COVID spread in households early in the pandemic
COVID-19 transmission was most commonly identified in households early on in the pandemic, but interviews also show an association with healthcare settings, according to a study yesterday in Emerging Infectious Diseases.
In a convenience sample of 202 COVID-19 patients from 16 states, the researchers looked at transmission factors from Jan 14 to Apr 4, 2020. COVID patients ranged from infantile (younger than 1 year) to 95 years. Almost all were symptomatic (96.5%), with symptoms more likely to develop in parents of index case-patients than other members, and one in three were hospitalized for symptoms.
Of the 82 case patients who had a known contact with lab-confirmed COVID-19 14 days prior to symptom onset, the most common exposure was in the household (53.7%) and the second most was healthcare (24.4%, of whom 70% were healthcare workers).
Case patients who didn’t have known COVID exposures worked in a variety of different settings. Still, 27.8% of 72 had a known contact in healthcare, and 23.8% of 84 had contact with an “ill person.” These patients were also significantly more likely to use public transportation (44% vs 16%), and at insignificant levels, more likely to report travel (38% vs 26%) or attendance at a mass gathering (36% vs 21%).
Sensitivity analysis results showed a plausible range of attack rates from 21% to 39%, with a median serial interval of 3 days, according to the study. Data indicated that transmission was more likely to stem from those 65 and older or from children to those ages 18 to 44.
“Case-patients reporting no known source of infection, travel, or any other exposure risk factor tended to be older and to have more underlying medical conditions—particularly diabetes mellitus,” the researchers add. “Persons with concurrent conditions may be not only more susceptible to severe outcomes from COVID-19 but also more susceptible to infection, as suggested by other analyses of SARS-CoV-2 and Middle East respiratory syndrome coronavirus; however, more investigation is warranted.”
Jun 30 Emerg Infect Dis study
ICE has worked to address COVID, GAO report says
US Immigration and Customs Enforcement (ICE) has worked to develop responsive COVID-19 protocols around facility intake processes, screening and testing, social distancing, and more, the Government Accountability Office (GAO) said in a report published yesterday.
In 2020, ICE tested 80,200 detainees for COVID-19, identified 8,622 cases (10.8%), and recorded 8 deaths. As part of its COVID response in 2020, the ICE also classified 14,729 detainees as high-risk, of whom 529 (3.6%) developed COVID-19 infections. As of March 2021, ICE confirmed more than 10,000 cases but the same number of deaths.
GAO talked with officials from six of 157 facilities that detained people for at least 72 hours. While COVID protocol was mostly in place, some facilities said it was difficult to quarantine at times and that detainees did not always adhere to mask wearing.
Additionally, the agency looked at recurring survey responses meant to measure COVID protocols. Among the selected facilities, one to six of 74 questions about pandemic response requirements were answered with a no (eg, the facility was not sanitizing detainee personal mail). Notably, one facility’s survey results showed that, through November 2020, the site had no policies to adapt social distancing and personal protective equipment use to religious practices.
“According to Detention Service Managers we spoke with, any issues identified with the survey responses were generally addressed informally through phone calls and other communications; however, we observed that several of the ‘no’ responses in the surveys we reviewed remained consistent over these course of several months,” GAO writes.
While Enforcement Removal Operations officials expected that continuing issues would be addressed by November 2020, assessment methods changed with an extensive survey revision in December 2020. Monthly on-site compliance checks also began.
Jun 30 GAO study