scholarly journals 396. Disparities in SARS-CoV-2 Antibody Prevalence: Findings from a Citywide Serosurvey in Holyoke, Massachusetts, November 2020–January 2021

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S299-S300
Author(s):  
Wilfredo Matias ◽  
Isabel Fulcher ◽  
Cody Nolan ◽  
Yodeline Guillaume ◽  
Jack Zhu ◽  
...  
Keyword(s):  
High Risk ◽  
Herd Immunity ◽  
Risk Groups ◽  
Dried Blood Spots ◽  
Antibody Testing ◽  
Local Responses ◽  
Antibody Positivity ◽  
Exposure History ◽  
Prior Infection ◽  
Probability Of Response

Abstract Background Seroprevalence studies are important tools to estimate the prevalence of prior or recent SARS-CoV-2 infections. This information is critical for identifying hotspots and high-risk groups and informing public health responses to the COVID-19 pandemic. We conducted a city-level seroprevalence study in Holyoke, Massachusetts to estimate the seroprevalence of SARS-CoV-2 antibodies and risk factors for seropositivity. Methods We invited inhabitants of 2,000 randomly sampled addresses to participate between November 5 and December 31, 2020. Participants completed questionnaires measuring sociodemographic and health characteristics, and COVID-19 exposure history, and provided dried blood spots for measurement of SARS-CoV-2 IgG and IgM antibodies. To calculate total and group seroprevalence estimates, inverse probability of response weights were constructed based on age, gender, race/ethnicity and census tract to ensure estimates represented the city’s population. Results We enrolled 280 households including 472 individuals. 328 underwent antibody testing. The citywide weighted seroprevalence of SARS-CoV-2 IgG or IgM was 13.9% (95%CI 7.8 - 21.8) compared to 9.8% based on publicly reported case counts. Seroprevalence was 16.8% (95%CI 5.7 – 28.0) among individuals identifying as Hispanic compared to 8.9% (95%CI 3.0 - 14.7) among those identifying as White. Seroprevalence was 20.7% (95%CI 2.2 – 39.2) for ages 0-19; 13.8% (95%CI 5.6 – 22) for ages 20 – 44; 9.6% (95%CI 0 – 20.5) for ages 45 – 59; 4.8% (95%CI 0 – 10.2) for ages 60 – 84; and 42.9% (95%CI 0 – 100) for ages >85. Table 1. Seroprevalence by antibody positivity profile Table 2. Unweighted and weighted seroprevalence by sociodemographic characteristics Figure 1. Seroprevalence by Medical, Symptom, Testing and Exposure History. Conclusion The measured SARS-CoV-2 seroprevalence in Holyoke was only 13.9% during the second surge of SARS-CoV-2 in this region, far from accepted thresholds for “herd immunity” and highlighting the need for expanding vaccination. Individuals identifying as Hispanic were at high risk of prior infection. Subsequent community-level serosurveys are necessary to guide local responses to the SARS-CoV-2 pandemic. Disclosures All Authors: No reported disclosures

scholarly journals Disparities in SARS-CoV-2 exposure: evidence from a citywide seroprevalence study in Holyoke, Massachusetts, USA

2021 ◽  
Author(s):  
Wilfredo Rafael Matias ◽  
Isabel R Fulcher ◽  
Sara M Sauer ◽  
Cody P Nolan ◽  
Yodeline Guillaume ◽  
...  
Keyword(s):  
Public Health ◽  
Herd Immunity ◽  
Antibody Test ◽  
Risk Groups ◽  
Dried Blood Spots ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Educational Materials ◽  
Seroprevalence Study ◽  
English Speaking

Background: Seroprevalence studies are important tools to estimate the prevalence of prior or recent SARS-CoV-2 infections, identifying hotspots and high-risk groups and informing public health responses to the COVID-19 pandemic. We conducted a city-level seroprevalence study in Holyoke, Massachusetts, USA to estimate the seroprevalence of SARS-CoV-2 antibodies and risk factors for seropositivity. Methods: We invited inhabitants of 2,000 randomly sampled addresses between November 5 and December 31, 2020. Participants completed questionnaires measuring sociodemographic and health characteristics, and COVID-19 exposure history, and provided dried blood spots for measurement of SARS-CoV-2 IgG and IgM antibodies. We calculate total and subgroup seroprevalence estimates based on presence of IgG antibodies using a Bayesian procedure that incorporates uncertainty in antibody test sensitivity and specificity. We account for clustering by household and weighting based on demographic characteristics to ensure estimates represented the citys population. Findings: We enrolled 280 households including 472 individuals. 328 underwent antibody testing. The citywide seroprevalence estimate of SARS-CoV-2 IgG was 13.1% (95%CI 6.9-22.3) compared to 9.8% based on publicly reported case counts. Seroprevalence was 16.1% (95%CI 6.2-31.8) among individuals identifying as Hispanic compared to 9.4% (95%CI 4.6-16.4) among those identifying as non-Hispanic white. Seroprevalence was higher among Spanish speaking households (21.9%; 95% CI 8.3-43.9) compared to English speaking households (10.2%; 95% CI 5.2-18.0) and among individuals living in high vulnerability areas (14.4%; 95% CI 7.1-25.5) compared to low vulnerability areas (8.2%; 95% CI 3.1-16.9). Interpretation: The measured SARS-CoV-2 seroprevalence of IgG antibodies in Holyoke was only 13.1% during the second surge of SARS-CoV-2 in this region, far from accepted thresholds for herd immunity. Already vulnerable communities were at highest risk of prior infection. Implementation of local serosurveys in tandem with proactive public health interventions that address disparities in SARS-CoV-2 exposure are crucial to ensure at-risk communities have appropriate educational materials and access to vaccines, testing, and timely treatment.

scholarly journals COVID-19: Rethinking the Lockdown Groupthink

2021 ◽  
Vol 9 ◽  
Author(s):  
Ari R. Joffe
Keyword(s):  
Public Health ◽  
High Risk ◽  
Cost Benefit Analysis ◽  
Health Care Systems ◽  
Herd Immunity ◽  
Cost Benefit ◽  
Risk Groups ◽  
School Closures ◽  
Trade Offs ◽  
Care Systems

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population's movements, work, education, gatherings, and general activities in attempt to “flatten the curve” of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. The initial modeling predictions induced fear and crowd-effects (i.e., groupthink). Over time, important information emerged relevant to the modeling, including the lower infection fatality rate (median 0.23%), clarification of high-risk groups (specifically, those 70 years of age and older), lower herd immunity thresholds (likely 20–40% population immunity), and the difficult exit strategies. In addition, information emerged on significant collateral damage due to the response to the pandemic, adversely affecting many millions of people with poverty, food insecurity, loneliness, unemployment, school closures, and interrupted healthcare. Raw numbers of COVID-19 cases and deaths were difficult to interpret, and may be tempered by information placing the number of COVID-19 deaths in proper context and perspective relative to background rates. Considering this information, a cost-benefit analysis of the response to COVID-19 finds that lockdowns are far more harmful to public health (at least 5–10 times so in terms of wellbeing years) than COVID-19 can be. Controversies and objections about the main points made are considered and addressed. Progress in the response to COVID-19 depends on considering the trade-offs discussed here that determine the wellbeing of populations. I close with some suggestions for moving forward, including focused protection of those truly at high risk, opening of schools, and building back better with a economy.

An evaluation of the performance of OraQuick® ADVANCE Rapid HIV-1/2 Test in a high-risk population attending genitourinary medicine clinics in East London, UK

2008 ◽  
Vol 19 (10) ◽  
pp. 665-667 ◽  
Author(s):  
J Zelin ◽  
N Garrett ◽  
J Saunders ◽  
F Warburton ◽  
J Anderson ◽  
...  
Keyword(s):  
High Risk ◽  
Test Performance ◽  
Predictive Value ◽  
Risk Groups ◽  
Antibody Detection ◽  
High Risk Population ◽  
Antibody Testing ◽  
Observer Error ◽  
The Uk ◽  
Hiv 1

To date, no data have been published on the use of OraQuick® ADVANCE Rapid HIV-1/2 Test (OraQuick) in the UK. We report preliminary findings of an ongoing evaluation of OraQuick in UK genitourinary (GU) medicine clinics. A total of 820 samples from patients in high-risk groups for HIV were tested with OraQuick and results were compared with standard HIV antibody testing. HIV prevalence (enzyme immunoassay [EIA]) was 5.73%, sensitivity of OraQuick was 93.64% (95% CI 82.46–98.66%), specificity 99.87% (99.28–100%), positive predictive value 97.78% (88.27–99.94%) and negative predictive value 99.61% (98.87–99.92%). This includes three false-negatives considered to be due to observer error and now rectified by further training. This has increased test sensitivity to 100%. Our observed test performance of OraQuick compares well with EIA and with other rapid tests. We believe that simple, non-invasive antibody detection tests such as OraQuick can increase HIV testing and diagnosis in UK GU medicine and community settings.

Preoperative HIV Antibody Testing: The Views of Surgeons and Patients

1995 ◽  
Vol 6 (6) ◽  
pp. 426-430 ◽  
Author(s):  
Jean Meadows ◽  
Gillian Irving ◽  
Kate Chapman ◽  
Brian Gazzard ◽  
Jose Catalan
Keyword(s):  
At Risk ◽  
High Risk ◽  
Hiv Infection ◽  
Risk Groups ◽  
Routine Practice ◽  
Antibody Testing ◽  
Hiv Test ◽  
Patient Consent ◽  
Hospital Doctors ◽  
Hiv Antibody Testing

Summary: Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counselling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging in high risk behaviours. Finally, when asked which health professionals they thought should be involved in HIV test counselling, both surgeons and patients agreed that hospital doctors, including surgeons themselves, should take on the responsibility of test counselling. The implications of this and routine HIV antibody testing are discussed.

scholarly journals Modeling Return of the Epidemic: Impact of Population Structure, Asymptomatic Infection, Case Importation and Personal Contacts

2020 ◽  
Author(s):  
Xinhua Yu
Keyword(s):  
Population Structure ◽  
High Risk ◽  
Young People ◽  
Herd Immunity ◽  
Risk Groups ◽  
Asymptomatic Infection ◽  
Old People ◽  
Imported Cases ◽  
High Risk Populations ◽  
The Impact

AbstractBackgroundProactive interventions have halted the pandemic of coronavirus infected disease in some regions. However, without reaching herd immunity, the return of epidemic is possible. We investigate the impact of population structure, case importation, asymptomatic cases, and the number of contacts on a possible second wave of epidemic through mathematical modelling.MethodsWe built a modified Susceptible-exposed-Infectious-Removed (SEIR) model with parameters mirroring those of the COVID-19 pandemic and reported simulated characteristics of epidemics for incidence, hospitalizations and deaths under different scenarios.ResultsA larger percent of old people leads to higher number of hospitalizations, while a large percent of prior infection will effectively curb the epidemic. The number of imported cases and the speed of importation have small impact on the epidemic progression. However, a higher percent of asymptomatic cases slows the epidemic down and reduces the number of hospitalizations and deaths at the epidemic peak. Finally, reducing the number of contacts among young people alone has moderate effects on themselves, but little effects on the old population. However, reducing the number of contacts among old people alone can mitigate the epidemic significantly in both groups, even though young people remain active within themselves.ConclusionReducing the number of contacts among high risk populations alone can mitigate the burden of epidemic in the whole society. Interventions targeting high risk groups may be more effective in containing or mitigating the epidemic.

Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda
Keyword(s):  
High Risk ◽  
Psychiatric Disorders ◽  
Suicide Rate ◽  
Risk Groups ◽  
The Elderly ◽  
Female Ratio ◽  
Suicide Notes ◽  
Suicidal Intention ◽  
Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

ON THE ROLE OF BIOMONITORING IN THE ASSESSMENT OF THE HEALTH OF THE POPULATION EXPOSED TO MERCURY

2017 ◽  
pp. 2-7
Author(s):  
L. V. Lukovnikova ◽  
G. I. Sidorin ◽  
L. A. Alikbaeva ◽  
A. V. Galochina
Keyword(s):  
High Risk ◽  
Biological Monitoring ◽  
Clinical Examination ◽  
Inorganic Compounds ◽  
Risk Groups ◽  
Comprehensive Approach ◽  
Chemical Monitoring ◽  
Environmental Objects

When examining the population exposed to organic and inorganic compounds of mercury, a comprehensive approach is proposed, including chemical monitoring of environmental objects, biological monitoring, clinical examination of persons exposed to mercury, identification of high-risk groups.

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