Health disparities and COVID-19: A retrospective study examining individual and community factors causing disproportionate COVID-19 outcomes in Cook County, Illinois.

Early data from the COVID-19 pandemic suggests that the disease has had a disproportionate impact on communities of color with higher infection and mortality rates within those communities. This study used demographic data from the 2018 US census estimates, mortality data from the Cook County Medical Examiner's office, and testing results from the Illinois Department of Public Health to perform bivariate and multivariate regression analyses to explore the role race plays in COVID-19 outcomes at the individual and community levels. We used the ZCTA Social Deprivation Index (SDI), a measure of ZCTA area level deprivation based on seven demographic characteristics to quantify the socio-economic variation in health outcomes and levels of disadvantage across ZCTAs. Principal findings showed that: 1) while Black individuals make up 22% of Cook County's population, they account for 28% of the county's COVID-19 related deaths; 2) the average age of death from COVID-19 is seven years younger for Non-White compared with White decedents; 3) residents of Minority ZCTA areas were 1.02 times as likely to test positive for COVID-19, (Incidence Rate Ratio (IRR) 1.02, [95% CI 0.95, 1.10]); 1.77 times as likely to die (IRR 1.77, [95% CI 1.17, 2.66]); and were 1.15 times as likely to be tested (IRR 1.15, [95% CI 0.99, 1.33]). There are notable differences in COVID-19 related outcomes between racial and ethnic groups at individual and community levels. This study illustrates the health disparities and underlying systemic inequalities experienced by communities of color.

Years of potential life lost secondary to COVID-19: Cook County, Illinois.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to substantial morbidity and mortality world-wide. Evidence suggests that ethnic and racial minorities have been disproportionately affected in the United States, particularly within major population centers. In this study, we evaluated the effect of the COVID-19 pandemic in Cook County, Illinois, and found that the rate of years of potential life lost (YPLL) was 4.8 times greater in the most affected racial group (YPLL: 2289/100,000 population in Hispanic people) than in the least affected group (YPLL: 480/100,000 population in Asian people).

The utility of video technology and enhanced infection control in reducing COVID-19 disease burden in a custodial setting.

We describe the use of video technology to enhance case interviews, identify COVID-19 contacts, and determine exposures risk within a large juvenile temporary detention center. We created a COVID-19 outbreak management protocol which included the formation of an outbreak management team and enhanced infection control practices using video surveillance. Currently, our institution's positivity rate remains low for both staff and residents largely because of the outbreak management team. Video technology combined with enhanced infection control practices can be a useful technique to reduce COVID-19 infections in custodial settings.

Clinical and laboratory characteristics of Clostridium difficile infection in patients with discordant diagnostic test results.

The aim of this study was to compare the clinical and laboratory characteristics of Clostridium difficile infection (CDI) in patients with discordant test results for the cytotoxin assay (CYT) and PCR assays. A retrospective study from May to August 2008 and March to May 2010 was performed. CDI was diagnosed in 128 patients. PCR increased the yield of C. difficile cases by 2-fold compared to that of the CYT assay. Fifty-six cases (44%) were detected by PCR only (CYT negative). Forty-nine percent of patients with non-NAP1 strains were detected by PCR only, compared to 28% of those infected with NAP1 strains (P < 0.05). No significant differences were found in the clinical severity of illness and outcome among patients that tested positive for CDI by both tests (CYT and PCR) compared to those that tested positive by PCR only.