SARS-CoV-2 Transmission Dynamics in Households With Children, Los Angeles, California

Objectives: Studies of household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) focused on households with children are limited. We investigated household secondary attack rate (SAR), transmission dynamics, and contributing factors in households with children.Materials and Methods: In this prospective case-ascertained study in Los Angeles County, California, all households members were enrolled if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal PCRs, serology, and symptom data were obtained over multiple visits.Results: A total of 489 individuals in 105 households were enrolled from June to December 2020. The majority (77.3%) reported a household annual income of <$50,000, and most (92.9%) were of Hispanic/Latinx ethnicity. Children <18 years old accounted for 46.9% index cases, of whom 45.3% were asymptomatic. Household index cases were predominantly children during low community transmission and adults during the high community transmission period (χ2 = 7.647, p = 0.0036. The mean household SAR was 77.0% (95% CI: 69.4–84.6%). Child and adult index cases both efficiently transmitted SARS-CoV-2 within households [81.9%, (95% CI: 72.1–91.9%) vs. 72.4% (95% CI: 59.8–85.1%), p = 0.23]. Household income and pets were significantly associated with higher SAR in the multivariable analysis of household factors (p = 0.0013 and 0.004, respectively).Conclusions: The SAR in households with children in an urban setting with a large ethnic minority population is much higher than previously described. Children play important roles as index cases. SAR was disproportionately impacted by household income. Vaccination and public health efforts need special focus on children and vulnerable communities to help mitigate SARS-CoV-2 spread.

Vaccination of elite athletes against SARS-CoV-2 and broader implications for public health policy

SARS-CoV-2, a human β-coronavirus implicated as thecausative agent in the COVID-19 pandemic, has been the subject of the most globally intensive vaccine development effort inrecorded history. The spectrum of SARS-CoV-2 vaccine candidates, deployedglobally, demonstrates an expansive diversity in regardsto design philosophies and immunological mechanisms of action. In the context of an aging, physically deconditioned, and overweight global population, which finds itself heavily burdened by a high prevalence of non-communicable chronic disease; elite strength, power and endurance athletes represent a minority population comprised of extreme physiological outliers. This report explores the molecular toxicity and pathophysiology of the SARS-CoV-2 spike protein, the design and immunological strategies embodied by the spectrum of SARS-CoV-2 vaccine candidates, and the intersection of these phenomena with the demographic, lifestyle and physiological characteristics of elite athletes; so as to inform vaccination strategies against SARS-CoV-2 which most protect this outlying minority population.

Barriers to African American and Other Minority Population Participation in Genomic-Related Health Research: A Systematic Literature Review

<p><a>The paucity of data for African Americans (AAs) participating in health-related research (e.g., genomic health research) is often attributed to difficulty in recruitment and retention. The COVID-19 pandemic, which has resulted in hundreds of thousands of deaths, particularly in AA communities, has amplified the problem. Reasons for not participating remain unclear and may account for health disparities observed in these communities. Failure and unwillingness to participate in research in general influences health disparities, which may lead to missed economic opportunities, inequalities, poor health, reduced quality of life, and premature death.</a> This review assesses barriers to acceptance of genomic-related health research among AAs and other marginalized populations. To investigate barriers to participating in health-related research involving deoxyribonucleic acid (DNA), 38 studies published in PubMed and Scopus between January 2008 and December 2018 were reviewed. Results were based on feedback collected by trained research assistants and phlebotomists during structured group, face-to-face, and telephonic<b>. </b>Reason for non-participation in genomic related research were pervasive and included perceived and/or actual experiences of mistrust and deceptiveness by investigators, misuse of genomic data, unethical research practices, healthcare system distrust, privacy concerns, socioeconomic influences, cultural beliefs, and other influences associated with psychosocial factors.<b> </b>These results are consistent with diminishing participation of AAs in DNA-related research attributable to a range of factors leading to health disparities. Addressing these factors among marginalized communities, and AAs who have not largely been represented in DNA-related research, will guide insights on how to conduct research in these communities.<b></b></p>

Barriers to African American and Other Minority Population Participation in Genomic-Related Health Research: A Systematic Literature Review

<p><a>The paucity of data for African Americans (AAs) participating in health-related research (e.g., genomic health research) is often attributed to difficulty in recruitment and retention. The COVID-19 pandemic, which has resulted in hundreds of thousands of deaths, particularly in AA communities, has amplified the problem. Reasons for not participating remain unclear and may account for health disparities observed in these communities. Failure and unwillingness to participate in research in general influences health disparities, which may lead to missed economic opportunities, inequalities, poor health, reduced quality of life, and premature death.</a> This review assesses barriers to acceptance of genomic-related health research among AAs and other marginalized populations. To investigate barriers to participating in health-related research involving deoxyribonucleic acid (DNA), 38 studies published in PubMed and Scopus between January 2008 and December 2018 were reviewed. Results were based on feedback collected by trained research assistants and phlebotomists during structured group, face-to-face, and telephonic<b>. </b>Reason for non-participation in genomic related research were pervasive and included perceived and/or actual experiences of mistrust and deceptiveness by investigators, misuse of genomic data, unethical research practices, healthcare system distrust, privacy concerns, socioeconomic influences, cultural beliefs, and other influences associated with psychosocial factors.<b> </b>These results are consistent with diminishing participation of AAs in DNA-related research attributable to a range of factors leading to health disparities. Addressing these factors among marginalized communities, and AAs who have not largely been represented in DNA-related research, will guide insights on how to conduct research in these communities.<b></b></p>

Problematising Young Male Victims in Twenty-First Century English Child Sexual Exploitation Policy: a Critical Discourse Analysis

Since 2000, English child sexual exploitation (CSE) policy has expanded, both in its understanding and response, to the increasing recognition and scale of the problem. Since 2011, with the move from statutory guidance to a government action plan, there was, for the first time, a substantial increase in CSE responses across English local authorities. Within English CSE policy, male victims are often referenced as a minority population in the ‘dance’ between gender-neutral and gender-specific guidance. For an observable eight-year period, specific CSE guidance was issued on ‘Boys and Young Men’ between 2009 and 2017. Using a qualitative case study methodology with 18 professionals in England, a critical discourse analysis, inspired by Foucauldian and liminality theories, was undertaken to understand the ‘ethics’ within professional perceptions of male victims in contemporary CSE policy. The key findings highlight an incongruity of existing CSE vocabulary with male victims due to overtly gynocentric connotations. This article identifies how male victims have been perceived in the ‘shadows’ of their female peers, perhaps, as a policy ‘afterthought’, with consequential professional practice. Essentially, male victims have been implicated through this gendered conceptualisation and are assembled awkwardly on the surface of mainstream CSE discourse in England.

Toward Equitable Micromobility: Lessons from Austin E-Scooter Sharing Program

This study revealed the inequitable societal impacts of E-scooters on disadvantaged populations. The study conducted a population distribution analysis to compare the use opportunities and space intrusion burdens of E-scooter sharing on four vulnerable population groups in Austin, Texas. Nearly all minority population experienced fewer E-scooter use opportunities. Ten percent of the minority population waited for a disproportionately longer time before a disturbance could be resolved. Ten percent of the low-income population were in a disadvantaged position in high opportunities and moderate burdens. Twenty percent of the physically disabled population faced more moderate-level burdens. The result did not show significant inequitable outcomes for the elderly population.

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a ‘deficit-based’ discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants’ knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants’ communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09–4.63), people with disabilities (OR: 2.43; 95% CI: 1.28–4.64), and unemployed people (OR: 2.64; 95% CI: 1.28–5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25–4.09), unemployment (OR: 4.07; 95% CI: 1.64–10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03–1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants’ knowledge, experience, and strengths has the potential to improve individuals’ diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.

The importance of saturating density dependence for population-level predictions of SARS-CoV-2 resurgence compared with density-independent or linearly density-dependent models, England, 23 March to 31 July 2020

Background Population-level mathematical models of outbreaks typically assume that disease transmission is not impacted by population density (‘frequency-dependent’) or that it increases linearly with density (‘density-dependent’). Aim We sought evidence for the role of population density in SARS-CoV-2 transmission. Methods Using COVID-19-associated mortality data from England, we fitted multiple functional forms linking density with transmission. We projected forwards beyond lockdown to ascertain the consequences of different functional forms on infection resurgence. Results COVID-19-associated mortality data from England show evidence of increasing with population density until a saturating level, after adjusting for local age distribution, deprivation, proportion of ethnic minority population and proportion of key workers among the working population. Projections from a mathematical model that accounts for this observation deviate markedly from the current status quo for SARS-CoV-2 models which either assume linearity between density and transmission (30% of models) or no relationship at all (70%). Respectively, these classical model structures over- and underestimate the delay in infection resurgence following the release of lockdown. Conclusion Identifying saturation points for given populations and including transmission terms that account for this feature will improve model accuracy and utility for the current and future pandemics.