scholarly journals Introduction, Transmission Dynamics, and Fate of Early SARS-CoV-2 Lineages in Santa Clara County, California

2021 ◽  
Author(s):  
Elsa Villarino ◽  
Xianding Deng ◽  
Carol A Kemper ◽  
Michelle A Jorden ◽  
Brandon Bonin ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Viral Genome ◽  
Public Health Intervention ◽  
The United States ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Clinical Samples ◽  
Post Mortem ◽  
Santa Clara County

Abstract We combined viral genome sequencing with contact tracing to investigate introduction and evolution of SARS-CoV-2 lineages in Santa Clara County, California from January 27 to March 21, 2020. Of 558 persons with COVID-19, 101 genomes from 143 available clinical samples comprised 17 different lineages including SCC1 (n=41), WA1 (n=9, including the first 2 reported deaths in the United States, diagnosed post-mortem), D614G (n=4), ancestral Wuhan Hu-1 (n=21), and 13 others (n=26). Public health intervention may have curtailed the persistence of lineages that appeared transiently during February–March. By August, only D614G lineages introduced after March 21 were circulating in SCC.

scholarly journals Attitudes and Perceptions Toward COVID-19 Digital Surveillance: Survey of Young Adults in the United States

10.2196/23000 ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. e23000
Author(s):  
Lauren Maytin ◽  
Jason Maytin ◽  
Priya Agarwal ◽  
Anna Krenitsky ◽  
JoAnn Krenitsky ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Young Adults ◽  
Online Survey ◽  
The United States ◽  
Contact Tracing ◽  
Health Crisis ◽  
Response Options ◽  
Health Technologies ◽  
Digital Surveillance

Background COVID-19 is an international health crisis of particular concern in the United States, which saw surges of infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and are an important target of the efforts to contain the pandemic. Scalable digital public health technologies could be deployed to reduce COVID-19 transmission, but their use depends on the willingness of young adults to participate in surveillance. Objective The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that may be associated with their willingness to participate in digital surveillance. Methods We conducted an anonymous online survey of young adults aged 18-24 years throughout the United States in June 2020. The questionnaire contained predominantly closed-ended response options with one open-ended question. Descriptive statistics were applied to the data. Results Of 513 young adult respondents, 383 (74.7%) agreed that COVID-19 represents a public health crisis. However, only 231 (45.1%) agreed to actively share their COVID-19 status or symptoms for monitoring and only 171 (33.4%) reported a willingness to allow access to their cell phone for passive location tracking or contact tracing. Conclusions Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). This is a potential obstacle to ongoing containment measures (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance for young adults.

scholarly journals Attitudes and Perceptions Toward COVID-19 Digital Surveillance: Survey of Young Adults in the United States (Preprint)

2020 ◽  
Author(s):  
Lauren Maytin ◽  
Jason Maytin ◽  
Priya Agarwal ◽  
Anna Krenitsky ◽  
JoAnn Krenitsky ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Young Adults ◽  
Online Survey ◽  
The United States ◽  
Contact Tracing ◽  
Health Crisis ◽  
Response Options ◽  
Health Technologies ◽  
Digital Surveillance

BACKGROUND COVID-19 is an international health crisis of particular concern in the United States, which saw surges of infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and are an important target of the efforts to contain the pandemic. Scalable digital public health technologies could be deployed to reduce COVID-19 transmission, but their use depends on the willingness of young adults to participate in surveillance. OBJECTIVE The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that may be associated with their willingness to participate in digital surveillance. METHODS We conducted an anonymous online survey of young adults aged 18-24 years throughout the United States in June 2020. The questionnaire contained predominantly closed-ended response options with one open-ended question. Descriptive statistics were applied to the data. RESULTS Of 513 young adult respondents, 383 (74.7%) agreed that COVID-19 represents a public health crisis. However, only 231 (45.1%) agreed to actively share their COVID-19 status or symptoms for monitoring and only 171 (33.4%) reported a willingness to allow access to their cell phone for passive location tracking or contact tracing. CONCLUSIONS Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). This is a potential obstacle to ongoing containment measures (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance for young adults.

scholarly journals Perspective: A National Public Health Workforce to Control COVID-19 and Address Health Disparities in the United States

2021 ◽  
Author(s):  
Peter H Kilmarx ◽  
Theodore Long ◽  
Michael J A Reid
Keyword(s):  
Public Health ◽  
United States ◽  
Health Disparities ◽  
Health Workforce ◽  
The United States ◽  
Public Health Workforce ◽  
Contact Tracing ◽  
Future Health ◽  
Health Security ◽  
Long Run

Abstract A large, well-trained public health workforce is needed to control COVID-19 in the United States in the short term and to address other disease burdens and health disparities in the long run. As the public health workforce declined following the 2008 financial crisis, many U.S. jurisdiction struggled to hire a sufficient number staff for roles initially including testing and contact tracing and more recently for vaccination. Ultimately, COVID-19 control will require a combination of vaccination and rapid investigation, contact tracing, and quarantine to stop chains of transmission. New federal resources for a public health workforce have been made available. With appropriate attention to addressing administrative barriers and ensuring equity, a 21 st-century U.S. public health workforce will hasten the control of COVID-19, provide economic relief to individuals and communities, reduce the burden of other infectious diseases, non-communicable diseases, and other disease burdens. A long-term commitment to a robust public health workforce is vital to ensuring health security and preparedness for future health threats.

scholarly journals Descriptive Norms and Prototypes Predict COVID-19 Prevention Cognitions and Behaviors in the United States: Applying the Prototype Willingness Model to Pandemic Mitigation

2021 ◽  
Author(s):  
Laurel M Peterson ◽  
Marie Helweg-Larsen ◽  
Sarah DiMuccio
Keyword(s):  
Public Health ◽  
United States ◽  
Health Behaviors ◽  
Behavioral Intentions ◽  
The United States ◽  
Contact Tracing ◽  
Willingness To Participate ◽  
Descriptive Norms ◽  
Prototype Willingness Model ◽  
Prevention Behavior

Abstract Background Early in the COVID-19 pandemic, prevention behavior adoption occurred in a rapidly changing context. In contrast to expectancy-value theories, the Prototype Willingness Model (PWM) is well-suited for investigating novel and socially informed behaviors. Purpose We explored whether PWM social cognitions predicted coronavirus prevention behaviors. Method A representative sample of United States adults (N = 738; Mage = 46.8; 51.8% women; 78% white; April 2020) who had not had COVID-19 reported PWM predictor variables (perceived vulnerability, prevention descriptive norms, prototypes engaging in prevention behavior, and prevention behavioral intentions). Two weeks later, participants reported their prevention behaviors (handwashing, mask-wearing, social distancing, etc.) and future public health behavioral willingness (contact tracing, temperature checks, etc.). Results Controlling for putative demographic, past behavior, and coronavirus-contextual (e.g., local infection rates) covariates, mediation models indicated that higher norms and favorable prototypes were associated with greater prevention behavioral intentions, which in turn predicted increased prevention behavior, F(18, 705) = 92.20, p < .001, R2 = .70. Higher norms and favorable prototypes associated both directly and indirectly (through greater prevention behavioral intention) with greater willingness to engage in emerging public health behaviors, F(15, 715) = 21.49, p < .001, R2 = .31. Conclusions Greater descriptive norms and favorable prototypes for prevention behavior predicted: (a) future prevention behaviors through increases in behavioral intentions and (b) willingness to participate in emerging public health behaviors. These results held across demographic groups, political affiliation, and severity of regional outbreaks. Public health efforts to curb pandemics should highlight normative prevention participation and enhance positive prototypes.

scholarly journals The emergence of SARS-CoV-2 in Europe and North America

Science ◽  
2020 ◽  
Vol 370 (6516) ◽  
pp. 564-570 ◽  
Author(s):  
Michael Worobey ◽  
Jonathan Pekar ◽  
Brendan B. Larsen ◽  
Martha I. Nelson ◽  
Verity Hill ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
North America ◽  
The United States ◽  
Washington State ◽  
Contact Tracing ◽  
Emerging Viruses ◽  
Transmission Networks ◽  
Health Measures ◽  
Global Spread

Accurate understanding of the global spread of emerging viruses is critical for public health responses and for anticipating and preventing future outbreaks. Here we elucidate when, where, and how the earliest sustained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission networks became established in Europe and North America. Our results suggest that rapid early interventions successfully prevented early introductions of the virus from taking hold in Germany and the United States. Other, later introductions of the virus from China to both Italy and Washington state, United States, founded the earliest sustained European and North America transmission networks. Our analyses demonstrate the effectiveness of public health measures in preventing onward transmission and show that intensive testing and contact tracing could have prevented SARS-CoV-2 outbreaks from becoming established in these regions.

scholarly journals State-level Stay-at-home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Kyle J. Bourassa
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health Intervention ◽  
State Level ◽  
Large Degree ◽  
The United States ◽  
Total Change ◽  
Social Distancing ◽  
Objectively Measured ◽  
At Home

Objective: Social distancing has been one of the primary interventions used to slow the spread of COVID-19. State-wide stay-at-home orders received a large degree of attention as a public health intervention to increase social distancing, but relatively little peer-reviewed research has examined the extent to which stay-at-home orders affected people’s behavior. Method: This study used GPS-derived movement from 2,858 counties in the United States from March 1 to May 7, 2020 to test the degree to which changes in state-level stay-at-home orders were associated with movement outside the home. Results: From the first week of March to the first week of April, people in counties within states that enacted stay-at-home orders decreased their movement significantly more than people in counties within states that did not enact state-level stay-at-home orders. From the first week of April to the first week of May, people in counties within states that ended their stay-at-home orders increased their movement significantly more than people in counties within states whose stay-at-home orders remained in place. The magnitude of change in movement associated with state-level stay-at-home orders was many times smaller than the total change in movement across all counties over the same periods of time in both cases. Conclusions: Stay-at-home orders are likely insufficient to reduce people’s movement outside the home without additional public health actions. Existing research on behavior change would be useful to determine what additional interventions could support social distancing behaviors during the COVID-19 pandemic if becomes necessary to reduce movement in the future.

scholarly journals Rapid relaxation of pandemic restrictions after vaccine rollout favors growth of SARS-CoV-2 variants: A model-based analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258997
Author(s):  
Debra Van Egeren ◽  
Madison Stoddard ◽  
Alexander Novokhodko ◽  
Michael S. Rogers ◽  
Diane Joseph-McCarthy ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health Intervention ◽  
The United States ◽  
Modern Medicine ◽  
Health Intervention ◽  
Natural Immunity ◽  
Vaccine Acceptance ◽  
High Burden ◽  
Model Based Analysis

The development and deployment of several SARS-CoV-2 vaccines in a little over a year is an unprecedented achievement of modern medicine. The high levels of efficacy against transmission for some of these vaccines makes it feasible to use them to suppress SARS-CoV-2 altogether in regions with high vaccine acceptance. However, viral variants with reduced susceptibility to vaccinal and natural immunity threaten the utility of vaccines, particularly in scenarios where a return to pre-pandemic conditions occurs before the suppression of SARS-CoV-2 transmission. In this work we model the situation in the United States in May-June 2021, to demonstrate how pre-existing variants of SARS-CoV-2 may cause a rebound wave of COVID-19 in a matter of months under a certain set of conditions. A high burden of morbidity (and likely mortality) remains possible, even if the vaccines are partially effective against new variants and widely accepted. Our modeling suggests that variants that are already present within the population may be capable of quickly defeating the vaccines as a public health intervention, a serious potential limitation for strategies that emphasize rapid reopening before achieving control of SARS-CoV-2.

scholarly journals Catch and Contain Novel Pathogens Early!—Assessing U.S. Medical Isolation Laws as Applied to a Future Pandemic Detection and Prevention Model

2021 ◽  
pp. 23
Author(s):  
April Xiaoyi Xu
Keyword(s):  
Public Health ◽  
United States ◽  
Diagnostic Tests ◽  
High Speed ◽  
Geographical Area ◽  
The United States ◽  
Contact Tracing ◽  
Metagenomic Sequencing ◽  
Outbreak Response ◽  
Health Crisis

As of July 2, 2021, there have been 196,553,009 confirmed cases of the Coronavirus Disease (COVID-19), including 4,200,412 deaths, globally. Unfortunately, infectious diseases have been an “unavoidable fact of life” throughout history. While the global community looks forward to a gradual return to normalcy from COVID-19 with an increasing number of individuals getting vaccinated on a daily basis, the COVID-19 public health crisis has exposed significant inadequacies in many countries’ pandemic responses—the United States included. Governing authorities must actively consider more effective solutions to quickly detect and prevent the spread of future pandemics. One proposed model that offers promising potential, but is not yet developed in greater detail, is a future pandemic detection and monitoring architecture. This Comment will refer to this architecture as the “test-and-isolate model.” In his May 2020 Scientific American article, biochemist Dr. David J. Ecker recommends strategically placing modern high-speed metagenomic sequencing technology in urban hospitals across the United States to flag previously-unknown pathogens before the infectious agents have the opportunity to spread widely and pose threats of a new pandemic. Under this model, during a time period without any apparent pandemics (peacetime), the 200 biggest metropolitan hospitals in the U.S. would automatically run diagnostic tests upfront for novel causative agents for patients who visit the emergency room with severe respiratory symptoms that are possibly infectious. If such a system detects a sufficiently serious pathogen, public health agencies would send out diagnostic tests to all residents in the affected geographical area(s) within weeks and isolate those who test positive. This system could be integrated with contact tracing and more standard outbreak response.

scholarly journals Optimization of SARS-CoV-2 laboratory testing in a rural healthcare facility in the United States

2021 ◽  
Vol 8 (5) ◽  
pp. 2155
Author(s):  
Tanvi S. Bharathan ◽  
Austan J. Trale ◽  
Tashi Bharathan ◽  
Nichol L. Dienes ◽  
Jackie Sansig ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Rural Community ◽  
Medical Center ◽  
Quantitative Polymerase Chain Reaction ◽  
Diagnostic Testing ◽  
The United States ◽  
Clinical Samples ◽  
Transport Medium ◽  
Viral Transport Medium

Background: The diagnostic testing for SARS-COV-2 (COVID-19) presented a profound challenge to the entire world, dominating the concern of most governments and public health systems, particularly rural community hospitals in the United States. Indiana University of Pennsylvania (IUP) in partnership with Indiana Regional Medical Center (IRMC) began on site, same-day COVID-19 testing in efforts to not only combat the challenges that health providers faced in rural Indiana community but also help to strengthen global diagnostic capacity.Methods: Clinical samples were collected as dry swabs from the nasopharyngeal (NP) regions and processed in phosphate buffer saline (PBS). The crude RNA was directly tested using real-time (RT) reverse transcription quantitative polymerase chain reaction (RT-qPCR) with PrimeDirect probe RT-qPCR Mix (Takara Bio USA) and optimized with probe-primer sets [Integrated DNA Technologies (IDT)].Results: Validation experiments with dry swabs from NP clinical samples showed no difference in the testing accuracy to those collected in viral transport medium or universal transport medium. Extraction of COVID-19 RNA in PBS reduced processing time of a batch of 50 NP clinical samples from 6 hours to an hour. This allowed for rapid diagnostic testing of nearly 200 clinical samples per day. Optimization of analytical variables helped to detect virus loads up to 2.0 copies/μl during routine diagnostic testing.Conclusions: During an infectious outbreak, the ideal response by public health authorities is rapid testing. The collaboration between IUP and IRMC attests to the importance of teamwork between local initiatives to detect and prevent further spread within a rural community.

scholarly journals The specter of Manaus: the risks of a rapid return to pre-pandemic conditions after COVID-19 vaccine rollout

2021 ◽  
Author(s):  
Debra Van Egeren ◽  
Madison Stoddard ◽  
Alexander Novokhodko ◽  
Michael Rogers ◽  
Diane Joseph-McCarthy ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health Intervention ◽  
The United States ◽  
Modern Medicine ◽  
Health Intervention ◽  
Natural Immunity ◽  
Vaccine Acceptance ◽  
High Burden ◽  
Fatal Flaw

The development and deployment of several SARS-CoV-2 vaccines in a little over a year is an unprecedented achievement of modern medicine. The high levels of efficacy against transmission for some of these vaccines makes it feasible to use them to suppress SARS-CoV-2 altogether in regions with high vaccine acceptance. However, viral variants with reduced susceptibility to vaccinal and natural immunity threaten the utility of vaccines, particularly in scenarios where a return to pre-pandemic conditions occurs before the suppression of SARS- CoV-2 transmission. In this work we model the situation in the United States at present, to demonstrate how the P.1 variant of SARS-CoV-2 can cause a rebound wave of COVID-19 in a matter of months, similar to what happened in Manaus at the beginning of this year. A high burden of morbidity (and likely mortality) remains possible, even if the vaccine is partially effective against new variants and widely accepted. Our modeling suggests that variants that are already present within the population may be capable of quickly defeating the vaccines as a public health intervention, a fatal flaw in strategies that emphasize rapid reopening before achieving control of SARS-CoV-2.

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