A Litany of Saints: Remembering the Early Years of HIV/AIDS Activism in the First Year of a New Pandemic

With the emergence of COVID-19 in the U.S., many LGBTQ people found ourselves reflecting upon the early years of HIV/AIDS and how our communities responded to the lack of robust federal and state response to this preceding public health crisis. As the leaders of the Bradbury-Sullivan LGBT Community Center (BSC) in eastern Pennsylvania became a central resource for our community sharing up-to-date information about COVID-19 and organizing vaccine clinics, they also recognized the historic nature of this moment as many elders in our community consistently tried to make sense of the current crisis by contemplating their past AIDS activism and organizing. In March of 2020, BSC staff and archivists received grant funding to conduct an oral history project called "40 Years of Public Health in the LGBTQ Community: Collecting and Curating Local LGBTQ Health Experiences From HIV/AIDS to COVID-19," which recorded both timely commentary on the impact of COVID-19 on LGBTQ people and memories of HIV/AIDS organizing that seemed urgent and relevant to our contemporary moment. Offering excerpts from oral histories collected in 2020, this piece explores how COVID-19 spurred LGBTQ people in the Lehigh Valley to share stories about communal grief, health inequity, political responses to pandemics, and organizing to support the health of minoritized communities.

Vincetoxicum nigrum (black swallowwort).

V. nigrum is a herbaceous climbing vine native to south-western Europe (Italy, France, Portugal and Spain). It has spread extensively throughout New England, the lower Hudson River basin and south-eastern Pennsylvania, USA. V. nigrum produces a large number of wind-borne, self-fertile seeds which readily disperse to new sites. Small patches of V. nigrum can coalesce to form large, monospecific stands that outcompete with native vegetation and alter habitats. In Vermont and New Hampshire, USA, the endemic and endangered species, Astragalus robbinsii var. jesupii, is under pressure by an expanding population of V. nigrum. In addition to this V. nigrum may have negative impact on the monarch butterfly, Danaus plexippus.

The King’s Jasper Quarry, Lehigh County, Pennsylvania

The King’s Quarry site (36LH2), located in the Reading Prong region of eastern Pennsylvania, is one of six remaining jasper quarries mapped by the late James Hatch and reported in 1994. Several archaeological investigations were conducted there in preparation for a housing development. These investigations included controlled surface collections, hand excavated test units, and extensive mechanical investigations of mining pits. Pre-Contact era quarry pits were profiled in what appeared to be the most intensively mined area of the site. Several charcoal samples were collected from the profile which documented a prehistoric excavation over 7 m deep. A Paleoindian fluted preform along with other typical Paleoindian tools were recovered from the perimeter of the quarry pit. We present the results of the field testing and an extensive analysis of the artifacts. Despite the jumble of overlapping mining pits and historic farming activities, the site retains both horizontal and vertical integrity.

PENNSYLVANIA’S ABANDONED MINE LAND (AML) EMERGENCY PROGRAM

The Pennsylvania Department of Environmental Protection’s Bureau of Abandoned Mine Reclamation (BAMR) implements an Abandoned Mine Land (AML) Emergency Program to address high-priority, abandoned mine land (AML) problems that suddenly occur throughout Pennsylvania’s coal fields. BAMR maintains two field offices: one in eastern Pennsylvania (Anthracite Region) in Wilkes-Barre and one in western Pennsylvania (Bituminous Region) in Ebensburg. Both field offices maintain in-house construction crews with significant equipment available to respond to and address many small AML Emergencies (hazards) such as pothole (or cavehole), subsidences, and mine drainage breakouts. For larger AML Emergencies such as subsidence events causing structural damage to homes, businesses, and roads; mine fires; coal refuse fires; landslides; or other large-scale or complex AML problems, projects are completed by outside contractors. Project designs are completed by BAMR engineering staff. The contractors are then hired through solicitation of bids or proposals with very short timeframes between bid issue and bid opening. Since October of 2010, BAMR has addressed nearly 800 AML Emergencies which equates to approximately 80 AML Emergency projects each calendar year. The average construction cost to address those emergencies was just over $3.25 million per year. Due to the increased precipitation over the Commonwealth the last several years, that number has increased to an average of 86 AML Emergency projects over the last five (5) years (2015–2019) with a record number of 127 addressed in calendar year 2018. The average cost to address those AML Emergency projects over that five-year period was $4.66 million per year. This paper will provide some background on Pennsylvania’s AML Emergency Program, some summary statistics including the annual number and types of projects completed including costs, and also highlight through both photos and video links some typical projects recently completed by the program.

Solving Community SARS-CoV-2 Testing With Telehealth: Development and Implementation for Screening, Evaluation and Testing

Background Telehealth has emerged as a crucial component of the SARS-CoV-2 pandemic emergency response. Simply stated, telehealth is a tool to provide health care from a distance. Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19–related concerns. Objective This study aims to describe the expansion and results of using a telehealth program to increase access to care while minimizing additional potential exposures during the early period of the COVID-19 pandemic. Methods Screening algorithms for patients with SARS-CoV-2–related complaints were created, and 150 new clinicians were trained within 72 hours to address increased patient demand. Simultaneously, Jefferson Health created mobile testing sites throughout eastern Pennsylvania and the southern New Jersey region. Visit volume, the number of SARS-CoV-2 tests ordered, and the number of positive tests were evaluated, and the volume was compared with preceding time periods. Results From March 8, 2020, to April 11, 2020, 4663 patients were screened using telehealth, representing a surge in visit volume. There were 1521 patients sent to mobile testing sites, and they received a telephone call from a centralized call center for results. Of the patients who were tested, nearly 20% (n=301) had a positive result. Conclusions Our model demonstrates how using telehealth for a referral to central testing sites can increase access to community-based care, decrease clinician exposure, and minimize the demand for personal protective equipment. The scaling of this innovation may allow health care systems to focus on preparing for and delivering hospital-based care needs.

1559. Methicillin Susceptible Staphylococcus aureus Is The Predominant Organism In Septic Bursitis With The Majority Involving The Olecranon Bursa: A Study Of 61 Cases

Background Bursae are fluid filled structures between mobile parts of the musculoskeletal system to reduce friction between surfaces by lubrication. The most frequently infected are the olecranon and prepatellar bursae. In reported studies there is male preponderance, a relationship to occupational or recreational activities, a mean age of about 50 years and the most frequent organism being Staphylococcus aureus. The frequency of methicillin resistance is not well documented. Methods We analyzed approximately 7000 Staphylococcus aureus isolates reported by the laboratory over a 3-year period in 10 of our network hospitals, 9 in Eastern Pennsylvania and one in adjacent Warren County, New Jersey and found 61 cases of S. aureus septic bursitis. Results Only 13/61 (21.3%) were caused by methicillin resistant S. aureus (MRSA), 8 olecranon (61.5%), 4 prepatellar (30.8%) and one subacromial (7.7%). Only one in MRSA group (olecranon bursitis) was female. The mean age of MRSA cases was 58.5. Methicillin susceptible S. aureus (MSSA) predominated with 34/48 (70.8%) olecranon bursitis (28M/6F), 11/48 (22.9%) prepatellar bursitis (10M/1F) and 3/48 (6.3%) sub acromial bursitis (1M/2F) with a mean age of 61.9. Overall (MRSA +MSSA), 51/61 (83.6%) were male and 10/61 (16.4%) were female. The olecranon bursa was involved in 42/61 (68.9%), prepatellar bursa 15/54 (24.6%) and subacromial bursa 4/54 (6.6%). The mean age for the entire group was 61.2 with the youngest 23 and the oldest 93. The occupational history was recorded only in a few patients e.g. roofer, floor worker, construction worker. Three in the MSSA group had bacteremia (2 subacromial bursitis and 1 olecranon bursitis). There was 1 death from gram negative sepsis which was unrelated. The majority were successfully treated with a combination of drainage and antibiotics. Conclusion In summary, our study shows a predominance of olecranon bursitis, with a higher incidence in males and majority caused by MSSA. The mean age around 61 was higher than the mean age in prior reports around 50 years. Elbows and knees accounted for 57/61 (93%) cases of septic bursitis. Avoidance of activities involving friction or repeated trauma to elbows and knees should help prevention of septic bursitis. As far as we are aware, this is the largest series of septic bursitis reported. Disclosures All Authors: No reported disclosures