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1.
Lab Med ; 52(5): e137-e146, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-2135433

ABSTRACT

OBJECTIVE: To describe a cross-institutional approach to verify the Abbott ARCHITECT SARS-CoV-2 antibody assay and to document the kinetics of the serological response. METHODS: We conducted analytical performance evaluation studies using the Abbott ARCHITECT SARS-CoV-2 antibody assay on 5 Abbott ARCHITECT i2000 automated analyzers at 2 academic medical centers. RESULTS: Within-run and between-run coefficients of variance (CVs) for the antibody assay did not exceed 5.6% and 8.6%, respectively, for each institution. Quantitative and qualitative results agreed for lithium heparin plasma, EDTA-plasma and serum specimen types. Results for all SARS-CoV-2 IgG-positive and -negative specimens were concordant among analyzers except for 1 specimen at 1 institution. Qualitative and quantitative agreement was observed for specimens exchanged between institutions. All patients had detectable antibodies by day 10 from symptom onset and maintained seropositivity throughout specimen procurement. CONCLUSIONS: The analytical performance characteristics of the Abbott ARCHITECT SARS-CoV-2 antibody assay within and between 2 academic medical center clinical laboratories were acceptable for widespread clinical-laboratory use.


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing/standards , COVID-19/diagnosis , Immunoassay/standards , Immunoglobulin G/blood , SARS-CoV-2/immunology , Academic Medical Centers , COVID-19/blood , COVID-19/immunology , COVID-19/virology , Humans , Observer Variation , Reproducibility of Results , SARS-CoV-2/pathogenicity , Sensitivity and Specificity , Virginia
2.
Infect Control Hosp Epidemiol ; 42(2): 228-229, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-2096442

ABSTRACT

Coronavirus disease 2019 (COVID-19) has migrated to regions that were initially spared, and it is likely that different populations are currently at risk for illness. Herein, we present our observations of the change in characteristics and resource use of COVID-19 patients over time in a national system of community hospitals to help inform those managing surge planning, operational management, and future policy decisions.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Hospitalization/statistics & numerical data , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/ethnology , COVID-19/mortality , Female , Hospitals, Community , Humans , Male , Middle Aged , SARS-CoV-2/isolation & purification , Virginia/epidemiology , Young Adult
4.
Clin Infect Dis ; 75(Supplement_2): S155-S158, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2051356

ABSTRACT

In April 2021, we assessed mRNA vaccine effectiveness (VE) in the context of a COVID-19 outbreak in a skilled nursing facility. Among 28 cases, genomic sequencing was performed on 4 specimens on 4 different patients, and all were classified by sequence analysis as the Beta (B.1.351) variant. Adjusted VE among residents was 65% (95% confidence interval: 25-84%). These findings underscore the importance of vaccination for prevention of COVID-19 in skilled nursing facilities.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Disease Outbreaks/prevention & control , Humans , RNA, Messenger , SARS-CoV-2/genetics , Vaccines, Synthetic , Virginia , mRNA Vaccines
5.
Health Aff (Millwood) ; 41(8): 1078-1087, 2022 08.
Article in English | MEDLINE | ID: covidwho-1951577

ABSTRACT

Medicaid is a critical antipoverty program. Since the Affordable Care Act expanded Medicaid eligibility, millions of newly eligible people have enrolled, creating positive financial improvements for low-income families. We examined the association of Virginia's 2019 Medicaid expansion and changes in health care-related and non-health-care-related financial needs among newly eligible Medicaid enrollees. Our unique survey collected responses between December 2018 and April 2019 from newly enrolled members reporting on experiences in the year before enrollment and between July 2020 and May 2021 from members reporting on experiences one year after enrollment. The follow-up period coincided with the COVID-19 pandemic. Medicaid enrollment was associated with decreases in concern about all financial needs assessed: housing, food, monthly bills, credit card and loan payments, and health care costs. These reductions were broadly similar across demographic subgroups and across the months of the pandemic that overlapped with the follow-up period. We add to the evidence that Medicaid expansion is a social safety-net policy that could improve equity among low-income families, potentially encouraging states that have yet to expand to do so.


Subject(s)
COVID-19 , Medicaid , Health Services Accessibility , Humans , Pandemics , Patient Protection and Affordable Care Act , United States , Virginia
6.
Perspect Sex Reprod Health ; 54(3): 68-79, 2022 09.
Article in English | MEDLINE | ID: covidwho-1917008

ABSTRACT

CONTEXT: Many people wanted to avoid or delay childbearing during the COVID-19 pandemic. This study sought to examine the extent COVID-19 influenced abortion care-seeking in a region that did not enact policy restricting abortion due to the pandemic, has high service availability, and few abortion-restrictive policies. METHODOLOGY: We conducted telephone surveys with adults (n=72) requesting abortion appointments between September 2020 and March 2021 at five clinics in Washington, DC, Maryland, and Virginia. We used χ2 tests to compare sociodemographic, reproductive history, service delivery characteristics, and pandemic-related life changes by whether COVID-19 influenced abortion care-seeking. RESULTS: Most respondents (93%) had an abortion at the time of the survey, 4% were awaiting their scheduled appointment, and 3% did not have an appointment scheduled. Nearly 40% of people reported COVID-19 influenced their decision to have an abortion. These individuals were significantly more likely to report "not financially prepared" (44% vs. 16%) as a reason for termination compared to people reporting no influence of COVID-19. They were also more likely to have lost or changed their health insurance due to pandemic-related employment changes (15% vs. 2%), report substantial money difficulties due to COVID-19 (59% vs. 33%), and report that paying for their abortion was "very difficult" (25% vs. 2%). CONCLUSION: COVID-19 influenced many people to have an abortion, particularly those financially disadvantaged by the pandemic. Expansion of Medicaid abortion coverage in Washington, DC and Virginia could reduce financial barriers to care and help people to better meet their reproductive needs amid future crises.


Subject(s)
Abortion, Induced , COVID-19 , Adult , COVID-19/epidemiology , District of Columbia/epidemiology , Female , Humans , Maryland/epidemiology , Pandemics , Pregnancy , United States/epidemiology , Virginia/epidemiology
7.
PLoS One ; 17(2): e0263820, 2022.
Article in English | MEDLINE | ID: covidwho-1793524

ABSTRACT

Many factors play a role in outcomes of an emerging highly contagious disease such as COVID-19. Identification and better understanding of these factors are critical in planning and implementation of effective response strategies during such public health crises. The objective of this study is to examine the impact of factors related to social distancing, human mobility, enforcement strategies, hospital capacity, and testing capacity on COVID-19 outcomes within counties located in District of Columbia as well as the states of Maryland and Virginia. Longitudinal data have been used in the analysis to model county-level COVID-19 infection and mortality rates. These data include big location-based service data, which were collected from anonymized mobile devices and characterize various social distancing and human mobility measures within the study area during the pandemic. The results provide empirical evidence that lower rates of COVID-19 infection and mortality are linked with increased levels of social distancing and reduced levels of travel-particularly by public transit modes. Other preventive strategies and polices also prove to be influential in COVID-19 outcomes. Most notably, lower COVID-19 infection and mortality rates are linked with stricter enforcement policies and more severe penalties for violating stay-at-home orders. Further, policies that allow gradual relaxation of social distancing measures and travel restrictions as well as those requiring usage of a face mask are related to lower rates of COVID-19 infections and deaths. Additionally, increased access to ventilators and Intensive Care Unit (ICU) beds, which represent hospital capacity, are linked with lower COVID-19 mortality rates. On the other hand, gaps in testing capacity are related to higher rates of COVID-19 infection. The results also provide empirical evidence for reports suggesting that certain minority groups such as African Americans and Hispanics are disproportionately affected by the COVID-19 pandemic.


Subject(s)
Big Data , COVID-19/prevention & control , Physical Distancing , Public Health , Travel/statistics & numerical data , COVID-19/epidemiology , COVID-19/virology , District of Columbia/epidemiology , Female , Humans , Male , Maryland/epidemiology , Masks/statistics & numerical data , Middle Aged , Quarantine , SARS-CoV-2/isolation & purification , Virginia/epidemiology
8.
Int J Environ Res Public Health ; 19(7)2022 04 05.
Article in English | MEDLINE | ID: covidwho-1785662

ABSTRACT

The purpose of this communication is to describe the preliminary evaluation of the Virginia Fresh Match (VFM) financial incentive program for fresh fruits and vegetables for Virginia Supplemental Nutrition Assistance Program shoppers and to determine if there were differences in incentive outcomes by race. In this cross-sectional study, a questionnaire was administered to shoppers using Virginia Fresh Match incentives at participating farmers markets and community-based food retail outlets. Repeated measures ANOVAs were used to detect differences in fruit and vegetable consumption between demographic groups over time. Chi-square tests were used to determine if there were associations between race and perceived impact of VFM incentives on making food last and the attribution of VFM incentives to changes in fruit and vegetable consumption frequency. Frequency of fruit and vegetable intake was significantly higher during VFM incentive use, with a difference of 1.17 ± 0.07 and 1.07 ± 0.07 on a Likert scale measure, respectively (p ≤ 0.001). There were racial differences in assertions that VFM incentives helped food to last. VFM incentives were effective at increasing fruit and vegetable consumption, but racial differences should be considered in the administration of VFM to avoid reinforcing systems or approaches that may contribute to disparities in food access and food security.


Subject(s)
Fruit , Vegetables , Cross-Sectional Studies , Demography , Motivation , Virginia
10.
J Sch Health ; 92(5): 436-444, 2022 05.
Article in English | MEDLINE | ID: covidwho-1704728

ABSTRACT

BACKGROUND: Schools have a long history of delivering health services, but it is unclear how the COVID-19 pandemic may have disrupted this. This study examined changes in school-based health services and student needs before and during the pandemic and the factors important for delivering school-based health services. METHODS: A web-based survey regarding the impact of the pandemic on school-based health services was distributed via email to all 1178 Virginia public elementary schools during May 2021. RESULTS: Responding schools (N = 767, response rate = 65%) reported providing fewer school-based health services during the 2020-2021 school year than before the pandemic, with the largest declines reported for dental screenings (51% vs 15%) and dental services (40% vs 12%). Reports show that mental health was a top concern for students increased from 15% before the pandemic to 27% (P < .001). Support from families and school staff were identified by most respondents (86% and 83%, respectively) as very important for the delivery of school-based health services. CONCLUSIONS: Schools reported delivering fewer health services to students during the 2020-2021 school year and heightened concern about students' mental health. Understanding what schools need to deliver health services can assist state and local education and health officials and promote child health.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Child , Humans , School Health Services , Schools , Virginia/epidemiology
11.
Am J Public Health ; 111(10): 1772-1775, 2021 10.
Article in English | MEDLINE | ID: covidwho-1690609

ABSTRACT

Rapid identification and management of students with COVID-19 symptoms, exposure, or disease are critical to halting disease spread and protecting public health. We describe the interdisciplinary isolation and quarantine program of a large, public university, the University of Virginia, Charlottesville. The program provided students with wraparound services, including medical, mental health, academic, and other support services during their isolation or quarantine stay. The program successfully accommodated 844 cases during the fall 2020 semester, thereby decreasing exposure to the rest of the university and the local community. (Am J Public Health. 2021;111(10):1772-1775. https://doi.org/10.2105/AJPH.2021.306424).


Subject(s)
COVID-19/prevention & control , Quarantine/psychology , Social Isolation/psychology , Students/psychology , Universities/organization & administration , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Nucleic Acid Testing , Female , Humans , Male , Pandemics , Patient Care Team , SARS-CoV-2 , Social Support , Virginia
12.
Eur J Psychotraumatol ; 13(1): 2022279, 2022.
Article in English | MEDLINE | ID: covidwho-1684419

ABSTRACT

Background: The COVID-19 pandemic has imposed fundamental challenges on nearly every area of life. Objective: The purpose of the current study was to expand on the literature on the impact of the pandemic on college students by a) examining domains of impact of the pandemic on psychiatric and alcohol outcomes and b) controlling for pre-pandemic outcomes. Method: Participants included 897 college students (78.6% female) from a larger longitudinal study on college student mental health. Structural equation models were fit to examine how COVID-19 impact (exposure, worry, food/housing insecurity, change in social media use, change in substance use) were associated with PTSD, anxiety, depression, suicidal ideation, and alcohol phenotypes. Models were fit to adjust for pre-pandemic symptoms. Results: No effects of COVID-19 exposure remained after adjusting for earlier outcomes. COVID-19 worry predicted PTSD, depression, and anxiety, even after adjusting for earlier levels of outcomes (ß's: .091-.180, p's < .05). Housing/food concerns predicted PTSD, anxiety, and depression symptoms as well as suicidal ideation (ß's: .085-.551, p's < .05) after adjusting for earlier levels of symptoms. Change in media use predicted alcohol consumption (ß's: ± .116-.197, p's < .05). Change in substance use affected all outcomes except suicidality (ß's: .112-.591, p's < .05). Conclusions: Domains of COVID-19 impact had differential effects on mental health and substance outcomes in college students during the first wave of the coronavirus pandemic. Future studies should examine the trajectory of these factors on college student mental health across waves of the pandemic.


Antecedentes: La pandemia de COVID-19 ha impuesto desafíos fundamentales en prácticamente todas las áreas de la vida.Objetivo: El propósito del presente estudio fue ampliar la literatura sobre el impacto de la pandemia en estudiantes universitarios, a) examinando dominios de impacto de la pandemia sobre resultados psiquiátricos y de alcohol, y b) controlando por resultados pre-pandemia.Método: Los participantes incluyeron 897 estudiantes universitarios (78,6% mujeres) de un estudio longitudinal más grande sobre salud mental de estudiantes universitarios. Se ajustaron modelos de ecuaciones estructurales para examinar cómo se asociaba el impacto del COVID-19 (exposición, preocupación, inseguridad de alimentos/habitación, cambio en el uso de medios sociales, cambio en uso de sustancias) con los fenotipos TEPT, ansiedad, depresión, ideación suicida y alcohol. Los modelos se ajustaron por síntomas pre-pandémicos.Resultados: No permanecieron efectos de la exposición al COVID-19 luego de ajustar por resultados previos. La preocupación por el COVID-19 predijo TEPT, depresión y ansiedad incluso luego de ajustar por niveles previos de resultados (ß's: .091­.180, p's < .05). Los problemas de habitación/alimentación predijeron síntomas de TEPT, ansiedad y depresión así como también ideación suicida (ß's: .085­.551, p's < .05) después de ajustar por niveles sintomáticos previos. El cambio en el uso de medios predijo el consumo de alcohol (ß's: ±.116­.197, p's < .05). El cambio en el uso de sustancias afectó a todos los resultados excepto suicidalidad (ß's: .112­.591, p's < .05).Conclusiones: Los dominios de impacto del COVID-19 tuvieron diferentes efectos sobre los resultados de salud mental y uso de sustancias en estudiantes universitarios durante la primera ola de la pandemia de coronavirus. Futuros estudios deberían examinar la trayectoria de esos factores en la salud mental de estudiantes universitarios a través de las olas de la pandemia.


Subject(s)
Alcohol Drinking/epidemiology , COVID-19/psychology , Mental Disorders/etiology , Students/psychology , Adolescent , Alcohol Drinking/psychology , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Female , Humans , Longitudinal Studies , Male , Mental Disorders/epidemiology , Psychiatric Status Rating Scales , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Students/statistics & numerical data , Suicidal Ideation , Universities , Virginia/epidemiology
13.
Int J Environ Res Public Health ; 19(3)2022 01 28.
Article in English | MEDLINE | ID: covidwho-1677688

ABSTRACT

BACKGROUND: Immigrants' oral health disparities have not been adequately investigated using a lifecourse approach, which investigates the cumulative effects of risk and protective exposures among other considerations. METHODS: We examined self-reported oral health outcomes and health care appointment outcomes among a sample of patients enrolled at a federally qualified health center in Richmond Virginia (N = 327) who were categorized into three groups by approximate age at arrival to the U.S. RESULTS: Study participants who arrived to the U.S. prior to age 18 had better retention of natural dentition, better oral health related quality of life, and a lower proportion of dental appointments to address pain than those who arrived after age 18 or were born in the U.S. CONCLUSIONS: Im/migrants' differentiated oral health outcomes by age at arrival to the U.S. suggest the relevance of lifecourse factors, for example the cumulative effects of risk and protective exposures, and confirm the merits of lifecourse studies of im/migrants' oral health.


Subject(s)
Emigrants and Immigrants , Oral Health , Adolescent , Health Services , Humans , Quality of Life , Virginia
14.
J Am Board Fam Med ; 34(6): 1189-1202, 2021.
Article in English | MEDLINE | ID: covidwho-1581435

ABSTRACT

BACKGROUND: Primary care is crucial to the health of individuals and communities, but it faces numerous structural and systemic challenges. Our study assessed the state of primary care in Virginia to prepare for Medicaid expansion. It also provides insight into the frontline of health care prior to an unprecedented global COVID-19 pandemic. METHODS: We surveyed 1622 primary care practices to understand organizational characteristics, scope of care, capacity, and organizational stress. RESULTS: Practices (484) varied in type, ownership, location, and care for medically underserved and diverse patient populations. Most practices accepted uninsured and Medicaid patients. Practices reported a broad scope of care, including offering behavioral health and medication-assisted therapy for opioid addiction. Over half addressed social needs like transportation and unstable housing. One in three practices experienced a significant stress in 2019, prepandemic, and only 18.8% of practices anticipated a stress in 2020. CONCLUSIONS: Primary care serves as the foundation of our health care system and is an essential service, but it is severely stressed, under-resourced, and overburdened in the best of times. Primary care needs strategic workforce planning, adequate access to resources, and financial investment to sustain its value and innovation.


Subject(s)
COVID-19 , Pandemics , Health Services Accessibility , Humans , Medicaid , Primary Health Care , SARS-CoV-2 , United States , Virginia
15.
Emerg Infect Dis ; 27(12): 3171-3173, 2021 12.
Article in English | MEDLINE | ID: covidwho-1528797

ABSTRACT

We report infection of 3 Malayan tigers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.7 (Alpha) variant at a zoologic park in Virginia, USA. All tigers exhibited respiratory signs consistent with SARS-CoV-2 infection. These findings show that tigers are susceptible to infection with the SARS-CoV-2 B.1.1.7 variant.


Subject(s)
COVID-19 , Tigers , Animals , Humans , SARS-CoV-2 , Virginia/epidemiology
16.
J Healthc Manag ; 66(1): 4-8, 2021.
Article in English | MEDLINE | ID: covidwho-1402722

Subject(s)
Universities , Humans , Virginia
18.
J Sch Health ; 91(9): 678-682, 2021 09.
Article in English | MEDLINE | ID: covidwho-1319340

ABSTRACT

BACKGROUND: In-school transmission of COVID-19 among K-12 students is low when mitigation layers are used, but the risk of acquiring COVID-19 during school bus transportation is not well defined. Given the operational limitations of many school districts, more data is needed to determine what mitigation is required to keep COVID-19 transmission low during bus transport. METHODS: An independent school in Virginia monitored 1154 students in grades 1 to 12 with asymptomatic PCR testing every 2 weeks from August 24, 2020 to March 19, 2021, during the highest community transmission. Fifteen buses served 462 students while operating at near capacity of 2 students in every seat, using a physical distancing minimum of 2.5 ft, universal masking, and simple ventilation techniques. RESULTS: A total of 39 individuals were present on buses during their COVID-19 infectious period, which resulted in the quarantine of 52 students. Universal testing and contact tracing revealed no transmission linked to bus transportation. CONCLUSIONS: This study demonstrates a model for the safe operation of school buses while near capacity. COVID-19 transmission can be low during student transport when employing mitigation including simple ventilation, and universal masking, at minimal physical distances and during the highest community transmission.


Subject(s)
COVID-19 , Travel , COVID-19/transmission , Communicable Disease Control , Humans , Schools , Students , Virginia/epidemiology
19.
Oncologist ; 26 Suppl 3: S1-S2, 2021 07.
Article in English | MEDLINE | ID: covidwho-1300418
20.
Pediatr Infect Dis J ; 40(7): e272-e274, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1258811

ABSTRACT

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity. While chronic medical conditions were not associated with having antibodies, previous fever and body aches were predictive symptoms.


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing , COVID-19/epidemiology , Adolescent , COVID-19/ethnology , Child , Child, Preschool , Chronic Disease/epidemiology , District of Columbia/epidemiology , Female , Healthy Volunteers , Humans , Immunoglobulin G/blood , Infant , Infant, Newborn , Male , Maryland/epidemiology , Seroepidemiologic Studies , Virginia/epidemiology , West Virginia/epidemiology , Young Adult
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