Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Following the Largest Initial Epidemic Wave in the United States: Findings From New York City, 13 May to 21 July 2020.

BACKGROUND: New York City (NYC) was the US epicenter of the spring 2020 coronavirus disease 2019 (COVID-19) pandemic. We present the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and correlates of seropositivity immediately after the first wave. METHODS: From a serosurvey of adult NYC residents (13 May to 21 July 2020), we calculated the prevalence of SARS-CoV-2 antibodies stratified by participant demographics, symptom history, health status, and employment industry. We used multivariable regression models to assess associations between participant characteristics and seropositivity. RESULTS: The seroprevalence among 45 367 participants was 23.6% (95% confidence interval, 23.2%-24.0%). High seroprevalence (>30%) was observed among black and Hispanic individuals, people from high poverty neighborhoods, and people in healthcare or essential worker industry sectors. COVID-19 symptom history was associated with seropositivity (adjusted relative risk, 2.76; 95% confidence interval, 2.65-2.88). Other risk factors included sex, age, race/ethnicity, residential area, employment sector, working outside the home, contact with a COVID-19 case, obesity, and increasing numbers of household members. CONCLUSIONS: Based on a large serosurvey in a single US jurisdiction, we estimate that just under one-quarter of NYC adults were infected in the first few months of the COVID-19 epidemic. Given disparities in infection risk, effective interventions for at-risk groups are needed during ongoing transmission.

Regional approaches to hospital preparedness.

This article describes issues related to the engagement of hospitals and other community partners in a coordinated regional healthcare preparedness and response effort. The report is based on interviews with public health and hospital representatives from 13 regions or states across the country. It aims to identify key ingredients for building successful regional partnerships for healthcare preparedness as well as critical challenges and policy and practical recommendations for their development and sustainability.

Systemic collapse: Medical care in the aftermath of Hurricane Katrina.

This article describes and analyzes key aspects of the medical response to Hurricane Katrina in New Orleans. It is based on interviews with individuals involved in the response and on analysis of published reports and news articles. Findings include: (1) federal, state, and local disaster plans did not include provisions for keeping hospitals functioning during a large-scale emergency; (2) the National Disaster Medical System (NDMS) was ill-prepared for providing medical care to patients who needed it; (3) there was no coordinated system for recruiting, deploying, and managing volunteers; and (4) many Gulf Coast residents were separated from their medical records. The article makes recommendations for improvement.

Getting medicine to millions: New strategies for mass distribution.

This article examines the feasibility of allowing private industries such as grocery stores, wholesale clubs, and community immunizers to partner with public health authorities for the mass distribution of vaccines or antibiotics. Retail grocery and wholesale stores already have experience with annual influenza vaccination and may be a resource in a public health emergency, including a bioterrorist attack. This analysis suggests that retail store executives are willing to work with public health authorities to plan for and respond to public health emergencies.

Bulls, Bears, and Birds: Preparing the Financial Industry for an Avian Influenza Pandemic.

Bulls, Bears, and Birds: Preparing the Financial Industry for an Avian Influenza Pandemic was a half day symposium on avian influenza for senior leaders and decision makers from the financial sector with responsibility for business continuity, health, and security. The event brought together experts and leaders from the medical, public health, business continuity, and financial communities to appraise financial industry leaders on the threat of avian influenza and to offer suggestions regarding what the financial industry could do to prepare and respond.

Navigating the storm: report and recommendations from the Atlantic Storm exercise.

Atlantic Storm was a tabletop exercise simulating a series of bioterrorism attacks on the transatlantic community. The exercise occurred on January 14, 2005, in Washington, DC, and was organized and convened by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. Atlantic Storm portrayed a summit meeting of presidents, prime ministers, and other international leaders from both sides of the Atlantic Ocean in which they responded to a campaign of bioterrorist attacks in several countries. The summit principals, who were all current or former senior government leaders, were challenged to address issues such as attaining situational awareness in the wake of a bioattack, coping with scarcity of critical medical resources such as vaccine, deciding how to manage the movement of people across borders, and communicating with their publics. Atlantic Storm illustrated that much might be done in advance to minimize the illness and death, as well as the social, economic, and political disruption, that could be caused by an international epidemic, be it natural or the result of a bioterrorist attack. These lessons are especially timely given the growing concerns over the possibility of an avian influenza pandemic that would require an international response. However, international leaders cannot create the necessary response systems in the midst of a crisis. Medical, public health, and diplomatic response systems and critical medical resources (e.g., medicines and vaccines) must be in place before a bioattack occurs or a pandemic emerges.

Persistence of virus-reactive serum immunoglobulin m antibody in confirmed west nile virus encephalitis cases.

Twenty-nine laboratory-confirmed West Nile virus (WNV encephalitis patients were bled serially so that WNV-reactive immunoglobulin (Ig) M activity could be determined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approximately 500 days after onset. Clinicians should be cautious when interpreting serologic results from early season WNV IgM-positive patients.