Geographic and temporal variation in racial and ethnic disparities in SARS-CoV-2 positivity between February 2020 and August 2021 in the United States

The coronavirus pandemic has disproportionally impacted racial and ethnic minority communities in the United States. Patterns of these disparities may be changing over time as outbreaks occur in different communities. Utilizing electronic health record data from the US Department of Veterans Affairs (VA), we estimated odds ratios, stratified by time period and region, for testing positive among 1,313,402 individuals tested for SARS-CoV-2 between February 12, 2020 and August 16, 2021 at VA medical facilities. We adjusted for personal characteristics (sex, age, rural/urban residence, VA facility) and a wide range of clinical characteristics that have been evaluated in prior SARS-CoV-2 reports and could potentially explain racial/ethnic disparities in SARS-CoV-2. Our study found racial and ethnic disparities for testing positive were most pronounced at the beginning of the pandemic and decreased over time. A key finding was that the disparity among Hispanic individuals attenuated but remained elevated, while disparities among Asian individuals reversed by March 1, 2021. The variation in racial and ethnic disparities in SARS-CoV-2 positivity by time and region, independent of underlying health status and other demographic characteristics in a nationwide cohort, provides important insight for strategies to prevent further outbreaks.

Hidden Pain: Children Who Lost a Parent or Caregiver to COVID-19 and What the Nation Can Do to Help Them

The COVID-19 pandemic has been the single deadliest acute public health crisis in American history, and these deaths are a salient threat to the functioning of family and social networks. We assess counts and rates of parental and other in-home caregiver loss using death data published by the CDC and household composition data available through the American Community Survey's Public Use Microdata Sample. We find that, through mid-November 2021, more than 167,000 children under the age of 18 lost a parent or other in-home caregiver to COVID-19. Most of these children are under the age of 13 and, though this experience is universal across racial and ethnic groups, ages, and states, racial and ethnic disparities in caregiver loss exceed already high disparities in COVID-19 deaths. We summarize literature on the impacts of parental loss and, after reviewing potential interventions for these children, offer recommendations to policymakers and practitioners.