Session
COVID-19 and Special Populations
APHA 2022 Annual Meeting and Expo
Abstract
Preventing COVID-19 in Classroom Settings at a Large Public Institution of Higher Learning – October 2020 to December 2021
APHA 2022 Annual Meeting and Expo
Background: As students and faculty returned to campus during the COVID-19 pandemic, there was a need to ensure that these activities could be carried out safely.
Objectives: To describe and evaluate a surveillance program to identify and address potential classroom transmission of COVID-19 at a large public university (~123,000 affiliates) in partnership with the local health department.
Methods: Classroom surveillance occurred between Fall 2020 and Fall 2021. The classroom monitoring team detected face-to-face class sections where a high proportion of students were “withheld (>10% for classes <50 enrolled, >5% for classes of 50+) as cases, contacts, or suspect cases. Case and contact interviews were reviewed to determine whether the withhelds were related and if other transmission venues could be ruled out. The team could then reach out to professors to provide education on mitigation, request an environmental assessment, or recommend targeted messaging to promote testing within a section.
Results: The number of sections identified ranged from 149 in Fall 2020 to zero during Summer A 2021. Targeted testing messaging was sent on four separate occasions, affecting 1627 students in total. These efforts identified 19 additional individuals who needed to be withheld and sections dropped below the threshold of concern after testing. Classroom monitoring also helped to identify other types of contact, like social gatherings, that were missed in traditional contact tracing interviews.
Conclusions: This passive surveillance system helped to identify and react to potential classroom transmission and could be replicated by other institutions during future waves or pandemics.
Abstract
Preparedness and Response of Assisted Living Facilities towards COVID-19, Houston Texas
APHA 2022 Annual Meeting and Expo
Background
COVID-19 pandemic adversely affected Long Term Care Facilities (LTCFs) within the United States. Houston Health Department (HHD) supported LTCFs in early detection of outbreaks, prompt institution of control measures and implementation of preventive strategies.
Objectives
Conducted onsite assessment of assisted living facilities (ALFs) to evaluate facility-level preparedness towards COVID-19, identify infection prevention/control (IPC) gaps, and ensure equitable distribution of resources for effective response.
Methods:
Modified CDC Infection Control Assessment and Response (ICAR) tool was deployed. Parameters assessed included monitoring and screening measures, staff training, IPC practices, and vaccination status. Facilities were classified as large, medium or small-scale based on their bed-capacity. Frequencies were tabulated and bivariate association determined.
Results:
A total of 118 facilities were assessed, 46 (39%) 47 (40%) and 25 (21%) were small, medium and large scale respectively. The facilities had 2,431 residents and 2,290 staff. Thirty-one (26%) facilities reported an outbreak in 2020, while 14 (12%) had an active outbreak at time of assessment. Twenty-three (97%) of large-scale and 12 (26%) of small-scale facilities had coordinated testing program. While 24 (96%) large-scale and 34 (77%) of small-scale facilities reported training their staff on IPC practices, 22 (92%) of large-scale and only 19 (56%) of small-scale facility staff demonstrated capacity (p=0.01). At time of assessment, only 39% and 57% small and medium-scale facilities had received their COVID-19 vaccines.
Conclusion:
ALFs had varying levels of preparedness and response towards COVID-19, with a lower preparedness observed among small-scale facilities. HHD in partnership with state and federal health agencies provided training, testing and vaccination support to meet identified gaps.
Abstract
Economic Effect of Changes to Industry-Specific Foot Traffic During COVID-19
APHA 2022 Annual Meeting and Expo
Background:
The COVID-19 pandemic has resulted in tremendous disruption to business activities across the entire economy. There are few resources available for understanding the relationship between changes in contact rate and business activity.
Objective(s):
Our intent was to examine these relationships under COVID-19. We describe a method that allows researchers and policymakers to: 1) classify industries as highly economically sensitive or robust to foot traffic changes over the course of the pandemic, and 2) assess the degree to which non-pharmaceutical interventions (NPIs) affected economic production across industries.
Methods:
We utilized a pre/post study design that controlled for seasonality. Our approach combines cell-phone-based mobility data and business activity (revenue) data from two different commercial data sources with a common business classification scheme and time interval. For our analysis we compared mobility data and economic activity changes between the second quarter of 2019 to the second quarter of 2020.
Results
While foot traffic (as proxied by mobility) declined 46% during this interval, the overall decline in economic activity by American businesses was much smaller, i.e., revenue declined approximately $2.5 trillion (7.5%). However, the distribution of these losses was deeply inequitable across industries. Finally, tolerance to observed NPIs and subsidies implemented in the second quarter of 2020 was relatively strong.
Conclusion
Our method has promise for the ongoing need to measure economic and contact rate changes during a pandemic, to design earlier and more targeted NPI interventions, and to focus subsidies on businesses that face the greatest risk from pandemics and response policies.
Abstract
Impact of COVID-19 on deceased organ donation in the U.S.
APHA 2022 Annual Meeting and Expo
Background: The COVID-19 pandemic directly impacted solid organ donation and transplantation during 2020 and 2021, causing excess mortality among organ transplant candidates and recipients, complicating organ procurement, and leading to organ failure and subsequent transplant waitlisting for some of the infected. However, shifts in the deceased donor pool during the pandemic have not been fully described in the scientific literature.
Objective: Describe the impact of COVID-19 on deceased solid organ donation in the U.S.
Methods: We examined the cohort of all deceased donors procured for the purposes of transplantation in the U.S. between 2006 to 2021 from Organ Procurement and Transplantation Network data. We calculated the number of donors each year, by demographic factor and by mechanism of death to determine trends over time and impacts on the donor cohort of the COVID-19 pandemic.
Results: Deceased donation increased to record levels in 2020 (12,588 donors) and 2021 (13,863), in spite of the pandemic. However, the types of donors procured during 2020 markedly shifted. Asphyxia mechanism donors decreased that year from 2019 totals, while drug intoxication mechanism donors increased sharply (1,604 to 2,031) and the number donors due to other mechanisms was nearly stagnant.
Conclusion: The COVID-19 pandemic led to shifts in the types of deceased donors who were procured in 2020, suggesting that future pandemics may also impact the organ transplant system. Assessing these impacts on the transplant system in the U.S. may improve public health system planning for future pandemics.