Development of a Bamlanivimab Infusion Process in the Emergency Department for Outpatient COVID-19 Patients

The coronavirus disease 2019 (COVID-19) pandemic has prompted the creation of new therapies to help fight against the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bamlanivimab is a SARS-CoV-2 monoclonal antibody that is administered as an intravenous infusion to ambulatory patients with mild or moderate COVID-19, but a concern that arose was deciding the optimal location for patients to receive the medication. This report describes the development and implementation of a bamlanivimab infusion center in the emergency department of three hospitals in Orange County, California, shortly after bamlanivimab received emergency use authorization. As a result, a total of 601 patients received bamlanivimab in one of these three emergency departments between December 2020 to April 2021. The emergency department was shown to be an optimal setting for administration of bamlanivimab due to its convenience, accessibility, and capabilities for monitoring patients.

GWEP TAG-TEAM Response: COVID-19 Health Disparities in Orange County, California

Health disparities follow zip codes, and in Orange County, CA, both COVID-19 cases and deaths are highly concentrated in our diverse geriatric populations in Santa Ana (44,075) and Anaheim (40,984) where our two UCI Federally Qualified Health Centers (FQHCs) are located, and Garden Grove (16,174) and Buena Park (7,581), where University of California Irvine (UCI) TAG-TEAM GWEP community partner FQHCs are located. Collectively, our FQHCs serve diverse populations, with 83-88% of patients identifying as Hispanic/Latino or Asian. As we support these clinics in becoming Age-Friendly Health Systems, UCI’s GWEP pivoted to provide COVID-19 education in the form of multi-lingual materials and videos available in Spanish, Vietnamese, Korean, Mandarin, and Farsi. Additionally, through our Age-Friendly Geriatrics Tele-ECHO Series we are working to build Mental Health care competencies among these FQHC providers since the pandemic morbidity and mortality disparities have resulted in a profound mental health crisis in our communities.

Distinct SARS-CoV-2 antibody reactivity patterns elicited by natural infection and mRNA vaccination

We analyzed data from two ongoing COVID-19 longitudinal serological surveys in Orange County, CA., between April 2020 and March 2021. A total of 8476 finger stick blood specimens were collected before and after a vaccination campaign. IgG levels were determined using a multiplex antigen microarray containing antigens from SARS-CoV-2, SARS, MERS, Common CoV, and Influenza. Twenty-six percent of specimens from unvaccinated Orange County residents in December 2020 were SARS-CoV-2 seropositive; out of 852 seropositive individuals 77 had symptoms and 9 sought medical care. The antibody response was predominantly against nucleocapsid (NP), full length, and S2 domain of spike. Anti-receptor binding domain (RBD) reactivity was low and not cross-reactive against SARS S1 or SARS RBD. A vaccination campaign at the University of California Irvine Medical Center (UCIMC) started on December, 2020 and 6724 healthcare workers were vaccinated within 3 weeks. Seroprevalence increased from 13% pre-vaccination to 79% post-vaccination in January, 93% in February, and 99% in March. mRNA vaccination induced higher antibody levels than natural exposure, especially against the RBD domain and cross-reactivity against SARS RBD and S1 was observed. Nucleocapsid protein antibodies can be used to distinguish vaccinees to classify pre-exposure to SARS-CoV-2 Previously infected individuals developed higher antibody titers to the vaccine than non pre-exposed individuals. Hospitalized patients in intensive care with severe disease reach significantly higher antibody levels than mild cases, but lower antibody levels compared to the vaccine. These results indicate that mRNA vaccination rapidly induces a much stronger and broader antibody response than SARS-CoV-2 infection.

A Mobile Platform for Food Donation and Delivery System using AI and Machine Learning

Within the last year through the turmoil of the Covid-19 pandemic, an increasing number of families and individuals are experiencing food insecurity due to a loss of job, illnesses, or other financial struggles [4]. Many families in the Orange County area and abroad are turning to free food sources such as community food pantries or banks. Using specified surveys to food insecure families, we discovered a need for a solution to enhance the accessibility and usability of food pantries [5]. Therefore, we created a software application that uses artificial intelligence to locate specific items for users to request, and allow volunteers to see those requests and pick up the resources from food pantries, and deliver them directly to the homes of individuals. This paper shows the process in which this idea was created and how it was applied, along with the conduction of the qualitative evaluation of the approach. The results show that the software application allowed families and individuals to receive quality groceries at a much higher frequency, regardless of multiple constraints.

Sabine Pass to Galveston Bay, TX Pre-construction, Engineering and Design (PED) : coastal storm surge and wave hazard assessment : report 3 – Orange County

The US Army Corps of Engineers, Galveston District, is executing the Sabine Pass to Galveston Bay Coastal Storm Risk Management (CSRM) project for Brazoria, Jefferson, and Orange Counties regions. The project is currently in the Pre-construction, Engineering, and Design phase. This report documents coastal storm water level (SWL) and wave hazards for the Orange County CSRM structures. Coastal SWL and wave loading and overtopping are quantified using high-fidelity hydrodynamic modeling and stochastic simulations. The CSTORM coupled water level and wave modeling system simulated 195 synthetic tropical storms on three relative sea level change scenarios for with- and without-project meshes. Annual exceedance probability (AEP) mean values were reported for the range of 0.2 to 0.001 for peak SWL and wave height (Hm0) along with associated confidence limits. Wave period and mean wave direction associated with Hm0 were also computed. A response-based stochastic simulation approach is applied to compute AEP values for overtopping for levees and overtopping, nappe geometry, and combined hydrostatic and hydrodynamic fluid pressures for floodwalls. CSRM crest design elevations are defined based on overtopping rates corresponding to incipient damage. Survivability and resilience are evaluated. A system-wide hazard level assessment was conducted to establish final recommended system-wide elevations.

Chicanx histories of the present: a praxis against gang injunctions in Orange County, California, 2008–2016

Chicanxs Unidxs de Orange County (CU) is a community organisation in Southern California. Founded in 2006, CU is small, multigenerational and multi-ethnic. Its organising has focused predominantly on building community power by focusing on local politics, abusive policing and the gentrification of Chicanx neighbourhoods. This article presents an evidence-based narrative of several CU campaigns (primarily between 2008 and 2016). CU’s tactical aggressiveness and strategic pragmatism forced significant changes to ‘civil gang injunctions’ in California. For decades, California law enforcement has used such injunctions to suppress a generation of young people of colour as ‘gang members’. Minors and adults have been prohibited indefinitely from engaging in otherwise legal activities without due process. CU’s emphasis on the longevity of institutionalised and societal racism, rooted in the colonial conquest, resembles arguments associated with critical race theory (CRT) – though CU was not inspired by CRT. CU’s praxis resembles practices of critical pedagogy – though it was not directly modelled on it either. Rather, we argue that CU’s praxis is embedded in the members’ lived experience and study of the local history of racism, community and social movements. All five of this article’s authors were members of CU and were involved in the organising described in this article. The authors wrote this at the request of the CU membership, and it has been discussed and revised by the full membership.