Clinical and epidemiologic features of SARS-CoV-2 in dogs and cats compiled through national surveillance in the United States

OBJECTIVE: To characterize clinical and epidemiologic features of SARS-CoV-2 in companion animals detected through both passive and active surveillance in the US. ANIMALS: 204 companion animals (109 cats, 95 dogs) across 33 states with confirmed SARS-CoV-2 infections between March 2020 and December 2021. PROCEDURES: Public health officials, animal health officials, and academic researchers investigating zoonotic SARS-CoV-2 transmission events reported clinical, laboratory, and epidemiologic information through a standardized One Health surveillance process developed by the CDC and partners. RESULTS: Among dogs and cats identified through passive surveillance, 94% (n = 87) had reported exposure to a person with COVlD-19 before infection. Clinical signs of illness were present in 74% of pets identified through passive surveillance and 27% of pets identified through active surveillance. Duration of illness in pets averaged 15 days in cats and 12 days in dogs. The average time between human and pet onset of illness was 10 days. Viral nucleic acid was first detected at 3 days after exposure in both cats and dogs. Antibodies were detected starting 5 days after exposure, and titers were highest at 9 days in cats and 14 days in dogs. CLINICAL RELEVANCE: Results of the present study supported that cats and dogs primarily become infected with SARS-CoV-2 following expo- sure to a person with COVID-19, most often their owners. Case investigation and surveillance that include both people and animals are necessary to understand transmission dynamics and viral evolution of zoonotic diseases like SARS-CoV-2.

Parent experience of neonatal hospitalization during the COVID-19 pandemic

Rationale: Prior to the COVID-19 pandemic, parental presence was encouraged through unrestricted visitation and family-centered care practices in neonatal intensive care units (NICU). Parental caregiving is essential to an infant's healthy development, especially during hospitalization. Parental presence encourages attachment, improves parental well-being and confidence, enhances management of illness, and promotes continuity of care. By examining parental experience of hospitalization during the pandemic, we can better understand parental needs during neonatal hospitalization. Therefore, our objective was to describe the impact of neonatal hospitalization during the COVID-19 pandemic from the parent perspective Methods: We conducted an online survey to explore parent's experiences of neonatal hospitalization during the first 6 months of the COVID-19 pandemic. We invited parents to participate via social media through parental support groups. Inclusion criteria included having an infant admitted to a NICU between February 1-July 31, 2020. We used a thematic analytic approach to identify shared patterns of how parents experienced their child's NICU stay. Free text responses from five open-ended questions covering topics such as visitation experience, transition home, and clinician interactions were analyzed using NVivo 11 qualitative data analysis software. Results: Of the 178 survey respondents, 169 answered one or more of the open-ended questions. We focused on examining continuities and discontinuities of parents' perspectives of neonatal hospitalization within the context of COVID-19. Through this lens, we identified three broad themes: 1) Parents' NICU experiences during COVID-19 were emotionally isolating and overwhelming, 2) Restrictive visitation policies split the family unit, and 3) Interactions with NICU staff exacerbated or mitigated the emotional strain on parents (figure 1). To quote a parent, “hospital policies [were] not in touch with the reality of families, making the impossible pain of [having] a baby in the NICU even more impossible.” Overall, parents of infants in the NICU experienced and expressed feelings of painful separation, disconnection, isolation, splitting, and alienation. Parents desired more empathy from providers and hospital administrators. Conclusions: Parental distress and disconnection were exacerbated amidst neonatal hospitalization during COVID-19. Perceived lack-of empathy and restrictive policies intensified parental distress related to lack of support, separation and isolation. Parents expressed a strong desire to engage in decision making and advocated for the value of connection and community during these challenging times. NICU clinicians need to support parents with empathy and connection to mitigate parental distress. (Table Presented).