed.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Cities , Communicable Disease Control , Environmental Monitoring , Humans , Pandemics , Particulate Matter/analysis , SARS-CoV-2 , Utah
17.
MMWR Morb Mortal Wkly Rep ; 70(21): 785-791, 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1248454

ABSTRACT

Cessation of kindergarten through grade 12 in-person instruction and extracurricular activities, which has often occurred during the COVID-19 pandemic, can have negative social, emotional, and educational consequences for children (1,2). Although preventive measures such as masking, physical distancing, hand hygiene, and improved ventilation are commonly used in schools to reduce transmission of SARS-CoV-2, the virus that causes COVID-19, and support in-person instruction (3-6), routine school-based COVID-19 testing has not been as widely implemented. In addition to these types of standard preventive measures, Utah health and school partners implemented two high school testing programs to sustain extracurricular activities and in-person instruction and help identify SARS-CoV-2 infections: 1) Test to Play,* in which testing every 14 days was mandated for participation in extracurricular activities; and 2) Test to Stay,† which involved school-wide testing to continue in-person instruction as an alternative to transitioning to remote instruction if a school crossed a defined outbreak threshold (3). During November 30, 2020-March 20, 2021, among 59,552 students tested through these programs, 1,886 (3.2%) received a positive result. Test to Play was implemented at 127 (66%) of Utah's 193 public high schools and facilitated completion of approximately 95% of scheduled high school extracurricular winter athletics competition events.§ Test to Stay was conducted at 13 high schools, saving an estimated 109,752 in-person instruction student-days.¶ School-based COVID-19 testing should be considered as part of a comprehensive prevention strategy to help identify SARS-CoV-2 infections in schools and sustain in-person instruction and extracurricular activities.


Subject(s)
COVID-19 Testing , COVID-19/prevention & control , Schools/organization & administration , Adolescent , COVID-19/diagnosis , COVID-19/epidemiology , Humans , Program Evaluation , SARS-CoV-2/isolation & purification , Utah/epidemiology
19.
Emerg Infect Dis ; 27(5): 1259-1265, 2021 05.
Article in English | MEDLINE | ID: covidwho-1201255

ABSTRACT

The coronavirus disease pandemic has highlighted the key role epidemiologic models play in supporting public health decision-making. In particular, these models provide estimates of outbreak potential when data are scarce and decision-making is critical and urgent. We document the integrated modeling response used in the US state of Utah early in the coronavirus disease pandemic, which brought together a diverse set of technical experts and public health and healthcare officials and led to an evidence-based response to the pandemic. We describe how we adapted a standard epidemiologic model; harmonized the outputs across modeling groups; and maintained a constant dialogue with policymakers at multiple levels of government to produce timely, evidence-based, and coordinated public health recommendations and interventions during the first wave of the pandemic. This framework continues to support the state's response to ongoing outbreaks and can be applied in other settings to address unique public health challenges.


Subject(s)
COVID-19 , Disease Outbreaks , Humans , Pandemics , SARS-CoV-2 , Utah/epidemiology
20.
Ann Epidemiol ; 59: 50-55, 2021 07.
Article in English | MEDLINE | ID: covidwho-1198609

ABSTRACT

PURPOSE: Contact tracing is intended to reduce the spread of coronavirus disease 2019 (COVID-19), but it is difficult to conduct among people who live in congregate settings, including people experiencing homelessness (PEH). This analysis compares person-based contact tracing among two populations in Salt Lake County, Utah, from March-May 2020. METHODS: All laboratory-confirmed positive cases among PEH (n = 169) and documented in Utah's surveillance system were included in this analysis. The general population comparison group (n = 163) were systematically selected from all laboratory-confirmed cases identified during the same period. RESULTS: Ninety-three PEH cases (55%) were interviewed compared to 163 (100%) cases among the general population (P < .0001). PEH were more likely to be lost to follow-up at end of isolation (14.2%) versus the general population (0%; P-value < .0001) and provided fewer contacts per case (0.3) than the general population (4.7) (P-value < .0001). Contacts of PEH were more often unreachable (13.0% vs. 7.1%; P-value < .0001). CONCLUSIONS: These findings suggest that contact tracing among PEH should include a location-based approach, along with a person-based approach when resources allow, due to challenges in identifying, locating, and reaching cases among PEH and their contacts through person-based contact tracing efforts alone.


Subject(s)
COVID-19 , Homeless Persons , Contact Tracing , Humans , SARS-CoV-2 , Utah/epidemiology
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